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Summary of Town Hall Presentation


As we mentioned, on January 16, 2014, the Federal Government issued new rules for the Medicaid program.  The Medicaid rules narrowed the types of settings in which Medicaid reimbursable services can take place, with a greater emphasis on integrated, community-based settings and outcomes. Because all of the individuals who receive services in New Avenues ICFs/Group homes, supported living program and Day Services program have their services paid through Medicaid, New Avenues has been monitoring how Ohio plans to become in compliance with the new rules. All States had to submit a plan to be in compliance with the new rule by March 2015. States will have as many as five years to come into full compliance. Ohio is requesting 10 years for certain provisions. As of today, none of the plans had been rejected but CMS has begun to return them for revisions by States. We have been informed that many of these requests for revised plans should be back in the States in the summer or early fall. Ohio is still waiting for approval for its plan. Here are the links to the Federal Register- CMS Rule and the link to Ohio’s HCBS Transition Plan submitted to CMS.

Also impacting the compliance with the new rules is Ohio’s new biennial budget. In February 2015, Governor Kasich announced his 2016-2017 biennial budget, which requires approval by the Ohio legislature. The Budget included substantial investments in developmental disability services: $112 million above 2015 levels over the course of the two years. DODD has announced that, if approved, spending would target ICF downsizing efforts, increased funding for community employment, and the addition of 3,000 HCBS Waivers. The DD budget as voted by the House of Representatives was reduced and passed on to the Senate. On May 14, there was an Ohio Senate Medicaid Committee Testimony Hearing in Columbus.  Director Martin from the Ohio Department of Developmental Disabilities testified regarding the need to restore the as-introduced budget, as all initiatives are related, and are required to achieve our policy objectives. Advocates testified and attended to show support and air concerns. As of today, Ohio does not have an approved budget for 2016-2017.

New Avenues is also monitoring the Federal budget because the Federal Government pays approximately 60% of the cost. In February, the president submitted the federal budget to the U.S. House of Representatives which passed the budget resolution along party lines (226-197) on April 30. On May 5th, the U.S. Senate passed its budget, on a party line vote of 51 to 48 as well. Under the Budget framework, Congress calls for $4.2 trillion in cuts over the next decade to federal benefit programs like Medicaid, Medicare and the Supplemental Nutrition Assistance Program (SNAP) — programs people with disabilities have historically relied on to make ends meet.

Throughout the years, New Avenues has relied heavily on Medicaid funding for the programs and services we offer to implement our annual budget.  Nearly 98% of the individuals we serve rely on Medicaid for their long-term care insurance as well as their health insurance. However, with the changes in the CMS rule, the proposed State Transition Plan, and impact on funding systems, agencies, like New Avenues, who receive government funding face particular challenges. So, for example, in 2014, we have had to rely on 6.8% from funding sources other than Medicaid to cover the cost of our programs. We anticipate that the funding gap will continue to grow.

New Avenues, along with providers, from around the country need to adapt to the changes of both the new CMS rule and their individual State Plan. New Avenues mission and values serve as a guide for our strategic initiatives. Our strategic initiatives along with our mission and values are outlined in the Family Forum Presentation document linked here.

As you can see, the coming changes will certainly impact New Avenues ability to continue to provide high quality programs and services. To that end, we developed a fundraising plan to help bridge the gaps in funding. A large part of the plan is the creation of a signature fundraising event which will raise much needed funds on an annual basis, as well as increase awareness about the issues that people with disabilities face. Please consider becoming a table host. Here is the Applause, Table Host flyer that contains all of the information. Please contact Linda Malicki, Development Specialist, at or (216) 481-1909 x223 to help.

At the Town Hall meeting, several parents requested sample letters that they could sign and send to their legislators. A sample letter about the Federal budget can be found here. Click here your Senator and Representative's contact information in Washington here. Because the Ohio budget has now moved on to the Ohio Senate and the Senate Medicaid Committee has begun to review the budget and once its work is complete, they will then pass it to the Senate Finance Committee, a sample letter to State Senators can be found here. Find your State Senator here.  See "Find your Senator" on middle left of the page. You may also want to visit for additional advocacy information and resources.

We’ve included two other documents that may be of interest to you. CCS Ohio at a Crossroads is a comprehensive overview of the developmental disabilities system in Ohio and detail pending changes facing the system. Lifelines in Ohio summarizes the impact of  Medicaid, Medicare, Social Security, and SSI in Ohio.

In addition to the information from the Town Hall meeting, we also wanted to share that effective June 1, 2015, Court-appointed guardians across Ohio will all have to follow new rules established by the Ohio Supreme court as they manage the affairs of Ohioans who are deemed unable to care for themselves. The Supreme Court's standards are the new minimum requirements for guardians statewide. Those rules had previously been left up to individual probate courts in Ohio's 88 counties. The new rules require training, monitoring and background checks and say that guardians must meet with their wards at least every three months. Although these rules do not directly impact providers, you should be aware of the rules impacting any of your residents' guardians. Among the highlights:

  • New and existing guardians must attend a 6-hour training course, and complete an additional Court approved 3-hour training course yearly.
  • All guardians must have a criminal background check
  • All guardians must file an annual guardianship plan with the probate court
  • The new rules indicate the duties of the guardian, including "person centered planning" and a requirement for meetings with their ward at least quarterly
  • Requires the courts to establish a process to receive and store comments and complaints, to provide the guardian with a copy of complaints, and to notify the complainant of how the comment or complaint was handled

A copy of the rules are available from the Supreme Court here.

If you have any questions, please contact the Resource Development Director at or (216) 481-1909 x249.