The Medina County Board of Developmental Disabilities has no intention of closing.
“That is certainly not the case and that will be my message tonight,” board Superintendent Annette Davis-Kramp said in an interview Tuesday with The Gazette.
After the interview, she repeated the promise to a public forum of about 60 people Tuesday evening that the MCBDD will continue to serve 1,100 children and adults at its facility at 4691 Windfall Road, Granger Township.
But changes are coming to the agency that has about 245 employees and an annual budget of about $25 million.
The Centers of Medicaid and Medicare Services, a federal agency, issued new rules in 2014 that define home- and community-based services.
“They must live, work and play in the community in the same manner that individuals without disabilities do,” Davis-Kramp said. “Therefore, there cannot be any segregated sites.”
The MCBDD is classified as a segregated site, she said.
“Last year, we completely re-did our operating plan,” she said. “We did a three-year operating plan.”
All of the 88 county boards in Ohio are trying to interpret the federal mandates. Many of them are becoming privatized. Medina County is one of nine to date that will continue to be county board-operated.
Davis-Kramp handed out a color-coded state map to the audience that showed which counties are privatized, which are “in process,” or “in discussion” or county board-operated.
A state mandate was issued last year by Gov. John Kasich that came with two key timelines.
“By 2020, county boards cannot serve more than 30 percent of individuals who receive waivers,” Davis-Kramp said.
Waivers are a funding source through Medicaid, MCBDD community relations coordinator Patti Hetkey said.
Looking further into the future, by 2024, county boards no longer may provide any services to individuals on waivers, Davis-Kramp said. The one exception to that rule is a “provider of last resort,” where no other provider will offer services.
About 75 percent of those enrolled in MCBDD’s adult services have waivers, the superintendent said, so they might have to find alternative funding.
“We are going to continue to provide services to anyone without a waiver who chooses us, along with the people we call last resort,” Davis-Kramp said.
Medicaid waivers fund many of MCBDD’s services.
“It does limit us in the amount of people we can serve,” she said. “Our numbers are going to dwindle drastically.”
That likely will result in staff cuts by 2024 but Davis-Kramp said she hopes no layoffs will be needed.
“We have a lot of long-term, dedicated staff here,” she said. “Through attrition, people getting other jobs and retirement, that amount of people we have to lay off will be minimal.”
Davis-Kramp said the agency is averaging about five employees leaving per month right now.
She said 80 percent of the $25 million annual budget is supported through voter-approved local levies. The facility on Windfall is 49 years old.
Among the services it provides are job training and placement, physical therapy, speech therapy, residential support and preschool classes.
“We provide womb-to-tomb services,” Davis-Kramp said.
She said the MCBDD’s enrollment has been growing steadily.
“What we do here at the Achievement Center is a very small portion of what we do in the community,” Hetkey said.
Davis-Kramp wants to refer to the Achievement Center as a hub or something similar to a school home room. Students get dropped off at the beginning of the day, check in with their supervisor, go to work or school, and then go home at the end of the day.
“We as an agency really support and have a large commitment to make sure people with disabilities are part of the community,” Hetkey said, “(to make sure) they are not segregated.”
That support will continue from the county board.
Davis-Kramp said in her 35 years in the field, the new mandates are some of the most difficult obstacles she has faced.