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State of Ohio Early Intervention Fiscal Initiative Cohort I State Application Presentation. Ohio Fiscal Initiative Team. Wendy Grove, PhD Part C Coordinator, Department of Health Kim Hauck, MEd Assistant Deputy Director, Department of Developmental Disabilities Yolanda Talley, MPA
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State of Ohio Early Intervention Fiscal Initiative Cohort IState Application Presentation
Ohio Fiscal Initiative Team • Wendy Grove, PhD • Part C Coordinator, Department of Health • Kim Hauck, MEd • Assistant Deputy Director, Department of Developmental Disabilities • Yolanda Talley, MPA • Administrator, Department of Medicaid
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
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
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
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
Ohio EI Finance System: LOCAL • County 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
Ohio EI Data System (1) • Ohiohas 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)
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) • Granteesreport 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
Challenges in Ohio EI: Financing • EI does not currently capitalize on any private or federalsources of funds except for IDEA Part C & Title XX • EIdoes 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 EIsystem • 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
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
Current Initiatives in Ohio EI • Developed grants with the DD Council for training in promising and evidence based practices and system change • Convening diverse stakeholder groups (including parents) to make recommendations for system change • 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
Current Initiatives in Ohio EI • Joint ODH/DODD agreement about using the Mission & Key Principles as the lens through which training, technical assistance and monitoring are done • New state plan for planning, training and technical assistance through 2 agencies (ODH and DODD), including engaging the ICC and additional stakeholders • Started discussions with our state Medicaid agency on financing parts of EI
Team Contacts • Wendy Grove, PhD • wendy.grove@odh.ohio.gov • Kim Hauck, MEd • kim.hauck@dodd.ohio.gov • Yolanda Talley, MPA • Yolanda.Talley@medicaid.ohio.gov