A developmental disability is a mental or physical impairment that:

• Occurs before 22 years of age                                   
• Continues indefinitely
• Causes substantial difficulties in self-care, language, learning, mobility, independent living and / or self-sufficiency

Examples of conditions that qualify as developmental disabilities may include, but are not limited to:  intellectual disability, autism, epilepsy, cerebral palsy, traumatic head injury, muscular dystrophy, sensory impairment, seizure disorders, orthopedic impairments or other neurological conditions.

Direct Line is a new tool to share information about changes to Ohio's DD system. Our system, both here in Ohio and nationally, is experiencing change. The expectations of and for individuals with developmental disabilities rightfully is increasing, and individuals want to more fully participate in their communities. Also, outside forces are causing us to look at how services are offered, including new federal regulations from the Centers for Medicare and Medicaid Services (CMS). Our system must evolve to respond to these needs, and that leads to a significant amount of change.

 A new tool has been developed to help you better understand these changes. Direct Line is a series of updates that will offer an overview on a specific topic, and connect you with more information.

Read more about Developmental Disabilities Services in Ohio.

In the State of Ohio, the guidelines for eligibility depend on the age of the individual. After the initial evaluation, eligibility has to be reevaluated at ages 3, 6 and 16 years. Contact your local County Board of Developmental Disabilities to see if your son or daughter qualifies for the following services:

• Ages 0 to 3 Years (Early Intervention)
• Ages 3 to 5 Years (Early Childhood)
• Ages 6 to 15 Years (Children)
• Ages 16 Years and older (Adult)

Ages 0 to 3 Years (Early Intervention)
Early intervention services are provided to children up to age 3 who have delays in development or who may be at risk for delays in development due to medical complications or environmental factors. The Ohio Department of Developmental Disabilities works with the Ohio Help Me Grow program to provide home-based therapy, programming and supports through the development of an Individualized Family Service Plan (IFSP). Families learn ways to improve and enhance their child's development and are connected to resources in the community. Contact your Ohio Help Me Grow county office or your local County Board of Developmental Disabilities to see if your child is eligible.

Ages 3 to 5 Years (Early Childhood)
Early childhood services are provided to children ages 3 to 5 if they have two developmental delays or a risk of developmental delay due to medical or environmental risk. Some areas offer preschool programs that are individualized to meet each child's needs and offer assistance and support to families. Families should also contact their local school district to see if their child is eligible for admission into the district's preschool program.

Ages 6 to 15 Years (Children)
Many children who received support before the age of 6 may not continue to qualify for services. Additional criteria for eligibility must be met. A child must have a diagnosis of a life long developmental disability. The diagnosis must be made by a qualified professional and a report submitted verifying the diagnosis. A representative from the Board of Developmental Disabilities will evaluate the child asking a series of questions from the Children's Ohio Eligibility Determination Instrument (COEDI). In order to be eligible for services, the child must show deficits in at least three of the six life skill areas considered:

• Self-Care
• Communication
• Mobility
• Learning
• Self-Direction
• Capacity for Independent Living

Ages 16 Years and Older (Adult)
The individual must have a diagnosis of a life long developmental disability that began before the age of 22. The diagnosis must be made by a qualified professional and a report submitted verifying the diagnosis. A representative from will evaluate the individual asking a series of questions from the Ohio Eligibility Determination Instrument (OEDI). In order to be eligible for services, the individual must show deficits in at least three of the seven life skill areas considered:

• Self-Care
• Communication
• Mobility
• Learning
• Self-Direction
• Capacity for Independent Living
• Economic Self-Sufficiency

Eligible individuals may qualify for a variety of specialized services including behavior supports, crisis intervention, educational programs through age 22, transition services, vocational training, employment, adult day programs, residential facilities, supported living in the community and therapy services. You can read more about adult day services from Developmental Disabilities Services.

Children and adults with developmental disabilities may also have mental health needs requiring intensive behavioral supports. Contact your local Ohio County Board of Developmental Disabilities to see if you qualify for services.

• Ohio Mental Illness Developmental Disabilities Coordinating Center of Excellence (MIDD CCE) helps communities build their knowledge and resources to serve individuals with a dual diagnosis of mental illness and developmental disabilities. The center, sponsored by the Ohio Department of Developmental Disabilities, will help coordinate regional resources for dual diagnosis assessment, trainings and grant funding.

The individual will be notified by letter if found ineligible to receive services. This decision can be appealed by contacting your local County Board of Developmental Disabilities and requesting a due process hearing called an Administrative Resolution of Complaint.

Eligible individuals and families should request that a Service and Support Administrator be assigned to identify and coordinate needed services.

A Service and Support Administrator (SSA) is a person who works for a County Board of DD and is assigned to you to act as the primary, or main point of coordination for your services and supports. Your SSA is a trouble-shooter, problem-solver and an advocate for you. The SSA can monitor supports, help families and individuals apply for and maintain medical benefits and financial assistance, provide crisis intervention and emergency services, assist with educational needs, identify residential options, connect with employment services, and link with programs and supports in the community. You can read more about the role of the Service and Support Administrator.

A waiver is one way that Medicaid enables an individual with intellectual, developmental disabilities or significant health care needs to live at home or in the community. While some eligibility requirements are "waived" for these programs, the individual must require a protective level of care related to daily living skills or skilled medical care. The financial criteria is based only on the income of the individual. For individuals on a waiver program, there are more choices about where they live and who will provide their direct services. Being on a waiver automatically qualifies the individual for a monthly Medicaid card.

