Community integration for all people with developmental disabilities
Promote and support opportunities for people with developmental disabilities to live, work, learn and fully participate in their communities
Hamilton County Developmental Disabilities Services supports more than 7,800 people with DD in our community. We treat each person we serve as a unique individual and connect them to services to reflect the life they want. By collaborating with more than 800 certified providers, we’re able to support people to live a life that is important and meaningful to them, on their own terms.
In 2016 we made strides in several areas, including significant state legislation. Ohio became the first state in the nation to offer STABLE accounts, which allow people with disabilities and their families to save and invest money without losing eligibility for certain public benefit programs like Medicaid, Social Security Disability Insurance, and Supplemental Security Income. In addition, Gov. John Kasich visited St. Joseph Home in July to sign the legislation finally removing the “R-word” from Ohio law.
We expanded partnerships with providers in Hamilton County to raise the quality of service through trainings like Northstar Advantage and the provider-directed Gold Standard initiative. Our work with providers has become a model for the rest of the state, and we saw seven more Gold Standard providers added in 2016.
While some rules and trends have increased the number of individuals on the waiver waiting list, we vastly improved our internal processes for monitoring the needs of those waiting for waivers. Throughout the year, we connected many individuals on this list with needed services while they wait for a waiver. We were also able to provide waivers to more than 200 people on the waiting list.
The biggest change in 2016 was our transition out of providing direct services through Beckman, Franks, and Kidd adult centers. During the last few years, federal rules from the Centers for Medicare and Medicaid Services (CMS), along with several other mandates, have required our agency, and every county DD board across the state, to change the traditional ways services have been delivered for more than 40 years. Last May we began a formal process to find a provider to operate the adult centers. We chose this option to give individuals and families the greatest control over their services and provide continuity for those who wish to continue attending the adult centers. Beginning May 1, 2017 operation of Beckman, Franks, and Kidd adult centers will become the full responsibility of Active Day. The buildings will retain the names to honor the legacy of each center once this transition occurs. Although Hamilton County DD Services will no longer operate the adult centers, we will continue to provide quality monitoring and remain the source of funding for individuals.
The dedication, care, and patience of our staff at the adult centers has been unparalleled, particularly during these recent times of uncertainty. We are tremendously grateful for each and every one of these wonderful people.
While the path in 2016 was not always easy, I’m extremely proud of the progress our staff and our community have made in supporting opportunities for people with developmental disabilities to live, work, learn, and fully participate in their communities. I look forward to continuing these positive trends in the years to come. Thank you to all of our employees, board members, providers, families, and community stakeholders for your ongoing support of the work we do.
Alice C. Pavey
For nearly half a century, our agency has been an ally for those with developmental disabilities, ensuring the quality care and support they need to live the life they choose. As we enter 2017 and prepare to celebrate our 50 year anniversary, we remember our history of service while continuing to look toward the future. The way we support people has changed over time, but our commitment to helping people live a good life always remains.
At Hamilton County Developmental Disabilities Services, two guiding principles drive us in every action we take. The first reflects our agency vision: to move toward community integration in everything we do. The second is to build the capacity of community organizations to meet the needs of people with disabilities.
We recognize we’re not in this alone. We have a rich network of high-quality providers in Hamilton County, in addition to an extensive network of community partners and natural supports that help people with developmental disabilities live a good life. Continuing to provide training, collaborations, and support to help these organizations flourish is critical to the future and to our ability to achieve our mission of promoting and supporting opportunities for community participation.
Our 2016 Report to the Community gives an overview of how we support people, shares some of the specific work we did to improve last year, and highlights a few stories to give you a window into the lives of people we serve. We divided this report into multiple sections to reflect the different ways we support people:
- Personalized Supports explains the role of person-centered planning to ensure an individualized life plan and the necessary supports for each person we serve.
- In the Community looks at our expanding efforts to provide opportunities for people with DD to fully participate in their communities.
- Health and Safety explores the work we do to keep people safe.
- High-Quality Providers recognizes the role of more than 800 providers and how we’re helping them become even better.
