OLRS action prompts oversight by federal agency
The U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS) is responding to OLRS' objection to the use of Home and Community-Based Individual Services (HCBS) / Individual Options (IO) waivers to fund institutional placements. CMS said, in an interim response to OLRS, "we take your allegations seriously and will work closely with ODJFS [the Ohio Department of Job and Family Services] to assure your concerns are adequately addressed."
OLRS alleged that Ohio's use of IO waivers to fund placement of seven children in a 60-bed psychiatric residential treatment facility violates Title II of the American with Disabilities Act and Section 504 of the Rehabilitation Act of 1973. These laws require that states provide individuals services "in the most integrated setting appropriate to their needs" when using federal funding such as Medicaid IO waivers. OLRS asserts that by providing services to children in an institutional setting Ohio violates the community integration mandates of the two federal laws. The practice also contradicts the purpose of the IO waiver program, which is to enable individuals to live in the community rather than in an institution.
OLRS determined that the facility was using IO waivers to fund placements during its investigation of conditions at the facility. OLRS also learned that the facility planned to admit and serve other children who were IO waiver recipients.
Five of the seven children on the IO waivers indicated to OLRS that they would like to live in a community-based placement rather than in the facility.
The facility and several state agencies, including the Departments of Mental Retardation and Developmental Disabilities, Mental Health, and Job and Family Services, did not take adequate measures to stop the use of IO waivers to fund placements. OLRS then requested an investigation from the U.S. Department of Health and Human Services Office for Civil Rights. That agency forwarded the complaint to CMS.
OLRS continues to monitor the use of IO waivers to fund placement of individuals in institutions.
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