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The concept for a new flexible support waiver has been developed and documented. ODMRDD FUTURES ... Interagency Council on Homelessness and Affordable Housing. ... – PowerPoint PPT presentation

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Title: 1


1
John L. Martin, Director Ohio Department of MRDD
2
  • The Mission of the ODMRDD is continuous
    improvement of the quality of life for Ohios
    citizens with developmental disabilities and
    their families

3
  • Less complex services, with fair and logical
    payment systems
  • Good stewardship of limited resources
  • Quality outcomes through a combination of people
    and processes
  • Service delivery models designed in response to
    choices made by the people served, in alliance
    with community supports
  • A system-wide vision developed with stakeholders

4
ODMRDD STATE OF THE STATE
OHIOS BUDGET SITUATION
  • Recently, a 540 million state budget adjustment
    was announced
  • Implemented with a 4.75 across-the-board
    reduction for all state agencies
  • Reduction is in addition to the 733 million
    budget adjustment plan announced in January,
    making a total of 1.27 billion in budget
    adjustments over the biennium

5
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6
ODMRDD STATE OF THE STATE
OHIOS BUDGET SITUATION
  • 198 million will come from agency reductions
  • The remaining 342 million will be made up
    through a variety of cash management actions
  • Situation presents challenging environment for
    Ohio
  • The ODMRDD Leadership Team is mindful of and
    sensitive to the impact that the required budget
    changes will have on Ohios MRDD community

7
ODMRDD STATE OF THE STATE
OHIOS BUDGET SITUATION
  • First phase was absorbed by Central Office
    Administration, as well as by a reduction to
    increased funds slated for protection services,
    and adjusting the census at Developmental
    Centers.
  • For this second phase of reductions, it will be
    necessary to again look at the Central Office
    Administration, as well as make further reduction
    to protective services. Unlike the first round of
    cuts, this round will significantly affect county
    subsidies.

8
ODMRDD STATE OF THE STATE
OHIOS BUDGET SITUATION
  • At ODMRDD, this means a reduction of
    approximately 16.9 million.
  • The approximate figures for the areas affected
    are
  • Central Office Administration - 273,555
  • Protective Services A reduction of 127,595
  • Residential and Support Services A reduction of
    554,642
  • Family Support Services A reduction of 624,501
  • County Board Subsidies A reduction of
    14,059,796
  • Tax Equity A reduction of 1,260,000

9
ODMRDD STATE OF THE STATE
OHIOS BUDGET SITUATION
  • During the last biennial budget ODMRDD had to cut
    17 million in General Revenue Fund
  • We anticipated the financial situation ahead of
    time and began to talk with stakeholders,
    Governor Strickland and the General Assembly to
    prepare
  • Out of these discussion, the MRDD community came
    together to create the Futures Committee

10
  • The Committee was charged with reviewing the
    state's MRDD system and focused on four themes
  • Accessing Services and Supports
  • Financing
  • Delivering Quality Services
  • Serving Populations with Specialized Needs

11
  • Committee members, representing diverse roles and
    perspectives across the MRDD community, came
    together to adopt 31 recommendations.
  • These recommendations emphasized involvement of
    individuals and families in directing services
    and defining quality of services.

12
In March 2008, the Committee delivered its
final report to Governor Strickland and the
General Assembly. This report set forth positive
steps to improve services, processes, and
supports for individuals and families.
13
  • To implement the Committees recommendations,
    ODMRDD established six internal project teams
    outlined work steps, objectives, and products
    and developed initial timelines for outcomes and
    products.

14
  • Access and Care Management
  • Patrick Stephan - Lead
  • Waiting Lists
  • Individual Service Planning
  • Service and Support Administration
  • Delivery System Management
  • Kate Haller - Lead
  • Quality
  • Planning Capacity
  • Developing Capacity

15
  • Empowering People
  • Lisa Walsh - Lead
  • Choice
  • Control
  • Family Support
  • Services Management
  • Michael Rench - Lead
  • Covered Services
  • Service Packages Design

16
  • Strategic Implementation
  • Becky Phillips - Lead
  • Policy
  • Strategy
  • Decision Support
  • Ann Rengert - Lead
  • Data/Fiscal/Legal Analysis

17
  • ODMRDD released the first phase of
    deliverables (products) related to the 31
    recommendations of the MRDD Futures Committee on
    August 6.

