Policy Milestones

Accomplishments in Achieving Quality Lives

Introduction

Ohio has a rich and long-standing history of addressing autism spectrum disorders (ASD) and is driven by a strong network of individuals, families, and advocates. Today the state’s response to autism is coordinated in a concentrated effort to move policy to action.

Current work is guided by a set of recommendations, Quality Lives, made possible through the work of Ohio’s Interagency Work Group on Autism (IWGA), a multi-agency collaborative effort, with leadership from the Ohio Department of Developmental Disabilities and OCALI. IWGA meets monthly to review state policies, learn from current research and data, share learning, and identify opportunities to better communicate and coordinate policy impacting the lives of individuals with ASD and their families.

The following presents a timeline of accomplishments, beginning with the first legislative task force charged in 2003 with investigating the increase of autism in Ohio and gaps in service delivery, to present day policy and initiatives – reflecting the state’s commitment to Ohioans with ASD to live their best life for their whole life.

Timeline of Accomplishments

2003

June

The Ohio Autism Task Force (OAT), established through Ohio House Bill 95, was a time-limited task force charged with investigating the increasing incidence of autism in Ohio and determining what, if any, gaps existed in the delivery of services to these individuals. The task force submitted 43 recommendations to Governor Taft and legislators, to be viewed as an extended action plan.

Fact: These recommendations set in motion many state initiatives to improve services and supports for individuals with ASD and their families in the years that followed.

October

Ohio Autism Scholarship, enacted in 2003 and effective in 2004, was the nation’s first school choice program designed specifically for students with autism. Currently, funding provides scholarships to any child between the age of three and 21 who is on the autism spectrum and has an Individualized Education Program (IEP) under the Autism category. The funding can be used at a participating school and/or private service provider(s) of choice. This is the only Ohio voucher program that is available to preschoolers.

Fact: During the 2017-2018 school year, over 3,450 children were enrolled in the Ohio Autism Scholarship Program.

2004

July

The Ohio Center for Autism and Low Incidence (OCALI), and its Advisory Board, were established through Ohio statute as the state’s clearinghouse of information, professional development, and technical assistance for ASD and low incidence disabilities, including visual impairment, hearing impairment, orthopedic disability, multiple disabilities, other health impairments, and traumatic brain injury. Today, OCALI continues to serve as the state’s central source for informing public policy on autism and low incidence disabilities.

Fact: In 2017, OCALICON, OCALI’s premier annual conference, drew nearly 2,000 participants from 39 states and 5 countries.

2006

October

Ohio’s Autism Awareness License Plates were made possible through Sub. H.B. 298. Today, Ohio residents can help increase awareness for autism and provide support to those who live and work with individuals with autism by purchasing the license plate. Revenue generated from sales of the plates benefits the Autism Society of Ohio and its local affiliates in their efforts to provide legislative advocacy, referrals, family support, education and training, and information dissemination.

Fact: Since inception, over 20,340 license plates have been sold with a total revenue of $527,025.

2007

June

Medicaid Buy-In for Workers with Disabilities was created when House Bill 119 was signed into Ohio law on June 30, 2007. The program continues to provide health care coverage to working Ohioans with disabilities, enabling them to work and keep their health care coverage.

Fact: As of December 2017, 9,000 working Ohioans with disabilities were receiving Medicaid coverage.

November

The Autism Internet Modules (AIM) project was launched as a way to provide parents and professionals with up-to-date information to help individuals with ASD achieve their highest potential. Developed by OCALI, in partnership with nationally-recognized experts and organizations across the U.S., AIM is an online training platform based on research on adult learning. Today, AIM continues to provide extensive high-quality information and professional development with modules that include instructional guides and videos, case studies, pre- and post-assessments, a glossary, and much more.

Fact: Nearly 300,000 users across the nation have used AIM -- at no cost with certificate and credit options available.

2008

January

Ohio’s Interagency Work Group on Autism (IWGA) was convened and coordinated by the Ohio Department of Developmental Disabilities as the designated lead agency on autism under the Strickland Administration. The Group brought together key state agency leadership to identify opportunities to better communicate and coordinate the state’s autism-related work and ensure efforts to serve individuals with ASD and their families were responsive and effective.

