A possible change in how the Delaware County Board of Developmental Disabilities provides services to clients prompted about 30 people to attend its meeting Thursday evening.
Many of those in attendance were therapists concerned about how their roles would change if the board changes how it provides services to families in Delaware County. A couple of parents showed up as well, looking for clarity on what changes might take place.
Before the meeting, Kristine Hodge, superintendent of the board, told The Gazette, “There are seven principles of evidence-based early intervention that were adopted by the Ohio Department of Developmental Disabilities in January 2015, and we are exploring those principles and comparing them to our current service delivery system.” This could pose a problem because the model currently used by the Delaware County Board of Developmental Disabilities may not comply with the state’s seven-principle model.
A post on the local board’s website had some therapists and families up in arms.
The initial post stated that “Help Me Grow Early Intervention is moving towards Evidence-Based practices.” The website has now been updated to read “Help Me Grow continues to explore Evidenced-Based Early Intervention (EBEI) practices.”
During the meeting, Hodge acknowledged the mistake and said that corrections were made as soon as the issue was brought to her attention.
Delaware County now uses an early-intervention program for children from birth until they are 3 years old, officials said. Therapists work with families in their homes, which are the natural surroundings for children. Under this model, children may see specialized therapists who observe children in their natural surroundings and then employ techniques to help children based on those observations. Depending on a child’s level of function, he/she may see more than one therapist. The three types of specialized therapists contracted by the board are speech, occupational and physical.
Board member Louis Borowicz, who spoke to The Gazette before the meeting, said, “There is a movement towards a newer model that incorporates more coaching of the primary service provider, the parents, the non-therapy members of the treatment team to learn how to do those therapies, those interventions.”
While the board is aware of the new model — known as the Primary Service Provider Model — board members say they don’t necessarily want to jump on the bandwagon.
“We’re right now in the process of evaluating where we’re at in our current early-intervention program, what we’re doing, how that aligns with that,” Borowicz said, “and, frankly, if we want it to align with that and if we don’t align with that but like our model, do we really have to follow that?”
Speech therapy provider Rachael Weis told The Gazette after the meeting that she understands the concerns. “Everybody has always been very satisfied with the services here,” she said. “So there’s a concern of why change it? And I think there’s a lot of fear of what that change is going to be. I think we’re changing it because the state says we’re not in compliance and we need to make some changes to be in compliance. It’s up to us about how we’re going to do that and what those changes are going to look like.”
She added: “Delaware County has a long legacy of self-determination, meaning families get to pick the provider that’s a good fit for their family. And I haven’t heard from anyone that they want that to go away.”
But the state of Ohio wants a model that will be uniformly applied in all 88 Ohio counties. That model may not include the self-determination model, according to sources that would be affected by changes adopted by the county board. Board member Borowicz acknowledged to The Gazette that state and federal government want counties to follow their new model but that it is not mandatory.
One concern over non-compliance is that state and federal funding may be cut off or reduced. “Medicaid waivers from state and federal funds pay for about 60 percent and the county board matches 40 percent,” Hodge said. But the county has no intention of changing, just yet, she said. “The most important part is that families and children are going to get what they need. They’re going to get the therapies that they need, they’re going to get the service coordination that they need, and they’re going to get the collaboration between the disciplines that are needed.”
Borowicz said: “So we’re trying to lead the way and ask all the right questions for our consumers, for our families, for the children and the population we serve. And we’re not following blindly, we want to lead on this issue.”
Steven Childers, who has a 21-month-old daughter who was diagnosed with cerebral palsy, told The Gazette after the meeting that he had concerns after hearing about the post on the board’s website so he decided to attend Thursday’s board meeting to try and get some answers.
Initially, when Childers wanted to ask questions concerning possible changes that may affect his daughter, board president Stephen Finney tried to shut down his questions, saying the board didn’t have time. Members of the audience pressured Finney into hearing Childers out. Other board members indicated they were also interested in what Childers had to say.
“I guess there was a post on the web that was removed that inferred that they were going to move to a different type of model which might reduce access to physical therapists’ program as it’s provided today,” he said. “We currently benefit from the program in that she is provided a physical therapist, an occupational therapist and a speech therapist through the program as it stands today. My daughter’s been thriving through that program.”
And if the government takes back some of its support? Borowicz said the board won’t know until it finds out exactly how much the state and federal government might withhold. Until then, the board can’t make any final decisions.
Whatever happens it won’t be happening soon. Hodge told The Gazette: “Recently we were notified that the Ohio Department of Developmental Disabilities will become lead agency for the ‘Help Me Grow’ program within the next year. So at this point we are awaiting direction from the ODDD.”
The local board has a tax levy renewal on the March 15 ballot. The levy generates $13.4 million annually.
Laurie Sickles is a free-lance writer for The Gazette.