18
The work completed in Phase One, which
includes 17 deliverables, is available at the
Futures website http//mrdd.ohio.gov/futures/
Draft documents are presented for the entire
MRDD community to review and provide feedback via
e-mail to futures-feedback_at_odmrdd.state.oh.us
19
  • Empowering individuals, families local
    communities to have the information and tools
    necessary to decide how best to move forward
  • Working together to develop ways to be better
    prepared for the future through data-driven
    analysis
  • Developing long-term funding approaches that
    address sustainability and determining viable
    strategies to protect individuals access to
    services

20
The biennial budget strategy for Fiscal Years
2010 and 2011, including identification of
necessary revisions to the Ohio Revised Code, has
been developed in collaboration with system
stakeholders.
21
  • We are working to protect individuals and
    families who receive services from being impacted
    by
  • - offsetting some subsidy reductions with
    replacement revenue
  • - reducing administrative burdens and thereby
    helping county boards and providers to reduce
    their administrative costs
  • - piloting some regional projects and
  • - increasing the number of people receiving
    services by
  • implementing a new flexible supports waiver.

22
ODMRDD FUTURESDELIVERABLE 1
  • We are implementing the recommendations of the
    MRDD Futures Committee during a time when
    resources are scarce.
  • ODMRDD submitted the budget to the Office of
    Budget and Management on September 15, 2008.

23
3.9 Billion Annual Tax Relief From Long-Term
Reforms (FY 2010)
Ohio Department of Taxation
24
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25
The concept for a new flexible support waiver
has been developed and documented.
26
  • The waiver will provide flexible options to
    support children with intensive needs living in
    the family home.
  • ODMRDD is sharing the waiver proposal with
    stakeholders for review and comment.
  • ODMRDD will collaborate with the Ohio Department
    of Mental Health and the Ohio Department of Job
    and Family Services to develop waiver template
    for submission to the Centers for Medicare and
    Medicaid Services (CMS) in late 2008.

27
A strategy including the use of multi-media
materials to assist individuals and families in
understanding, accessing, and navigating the
service delivery system has been developed and
disseminated.
28
  • Existing materials were inventoried and
    out-of-date materials will be revised.
  • ODMRDD is working with the Ohio Legal Rights
    Service, The Arc, county boards of MRDD, and
    others to improve information sharing and
    availability of materials to individuals and
    families in a variety of formats.
  • An audio-visual tour of the ODMRDD website,
    designed to take users through the site
    step-by-step, has been developed.
  • Family Chat, a discussion listserv for families,
    is being pilot tested.

29
An analysis of the existing provider search
website has been conducted to identify potential
short-term refinements.
30
  • ODMRDD has created a list of recommended actions
    including a status/tracking mechanism.
  • A review of proposed enhancements is underway to
    determine additional functionality options and
    opportunities for future versions of the website.
  • The website has been updated to improve
    visibility of information on various monitors and
    screens.

31
A regional model to support young adults to
successfully transition from school to work has
been developed to be pilot-tested.
32
  • ODMRDD is securing additional funding totaling
    500,000 from the Ohio Department of Job and
    Family Services through a Medicaid Infrastructure
    Grant beginning in 2009.
  • A model school-to-work transition program will be
    piloted in a region and then be available for
    statewide implementation.

33
An analysis has been completed to determine
how Atlantes health care management software
aligns with individual service planning needs in
the MRDD system.
34
  • ODMRDD previewed the Atlantes system to determine
    if it would meet needs such as the on-line
    Individual Service Plan and assessment processes
    and support improved case management, care
    coordination, and service to individuals and
    families.
  • ODMRDD staff will work with staff of the Ohio
    Department of Job and Family Services to identify
    additional questions and issues related to
    Atlantes and how it will be used by Ohio.

35
A standardized, on-line individual service
plan (ISP) format has been developed to be
pilot-tested.
36
  • A draft ISP form has been developed.
  • Based on the feedback, ODMRDD will identify
    crucial ISP elements and potential alternatives
    to adoption of the ISP template.

37
A statewide strategy to revise and better
manage waiting lists has been developed.
38
  • The strategy shifts from current process of
    waiver allocation first, service needs second to
    new paradigm service needs first, delivery
    options second.
  • Calls for one waiting list based on services
    needs.
  • Requires modification to the Individual
    Information Form (IIF) system to collect concrete
    data about individuals service needs.
  • Priority categories and their role in service
    delivery need further definition and refinement.

