Answers to frequently asked questions about changes for sheltered workshops, conflict-free case management and Summit DD’s role as a provider. (Updated July 2016)
Questions about integrated day programs and sheltered workshops
What did the federal government change about federally funded programs?
The federal government, specifically the Center for Medicaid Services (CMS), enacted a rule in 2014 that says that Medicaid funded programs, such as day programs, must be delivered in a way that does not have the effect of isolating or segregating people from the community. Each state must come into full compliance by March. Ohio received initial approval of its Statewide Home and Community-Based Services (HCBS) Transition Plan from CMS on June 2, 2016.
What does it look like when you say “as long as it does not isolate them from the broader community?”
This means that those with disabilities should be able to experience the same things as people who do not have disabilities. Providers are required to offer opportunities for all individuals served to get involved in their communities. This could include community employment or it can mean participating in community-based events/activities. These opportunities should be meaningful and based on each individual’s interest or goals. It does NOT mean that workshops are closing or going away and it does NOT mean that individuals are required to work in the community.
Are services going away?
No, services for people with disabilities are NOT going away. Individuals who participate in day programs (commonly referred to as workshops) will still have the opportunity to participate in day programs, if they choose. Summit DD is currently working with the private provider community to develop best practices and options that will help all day programs meet these new guidelines. Many providers already meet the requirements of the new rule.
I’ve heard a lot about community employment. What about those who can’t, or don’t want to, work in the community?
Summit DD believes that everyone should have the right to work in the community, if they choose, however community employment is not a requirement of the CMS Rule. We understand that not everyone is ready to work in the community, and your SSA will listen to what is important to you and coordinate right-fit supports. If an individual is not capable of, or does not want to, work in the community they will not be required to do so.
What if my loved one isn’t ready for employment after high school? What does the transition from school-age services to adult services look like?
Every new graduate supported by Summit DD will work with their SSA (and their team) to create an Individual Service Plan (ISP) for services, based on their needs. Summit DD has already put in place several initiatives to work with families and schools even earlier to help with much needed transition services. If you are able to and want to work in the community, we will connect you with providers to work on job development skills or job follow along services, at your pace. If you do not want to or can’t work in the community, integrated day opportunities and workshops will continue to be available.
How will my SSA help us plan for the future?
When you meet with your team to complete your ISP you will notice some differences. We will be completing a strength-based assessment to determine what you or your loved one can do and what they are interested in to develop a person centered plan based on what is important to each individual. You should be prepared to become an active participant of that team to advocate for your goals. Paid and natural supports will be built upon your goals and your interests. The ISP is just not about where you go during the day, but what is important in your life.
Summit DD’s phasing out of Waiver services
What is the conflict of interest issue?
The federal government, through CMS, has also called for what they refer to as “conflict-free case management.” County Boards, including Summit DD, employ Service and Support Administrators (SSAs) who determine eligibility, develop service plans and connect people to service providers. These are considered case management functions by CMS. In addition to providing these SSA services, or case management services, many County Boards (including Summit DD) also provide transportation and adult services (like day programs and community employment services) directly to individuals, which are funded through federal Medicaid Waivers. According to the federal government, this is an inherent conflict of interest – overseeing the service coordination AND providing services directly to individuals. The federal government is requiring County Boards to resolve this conflict by no later than 2024 by phasing out of providing these services directly to individuals.
What services are impacted?
Only Summit DD provided Home and Community-Based Services (HCB Services) are impacted. More specifically, this means Summit DD supported employment services, Summit DD adult day and vocational habilitation (Summit DD Workshops) and Summit DD provided transportation services. Day programs, employment and transportation services provided by agency and independent providers other than Summit DD are not impacted by the new conflict of interest federal government rule. As of summer of 2016, more than 80% of people already receive services from a provider other than Summit DD.
What is the timeline?
