OhioSchools december 2014

A PUBLICATION of The OHIO EDUCATION ASSOCIATION

Speech Pathologist Katherine Smith talks with Eric who uses an iPad to communicate. Smith helps Eric input information on his daily activities and interests.

Freedom of choice OEA members and the individuals they serve are speaking out about changes in federal Medicaid rules that threaten their ability to provide quality services for p16 the developmentally disabled

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Ohio’s plan must protect the ability of individuals to choose their provider by ensuring that the quality of the programs directly offered by County Boards of Developmental Disabilities remains viable. Professionals, paraprofessionals and support staff employed by County Boards throughout the State of Ohio go to work every day to provide excellent services to individuals with developmental disabilities who choose to receive these services. The CMS rule jeopardizes these opportunities. Christina West Ohio Association of Developmental Disabilities Professionals (OADDP) Chairperson

Jeannette holds the hand of her son Joey as they leave the workshop in Willoughby. Jeannette fears that her son would be lost if he can no longer attend the County Board-operated program.

Freedom of choice

OEA members and the individuals they serve are speaking out about changes in federal Medicaid rules that threaten their ability to provide quality services for the developmentally disabled Each weekday, Joey takes a bus to the Lake County Board of Developmental Disabilities workshop in Willoughby, a place where he is able to do meaningful work in a high production group and spend time with friends. At the end of the day, his mother Jeannette meets him to take him home. Joey has participated in programs through the County Board of DD since he was nine years old. Now 54, his choice to attend the workshop is in jeopardy due to changes in federal rules regarding federal funding for Home and Community Based Services. His mother, Jeannette, says the workshop is the safest and best environment for her son who cannot speak and would have difficulty working in the community. “The people who want to change the rules should take a tour of the sheltered workshop,” she says. “My son wants to stay here. He is comfortable and happy. He is able to work, but he needs instruction. A private provider wouldn’t motivate him to try new things or to do the work he enjoys doing. “Ohioans have many private provider options but none provide the excellent quality, protections and accountability of services that my son has received through the County Board.”

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icole spends her mornings cleaning a local restaurant, work that she does through Community Employment Services (CES). After her work is done, she comes to the workshop for the second half of her day to supplement her work and to see her friends. She was bullied in the community before, when she did not have the support or shelter, of the County Board of DD’s services. “I’ve had my share of issues with work in the community,” Nicole says. “I was harassed—told that I couldn’t do my work fast enough, that I wasn’t getting enough done, that my transportation issues were a problem. “I love it at the workshop. I have a lot of friends here. I don’t feel that I am being pushed to do stuff and I can take my time. But the best benefit is the extra support that you get. It makes the difference. I look forward to coming to work each day. It’s my choice to be here and if they take away that choice, I’m screwed.” In early 2014, the federal Centers for Medicare and Medicaid Services (CMS) released new rules regarding federal funding for Home and Community Based Services (HCBS). These changes will almost certainly affect OEA members working in Ohio County Boards of Developmental Disabilities (DD) and the individuals to whom they provide services.

A group of individuals works to make FiberCore Eco-Forage Paks, nesting/foraging material for birds. photos by Tim Revell Nicole works as she discusses problems she has had working outside the workshop.

Dino shows a part he has assembled.

One element of the CMS rules deals with a Conflict of Interest provision statement that severely restricts a County Board of DD’s ability to provide direct services while also providing service and support administration services. In Ohio, County Boards of DD offer varying ranges of services. There are County Boards that offer no direct services and there are County Boards that offer a full complement of direct services, including school-based, vocational and habilitation center-based, community-based supported employment, residential, ancillary professional and recreation services. When CMS first raised the issue of a Conflict of Interest, Ohio successfully established a Firewall Document to address the concerns. OEA is particularly concerned with the provision in the HCBS rule that would restrict the ability of a County Board of Developmental Disabilities to provide direct services to thousands of individuals like Joey and Nicole. OEA’s specific request is that Ohio’s compliance plan preserves individuals’ access to a broad choice of providers, including those quality services provided by County Boards. Additionally, the plan should focus on building a better firewall to address the perceived conflict of interest concerns of CMS regarding the same individual assessing eligibility for services and also providing those services. The Ohio Department of Developmental Disabilities (ODODD) and other state agencies are drafting a plan to comply with the new rules. Although the federal agency

