Questions & Answers
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Click here to download a list of the acronyms that are frequently used.
What is a developmental disability?
A developmental disability is a significant mental or physical impairment that occurs before the age of 22 that is likely to be a life long condition, requiring individually planned supports and services.
Who qualifies for services?
Eligibility for service varies depending on the age of the individual and the applicable State Department standards. An individual’s limitations are determined by using the Ohio Eligibility Determination Instrument, OEDI, for adults and the Children’s Ohio Eligibility Determination Instrument, or COEDI, for those under the age of 21.
To be eligible for County Board services, substantial limitations must be found in at least three of the following areas: Self Care, Receptive Expressive Language, Mobility, and Capacity for Independent Living, Self-Direction, Learning, and Economic Self-Sufficiency.
How many individuals are served by the Butler County Board of DD?
The Butler County Board of Developmental Disabilities provides services and supports to more than 2,000 individuals with developmental disabilities and their families who reside in Butler County.
What is the difference between an intellectual disability and a mental health condition?
Mental Retardation is a medical diagnosis. We prefer to use the term developmental disability, or more specifically, intellectual disability. An intellectual disability refers to sub-average intellectual functioning and refers to impairment in social adaptation. National incidence: 3 percent of the general population. Ohio incidence: 1.4 – 1.9 percent of the general population of Ohio is estimated to have a severe functional limitation due to a developmental disability. An intellectual disability is present at birth or usually occurs during the period of development, before the age of 22. With an intellectual disability, some degree of intellectual impairment can be expected to be permanent. A person with an intellectual disability can be expected to behave rationally at his/her functioning level. People with an intellectual disability can also experience different types of mental illness with symptoms such as hallucinations, or severe depression, secondary to the condition of the intellectual disability.
Mental illness has nothing to do with intelligence. Mental illness is just that; an illness. It can be controlled with appropriate treatment and/or medication. Many people recover completely from mental illness. A person with mental illness may be very competent socially, but may have a character disorder or other aberration. National incidence: 16-20 percent of the population. Ohio incidence: while approximately 17.5 percent of the adult population in Ohio could benefit from receiving mental health services, only about 1.3 percent are considered to be severely disabled as the result of mental illness. Mental illness may occur at any age, is often temporary, and in many instances the condition is reversible. A person with mental illness may fluctuate between normal and irrational behavior. The term mental illness covers a wide variety of symptoms that may indicate that someone is in emotional trouble, including: belligerence, excessive moodiness, suspicion and mistrust, or poor emotional control.
Who qualifies for residential support from Butler County Board of Developmental Disabilities?
To receive residential supports from the Butler County Board of Developmental Disabilities, a person must be determined eligible for Board services according to the requirements set by state statute The person should also be on Medicaid or be willing to apply for Medicaid eligibility. The type of residential support a person can receive depends on: 1) their assessed needs, 2) available funding, 3) a willing provider of supports and, 4) a determination of the person’s need in relation to the County Board’s prioritization of services.
Does it help for individuals to have recommendations from other Medical professionals or Social Service Agencies?
No, once eligibility for Board Services is determined, residential supports with Medicaid funding must be determined according to the process defined in statute, which falls to the Ohio Department of Developmental Disabilities and the local County Board of DD.
What supports does the Board provide?
Once eligibility is determined, an individual is assigned to a Support Coordinator. The Support Coordinator will assess the individual’s needs and help to develop an individual plan of service. The Support Coordinator can also provide information regarding the various options for residential supports and types of funding and, if appropriate, will supply the individual with information about finding a place to live in the community. The Support Coordinator can also make a referral for the person to be placed on a waiting list.
Does the Board provide special homes for people with disabilities?
The Board works with private landlords and with a housing corporation and a non-profit board that purchases and maintains homes in the community. People must use their incomes to pay rent and basic living expenses. Some people live with family and can receive non-medical in-home supports so they can stay with their family. The Butler County Board of DD staff does not provide direct services in the home nor does the Board typically contract directly with providers. The Butler County Board of DD will pay a portion of the in-home care if a Medicaid waiver for that care is assigned to that person.
What is a Medicaid waiver?
Medicaid funding is issued to Ohio through community-based waivers. The term refers to the fact that the person is waiving their need to go into an institutional care facility and instead, they need supports to live in the community.
The State Department of Developmental Disabilities works with the Federal Center for Medicaid Services to determine the number of waivers for community residential that are allocated to the state each year and the terms of allowable expenses for in-home supports.
How does the Medicaid funding for the in-home supports get allocated for a person?