Summit DD has developed a timeline to phase out of Summit DD provided direct services. We estimate the entire transition from County Board provided services to be completed by 2020. As we work through the transition, we will review enrollment, needs of individuals, buildings, and efficiency in our programs to make responsible decisions for the future. The first center impacted by the phase out of services was Akron Center, which closed on June 30, 2016. Families, individuals, and staff worked together to make this transition as smooth as possible. All 75 participants from Akron Center found a new provider with which they are happy with. While some participants went on to new opportunities like community employment or integrated senior program, most chose a setting very similar to the one at Akron Center. The next centers scheduled to close are Summit DD’s Ellet and Southern Centers by June 30, 2017. The detailed timeline can be found on SummitDD.org.
How will Summit DD communicate with me about these changes?
We believe in being transparent and want to continue to be a resource for families. We will continue to host community meetings when new information is available. We will provide information on our website at SummitDD.org. We will also keep you informed through letter or postcard mailings, monthly email newsletters (visit our website to sign up online), and printed newsletters mailed to your house three times a year. We encourage you to connect with us on Facebook as well to stay current as well.
Will the staff who take care of my loved one remain the same?
You will more than likely see some different staff taking care of you or your loved one throughout this journey. As the number of individuals supported by Summit DD gets smaller, our workforce will get smaller as well. We have already experienced higher voluntary turnover as staff find new opportunities. We are committed to high standards with all of our staff and can assure you that any Summit DD staff you work with will understand the needs of you or your loved one.
How do I choose a new provider?
Person-centered planning ensures that each individual is the lead on their team. Our service coordinators (SSAs) are here to help you through the provider selection process. Your team will meet with you, at least once annually, to determine what is important to you and help build your individual service plan. We are committed to providing you the best information possible to choose a new provider.
How will Summit DD ensure that individuals receive quality services from providers?
Summit DD already has several processes in place to build quality services, regardless of who provides that service, including ongoing monitoring by SSAs, compliance reviews and investigations of unusual incidents. We work as a team with providers to ensure the individuals we support receive the best supports possible. Provider oversight and quality assurance is one area where Summit DD will become even more relevant over the next several years.
What if there aren’t enough providers to fill the need?
Summit DD continues to work with current providers as well as seek additional opportunities and resources to ensure capacity for adult day support, inclusive community programs, supported employment and non-medical transportation. Many providers have already opened new building and have expanded their program. There are also some new providers in Summit County. We are confident that there is enough provider capacity to meet the needs of individuals currently served by Summit DD.
What happens I don’t like my new provider? How long before we have to wait to change it?
As always, if you are unhappy with your provider, or would like a new setting, you can revise your service plan at any time. Person-centered planning ensures that the individual is the lead on each team. Our service coordinators are here to help you through the provider selection process. Your team will meet with you, at least annually, to determine what is important to you to help build your individual service plan.
What if I disagree?
As always, if you disagree with your service, you are entitled to due process. We encourage you to settle disagreement with your SSA and team first.
Local funding and levy dollars
How does this impact the levy and future levy dollars?
Levy dollars are there to ensure services are available to adults and children with developmental disabilities in Summit County, that need does not go away. Services will continue to be funded through a combination of local and federal dollars. Together, Summit DD and families must work to re-educate the public about levy tax dollars. It is important that the community understands that these dollars are vital regardless of who provides the service.
What do local dollars fund?
Local dollars fund a variety of programs and services for children and adults. Many services for adults are funded through a combination of Medicaid Waiver (federal) programs and local levy dollars. When Medicaid Waiver funding is available, Summit DD pays for the non-federal match (or share) which is approximately 40% of the cost of service, regardless of who the provider is. The other 60% is paid for through federal Waiver funds.
Local dollars also fund Early Intervention services for approximately 800 families each year, inclusion support for approximately 100 children who attend day care centers in their communities, service coordination for more than 3,000 adults and children, health and safety services, quality of life activities and day array and residential services for adults who do not qualify for Medicaid funding, among other locally funded programs, collaborations, and innovative practices. Our goals and initiatives our outlined each year in our Annual Action Plan.
Questions? Call our information hotline at 330-634-TALK (8255) or visit SummitDD.org and Contact Us.
Download a copy of these FAQS here.