Fact: 2018 marks the 10-year anniversary of the IWGA, demonstrating the commitment of state agencies to continue shining a light on autism to assure the state’s policy development and decisions reflect the concerns of individuals and families impacted by ASD.

January

The Autism Diagnosis Education Pilot Project (ADEP) was an important first step for Ohio to improve its practices to identify and diagnose children with ASD. Piloted in five counties, ADEP provided autism-specific training and facilitated unique partnerships between community-based physicians and professionals providing early intervention and early childhood services to increase opportunities for children to receive timely and comprehensive evaluations. The project has provided answers locally for hundreds of families, who are not in close proximity to a major diagnostic center.

Fact: ADEP has reduced the time from when families first suspect autism to when a diagnosis is received. The average age of diagnosis for children seen through the ADEP process is 31.0 months, as compared to the national average of 4+ years old, as reported by the Centers for Disease Control and Prevention (visit https://www.cdc.gov/ncbddd/ autism/ data.html, under “Diagnosis”)

September

Transition Team Training Project, a two year investment totaling $650,000 from the Ohio Department of Developmental Disabilities, in collaboration with the Ohio Department of Education, placed a focus on transition-age youth. The project laid an important foundation for Ohio’s current Employment First work related to transition and employment through its local Transition Team Training opportunities, the building of local collaborative partnerships, and the creation of Transition to Adulthood Guidelines and other online resources.

Fact: Project conclusions reported that 75% of participants planned to focus on continued collaboration with local partners and 83% planned to focus on training or professional development related to transition issues for educational staff, parents, and/or community members. These results, and the relationships established, continue to impact current Employment First efforts.

2011

June

Ohio’s Interagency Work Group on Autism was codified in statute. Through Ohio Revised Code (ORC) 5123.0419, the group’s purpose to improve the coordination of the state’s efforts to address the service needs of individuals with ASD and their families was affirmed. This set the precedence for ongoing meetings and correspondence between state agency partners, strengthening the collaboration and commitment to Ohio’s autism-related work.

Fact: Key state agencies and organizations continue to meet monthly to coordinate efforts. Current representation includes OCALI, Opportunities for Ohioans with Disabilities, the Office of Budget and Management, and the Ohio Departments of: Developmental Disabilities, Mental Health and Addiction Services, Health, Education, Medicaid, and Job and Family Services.

September

Equal Opportunity for those with ASD to Utilize Service Dogs was achieved through amending section ORC 955.011, to afford individuals with autism the same opportunities to utilize service dogs in schools and community settings as other individuals with disabilities.

Fact: Emerging research suggests use of service dogs can increase prosocial behavior and decrease anxiousness in children with autism, while also increasing parental confidence for their child’s safety.

September

Jon Peterson Special Needs Scholarship Program provides scholarships to students with special needs that can be used toward educational services and/or tuition at the participating school or private service provider(s) of their choice. The scholarship is renewable through high school graduation or the student’s 22nd birthday. Any student in grades K-12 with an Individualized Education Program (IEP) from his or her home school district is eligible to apply for a Special Needs Scholarship. Special Needs Scholarship amounts vary based on the child’s special education category.

Fact: During the 2017-2018 school year, over 5,000 students were enrolled in the Jon Peterson Special Needs Scholarship Program.

October

Autism State Implementation Grant Funding was awarded to the Ohio Department of Developmental Disabilities from the U.S. Department of Health and Human Services, and Health Resources and Services Administration bringing to Ohio over $800K for a three-year project. The grant strengthened public awareness of ASD, early identification and intervention, training for medical school programs, and continued state interagency coordination. The grant created lasting partnerships with individuals, families, the public service system, the medical community, higher education, and service providers that have stood the test of time and have been the impetus behind several autism-related initiatives in the years that followed.

Fact: ASD curriculum is now incorporated into the education program of all medical students at The Ohio State University College of Medicine. Additionally, counties across Ohio continue to access virtual tele-early intervention services, piloted through the project, bringing much-needed specialized services to families that they otherwise might not be able to access close to home.

