KINGSVILLE TOWNSHIP – During a Feb. 28th Ashtabula County Board of Commissioners meeting, Director of Adult Services Lynda Perry said the Ashtabula County Board of Developmental Disabilities faces serious challenges in light of recent regulatory changes by the Center for Medicare and Medicaid Services (CMS) that may force Ash/Craft Industries to spin off from the Board of DD and become a private nonprofit.
“CMS have said county boards of DD cannot provide direct services to anyone on waivers by 2024,” Perry said. “We're supposed to be making plans to work with private providers.”
Medicaid waiver programs help provide services to people who would otherwise be in an institution, nursing home or hospital to receive long-term care in the community. Prior to 1991, the federal Medicaid program paid for services only if a person lived in an institution. The approval of federal Medicaid waiver programs allowed states to provide services to consumers in their homes and in their communities, according to CMS.
Ash/Craft Industries operates a greenhouse, garden shop and woodworking workshop, as well as supervised community employment services for disabled persons under its charge.
Recent changes to CMS regulations has meant disabled individuals can no longer obtain services directly from boards of DD. Ash/Craft Industries is a partner organization to the Ashtabula County Board of DD and all Ash/Craft staff are currently employees of the board.
“Ash/Craft is willing to take steps to become a private provider,” Perry said. “Staff would become Ash/Craft employees.”
Perry said the proposed move to make Ash/Craft a private, nonprofit service provider would not affect Happy Hearts School, which is a separate entity also operated by the Board of DD.
Another recent change to CMS regulations posing problems for Ash/Craft is the result of the 2013 Workforce Innovation and Opportunity Act (WIOA), which has barred Ash/Craft from paying disabled person for piece work between the ages of 18 and 26.
“Under WIOA, individuals cannot be paid less than minimum wage under age 26,” Perry said. “We have a specific minimum wage certificate and we had to jump through a lot of hoops to get that and keep our piece rate. So, we currently cannot accept individuals under age 26, who are supposed to be getting vocational rehabilitation.”
Disabled individuals between ages 18 and 26 are supposed to find work in the community at private employers, regardless of their functional level. Only after spending eight years with vocational rehabilitation services and finding little or no success can they apply for services through Ash/Craft, according to Perry.
The spin-off of Ash/Craft is currently on hold, pending further instructions from CMS, according to Perry. The original deadline set by CMS to shift Board of DD clients to private providers was set for 2017, but was extended to 2024, according to Perry.
“We were really aggressively moving ahead on this and then they moved the deadline, so we put the brakes on,” Perry said.
Regardless of whether Ash/Craft remains under the Board of DD or becomes a private service provider, the Ashtabula County Board of DD will be responsible for 40 percent of service expense for disabled persons under its care, according to Perry.
“Explaining this to the community will be very important,” Perry said. “We will still need a levy to pay that 40 percent.”
The Ashtabula County Board of DD is currently funded by a 1.3 mill levy first passed in 2003 and most recently renewed in 2016. The Board of DD general fund budget for 2016 was $13.3 million, according to Fiscal Director Lori Burdick.