On Oct. 30, 2017, DODD mailed letters to all people with developmental disabilities, and their guardians, who are enrolled on an Individual Options (IO), Level 1 or SELF waiver but who have not used any of their waiver services for more than a year. This letter served as a notice, informing people of the need to use their waiver. People were advised to contact their SSAs to discuss needed services and discuss whether or not enrollment in the waiver is still needed.
DODD has directed all SSAs to conduct monthly monitoring of the use of waiver services for each person with a waiver. If a person is enrolled, but is not using the services available, DODD has advised that SSAs must recommend the person for disenrollment. The Ohio Administrative Code section that details the process for disenrollment can be viewed at http://codes.ohio.gov/oac/5123:2-9-01v1.
What to look for?
A letter from DODD stating you need to use your waiver. If you don’t know if you received a letter, you can always contact your SSA to find out. Failure to respond if you received a letter could result in waiver disenrollment and loss of services.
Who this notice is affecting?
People enrolled on an Individual Options, Level 1 or SELF waiver, who have not had services billed under the waiver for more than a year. If there is no need for waiver services, your SSA will start the disenrollment process. DODD warned that disenrollment processes will begin on January 3, 2018.
Why is this important?
In order to continue being eligible for waiver services, you must receive at least one waiver service a month. If you do not use your waiver services, you could lose your eligibility for the services designed to help you live in the community and it may be hard to get the waiver services back if you lose them. You may not be eligible in the future, and even if eligible you may be put on a wait list.
If you are disenrolled from the waiver, you may also no longer be financially eligible for non-waiver Medicaid services (“plan” or “card” services).
What you should do if you get this notice and you still need services?
- If you need the waiver services available under your waiver, but are having difficulty getting providers or otherwise accessing services, it is vital that you contact your SSA or county board of developmental disabilities immediately and let them know, in writing if possible, that you need help in getting the necessary services in place. If services are needed, SSAs have been instructed to complete an updated ISP so that services may begin.
- If they don’t hear from you, they may assume you don’t want or need waiver services and this could result in your dis-enrollment from the waiver and a loss of services. DODD warned that disenrollment processes will begin on January 3, 2018.
- Remember, there are a lot of different services that could be available depending on the waiver you have. Contact your SSA and ask them about all of the different kinds of services available under your current waiver and ask for help to access those services you need.
- You should receive notice of hearing rights, and may wish to file for a hearing to protect your rights.
How can Disability Rights Ohio help?
Please contact Disability Rights Ohio if you or your family member received a letter from DODD and have any additional questions or concerns. As mentioned above, you should contact your SSA to assist you in evaluating your service needs, locating a provider if needed and developing an active service plan that is person-centered.
You may reach Disability Rights Ohio at:
Mail or Drop-In: 200 Civic Center Drive, Suite 300, Columbus, OH 43215-4234
Phone: 614-466-7264 or 800-282-9181 (Toll free in Ohio only)
Online Intake Form: http://www.disabilityrightsohio.org/intake-form