As part of Amended Substitute House Bill 1 (ASHB1), the Director of the Ohio Department of Developmental Disabilities (ODODD) was required to submit a plan to the Director of the Ohio Department of Jobs and Family Services (ODJFS) by December 31, 2009, with recommendations to ensure the fiscal sustainability of Medicaid Home and Community-Based Services (HCBS) waivers administered by ODODD. Specifically, the legislation called for recommendations in three areas: 1) changing the funding ranges for Medicaid HCBS individuals; 2) establishing one or more maximum amounts Medicaid will pay for HCBS individuals; and 3) modifying the payment rate methodology used to pay for Medicaid HCBS individuals.
ODODD Director, John Martin, convened the HCBS Waiver Sustainability Group to examine and address these areas and formulate recommendations designed to ensure Ohio’s HCBS waiver program remained viable. Comparing its Medicaid HCBS program nationally, Ohio ranks in the midrange on several levels, including average annual cost per waiver enrollee ($53,000) and average overall state budget spent on most expensive clientele (13.8%). Based upon this and various other benchmarks, the data indicates Ohio’s HCBS waivers are responsibly managed. However, given the current economic conditions and likely increase of HCBS services in the future, the system must continually look for new revenue sources and streamline system expenses.
The HCBS Waiver Sustainability Workgroup developed 15 recommendations in response to their charge, building on the vision of the MRDD Futures Committee, ODODD’s Priority Work plan, and collaboration amongst other stakeholders. Key HCBS Waiver Sustainability Workgroup recommendations intended to:
1. Improve the developmentally disabled community’s ability to increase the number of individuals served
2. Increase the effectiveness of current cost management features of the waivers
3. Create additional waiver options to meet the varying needs of individuals and families
4. Reduce direct care wage disparity across program settings
5. Develop systematic tools to address future economic constraints of the waiver system
Ohio Medicaid HCBS waiver services can be a natural complement for Medicaid facility-based providers, offering a source of continuing care for individuals served. Please see the full HCBS Waiver Sustainability Workgroup report or contact us for additional information regarding Ohio Medicaid HCBS waiver services.