Since waiver programs pay for services for a limited number of people, their openings can fill up quickly and there may be a waiting list. However, children under 6 years of age who have been hospitalized for more than 30 days will go to the top of the waiver waiting list, thereby significantly reducing their waiting time. You can read more about waiting lists from Developmental Disabilities Services.

The Ohio Department of Developmental Disabilities oversees the Individual Options (I/O) Waiver, the Level One Waiver and the Self-Waiver programs through their local county boards:

Waiver	Eligibility	Services	Agency
Individual Options Waiver	Developmental Disabilities, Skilled Level of Care, Financial Criteria, All Ages	Respite, Supported Employment, Environmental Adaptations, Transportation, Specialized Medical Equipment, Homemaker / Personal Care, Social Work	Ohio Dept. of Developmental Disabilities
Level One Waiver	Developmental Disabilities, Skilled Level of Care, Financial Criteria, All Ages	Respite, Environmental Adaptations, Transportation, Specialized Medical Equipment, Homemaker / Personal Care, Emergency Services	Ohio Dept. of Developmental Disabilities
Self Waiver	Developmental Disabilities, Skilled Level of Care, Financial Criteria, All Ages	Helps fund items or services in the Individual Services Plan. There is an annual cap of $25,000 for children and $40,000 for adults. The waiver becomes effective 7/1/12.	Ohio Dept. of Developmental Disabilities

You can search an online directory for Individual Options and Level One waiver providers.

Some Ohio county boards operate school programs that provide an option for children whose intense needs cannot be met in their neighborhood schools.

Schools districts using the agency schools pay an annual cost per student.

• Clermont County
• Hamilton County

Sometimes a family needs to take a short break from caring for a child with intense special needs. Respite care is usually periodic, overnight care to cover family illnesses, special events, vacations and stressful family times. Read more about day care and respite options.

• Family Support Services Program can assist eligible families with specific expenses including respite, adaptive equipment, home modifications and special diets. A sliding fee scale is used to determine the percentage a family will pay for services. You can reach them at 513-559-6800.
• Planned Respite is available through the Ohio Department of Developmental Disabilities for eligible families. Contact your Service Facilitator to begin the process. 

There are a variety of residential options available that range from supported living in the community to large state facilities. Read more about residential options supported by the Ohio Department of Developmental Disabilities.

In Ohio, the trend is toward placement into community residential settings over group homes or large facilities. Individuals are served based on emergencies, intensity of needs, caregiver situation and/or waiver waiting lists. Possibilities include:  

• Supported Living provides residential services in the community instead of in a more structured facility or group home. An individual can choose to live with their family or may decide to live in an apartment or house in the community. Supported living can be provided either through the County Board funds or through a waiver. 
• ICF/IDD Facilities are Intermediate Care Facilities for Individuals with Developmental Disabilities. These are for individuals who have a moderate, severe or profound level of need and require a high level of medical, nursing or support services. ICF/IDD settings are usually at maximum capacity and are state and federally monitored. An ICF/IDD facility can range in size from a small group home to a large residential facility.  
• State Developmental Centers are located throughout Ohio and support approximately 1600 individuals with extremely intense needs. State Developmental Centers are the most restrictive settings for individuals who cannot be adequately or appropriately served in the community. They provide residential services for individuals with a moderate, severe or profound level of developmental disability who may also have mental health issues or severe behavior problems.  Developmental Centers are operated by the Ohio Department of Developmental Disabilities and are federally monitored.

While there are many supports available for families and individuals, some programs such as waivers, supported living and residential options often have limited funding and waiting lists. Your Case Manager can place you on these waiting lists and advise you of other available services and options.

Web sites for local Ohio counties include:

• Butler County
• Clermont County
• Hamilton County
• Warren County

Check the local County Board of Developmental Disabilities to locate other counties in Ohio.

Additional services are available to help families support the unique needs of their child with developmental disabilities. 

• CITE (Community Integrated Training and Education) services, a program of Envision located in Hamilton County, offers school-based and home-based behavioral support consultation and programs.
•  Emergency Services are available but may differ between counties. Every County Board of Developmental Disabilities develops its own policies and criteria to identify what constitutes an emergency and then recommends available programs and supports. An example of an emergency may include the death of the caregiver or severe health and safety risks. Contact your case manager to begin the process.
• Families Helping Families, Hamilton County provides the opportunity to network with other families who have a child with developmental disabilities. Directories are available with contact information for volunteer families with life experience in areas including autism, attention deficit disorder, behavioral challenges, transition, residential and navigating the school system.
• Ohio Department of Developmental Disabilities has a Family Liaison, Family Advisory Council, Family Chat and DODD Pipeline online newsletter to help keep you informed.

• Division of Developmental and Intellectual Disabilities, part of the Kentucky Cabinet for Health and Family Services.

• The Point / ARC of Northern Kentucky provides advocacy, residential, employment and social opportunities for individuals with developmental disabilities.

• Arc of Kentucky is a statewide organization that advocates on behalf of people with developmental disabilities, related disabilities and their families. The organization supports local chapters providing early intervention programs, services to adults, advocacy, information and referral.
• New Perceptions provides home-based developmental education and physical, occupational and speech therapy for infants and children residing in Northern Kentucky, as well as job placement and long-term training / coaching with community employers for adult residents.

• Bureau of Developmental Disabilities Services, part of the Indiana Family and Social Services Administration.
• Arc of Indiana is a statewide organization that advocates on behalf of people with developmental disabilities, related disabilities and their families. The organization supports local chapters providing early intervention programs, services to adults, advocacy, information and referral.