2012

March

Ohio’s Employment First Initiative was launched by Governor Kasich with Executive Order 2012- 05K. This made community-based employment the preferred outcome for individuals with developmental disabilities, including ASD. Now in its sixth year, Employment First continues to create opportunities and pathways for meaningful community-based employment and independence.

Fact: Today, more than 9,300 Ohioans with developmental disabilities are working in their communities. That’s an increase of 2,159 people since Employment First began.

July

The Self Empowered Life Funding (SELF) Waiver was Ohio’s first participant-directed waiver, giving authority to individuals with developmental disabilities, including ASD, to make decisions about their waiver services and accept responsibility for taking a direct role in managing services. The waiver embraced an individualized planning and budgeting approach and offered new types of services such as Functional Behavioral Assessment, Clinical/Therapeutic Intervention, and Community Inclusion providing supports that promote individuals’ participation in their communities. The Ohio Department of Developmental Disabilities committed to 100 state-funded waivers for children with significant behavioral needs, including children with ASD.

Fact: Current enrollment for the SELF waiver is now at 1,665 individuals with over $11.5M spent on services and supports in fiscal year 2017.

August

Ohio Autism Recommendations for the state were created through the collaborative efforts of Ohio’s Interagency Work Group on Autism, under the leadership of the Ohio Department of Developmental Disabilities and OCALI. These recommendations, entitled “Quality Lives,” served to chart a course for Ohio to systematically and comprehensively improve its response to autism.

Fact: Today, the Recommendations continue to serve as a timeless roadmap to improve the state’s response to ASD across the lifespan and guide the efforts of the IWGA.

December

Increased Coverage of Needed Services for Children with ASD was a result of policy changes Governor Kasich announced for state employee health insurance, health insurance sold in the private market, and health insurance sold through the federally-managed health insurance exchange. As part of the requirements of the Affordable Care Act, each state has in place a benchmark plan that includes coverage for required Essential Health Benefit (EHB) services. Ohio included autism benefits in its EHB Benchmark Plan.

Fact: Beginning July 2013, State of Ohio employees and their dependents gained access to quality healthcare for ASD, including physical, speech and occupational therapy, clinical therapeutic intervention, and mental and behavioral health outpatient services.

2013

January

Improved Statewide Early Identification and Intervention was made possible through Health Transformation Innovation Funds awarded to the Ohio Department of Developmental Disabilities totaling $1.3M for projects to improve identification and diagnosis of autism, and intervention for Ohio’s youngest. Funds expanded the work of the Autism Diagnosis Education Project (ADEP), enabling growth in the number of local diagnostic partnership teams statewide to increase opportunities for children to receive timely and comprehensive evaluations for ASD diagnosis and referral to early intervention. Innovation funds also helped build a new level of specialized expertise within the county boards of developmental disabilities through PLAY Project training for professionals serving infants and toddlers. PLAY Project is a parent-implemented, relationship-based intervention approach that empowers families and nurtures the critical parent/child relationship early in a child’s development.

Fact: Since inception of ADEP, 53 counties have been trained and participated. And over 70% of Ohio’s counties now have access to PLAY Project through Ohio Early Intervention, granting parents access to a timely, low-cost intervention that enhances their child’s ability to socially and emotionally connect and communicate with those around them.

January

Realizing Employment First Project launched a training series for stakeholders to further the understanding and implementation of Employment First. Funding for the project, in the amount of $350,000 for one year, was made possible through Health Transformation Innovation Funds awarded to the Ohio Department of Developmental Disabilities. These training opportunities allowed for a diverse group of professionals and families to understand the importance of the critical years, beginning at age 14, during which adolescents prepare for life beyond high school.

Fact: Growing the capacity of trained professionals resulted in increased awareness of the components and skill development necessary to lead to integrated employment opportunities.

February

Governor Kasich Courage Award was presented to Sondra Williams, an adult with ASD and national advocate, during his third State of the State Address. The annual award honors extraordinary Ohioans. As an individual on the spectrum, as well as the mother of 4 children on the spectrum, Sondra has helped reframe and redefine what it means to live with autism.

