- Medicaid Buy-In Program allows people to work and keep their Medicaid benefits
- Court finds that schools must provide age-appropriate transition assessments, regardless of student's disability
- New case management agency assigned for some Northeast Ohio area consumers
- Reports indicate some people with developmental disabilities have been disenrolled from waiver services
- Actions and Results: Case Summaries
- Help us keep the victories coming! Donate online to Disability Rights Ohio
Many people who receive Medicaid benefits believe they cannot work without putting their much-needed services at risk. However, the Medicaid Buy-In for Workers with Disabilities (MBIWD) allows individuals to earn money from a job and keep their Medicaid health care coverage. The total income allowed under the MBIWD is 250% of the federal poverty level, which is currently $28,725 after tax deductions. Those with incomes greater than 150% of the federal poverty level, or $17,235, may have to pay a monthly premium based on a sliding scale and deductions/exclusions to keep their benefits.
Under MBIWD, a person with a disability also can have resources up to $11,148, including savings accounts and some insurance policies. This is far greater than traditional Medicaid, which has a $1,500 resource limit. If they lose disability status, they may also be able to keep health care coverage under the medically improved category. If a person in the program loses his or her job, he or she will have six months of coverage, provided they maintain certain conditions.
Every county in Ohio offers this program. To qualify, a person must meet the following criteria:
- Be a U.S. citizen or meet citizenship requirements;
- Be a resident of Ohio;
- Be 16 to 64 years old;
- Have a disability as defined by the Social Security Administration (SSA) or be eligible under the MBIWD medically improved category;
- Be employed in paid work (includes part-time and full-time work);
- Pay a premium, if necessary;
- Meet certain financial criteria.
Even if a person believes he or she makes too much money to qualify, they should still be encouraged to apply. Inclusions, exceptions and deductions to an individual's income can often be applied, which would adjust the final income counted in the program. Only applying will help the individual make an informed decision about whether he or she might benefit.
To apply for MBIWD, contact your local county Job and Family Services office. If you don’t know how to contact your local office, phone 1.800.324.8680 or visit www.jfs.ohio.gov/ohp/consumers to find the office in your county.
For more information about the program, visit the Disability Rights Ohio Medicaid Buy-In for Workers with Disabilities page.
Court finds that schools must provide age-appropriate transition assessments, regardless of student's disability
A Southern District court ruling on a Disability Rights Ohio case has made it clear that school districts must provide age-appropriate transition assessments to students with disabilities. In Gibson v. Forest Hills School District Board of Education, the court found that the district did not ensure the student received age-appropriate transition assessments from age 16, did not invite the student to her transition IEP meetings and did not take appropriate steps to get the student's input, preferences and interests for her future. Therefore, the court held that the district denied the student a free, appropriate public education (FAPE ), which is her right. The court’s decision also clarified that because the district failed to complete these assessments, the district did not provide her with transition goals, as is required under the Individuals with Disabilities Education Improvement Act (IDEA ).
The IDEA calls for every student with a disability to have age-appropriate transition assessments in three areas — employment, further education and independent living — starting at age 16. The IEP team is required to develop measureable post-secondary goals in each area, based on the results of those age-appropriate assessments. The IDEA also requires that the IEP team seek out and consider the student’s preferences and interests in developing their transition plan to prepare the student for further education, employment and independent living. The court held that it is not sufficient for the team to simply rely on the teacher's informal idea of the student's preferences. Transition assessments are to be provided by individuals who have specific training and experience in vocational education and who are qualified to provide transition services.
School districts also must invite the students with disabilities to any meetings about their Individualized Education Program (IEP) when the IEP team will be discussing the students’ postsecondary goals and services, regardless of their nature or severity of the disability. If students choose not to attend the transition IEP meeting, school districts must take other steps to determine the students’ preferences and interests and make sure the IEP team considers the students' interests and preferences in developing the student’s transition plan.
Find more information on special education issues on the Disability Rights Ohio Special Education page.
The Ohio Department of Medicaid recently announced that it has contracted with Care Source to be a second case management agency for consumers in Northeast Ohio who are enrolled on the Ohio Home Care Waiver or the Transitions Carve-Out Waiver. Consumers have been assigned to either continue receiving case management services from Care Star or to begin receiving case management services from Care Source. Care Source will be contacting consumers who are being transferred from Care Star to Care Source.
The counties affected by this change are: Ashtabula, Columbiana, Cuyahoga, Geauga, Lake, Lorain, Mahoning, Medina, Portage, Summit, Stark, Trumbull and Wayne. Care Star will continue to provide case management for all consumers on these waivers in other areas of the state.
The department plans to contract with additional case management agencies in other areas of Ohio. In addition, the department is working on a process for consumers to select their case management agency, instead of being automatically assigned. The case management agencies will make decisions about whether an individual is eligible for a waiver (including the individual’s level of care) and provide other case management services.