- Financials reflects our commitment to transparency to taxpayers and other stakeholders.
Our agency’s focus is always ensuring quality care and support while efficiently using our available funding. And although we will no longer provide direct services through the adult centers, we will continue to plan, fund, and ensure the quality of services delivered by certified providers. I’m proud of our accomplishments in 2016, and I look forward to continuing to improve our ability to support people with developmental disabilities in Hamilton County. Thank you for your support.
Stephen J. Jones
Our Service and Support Administrators (SSAs) work with people with disabilities and their families to create a life plan. SSAs use the person-centered planning model to foster advocacy and generate meaningful outcomes for each person we serve. Using this approach, SSAs help people identify the attributes that make them unique, including skills, relationships, and a vision for the future. We then use that knowledge to create an individualized plan that connects people with local service providers and puts the necessary supports in place, empowering them to achieve what matters most to them.
We also work with children younger than three and their families to address development issues. Through our Early Intervention program, professionals, including physical, occupational, and speech therapists, support families in their homes or in community settings to help children learn necessary skills and overcome developmental delays.
In 2016 we focused on improving our ability to provide quality, individualized supports to people at every stage of their lives, from babies to senior citizens. We continue to provide planning resources that connect families with information and opportunities to prepare for the future.
People Received Services
People with Service and Support Administrators
Average Monthly Early Intervention Visits
Supporting Aging Caregivers
We were awarded the Future Is Now: Supporting Aging Caregivers grant from Ohio DD Council. It provides $50,000 per year over the next five years to help streamline and integrate aging and DD services. We will pilot small family-directed budgets to maximize safety and quality of life, as well as adapt Future Is Now planning sessions to meet the needs of aging caregivers.
Connecting to Resources
Our waiting list team has reached out to each person waiting for a waiver to assess their immediate needs and make referrals for alternative supports, including internal referrals to the transition, employment, and community integration teams. Additionally, we’ve collaborated with the Ohio Department of Developmental Disabilities to ensure that the state and local waiting lists mirror each other.
Navigating the LifeCourse
This year we joined local partners on Charting the LifeCourse training to help families plan for the future at every age or stage of life. We’re also working with local hospitals to support early resource and education for new parents. We continue to host regional information sessions, like Common Threads, and offer opportunities to participate virtually in statewide Family Advisory Council meetings so families are informed as their children grow.
Ken loves riding his bike anywhere he can, but an accident rattled his confidence on two wheels. With help from his friends, local bike shops, and his provider, Ken is back on the road with a custom trike.
Zachariah absolutely loves his job at Panera washing dishes and cleaning up the dining room, often at a pace that makes it hard to keep up and with his happy, contagious laugh echoing throughout the restaurant.
In the Community
In the Community
Integration can be intimidating, but we’re here to support families and identify opportunities that fit each person’s unique needs and aspirations. We’re working to connect people with their communities and create real opportunities to make friends, engage with neighbors, land a job, and fully participate as citizens.
In 2016 we shifted our focus to empowering people with disabilities to more fully join their neighborhoods and communities as genuine, engaged citizens. History and experience have shown that regardless of a person’s level of disability, participating and contributing as a citizen is the safest, healthiest, and most productive way forward. We’re working with people to get involved with their communities, help their neighbors, support local business, do good civic deeds, pursue their passions, and, in doing these things, become the best neighbors in Hamilton County. We’re a primary navigator and essential support in helping people with developmental disabilities to live the life they choose.
People receiving supported employment services
People receiving transition services
Providers joined the integration initiative
Our model gets people on the road to active citizenship and community participation. This initiative promotes real opportunities for people to live a life that fully reflects their choices. We’re connecting with partners to provide people with options to be part of their community. We began with four providers and have now invited every provider in Hamilton County to participate in this cutting-edge effort.
We’re supporting people to develop vibrant, lasting relationships to reduce loneliness and isolation while increasing independence. We’ve reshaped our service approach into a comprehensive plan that is already building partnerships beyond our system’s limitations. We’re constantly building networks and resources to enhance opportunities for better relationships with and for people by emphasizing engagement with others over simple activity.