April

Visits by First Lady Kasich were made to programs serving individuals with ASD and their families to participate in conversations to further the understanding of the unique characteristics of autism and the importance of effective intervention. Visits were made to two programs, one in Columbus and another in Cincinnati, and included direct interactions with staff, individuals with autism, and family members. Topics of discussion included supporting children with autism at a young age and through the early school years at home and at school, and the impact of autism on adolescents, adults, and their families during the critical years after formal schooling and beyond.

July

Increased Capacity and Competence for Individuals Supporting those with ASD was achieved pursuant to Section 747.40 of House Bill 59 stating, “the Departments of Developmental Disabilities, Mental Health and Addiction Services, Health, and Education; and other state agencies shall work with the Ohio Center for Autism and Low Incidence (OCALI) or another qualified entity to create a certification or endorsement process for individuals providing evidence-based interventions to serve or support an individual with an autism spectrum disorder.” The result was the development of a groundbreaking, online video-based training series, ASD Strategies in Action, designed to provide practical information, real-life examples and skills anyone can use to care for and support loved ones with ASD from early childhood through young adulthood. Free to Ohioans, ASD Strategies in Action, was funded by the Ohio Department of Developmental Disabilities, Ohio Department of Education, and the Governor’s Office of Health Transformation for $1.25M.

Fact: ASD Strategies in Action launched at OCALICON in 2015. To date, there are over 22,000 users in Ohio and across the nation.

October

Expanded Access to Medicaid Coverage for individuals earning up to 138% of the federal poverty level, including single males, was approved by the Ohio State Controlling Board to take effect January 2014.

Fact: As of December 2017, approximately 700,000 Ohioans have received coverage through Medicaid expansion.

2014

February

Strong Families, Safe Communities was initiated during the FY 14-15 budget process to help local communities assist families with children in crisis who present a risk to themselves, their families, or others because of mental illness or a developmental disability, including ASD. This was a joint initiative of the Ohio Department of Mental Health and Addiction Services and the Ohio Department of Developmental Disabilities. The initiative continues to engage local systems to identify community-driven solutions that highlight collaboration across agencies to develop the best possible outcomes for these families, reducing the risk of harm and helping them remain together.

Fact: For FY 2018-2019, $4M per year was appropriated and 11 projects were funded across 40 Ohio counties. Aimed at creating best practice supports for children and youth at risk for violence, aggression, or out of home placement, the projects focus on a variety of models and interventions, including, but not limited to crisis response, respite, wrap around services, and trauma responsive services.

2015

July

Expanding Access to PLAY Project Intervention for Young Children and Families was made possible through the passage of the biennial budget. An appropriation of $1M over the biennium was made for The Childhood League Center to expand PLAY project training and intervention to increase capacity to serve young children with autism in Franklin County.

Fact: Through this funding opportunity, the Childhood League Center, became the first PLAY Project Center in the nation, which focused on increasing community awareness and understanding of the PLAY Project, and created more opportunities for providers and parents to access high-quality education and resources, including interactive online resources and in-person trainings.

July

Coordination of Ohio’s Interagency Work Group on Autism was shifted to OCALI with oversight from the Ohio Department of Developmental Disabilities.

Fact: This coordinated relationship ensures a close connection between state policy and current autism-related research and evidence-based practices.

July

Historic Investment Transforms Ohio’s Developmental Disability System through $350M in funds that afforded individuals with disabilities, including those with ASD, the opportunity to live and work in their communities. The investment was a collection of policy improvements that were driven by the initiative of passionate stakeholders; from self- advocates, to caregivers, to county boards of developmental disability. In order to provide these opportunities, focus was shifted to ensuring continuity of care from early intervention through adulthood, making it easier for direct care staff to tend to an individual’s medical needs, and policies helping individuals and families, direct support staff, providers, and county boards.

Fact: Supporting the right of all Ohioans to choose where to live, Ohio’s Developmental Disability System provides greater opportunities for individuals to receive home and community-based services and to leave institutional residential settings.

September

Opportunities for Ohioans with Disabilities made a substantive change to the Transition Services procedure to allow staff to accept all 14 of the evaluation team review disability categories, including the category of “Autism” as documentation that the student has a physical, cognitive and/or mental disability. This has helped to expedite eligibility for services and decreases the need for additional psychological or other assessments and testing.