is giving states until March 2015 to submit final transition plans to CMS, Ohio’s draft transition plan was released on December 15 for public comment. The draft plan is available at bit.ly/draftplanforDD. The CMS rule changes are especially troubling for the individuals who use County Board of DD services and those who work with—and advocate for—the developmentally disabled. “Why would you take people away from their friends, from a place where they have everything they need?” says Katherine Smith, a speech pathologist at the Willoughby workshop and local president of LEADD. “For many private providers, success is defined as having a client working at minimum wage for two hours a week,” she says. “What does this person do for the other 38 hours? What about a person who has been working in the workshop for 40 years and suddenly has no job?” At the Willoughby workshop, 150 individuals work on customer projects as diverse as Eco-Forage Paks for parrots, lanyards used by the military and Cirque de Soleil, plow markers and plumber’s handles sold at Home Depot. At times, there can be 11 customer jobs on the workshop floor. The workshop accommodates a variety of individuals with different interests, work styles and skill levels. And it offers employment, vocational training, habilitation services, communication and speech therapy, leisure, social and self-help activities.

➤ Continued

(Left to right) Deb laughs as she assembles Eco-Forage Paks for birds. Christopher stuffs Eco-Forage Paks used by parrots in their nests. Nathan crimps lanyards at the workshop. Mike operates a forklift in the workhop’s shipping and receiving area.

For Smith, however, the workshop’s most important benefit is the support and encouragement it provides. “Here, they are somebody,” she says. “This is why it is so important that an individual’s right to choice is maintained. County Boards of DD must remain a ‘Provider of Choice’ for individuals throughout Ohio. County Boards of DD have long been a leader in the development of new and innovative programs for the delivery of services to individuals with disabilities, says Smith, who has spent her career in special education and developmental disabilities work. “I love it—people think outside the box here. It’s so exciting. We know so much more now than we did 20 years ago and we are able to provide so much more.” Christina West, chairperson for the Ohio Association of Developmental Disabilities Professionals (OADDP), an affiliated department of the OEA that advocates for the professionals, paraprofessionals and support staff working with persons with developmental disabilities and for individuals who receive services from local County Boards, says, “Our local County Boards of Developmental Disabilities that choose to remain direct service providers should be permittedto do so in order to preserve a full range of service options. “Our County Boards have been providing services for years and care greatly for those we serve on a daily basis. Individuals with a developmental disability should have a choice of providers—the CMS rule is possibly eliminating one of those choices.” 18

Help preserve Free Choice of Provider for Ohioans with Developmental Disabilities OEA’s County Board of Developmental Disabilities local in Lake County (LEADD) has created a short video showcasing what’s at stake regarding the development and implementation of Ohio’s compliance plan. You can view this at bit.ly/LakeCountyDD. Additional video clips will be posted and can be found by searching LEADD documentary. More information is available on the OADDP website, http://oaddp.ohea.us/. The ODODD has released a schedule of regional forums and two hearings in Columbus to educate the public on the transition plan and to provide feedback on the plan. Additionally, comments can be sent to [email protected] or by calling toll-free to leave a voicemail message at 1 800 364 3153. OEA encourages you to share the video link and attend one of the forums listed below. January 6, 5:30-7:30 p.m. January 10, 10:00 a.m.-noon Athens County Board—Beacon School Hamilton County Board—Beckman Adult Center 801 West Union Street, Athens 45701 2600 Civic Center Drive, Cincinnati 45231 January 7, 1:00 pm (public comment only) January 15, 1:00 pm (public comment only) Rhodes State Office Tower Rhodes State Office Tower Lobby Hearing Room, 1st Floor Lobby Hearing Room, 1st Floor 30 East Broad Street, Columbus 43215 30 East Broad Street, Columbus 43215 January 8, 6:00-8:00 p.m. ESC Conference Center 6393 Oak Tree Blvd. South, Independence 44131