Sharing Job Leads
We implemented an innovative approach to helping people find jobs by sharing job leads across multiple systems. By utilizing connections to other departments and systems, including Opportunities for Ohioans with Disabilities, local schools, and more, we’ve been able to better match potential employees to an employer’s need. This approach results in more people earning jobs and increased engagement from local businesses.
Matthew works 20 hours a week at the Spring Grove Village Kroger. “I like talking with customers and co-workers, and making some money,” he said. “It feels good to have a job. I’m proud of myself.”
Rost Gives Back
The students and staff at Rost School have come together to help those in need. Since the beginning of the school year, students in Kathi Spiller’s class have been helping Sissy’s Pantry.
Health and Safety
Health and Safety
We work tirelessly to ensure people we serve are healthy and safe. The Major Unusual Incident (MUI) Prevention department fully investigates all reports of abuse, neglect, exploitation, and other incidents against people with disabilities. Our investigators examine allegations to understand what happened and why, then put a prevention plan in place to reduce future risks. We also work with providers, law enforcement, and other members of the community to make certain all incidents are reported as quickly as possible.
Our behavior support team also helps prevent incidents by focusing on both real and perceived safety. Using person-centered practices, behavior support seeks to understand the path a person has traveled in life, their resiliency skills, and their personal history. Developing this comprehensive picture of a person’s unique life drives the support strategies to keep that person safe.
In 2016 we expanded partnerships with local law enforcement, improved access to report incidents, and used innovative practices like trauma-informed care to prevent unsafe incidents from happening.
Investigations to ensure safety
Reduction in restraints
Decrease in unreported MUIs
24/7 Reporting Hotline
In August we launched a new hotline for reporting abuse, neglect, and other MUIs. This service allows anyone to call 24 hours a day, 7 days a week, and leave an incident report or speak directly to our staff for immediate assistance.
This year we continued to provide training through Hamilton County’s Crisis Intervention Team. This training for law enforcement and first responders occurs several times a year. Our MUI staff provides crisis intervention strategies, tips, and shadowing opportunities that equip professionals to ensure the health and welfare of people with disabilities.
In 2016 the behavior support team concentrated on embedding trauma-informed care in our routine practice to increase safety and decrease risk for those we serve. This has allowed us to emphasize positive supports through compassionate understanding and respect, which has proven to be the most effective way to keep those we serve safe and happy.
Robert has a visual impairment that can make crossing the street dangerous. Many streets do not have audible crossing signals, so Robert decided to do something about it by working with the city.
Victoria’s shared living experience helps her feel safe at home. “I like the fact that I have people who love me,” she said. “And I like the environment. It’s really nice and comfortable.”
We connect people to service providers who fit their individual lives. The outstanding network of providers in Hamilton County forms the backbone of our system for supporting people with developmental disabilities. These stellar providers become more important every year as the traditional way services have been delivered for more than 40 years continues to change. We work to empower our local providers to offer the highest quality services possible.
We’re recognized statewide for responsive support to our providers through programs like Northstar Advantage, Gold Standard, and integration consultation. Each of these programs responds to providers changing needs and helps them improve services through training, resource materials, and information sharing with other providers to learn best-practices.
In 2016 we began the process of complying with federal mandates requiring that we no longer provide direct services and selected Active Day to operate Beckman, Franks, and Kidd adult centers. We chose this option to give individuals and families the greatest control over their services and provide continuity for those who wish to stay at the adult centers. Although the way we support people has evolved over our history, our longstanding tradition of caring for people with developmental disabilities will always continue.
Providers attended training sessions
In 2016 we began completely rebuilding our provider search web app. The new app will launch in 2017. It’s a simple, intuitive and powerful tool that helps people connect with the service providers that best fit their unique needs and goals.
We provided multiple training opportunities to help providers hone their operations and prepare for various changes. These trainings included an ongoing class hosted by our funding team that provides valuable information to help providers successfully navigate the ins and outs of payment through the Medicaid Waiver program. We also host bimonthly provider forums to provide training and share important information.