This change does not affect individuals who are not enrolled on a waiver, or who are enrolled on a waiver that is administered by the Ohio Department of Developmental Disabilities, including the Individual Options [IO] Waiver, Level 1 Waiver, Transitions DD Waiver, or SELF Waiver, or the Ohio Department of Aging, including the PASSPORT Waiver, Choices Waiver, or Assisted Living Waiver.
If you have concerns about this change, you can contact the Bureau of Long-Term Care Services and Support at 614.466.6742 and ask to speak to someone about your case management agency, or you can email BHCS@jfs.ohio.gov.
If you have contacted them and continue to have problems with your waiver services, please contact our Intake Department.
Reports indicate some people with developmental disabilities have been disenrolled from Medicaid waiver services
Disability Rights Ohio has recently received reports of a serious systemic issue involving people (including children) with developmental disabilities across the state. Some people have reportedly been disenrolled from the Ohio Home Care waiver, a Medicaid home and community-based services program for people with a nursing facility level of care. Without these services, many of these people may have to resort to institutional care, and others may be at risk of the same fate, a violation of their rights under the Americans with Disabilities Act and the U.S. Supreme Court’s decision in L.C. v. Olmstead to receive services in the most integrated, least restrictive setting.
People are reportedly being terminated from this Medicaid program because a determination has been made that they no longer meet a nursing facility level of care and instead meet the level of care for people with developmental disabilities. Prior to January 1, 2013, a person who was enrolled on the Ohio Home Care waiver but who had this change in his or her level of care could simply be enrolled on the Transitions DD waiver, which covers identical services as the Ohio Home Care waiver. However, the Ohio Department of Developmental Disabilities decided to effectively close enrollment on the Transitions DD waiver completely, leaving these people in extremely vulnerable situations.
It appears that at least one person has been disenrolled without receiving prior written notice informing him of his right to request a state hearing to challenge this decision. This is also a violation of his rights under state and federal law. A person has a right to request a state hearing within 90 days and, importantly, if this request is made within 15 days, his or her enrollment on the Ohio Home Care waiver cannot be terminated until a state hearing is held and an adverse decision is issued.
If you have experienced this problem, please contact our Intake Department.
Limo company informed of person's right to have a service animal
An individual who uses a service animal to accommodate his disability contacted Disability Rights Ohio because he was denied a limo ride after the owner discovered that his client’s service animal would accompany him in the hired car.
A staff attorney researched the issue and contacted the limo company, which indicated that they felt strongly that this law did not apply to them and that they would never allow any animals in their limos. After receiving this response, the attorney researched the company and prepared to file a complaint with the Ohio Civil Rights Commission. Just prior to filing the complaint, the company agreed to modify their policy to allow for service animals. The company reversed their policy and apologized to the client, welcoming him and his service animal to use their limo service if he so desired. The client was extremely pleased with this outcome.
Client moves to a more accessible property
A relative of an individual with a physical disability contacted Disability Rights Ohio with concerns about the conversion of an end exit door in her apartment unit to a fire escape only door. The source frequently used this door as an accommodation, as she needed to push her mother in a wheelchair and the source’s own disabilities made that difficult.
A P&A attorney visited the site and ultimately negotiated with the landlord on the client's behalf. In the end, an agreement was reached between the client and the landlord to allow her to move to another property to resolve the issue.
Man gets go-ahead to attend truck-driving school
A client with a psychiatric disability contacted Disability Rights Ohio when he needed assistance to attend truck-driving school. The client had been working with the Bureau of Vocational Rehabilitation (BVR) for several years but had not had much success in maintaining employment because he felt his employment goals were not suited for him.
A DRO advocate and a staff attorney reviewed his case and researched several issues to determine if he was eligible for the program. They participated in an informal hearing with the client where a decision was reached to have new assessments completed for the client. The results of the assessment provided the impetus for BVR to move ahead with a new employment goal and VR services for the client, including paying for him to attend truck-driving school.
Client successfully negotiates for interpreter at medical appointments
Recently an individual contacted Disability Rights Ohio for assistance in self-advocacy due to difficulties obtaining an effective interpreter at medical appointments. At one office, they agreed to provide an interpreter, but the individual was ineffective and often inaccurate. When he requested a different interpreter for his next appointment, they refused, saying they had a contract to use this specific individual for interpreter services. Another office refused to provide an interpreter and told him to provide his own interpreter or go elsewhere.
A staff attorney spoke with the client via email on multiple occasions, conducted legal research, and provided information to the client on his right to effective communication at medical appointments. She advised the client to contact the medical office to discuss the contracted interpreter and why they don’t provide effective communication. Regarding the second office, DRO provided information on filing a complaint but did not represent the client, as he did not intend to return to the office. The client reports he was able to successfully negotiate for a different interpreter.
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