Community life and employment for people with DD

The U.S. Department of Justice has told Ohio and other states that people with developmental disabilities need to be provided services in the most integrated settings possible.

A 2014 ruling from the Centers for Medicare and Medicaid Services (CMS) says the Home and Community-Based Services setting ‘provides opportunities for individuals to seek employment and work in competitive integrated settings, engage in community life, and control personal resources.’

Ohio is taking steps to comply – through both Employment First and Community Life Engagement.  It’s a big change, not only for county boards of developmental disabilities but also for our provider partners.

“Our main focus over the next two years, if not moving forward, is really helping ensure that individuals that are served throughout our system have opportunities to thrive in their communities, whether that’s work or not,” says Britta Hough, regional Community Life Engagement project manager for the Ohio Department of Developmental Disabilities (DODD).

The Richland County Board of DD and others across the state are focused on person-centered planning that leads to individualized and flexible services and supports.  Agency and independent providers are being asked to do the same thing.

Hough admits it’s a challenge as providers need to start thinking differently about how they provide services that support individuals to live and work in their communities.

She points out Employment First doesn’t mean everyone has to work, but they should have that opportunity to explore work, regardless of their disability.

“We want to focus on what people can do, not what they can’t do.  We want to focus on their abilities and their strengths and their interests,” says Hough, who notes the highest unemployment rate is for people with disabilities.

As part of Ohio’s transition plan that was submitted to Medicaid, the state has benchmarks that it must meet by 2024.  In addition to addressing employment, home and community-based services need to change so they’re focused on giving people a choice and facilitating connections so someone isn’t just doing things in the community only with people with disabilities.

“People on ground level, like providers, need to take steps to figure out how to meet individualized goals,” Hough says. 

The goal is that individuals have services and supports that are built around them, that are flexible enough to support their outcomes, and that are helping them have full, meaningful participation in their community or community employment.

“Every single person should have the opportunity to at least explore and we, as a system, our job is to help figure that out; to help work towards that,” she added.  “It might be really small.  It might be really slow, and we might hit a lot of dead ends.”

For current agency providers, the biggest challenge is to figure out how to individualize supports without the need for one-on-one staffing.  They have less than six years left to figure that out.