Raising the Bar
Our Northstar Advantage and the provider-directed Gold Standard groups continue to help providers improve their procedures and services and reach their highest potential. This year we provided additional training and resource materials so provider agencies have the tools to locate, hire and retain direct support and management staff. Having high-quality staff at provider agencies means the best possible support to people with DD.
Gloria & Emma
When they’re not visiting local museums or parks, or heading to restaurants, shops and movies, Gloria, Emma, and Jeremy are often creating new décor for their apartment that would make Martha Stewart jealous.
Amanda loves art and wanted to create a place for fellow artists to get together and create. So, with the help of her provider, Starfire, she developed a way to connect to other artists through a regular meet-up at a coffee shop called “Sip N Sketch.”
Total Revenue: $102,061,037
Total Expenditures: $84,853,717
Total Revenue: $102,061,037
Total Expenditures: $84,853,717
Federal Medicaid Waivers provide funding for 50% of individuals supported by HCDDS.
For each waiver service provided, Medicaid pays about 60% and HCDDS pays the remaining 40% using local levy dollars.
Medicaid waivers efficiently use our levy to secure more than $86 million of federal funding that’s reinvested in our local economy.
Medicaid waivers guarantee that people are free to choose any willing and qualified provider who fits their unique needs.
No matter what provider people choose, HCDDS coordinates all services ensuring quality standards while keeping people safe.
With more than 800 certified providers, people have a wide range of choices for quality services that offer the support they need.
How we fund services
When possible, HCDDS funds services through federal Medicaid Waivers. There are three different types of waives, each with different funding levels and requirements. All of them require HCDDS to pay about 40% of a service’s cost while Medicaid pays the remaining 60%. Funding services this way allows us to make the most of our local levy dollars and serve as many people as possible within a limited budget. When someone receives a waiver, we’re making a lifetime commitment to support that person’s needs, and we don’t take that commitment lightly.
Below are three examples of how a person might use each type of waiver and how the funding would break down. Remember, these are simply potential ways a person might use a waiver. Each person we serve has their own unique needs and goals, and our SSAs use person-centered planning to put supports in place that take that individuality into account.
Level 1 Waiver
Level 1 Waivers make up 35% of Medicaid Waivers in Hamilton County
I’m in my mid-thirties and live in an apartment with my boyfriend. I receive a few hours of in-home support each week from a provider to help with appointments as well as finding and participating in volunteer opportunities. I volunteer with my church, Girl Scouts, and various charity events. I work one day a week in the community as part of an Adult Day Array program. I also attend two other Adult Day Array programs, one twice per week and the other once per week.
Total Cost: $12,626
Medicaid Share: $7,576
HCDDS Share: $5,050
Total Cost: $5,165
Medicaid Share: $3,099
HCDDS Share: $2,066
Total Cost: $1,969
Medicaid Share: $1,181
HCDDS Share: $788
Total Cost: $5,492
Medicaid Share: $3,296
HCDDS Share: $2,196
SELF Waivers make up 2% of Medicaid Waivers in Hamilton County
I am 15 years old and have a SELF waiver. I use it to attend a community respite program and to get support from a provider in my home, which I share with my family. The provider helps me learn to prepare food and other things that will allow me to become more independent in my home. They also work with me on communicating more effectively and expressing myself so others can better understand me.
Total Cost: $20,600
Medicaid Share: $12,360
HCDDS Share: $8,240
Total Cost: $16,478
Medicaid Share: $9,887
HCDDS Share: $6,591
Total Cost: $4,122
Medicaid Share: $2,473
HCDDS Share: $1,649
Individual Options (IO) Waiver
IO Waivers make up 63% of Medicaid Waivers in Hamilton County
I’m in my early forties and have an IO waiver. I use my waiver to receive supports in my home from a provider who is helping me learn skills to become more independent. My provider helps me with things like getting in and out of my wheelchair, preparing meals, and personal hygiene tasks. They also help me understand how to budget my money and how to support my daughter. I recently secured a community job, and I receive transportation to and from work.
