Project Transformation an effort by state and local agencies to respond to requests from the Federal government to help people connect in meaningful ways to their community. Eventually designed as a state-wide project, Fairfield County is among the first eight agencies selected to help develop the tools we will use in the future.
Read the letter explaining Project Transformation from Superintendent John Pekar
What is Driving the Change?
The Ohio Department of Developmental Disabilities (DODD) and the County Board are preparing for change to comply with new federal Medicaid rules and changes proposed in the Governor’s budget. The interesting thing about these changes is that they focus on the quality of the experience for each person in our program. The Fairfield County Board of Developmental Disabilities Board (Fairfield DD) has a long history of being progressive and innovative in how we provide our services to the people of Fairfield County. The challenges from our authorities can be daunting, but we also consider them a great opportunity.
Key Issues Driving Change
CMS Rule Change
The Centers for Medicare and Medicaid Services (CMS) implemented a new rule last year that states Medicaid funds can no longer be used to provide waiver services in settings that isolate individuals and don’t provide full access to the greater community, such as sheltered workshops and large group living arrangements.
Additionally, the CMS rule also calls for what they refer to as “conflict free case management.” County Boards, including Fairfield DD, employ Individual Service Coordinators (ISC) who determine eligibility, develop service plans and connect people to providers to fill the needs in their service plans. These are case management functions as defined by CMS. In addition to providing these ISC services, Fairfield DD also provides transportation and adult services directly to individuals that are funded locally or subsidized through Waiver funding. According to CMS, there is an inherent conflict of interest with this structure and CMS has requested that Ohio develop a plan to phase-out this conflict.
Many states, including Ohio, needed to develop a transition plan to come into compliance with the new rule. In a transition plan submitted by DODD to CMS in mid-March, Ohio requested 10-years to come into full compliance. DODD chose to not propose a resolution to the conflict free case management issue in the transition plan and instead has requested to work directly with CMS to resolve that provision of the rule.
Some people don’t know that along with the Opportunity Center and Forest Rose School, Fairfield County also has over 130 private providers of services. The work they do range from residential and job coaching to personal services. Many are independent providers, while others are larger agencies.
The Governor’s Budget
Governor John Kasich’s 2016 biennial budget is intended to invest an additional $112 million above 2015 dollars over the course of two years and funds efforts outlined in the CMS transition plan. The budget has yet to be approved by the Ohio legislature but, if approved, it would target ICF downsizing, add waivers and increase funding for community employment. In addition, the budget includes several initiatives related to funding and training for providers of home and community based services that are intended to improve the stability of the direct care workforce.
Fairfield County’s Future
Fairfield DD supports each individual through their life journey. Additionally, we strive to transform public perception so that together we will build an even more welcoming community. Through long-range planning the Agency has built a more robust person-centered planning process that respects the wishes and choices of each individual. Through JobFusion we have developed employment opportunities and ensured that each person has an opportunity to discover where his/her future path may take him/her. For everyone, we have worked to ease transition points for families, and developed a quality provider community that can support individuals’ wishes and needs.
Fairfield DD will continue to work with families and partners to implement any system changes over a period of time through the person-centered planning process. In the meantime, we will continue to work to ensure people with developmental disabilities live in the same community and are able to do the same things as people who do not have disabilities.
Fairfield DD will also strengthen its provider development and quality assurance activities to ensure families have choices among quality providers. All providers of service must ensure that their services meet home and community based CMS requirements.
With external factors compelling system redesign, local and state plans in place to execute that redesign, and a budget that funds meaningful change – Ohio and Fairfield County are on a wave of change that can be both exciting and somewhat overwhelming to everyone involved. Fairfield DD’s goal is to be proactive and transparent with communication and changes as we continue our practice of honoring the choices of individuals.
Superintendent John Pekar recently stated, “The changes we are planning center on the needs of each individual and family we serve. Project Transformation will aggressively pursue options for people to work and connect throughout our county. The goal is to create a future for each individual that is uniquely their own.”
We're often guilty of using words and phrases and assuming everyone knows what we mean. Here's our attempt to help you understand some of the words we use.
Person Centered Thinking
This is a simple philosophy; the best plans we can make consider those things that are important FOR a person, in balance with what is important TO a person. We want to know those things that are risks in a person, but we also want to discover their dreams, and their passions.
In 2012 Governor Kasich signed an executive order proclaiming Ohio an "Employment First" state. That means that all individuals will be assumed of being capable of community employment, regardless of the severity of their disability.
This is Fairfield County's interpretation of Employment First. We know that for some people, a job will be most important. For others, finding their own way to connect in the community will be just as important. At the end of the day, the process is driven by the needs and desires of the individual.
Ask a Question
What's on your mind? As we go through this transition, we want to make sure your questions are being answered. Click on this link to send your question as an email to Ray Schmidt, Director of Quality. He will either answer your question, or direct it to the right person to get the answer you need. Please indicate in your email if it's OK to share your question on our web site; chances are there are a lot of other people out there wondering the very same things as you!
For more information, contact Fairfield DD at 740-652-7220