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Scioto County Board of DD's Role Changing in the Adult Services Arena

At the June 16, 2016 meeting of the Scioto County Board of Developmental Disabilities (SCBDD), a resolution was signed that sets the stage for an eventual end to the board’s role as a provider of Adult Day Services funded through the Home and Community-Based waiver (HCBS) program.

For several years, the SCBDD has been the service provider for adults through the adult center and community-based programs operated by STAR, Inc. Payment for these services is received primarily from the federal government through HCBS waivers, and the county board is responsible for paying a match of 40 percent.

According to Superintendent Julie Monroe, the federal Centers for Medicaid Services (CMS) adopted a rule in 2014 prohibiting all county boards of developmental disabilities in Ohio from providing direct services under HCBS while at the same time providing Service and Support Administration (SSA) services. “The SSA function, provided exclusively by County Boards, provides case management, quality control, authorizes waiver services, coordinates service planning and assists with provider selection,” Monroe said. “CMS believes it is a conflict of interest for a county board to provide waiver services and also SSA services.”

CMS has given Ohio until 2024 for those enrolled in a county board-operated program to come into compliance with this rule prior to the 2014 effective date. However, new enrollees should not be enrolled in county board-operated programs after 2014 unless there is no other willing or qualified provider in the area. This fact, along with projected financial implications, is why the SCBDD has set the date to cease being the provider of record on or before July 1, 2018. 

At that time, STAR, Inc., will operate as a private entity, with a chief executive officer. All staff will be employed by STAR. The Scioto County Board of Developmental Disabilities will continue to provide SSA services and will continue to pay the 40 percent non-federal share match for services. However, STAR will be the provider of record and bill Medicaid directly for payment.

Services to individuals provided by STAR, Inc. will not change. 

“This transition was jumpstarted in 2011 when the board decided not to replace outgoing direct service staff in the Adult Services Program. Through attrition, most of the Adult Services staff are already STAR, Inc., employees,” said Mike Thoroughman, chair of SCBDD’s Finance Committee. SCBDD staff remaining when the final transition occurs will be considered carry-over employees and will be able to keep their positions.

“Individuals can expect to receive the same level of quality service as always when the transition is complete,” Monroe said.

Representatives of the boards of both STAR and SCBDD will participate in the transition planning process over the next few years with the goal being a seamless transition for all involved.

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