Each County Board of DD decides, based on fiscal resources and need, how many waivers it will request each year from those that are allocated to the State of Ohio. The amount of supports is individually determined through a state determined assessment process and the particular supports are defined in the individual Support Plan. Currently, there are two different waivers with different funding levels. Depending on the person’s assessed need, funding for in-home supports can range from $0-$5,000 and those over $5,000. Once the state approves the funding for the person, the provider invoices Medicaid for the care provided according to the individual’s service plan. The County Board of DD is responsible for paying a percentage of that approved amount. The amount allocated is based on the assessed needs according to state guidelines and is not based on whatever the individual wants.
Who selects the private providers and are they licensed or certified?
Providers must apply to the State of Ohio Department of Developmental Disabilities for certification to provide the service to qualify for Medicaid funding. There are state rules for compliance of certain standards that the providers must maintain. On the State Department of DD website, there is a list of all the providers. An individual has the right to select a provider, but a provider must also be willing to provide the support to that person. A support coordinator will assist an individual with the process of locating and interviewing providers.
How long can a person receive the Medicaid funded in-home supports?
Once a person’s waiver has been approved, Ohio Job and Family Services will review the waiver annually to determine approval for another year. The individual’s team has to review the needs and supports that need to be in place for the next waiver period being requested. The individual also has to maintain Medicaid eligibility. If the person’s disability, behavior or medical statue creates a significant risk to that person’s health and safety, they can be dissenrolled from the waiver funding because the risk indicates that a more restrictive residential arrangement is needed. The person can dissenroll themselves, anytime, from the waiver program.
Does the Board have to provide residential supports to everyone who requests it?
According to statue, the Board does not have to provide residential supports if it does not have the resources to do so. Because there are not enough resources for everyone who requests them, the Board has a three year plan of how many new people it will support, based on their projected resources. Because of this, in Butler County, there is a waiting list for these supports. The board’s plan also includes what cases will be considered priorities. Nationally as well as statewide, there is a lack of sustainable and adequate resources to meet the residential requests by people with developmental disabilities. Butler County is not unique in this. We do not have the resources to provide residential supports to everyone who requests them.
The request for a residential waiver must be approved by the county and the state, according to the Medicaid statutes.
Do people get assigned waivers based on their position on the waiting list?
Yes and no. There are provisions in the statute that allow people to get waivers and not be the next one on the waiting list. First, the board can assign waivers for emergencies, which is strictly defined by the statute (An example is a loss of caregiver.) Second, the Board, in their three year plan, indicates priority categories, such as persons who are living with elderly caregivers. If the priorities and emergencies are at bay, then the Board can assign waivers to people according to their position on the waiting list. The current Butler County three year plan says it will request 45 higher level residential support waivers ( those over $5,000) and 100 residential support waivers of up to $5,000. Likely, these will be needed for emergencies and priority cases.
How is funding allocated once a waiver is approved by the County and the State?
For Individual Option waivers, an assessment is administered to identify the individual’s skills, need/functional limitations. Funding is used for homemaker/personal care, respite, social work, home-delivered meals, nutrition, interpreter services, specialized medical equipment and supplies, home modifications and adaptations, supported employment.
A Level One waiver is allocated on priority codes and level of need. Funding is used for homemaker personal care, respite, transportation, personal emergency response system, specialized medical equipment and supplies, and environmentally accessibility adaptations,
The state sets ranges of funding depending on the assessment. In both cases, supports and funding is based on assessed need to meet health and safety of the individual; it is not determined by the expressed wants by individual, their guardian or family. The funding is capped and so an individual and their provider must work within the funding limits and according to the supports identified in the individual’s service plan.
How much of the County Board’s financial resources go towards residential supports?
In 2011, the annual amount that the Board budgeted for its residential waiver match obligation was over $4 million. This amount supports a little over 650 individuals.
Who do I contact if I have concerns about abuse, neglect, theft or other mistreatment of an individual with a developmental disability or need to report a “MUI”?
It is important to report any suspicions that an individual with a developmental disability is being mistreated. Reporting abuse, neglect or theft against a person with an intellectual or other developmental disability is not only the right thing to do, it’s the law. If someone is in immediate danger, call 911.
If there is no immediate danger, but you believe someone with a disability has been abused, please report it as designated below:
Between the hours of 8 a.m. and 4 p.m. call 513-867-5992 or fax 513-867-8028 or send an email.
After 4 p.m. Call the after-hours emergency line at 513-867-5913 and leave a message. Your call will be returned quickly.
For more information about the Office of Incident Review/MUIs, click here.