Total Cost: $116,553
Medicaid Share: $69,932
HCDDS Share: $46,621
Total Cost: $109,483
Medicaid Share: $65,690
HCDDS Share: $43,793
Total Cost: $7,070
Medicaid Share: $4,242
HCDDS Share: $2,828
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Habilitation Opportunities of Ohio, Inc.
Halom House, Inc.
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Happy & Healthy Home care, LLC
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Hearing Speech and Deaf Center of Greater Cincinnati
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Home Care Network Inc
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Homefront Nursing LLC
Hometouch Care LLC
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HopeTree Care, LLC
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Independent for Life
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International Quality Healthcare Corp.
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ISIS Home Healthcare and Staffing
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Just For You Supportive Living LLC
Ken Bryan Construction Inc.
LaBelle Home Health Care Services LLC
Lawrence County Board of DD
LCD Nurse Aide Academy and Home Health Agency
Lend A Hand Services LLC
Liberty Care Agency
Light of Hope Supported Living Services LLC
Lipsence Home Health Care
Living Arrangements for the Developmentally Disabled, Inc.
Lordess Care and Medtrans LLC
Love Care Home Inc.
Loving Care Transitional Home
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Maximum Homecare LLC
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Motion Mobility and Design Inc.
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Multi Options Residential Enrichment, Inc.
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New Horizon Center for Autism
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Northstar Care Services, LLC
Ohio Community Support LLC
Ohio Consumer Care LLC
Ohio First Home Healthcare Inc.
Ohio Valley Goodwill Industries
Ohio Valley Residential Services, Inc.
Once At Home Care Solutions
Opportunities to Succeed, Inc.
Optimistic Medical Equipment Supply LLC
People First Health Services, LLC
People Working Cooperatively Inc.
People’s Choice Residential Corp
Precious Life Center
Preferred Home Health Care LLC
Primary Care Nursing Services
Prime Home Care, LLC – Maineville
Prosperity Care, LLC
Providing Assisted Living Services LLC
Quality Care For Independence
Quality Care Nursing Agency
Queen City Med Mart, Inc.
Recreation Unlimited Farm & Fun
Rem Ohio Inc.
Residential Concepts Inc.
Residential Homecare Services, LLC
Rest Assured LLC
Right At Home
Rising to Attain Independence Self Sufficiency and Education
RMS of Ohio Inc.
Romy’s Plumbing, Inc.
Roslyn O’Hara Outreach Services LLC
Safe Haven Home Healthcare LLC
Sam’s Care LLC
Schiller Supportive Living, LLC
Seeing Beyond Disabilities
Sheffield Care, LLC
Southwest Home Health Care Inc.
St. Joseph Infant and Maternity Home
Starfire Council of Greater Cincinnati
Stateline Medical Equipment
Stepping Stones, Inc.
Sunshine In Homecare and Assistance
T N T Residential Services
T.F.Herceg Inc., dba SureHands Lift & Care Systems
T.J. Young General Contractor
Target Health Care LLC
Tender Care Supported Living LLC
The AMT Group, LLC
The Arc Of Ohio Inc
The Center for Practical LIving
The Glines Company, LLC
The Housing Network of Hamilton County
The In Good Hands Group
The Tall Institute
Three Women, Incorporated
Total Homecare Solutions, LLC
Toward Independence, Inc.
TriCounty Visiting Nurses
Trinity & Nulife Solutions, Inc.
Tri-State Premier Healthcare Services
Triumph Nursing Agency LLC
True Alternatives LLC
Trustaff Personnel Services
Ultimate Support Homecare Inc
United Seating and Mobility, LLC dba Numotion
University of Cincinnati
Valued Relationships Inc.
ViaQuest Day Services, LLC
ViaQuest Home Health and Hospice
ViaQuest Residential Services
Vibrant Assisted Living LLC
Visionaries and Voices
Visions Home Care Services LLC
Vogel Woodworking LLC
Walk Of Joy LLC
Wellness Residential Services
Wesley Community Services
Winton Transportation Inc.
WMK Equity Holdings, LLC
Wrap Around Supportive Living
YMCA Camp Kern
Yosi International, Inc.
You First Supported Living, LLC
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And more than 500 independent providers