John's usual excuses & apologies--
Get ready for some confusion over the next few months as Ohio's DD system sorts out how to reopen services. On one hand, vaccinations should make it safe to resume group activities in most settings. On the other hand the same changes to Ohio law that forced CLI and other providers to privatize away from the County Board of DDs also eliminate segregated large workshop-style services as a legal, long-term option. It will be interesting as we (collectively) sort out what "re-opening" looks like. Frankly, CLI can no longer afford to do both segregated and community based services. CLI believes that small group, person-centered, community-integrated services are the future of our field, so we're leaning in hard on that.
In one way the state-wide crisis has been helpful. CLI was struggling pre-COVID because the way that programs were funded ran opposite to the mandates of community employment and community integration. The old reimbursement paid a lot more per staff person to provide facility-based services. Without the safety concerns related to COVID, I don't think there really would have been the political will to change the funding incentives. CLI used to lose money every time we did small group activities in the community under the old model. Then came COVID and eliminated that old model and suddenly paid providers enough to support 3-4 person groups.
There are many people who want things to go back to the old way. I do not. I think that we need to figure out ways to manipulate STEP and community employment services to better support people who live with families and need support all day. I get frustrated when philosophical arguments ignore this systemic need and forget that Ohio advocates created the original 169 legislation more than 50 years ago to provide parents of kids & adults with DD daytime school & work so that the rest of the family could also go to work & school.
Our system needs to establish ways to enable real person-centered planning that build what each person needs based on not just choice, but also their living situation. 24/7 residential supports are very expensive. Individuals with DD who live with family with little or no outside supports should be entitled to a bigger allocation for STEP and/or community employment services by virtue of saving residential dollars that would otherwise support that person. Families of adults with DD support their loved one by choice. They are not legally required to do it. It is in the state's best interest to support those families. I think it's also in the individual served's best interest too by supporting that natural resource-- separate from the money. Good staff are priceless, but even if you can count on them for 10, 20, even 30 years-- we all eventually go away. Family is forever.
That's all I've got. Have a great week. And-- so as not to disappoint the nurse-- wash your hands!