Rule change disallows segregation of those with disabilities

A change in rules at the federal level will no longer allow Medicaid funds to be used to provide waiver services in settings that have the effect of segregating people with disabilities from people without those issues.

Stakeholders in the Athens County Department of Developmental Disabilities met Thursday night at Beacon School to discuss the rule changes to identify which settings are not in compliance with the new regulations and to develop recommendations for how to bring them into compliance.

ACBDD Supt. Eric Young said Friday that audience members questioned whether people would be "forced" to be integrated if that was not their choice, and were assured that an individualized person-centered planning process would ensure that no one will be forced to do anything they do not want to do.

The rule change was brought about by the Center for Medicare & Medicaid Services (CMS). The federal agency and branch of the U.S. Department of Health & Human Services administers Medicare, Medicaid and the Children's Health Insurance Program (CHIP) program in partnership with state governments.

CMS also administers the Medicaid funding program that pays for services for individuals with developmental disabilities. County Boards of DD rely heavily on Medicaid funding to provide services such as residential supports, day programming, transportation and supported employment.

County Boards of DD stretch their state and local funding further by accessing Medicaid funding that pays 60 percent of the cost of services while the County Board of DD provides a 40 percent match, according to information from the Ohio Department of Developmental Disabilities.

Last year, the CMS announced a new rule that essentially says that federal Medicaid funds can no longer be used to pay for waiver services that are offered in an institutional setting - or settings adjacent to institutions or other settings - that have the effect of segregating people who are receiving home and community-based services.

The Ohio DODD has implemented a transition team to deal with the changes, while Young Friday highlighted some of the work the Athens County Board is doing to ensure everything is in compliance and emphasizes integration.

"It was explained to stakeholders that integration opportunities be explained, encouraged and offered, as many individuals have not been exposed to a wide variety of community life experiences and they don't know what's out there," Young said of the meeting.

He said that ACBDD Adult Services Director Mark Cullison offered some examples of how the ATCO day program is offering more integrated services.

They dropped the "sheltered workshop" from their name, for instance, and are now known as "ATCO" - Advocacy, Training, Careers, Opportunities.

"Initiatives have been undertaken to integrate, collaborate and partner with other groups in the community such as the Senior Citizen's Center and volunteering at Good Works," Young said. "There are eight other private and non-profit day program providers in the county who will be under these integration requirements as well."

PersonnelPlus, he said, also continues to provide opportunities for integrated community employment experiences working alongside persons without disabilities doing similar work for similar wages.

He said that although CMS has a deadline for states to come into compliance by 2019, the state-level DODD will be asking in its transition plan to extend that to 2024 so that the system has time to change.

This, Young said, would help make sure that things don't happen too fast and disrupt clients' lives.

The meeting in Athens was one of five around the state of Ohio.

http://www.athensnews.com/ohio/article-44132-rule-change-disallow.html