State of Ohio Early Intervention Fiscal Initiative

Cohort IState Application

Presentation

Ohio Fiscal Initiative TeamWendy Grove, PhD

Part C Coordinator, Department of HealthKim Hauck, MEd

Assistant Deputy Director, Department of Developmental Disabilities

Yolanda Talley, MPAAdministrator, Department of Medicaid

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Ohio Service Delivery Structure (1)• Ohio has 88 counties that administer early

intervention supports and services• ODH grant funds (Fed & State $$) public awareness,

child find and referral, data entry, service coordination and some part of the child/family evaluations/ assessments

• Services provided by local County Boards of Developmental Disabilities (CBDD) utilizing local levy funds

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Ohio Service Delivery Structure (2)• Families seeking services outside those offered through the

CBDDs may be able to access providers who contract directly with ODH through payor of last resort, when determined unable to pay

• Regional Infant Hearing/Vision Services Network• Services may sought through hospitals, clinics and private

providers, but these providers are not obligated to provide a service through the IFSP or in accordance with the IDEA regulations

• Great variation exists in available services (from any source) in metropolitan vs. rural and Appalachian areas of the state

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Ohio EI Finance System: FEDERAL$14 M in federal IDEA Part C (SFY 14/FFY 13)Tydings/Carryover funds filled in as needed•ODH grant (Service Coordination) $13.2 M•Regional Infant Hearing $0.6 M•Hospital Based Regional Child Find $0.26 M•POLR direct contracts (Services) $0.4 M•Administration/IAAs $2 M

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Ohio EI Finance System: STATE$13 M in state general revenue funds annually(EI share of 33.5 M GRF with Home Visiting)•ODH Grant (Service Coordination) $8 M•ODH Contract (Central Coordination) $5 M•POLR direct contracts (Services) as needed

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Ohio EI Finance System: LOCALCounty Boards of Developmental Disabilities contribute $100 M annually of County levy funds•CBDDs set own priorities & support for EI•No legislation to bind the contribution, but most support EI•Largest contributor into EI system

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Ohio EI Data System (1)• Ohio has a self-created data system, Early Track• Data system is web-based in real time• Ever-evolving to keep up with rule & CQI changes• Data Quality plans required• Data collection and records rule requires data entry within

30 days of any event in EI• Systematic analysis of needed versus unneeded data to start

by June 2014 to pare down old needs and update for new needs (ex. Income required, but in categories; insurance information not required)

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Ohio EI Data System (2)• Ohio’s Early Track data system collects self-reported income

and private insurance information on participants who provide it (currently only 32% of the families served in 2012)

• Grantees report quarterly expenditures, including any sub-contracts and in-kind paid expenses. We have annual close-out calculations for money expended and unspent for each grantee (88 counties, 88 grantees)

• Ohio Department of Developmental Disabilities provides an annual self report from County Boards of Developmental Disabilities for services provided to children under the age of three

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Challenges in Ohio EI: Financing• EI does not currently capitalize on any private or federal

sources of funds except for IDEA Part C & Title XX• EI does not currently receive funds from other state sources

such as CAPTA, Mental Health, Education, or state Medicaid• The economic downturn over the last ten years has resulted

in state agency contributors no longer being able to contribute financially to the EI system

• CBDDs frustrated by state regulations without funding; no state requirement for local participation. EI system has long history of over-dependence on what CBDDs can provide

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Challenges in Ohio EI: Infrastructure• Ohio is a county-ruled state • Lead Agency not granted ability to assign financial

responsibility for EI to other state agencies• Significant change in program leadership over the

past five years has slowed progress while new leaders learned the program and built trust

• Unknown changes coming with ACA and Managed Care changes in state

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Current Initiatives in Ohio EIA. Developed grants with the DD Council for training

in promising and evidence based practices and system change

B. Convening diverse stakeholder groups (including parents) to make recommendations for system change

C. Contracted with an outside vendor to examine Ohio’s system and develop recommendations on how Ohio could make a change in practices and implement the stakeholder recommendations

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Current Initiatives in Ohio EID. Joint ODH/DODD agreement about using the

Mission & Key Principles as the lens through which training, technical assistance and monitoring are done

E. New state plan for planning, training and technical assistance through 2 agencies (ODH and DODD), including engaging the ICC and additional stakeholders

F. Started discussions with our state Medicaid agency on financing parts of EI

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Team ContactsWendy Grove, PhD

wendy.grove@odh.ohio.gov

Kim Hauck, MEdkim.hauck@dodd.ohio.gov

Yolanda Talley, MPAYolanda.Talley@medicaid.ohio.gov

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