Presented by The Ohio Department of MRDD

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Presented by The Ohio Department of MRDD

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• In early 2007, Ohios MRDD community agreed that
  it was time to take stock and to develop a
  strategic plan to continuously improve services
  for individuals with mental retardation and other
  developmental disabilities.
• Governor Strickland, members of the 127th General
  Assembly, and the MRDD community came together to
  create the MRDD Futures Committee.

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• 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

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• 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.

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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.
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• 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.

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• 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

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

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

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

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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
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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.
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• We are implementing the recommendations of the
  MRDD Futures Committee during a time when
  resources are scarce.
• We are trying to protect individuals and families
  who receive services from being impacted by the
  smaller budget 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.

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ODMRDD FUTURESDELIVERABLE 1 (Continued)

• ODMRDD will submit the budget to the Office of
  Budget and Management by September 15, 2008.

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The concept for a new flexible support waiver
has been developed and documented.

• 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.

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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.
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• Existing materials were inventoried and
  out-of-date materials are being 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.

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An analysis of the existing provider search
website has been conducted to identify potential
short-term refinements.

• 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.

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A regional model to support young adults to
successfully transition from school to work has
been developed to be pilot-tested.

• 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.

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An analysis has been completed to determine
how Atlantes health care management software
aligns with individual service planning needs in
the MRDD system.

• 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.

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A standardized, on-line individual service
plan (ISP) format has been developed to be
pilot-tested.

• 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.

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A statewide strategy to revise and better
manage waiting lists has been developed.

• 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.

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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.
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• 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.

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Materials that support care providers and
promote the Behavior Support Advisory Councils
Positive Intervention Culture have been
developed.

• 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.
• 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.

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A statewide housing survey has been initiated.

• 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
  in Ohio.

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• County boards of MRDD will be equipped to create
  county-based housing plans for citizens with
  disabilities that integrate seamlessly with the
  statewide housing plan.
• ODMRDD staff will participate on the Council and
  provide logistical support to TAC throughout the
  project.
• ODMRDD staff will collaborate with the Disability
  Housing Network and monitor completion of
  contracted deliverables.

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The National Core Indicators have been
implemented.

• 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
• The Center for Marketing and Opinion Research has
  been selected to conduct individual and family
  surveys.

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Methods for measuring individual satisfaction
have been analyzed and a plan for incorporation
into the quality review process has been
developed.

• 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.

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A draft administrative rule for provider
certification that implements time-limited
certification and application fees has been
developed and disseminated for review.

• 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.

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Duplication between ODMRDD licensure and Ohio
Department of Health (ODH) certification for
Intermediate Care Facilities for the Mentally
Retarded has been identified.

• 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.

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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.

• 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.

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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.

• ODMRDD staff are designing a single standardized
  review tool that will apply to every type of
  provider.

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Submit comments by e-mail to futures-feedback_at_odm
rdd.state.oh.us Or, mail comments to Becky
Phillips 30 East Broad Street, 12th
Floor Columbus, Ohio 43215