43
MCBDD: Waivers a bargain
AUSTINTOWN
Officials at the Mahoning County Board of Development Disabilities say they spend more than $7.7 million a year on Medicaid waivers for services for clients and consider it a bargain.
That sum represents about a 37 percent local share that leverages more than $21 million worth of Medicaid waiver-funded services for clients who live at home or in supported living facilities, said Kristine Hodge, assistant superintendent and director of community services for MCBDD.
Waiver is a Medicaid-funding program that allows people to have care in their homes, such as help with personal care, supervision of medications and transportation to and from doctor’s appointments, activities and day programming.
Level One and Individual Options Waivers are for home and community-based services that keep individuals in the community and out of institutional care. Absent the waiver, individuals would need the services of an intermediate-care facility for the developmentally disabled, Hodge said.
Without the waivers, the local board would have to pay 100 percent of the costs and would not be able to help as many clients because money would not be available, she added.
Waiver services are funded by federal dollars, with the agreement that the county board pays the local share.
“By requesting waivers, we can offer help to families who are in so much need, at only a fraction of the cost locally,” Hodge said.
The biggest cost out of all the services is home-care services in the client’s own home with their family or a residential living site, said Larry Duck, MCBDD superintendent.
The next two highest-cost categories are adult-day programming provided by MCBDD’s MASCO sheltered workshops and other agencies, Duck said.
“We’ve done very well over the last five years enrolling clients into waiver programs by using local and state dollars to leverage federal dollars. We couldn’t afford it at the local level,” Duck said.
The local board is continuing its push for more waiver clients, Hodge said.
Level One waivers were offered to 10 children in the first quarter of 2010, and the board plans to enroll at least 30 more by December 2011 and 40 more a year until the waiting list “becomes manageable,” Hodge said.
As of the first part of this month, 176 children under 22 are on the Level One waiting list, and the number will grow as children are determined to be eligible for services, she said.
With the 30 additional children enrolled by the end of the year, the waiting list will be reduced from 176 to 146. But the list is fluid, and the numbers determined eligible are likely to increase. In 2010, 72 individuals were found eligible for services, Hodge said.
Level One often is called the “small waiver” because it has a capped amount of personal-care services of $5,000 per span year. But it also has three other separate caps: $6,000 per three-year period for services such as personal emergency response systems, special medical equipment and supplies and environmental accessibility adaptations to the home; $8,000 per three-year period for emergency assistance; and an amount based on assessed needs for adult services and transportation.
The Individual Options waiver, sometimes referred to as the “big waiver,” is based on an assessment of all aspects of a client’s life that determines a funding range from $5,001 to $19,000. This waiver typically is seen in residential settings with two to four individuals living together who share services.
The Level One waiver pays for services such as respite care, assistance in the home for the individual, such as help with personal care and grooming tasks, helping the person to and from the bathroom, assistance with medication and transportation.
As of Dec. 31, 2010, there were 258 individuals enrolled on Individual Options waivers and 243 individuals enrolled on Level One waivers, for a total of 501 waivers, Hodge said.
The developmental disabilities board gets its funding from federal, $4,076,500; state, $4,020,932, and its local levy, $16,834,830.