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After three decades with county disabilities boards, Bob Gaston figured he’d ride out his career as a government employee, eventually retiring as director of adult services for the Franklin County Board of Developmental Disabilities.
Gaston still works in the field and largely with the same people. But since January, he’s been CEO of a local nonprofit group.
“Initially, I had a lot of trepidation,” said Gaston, who went from county employee to head of ARC Industries, which offers employment and programs to people with disabilities. “But I will say I’m thrilled with the plan that’s been developed here in Franklin County. It’s going well.”
Federal rule changes about case management and Medicaid payments are forcing county disabilities boards throughout the state to privatize and outsource many of their remaining programs. The Centers for Medicare and Medicaid Services has mandated “conflict-free case management” by 2024 in Ohio, which means counties cannot be both the coordinator and the provider of services paid with Medicaid waiver funds.
But county boards still must pay for services and put up the local share of the Medicaid match — in Franklin County, more than $60 million a year for adult waiver services. Medicaid waivers provide money for community-based services so that people don’t have to be in an institution to get the care and programs they need.
“It’s easier said than done in a big county,” board Superintendent Jed Morison said of the privatization shift. “Frankly, we would rather not have to do it. But staff understands that we have to.”
Some 300 members of the county’s adult-services staff are to become ARC Industries employees in January 2019. Administrators also announced on Friday that the board is considering a plan that would move about 80 adult-transportation employees to ARC as well.
“We want to do this without layoffs,” Morison said, and without significant service changes.
ARC is the disabilities program that provides job training, workshop employment, transportation and other services. Although ARC already was a nonprofit employer for people with disabilities, the workshops and programs have been staffed by county employees.
Early childhood and school programs can continue to be operated by the board because they’re not funded through Medicaid waivers.
“This is being mandated to us, of course, by the feds. There’s not a whole lot of ‘Can we change it?’” said Jim Gollings, regional director for the Ohio Association of Public School Employees, the union that represents county bus drivers and transportation aides. “The employees want to keep their union and their benefits. And we want to make sure it’s as smooth a transition as possible, both for clients and employees.”
Initially, Morison said, the board’s costs might increase as a new infrastructure is established. He expects it to even out in coming years.
Franklin County taxpayers support the disabilities board through two property-tax levies, one of which is up for renewal on the Nov. 7 ballot.
The need for that revenue remains, Morison said, because the board still pays for services for some 21,000 people each year, whether the programs are provided directly, through contracted partner agencies or via Medicaid waivers.
The 10-year, 3.5-mill property tax is a renewal of an expiring levy and will not raise taxes. It generates about $94 million annually and costs about $107 a year for every $100,000 in property valuation.
“We’re committed to staying within the budget,” Morison said.
Gaston agreed that the changes are difficult, but he sees a bright side. Being funded by a government agency instead of controlled by one could lead ARC to more “nimble, creative” approaches, he said. “Our goal is to become the premier service provider here in Franklin County, and this kind of opens the door for us to look at some other things.”
This article has been reproduced for educational purposes only and appeared in the Columbus Dispatch. The original story can be found at: http://www.dispatch.com/news/20171030/county-services-for-disabled-moving-to-private-providers
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