Community/Residential Services & Support

There are a variety of residential services currently in Butler County.  The majority of individuals receiving residential services in Butler County live in their own home in the community with housemates, or continue to live with family members, and receive services in their family home.  The trend has changed from the mid to late 1990’s when most individuals receiving residential services resided in Intermediate Care Facilities for the Mentally Retarded and Developmentally Disabled (ICFMR).

Residential Facilities
There are five ICF/MR's in Butler County.  These facilities range in size from seven to 119 individuals receiving services in each of the facilities.  Butler County also has five facilities that are licensed by the Ohio Department of Mental Retardation and Developmental Disabilities and the individuals in these homes/facilities receive their services and supports paid for with private funds or through a Home and Community Based Waiver (Medicaid and state/local funded).  These facilities range in size from four to eight people living in each of the homes. 

Throughout the years in the 1980's and 1990's, and through the present time, the State of Ohio has seen a dramatic shift in how residential services are provided to individuals.  ICF/MR facilities and licensed group home placements have seen a dramatic decline in being the focus of the kind of service people want.  However, these types of placements continue to be not only an option, but a need for some individuals, and the facilities and group homes are generally at maximum capacity.  

Supported Living
The State of Ohio began an option of providing residential services in the community for individuals instead of the more structured ICF/MR or licensed facility/group home setting.  These types of placements were identified as Supported Living.  In essence, it provides whatever kind of support or service a person needs in their family home or in a home in the community (ie:  staff support and supervision, equipment, renovation needs to a home, etc…).
Supported Living services are generally described as giving the individual what they want or need, and nothing else; whereas a facility placement already has existing services for a large variety of people that not everyone may need.  Supported Living services personalized the development of an individual's service needs.  The county board is required to monitor and assure each individual's health and safety in Supported Living services.  

What Is A Waiver?
The Home and Community Based Waiver Programs are based on the framework of Support Living.  The benefit of Waiver Programs for the state and local governments is that it draws down additional federal dollars for use in serving individuals.

The waiver program is a program that provides funding for residential services to people who choose to live in the community and receive services rather than live in an institutional setting such as an ICF/MR facility. 

The waiver program is funded from Federal, State and Local monies.  This program is important for states because with waivers the federal government will pay for approximately 60% of the cost of the service, rather than the state or local county governments being responsible for 100% of the cost of services.  

The Ohio Department of Job and Family Services in conjunction with the Ohio Department of Mental Retardation and Developmental Disabilities request a certain number of "waiver slots" for the entire State of Ohio.  Waivers are then allocated to County Boards by the Ohio Department of Mental Retardation and Developmental Disabilities, based on the population of the county and that counties’ ability to provide the "matching" 40% of the cost of services.  Hence, there are only a certain number of waivers in the state that may be used for individuals who have a developmental disability.

People on a waiver can get the same kind of service as Supported Living (ie: 24 hour staffing per day, a few hours per week, help to handle their money, grocery shopping, doctors appointments, medications, cooking, transportation, equipment, home renovations, etc.) 

There are two types of Waivers in the state of Ohio that are designated for use by individuals who have mental retardation or some other type of developmental disability.  They are the Individual Options (IO) Waiver and the Level 1 Waiver.  Both of these waivers provide funding for the following areas:  staff supports within the persons home, equipment, transportation, home renovations, day habilitation services, Supported Employment services, etc…  If you are eligible to receive an IO Waiver there is a state required tool that is used to determine how much funding you will receive per year for the services that you need or want.  This tool is called the Ohio Developmental Disabilities Profile (ODDP).  If you require less than $5,000 of service per year, you do not have to have the ODDP completed, but you would only be eligible for the Level 1 Waiver.  
A person may live with their family or live in their own home.  They could begin receiving services in their family home and move to a community home at a later time, and their waiver funding will follow them.  With a waiver the person can move out of a county and funding will follow them, but they cannot move out of state if they want to keep funding through the waiver.  People use their own benefits (social security and/or wages) to pay for their room and board or living expenses.  The waiver pays the cost of the staffing and services only.
Currently there are waiting lists for placement in an ICF/MR, licensed facilities/group homes, Supported Living services and Waiver Services. 

Support Coordination
Support Coordination assist individuals and families in getting the services and supports they want and need, including getting and maintaining medical benefits and financial assistance, linking with services in the community, and linking with employment services as described in the individual's Individual Service Plan (ISP).
Support Coordinators develop the ISP and then ensure that the services listed in the ISP are delivered in a satisfactory way to the person using the services.
Support Coordinators help individuals find affordable housing. The range of help varies according to an individual's specific situation.

The forms of short-term help may include:

• Use of local shelters
• Assistance with "HUD, Section 8" applications for rent-support
• Assistance with other forms of rental discounts
• Introductions to local residential provider-agencies

Long-term assistance might include:

• Referral to a structured 24 hour supervised setting like an Intermediate Care Facilities for individuals with MRDD.
• Supported Living/Home and Community Based Waivers- Living in an apartment or house with support as identified in their Individual Service Plan (ISP).  These supports may also be provided in the family home as requested.

Support coordinators monitor expenses for people in Supported Living situations to ensure responsible spending for housing and in-home support.

Family Resources

Family Resources supports families for caring for their family members who have disabilities living in their home.

Family Resource Services assist:

• Incontinence/medical supplies (briefs, catheters, etc.) A physician’s written prescription is needed.
• Communication devices will be considered
• Dietary supplements – written prescriptions are required
• Hearing aids, basic frame eyeglasses – written prescription required
• Respite Services – Respite means to get a “relief” or a “breather”. In FR, respite means paying someone to provide care for the person who is eligible for MRDD services; either in your home or in the home of the provider of this care. Prior approval is necessary for respite services.  Certified provider information is available at orientation.
• Parent Training/Consultation includes the consideration of costs for teaching parents techniques that can be used at home. The cost and number of visits will be determined on a case-by-case basis.