From the Superintendent July 3, 2015
Updates on Conflict Free Case Management, State Budget
Bicentennial, Balloon-fest, Independence Day, summertime fun and time flies bye. Life and business goes on here at the Ashland County Board of Developmental Disabilities and Dale Roy School. Summer camp has come and gone, many building and grounds projects are underway. Accreditation is in process with MUI completed and two more days scheduled for July 15 & 16 for the rest of our program. A few developments have occurred that we've been waiting for and talking about for many months. These are about the 2015-16 state budget and the ongoing federal and state issues driving changes in service delivery for people with disabilities.
One part of the federal Centers for Medicare and Medicaid (CMS) Rule related to conflict free case management has been resolved. CMS announced at the end of June that they've decided to give Ohio until 2024 to come into compliance with this rule. This gives us a little more time than we originally thought we'd have, though the clock started ticking in March 2014.
The conflict free case management rule says that providers of services cannot also be providers of case management. Most county boards across Ohio operate adult centers as well as provide case management (called Service and Support Administration in Ashland County.) County boards that operate direct services will either not be able to bill Medicaid or not provide those services at all in nine years. Adult centers will be impacted, though we are still learning exactly how that will work out.
Our board and leadership team will continue to study and work through this issue, and preliminary plans are being developed for approval early fall. There were many other requirements in the 2014 CMS rules. Ohio submitted a plan to be in compliance by 2024. So far we have not received a response from CMS regarding that plan. What compliance looks like is still being debated and no decisions have been made.
In other developments, Ohio Governor John Kasich signed the final budget on June 30, making it official for the next two years. We have been carefully following the budget process, along with many of you who have given your input to the legislature and Governor Kasich. Clearly your voices were heard. Governor Kasich vetoed several items before he signed the budget that will impact people with disabilities statewide.
I know people have questions:
-
Will there be enough providers?
We have four private agency providers in Ashland so far. We will be meeting with current providers and inviting additional providers to Ashland to increase capacity to meet the needs. We will continue to be involved in training and monitoring provider services to assure quality services.
-
These changes are scary for me or my family member what will happen?
We will be planning at both levels. County wide we will be developing plans for bringing in more services, developing providers and preparing SSAs to meet with individuals. Making plans for staff, buildings, transportation etc.
Just as importantly we will be work with each individual and team. Looking ahead, identifying what services each one needs and wants. Looking at choices and giving time when needed to check out choices and make a decision that works for them. Individuals on a Medicaid waiver are free to choose other providers as soon as they like. We will work together with families and individuals and help those who are more comfortable make changes sooner and for those who are hesitant we will do our best to give time to think options through before making changes.
These developments and more to come are driving our state and local system of services for people with disabilities to look very different than our past. We know we have to change toward community integration, with emphasis on employment and utilizing more private providers. We have already shifted our focus on the individual with person centered plans and free choice of provider.
We are not going away and will keep focused on what is best for each person. As we join hands with families, neighbors, providers, employers and other agencies we will continue to be even better at making sure that Ashland County, is a place, where people who happen to have disabilities, will have the supports and encouragement they need, to live, learn, play and work in our community.
We will keep you posted as we get more information and make local plans
Jim Huntington, Superintendent!