The MCBDDS recently announced plans for 62 layoffs and the suspension of non-mandated services to address an $8.9 million budget shortfall.
Expenses have been rising due to increases in the number of clients served and the cost of services, as well as mandated Medicaid waiver service increases from the state of Ohio.
“MCBDDS has been aware of the need to transition more services to alternative means and providers, to improve efficiencies while maintaining or improving services and outcomes for consumers. However, increases in expenses and the number of people served have outpaced the MCBDDS’ resources,” said Greg Holler, Human Services Levy Council chair.
The MCBDDS follows a structure outlined by the Ohio Revised Code and the Ohio Administrative Code, said Pamela Combs, MCBDDS superintendent. Since 2006, Montgomery County Developmental Disabilities has experienced a 166% increase in the number of individuals served, but also a 173% increase in waiver enrollment, according to the agency.
The Montgomery County commission awarded $17 million in American Rescue Plan Act funds to MCBDDS after it declared a fiscal emergency in 2023. That one-time funding source, according to MCBDDS officials, was used to cover costs related to Medicaid waiver matches and other expenses.
Combs said Medicaid waivers are the largest budget item for the Montgomery County Board of Developmental Disabilities Services and are a mandated service. Waivers are used to pay for services that support someone with developmental disabilities, whether they are living on their own, with family, with a roommate, or with a provider through Ohio Shared Living.
Once a person receives a waiver, they are guaranteed this funding for their lifetime as long as they live in Ohio. The Ohio county that granted the initial waiver funding is responsible for continuing to grant the level of waiver funding they authorized, according to the Ohio Department of Developmental Disabilities.
In January 2024, the Ohio Board of Developmental Disabilities implemented a 32% rate increase for Medicaid waivers, of which every one of the 88 county boards statewide is expected to pay 8%. In the case of MCBDDS, this 8% equated to $6 million in 2024. The board received its invoice with this updated rate in July.
“Our families rely on us to support their loved ones who require a high level of care — support they can’t provide themselves. We appreciate the way the BCC and the Levy Council is stepping up to provide supports and services for those with developmental disabilities,” said Combs.
Montgomery County commissioner Judy Dodge said the emergency funding may give the MCBDDS a little more time to plan and preserve jobs that were at risk of budget cuts.
“It will take some time to transition to reliable providers that our residents and their families deserve,” said Dodge.
The MCBDDS is overseen by a seven-member board; five members are appointed by the Montgomery County commission and two by the Montgomery County Probate Judge.
The Montgomery County commission approved $58.7 million of its 2024 budget for MCBDDS. The latest $5 million in emergency funding will augment the 2025 budget submission.
Social Services represent 43% ($443.4 million) of the county’s 2024 budget, according to a Montgomery County press release.
Combs said she and others at the board are grateful for the funding, which will help the Board in 2025.
“But it is important to note that this one-time funding is not a long-term solution that allows us to respond to changing system mandates and the ever-growing costs of service delivery necessary to address the ongoing needs of people with developmental disabilities in Montgomery County, who face a lifetime of services,” Combs said.
Dodge and Lieberman, both Democrats, face Republican challengers in the Nov. 5 general election. Both challengers, Kate Baker and Mary McDonald, voiced sadness over the financial challenges faced by the MCBDDS.
“I’m very disappointed. These are some of the most fragile people we have in our community,” Baker said. “And they’re getting left behind.”
McDonald said a deep look at the budget of the Developmental Disabilities board, and other agencies that work with tax dollars, is owed to citizens.
“We should be able to look at these budgets and express concerns over where they’re holding the line and how they’re prioritizing spending,” she said.
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