39
A model for regional planning and
partnerships, including a framework for
development of county boards' annual strategic
plans that requires meaningful participation of
individuals and families has been developed and
necessary revisions to the Ohio Revised Code have
been identified.
40
  • ODMRDD has developed a template and instructions
    to guide county board strategic plan submission
    (with options for regional partnerships built
    into template).
  • Individuals and families who receive services
    will approve plans.
  • County level plans will roll up into regional
    and state plans.

41
Materials that support care providers and
promote the Behavior Support Advisory Councils
Positive Intervention Culture have been
developed.
42
  • The elimination of aversive interventions is a
    key factor in ensuring that individuals
    experience a quality of life that is in line with
    the Positive Intervention Culture
  • A draft Information Notice regarding the Positive
    Intervention Culture has been developed.
  • Additional materials, including data collection
    instruments and the Crisis Intervention Program
    Assessment Tool, will be shared with stakeholders
    after the Information Notice has been finalized.

43
A statewide housing survey has been initiated.
44
  • Through two initiatives, groundwork is being laid
    for a statewide housing plan to be developed by
    the Governor's Interagency Council on
    Homelessness and Affordable Housing.
  • The Technical Assistance Collaborative (TAC) was
    selected to review and analyze housing resources.
    County Boards will be equipped to create housing
    plans for citizens that integrate with the
    statewide plan.
  • ODMRDD will participate on the Council and
    provide logistical support to TAC throughout the
    project.

45
The National Core Indicators have been
implemented.
46
  • The Center for Marketing and Opinion Research has
    been selected to conduct individual and family
    surveys.
  • ODMRDD will be able to measure system
    performance, compare data with other states, and
    make improvements that better support individuals
    with disabilities and their families

47
Methods for measuring individual satisfaction
have been analyzed and a plan for incorporation
into the quality review process has been
developed.
48
  • ODMRDD has selected the Participant Experience
    Survey as the tool to gather information from
    individuals receiving services as part of the
    quality review process.
  • This survey tool provides indicators in the areas
    of Choice and Control, Respect/Dignity, Access to
    Care, and Community Integration/Inclusion.
  • The Survey will be incorporated into the quality
    review process for individuals receiving HCBS
    waiver services.

49
A draft administrative rule for provider
certification that implements time-limited
certification and application fees has been
developed and disseminated for review.
50
  • A draft rule and supporting procedures have been
    developed.
  • The rule calls for direct services workers and
    chief executive officers of agency providers to
    meet basic requirements and requires most direct
    services workers to hold valid certification in
    first aid and CPR and to complete training prior
    to obtaining certification.
  • Existing providers will be notified that their
    certification will expire and will need to
    reapply to renew.

51
Duplication between ODMRDD licensure and Ohio
Department of Health (ODH) certification for
Intermediate Care Facilities for the Mentally
Retarded has been identified.
52
  • An analysis of ODMRDD licensure and ODH
    certification has been conducted.
  • ODMRDD intends to reduce the amount of time spent
    on-site by enabling providers to submit
    documentation prior to the review.
  • The on-site review will focus more specifically
    on quality indicators and performance that must
    be verified by visual observation.

53
Requirements to update training curriculum and
develop a new course regarding specialized
service needs have been specified in the Fiscal
Year 2009 contract with the Ohio Alliance of
Direct Support Professionals.
54
  • A course on Autism and Behavioral Supports is
    being developed.
  • ODMRDD will continue to facilitate partnership
    between the Ohio Alliance of Direct Support
    Professionals and the Ohio Center for Autism and
    Low Incidence.

55
Framework has been outlined for state
accreditation, licensure, and provider compliance
which meets the Centers for Medicare and Medicaid
Services (CMS) requirements, focuses on outcomes,
and promotes best practices.
56
  • ODMRDD staff are designing a single standardized
    review tool that will apply to every type of
    provider.

57
The work completed in Phase One, which
includes 17 deliverables, is available at the
Futures website http//mrdd.ohio.gov/futures/
Draft documents are presented for the entire
MRDD community to review and provide feedback via
e-mail to futures-feedback_at_odmrdd.state.oh.us
58
John L. Martin, Director Ohio Department of
MRDD Phone (614) 466-0129 Fax (614)
644-5013 Email John.Martin_at_dmr.state.oh.us
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