Fact: This shift streamlined eligibility determination for individuals with ASD and their families.

November

ASD Strategies in Action was adopted by Ohio’s Interagency Workgroup on Autism (IWGA) as a collective impact initiative to engage multi-system partners around a common goal of improving the lives of individuals with ASD.

Fact: Since its launch, ASD Strategies in Action has been integrated into professional development opportunities within IWGA state member agencies as well as stakeholder trainings including: child welfare caseworkers; foster care providers and families; children with medical handicaps care coordinators and family members; nurses and care coordinators within Medicaid managed care plans; federally qualified health centers staff; child caring centers and early care and education providers; regional early childhood mental health care coordinators; local family and children first agencies; parent mentors and school staff; and most importantly, family and community members.

2016

June

Improving Outcomes for Youth with Complex Needs was the focus of a pilot project, supported through the Ohio Department of Developmental Disabilities, in conjunction with the Departments of Medicaid, Job and Family Services, Mental Health and Addiction Services, and Ohio Family and Children First Council. The pilot targeted a population of youth with intellectual and/ or developmental disabilities including, but not limited to, youth with autism, and extremely aggressive behaviors. The project’s goal was to improve outcomes for these youth (and their families) by: building in-state capacity to serve them; coordinating their care; maximizing all available funding; and minimizing or preventing out-of-state placement, institutionalization in state-operated facilities, and/or custody relinquishment.

Fact: Funds were awarded to Oesterlen Services for Youth in Springfield for this pilot project, giving the state information to inform future services and funding decisions.

June

The Achieving a Better Life Experience Act, or federal ABLE Act, created tax-advantaged savings accounts for people with disabilities and their families, permitting them to save money without the risk of losing their eligibility for benefits, such as Social Security Income (SSI), Medicaid, and food assistance. STABLE, Ohio’s ABLE program, was the first ABLE account program in the country to be open to the public. Ohioans with disabilities can open STABLE accounts and get all of the benefits that ABLE accounts offer.

Fact: STABLE accounts now offer Ohioans with disabilities more independence, financial security, and coverage for qualified expenses, such as medical and dental care, education, housing, transportation, assistive technology, employment training, and other community-based supports.

December

Increased Coverage of Needed Services for Children with ASD was made possible with the passage of House Bill 463, legislation requiring health insurance plans to cover ASD services, screening, diagnosis, and treatment. This includes, but is not limited to, applied behavioral analysis (ABA) for individuals through age 14. The bill was strongly supported by families of children with ASD who were unable to secure coverage for screening and services.

Fact: Ohio joined 44 other states to enact autism insurance reform.

2017

July

Support for Youth with Complex Needs was enhanced through new funding appropriated in the state’s biennial budget, House Bill 49. The funds continue to support youth with complex needs who are served by multiple state systems and run the risk of needing out-of-home placement in a state institution and whose families are at risk of relinquishing custody.

Fact: The funding totals $1M in each fiscal year.

October

Improving Systems of Care for Children and Youth with Mental Health Challenges is happening through two federal funding opportunities awarded to the Ohio Department of Mental Health and Addiction Service from the Substance Abuse and Mental Health Services Administration. ENGAGE 2.0 expands the system of care approach statewide for youth and young adults with mental health challenges, co-occurring disorders, and multi-system needs. The Youth Treatment-Implementation Grant seeks to improve treatment and recovery supports for youth and young adults with substance use disorders (SUD) and/or co-occurring SUD and mental health disorders. Each grant was awarded for a 4-year project period of 10/1/17 through 9/30/21.

Fact: Recent research has shown that over 90% of individuals with ASD have co-occurring mental health challenges.

November

Governor Kasich Receives Excellence in Autism Award at OCALICON 2017. Recipients of this award are recognized and celebrated for the impact of their leadership, achievements, continued work, contributions, and stewardship to help support and improve outcomes for people with autism, sensory disabilities, and low incidence disabilities.

2018

February

House Bill 115, creating a voluntary registry for individuals diagnosed with a communication disability, including ASD, passed out of the Senate Government Oversight and Reform Committee. The bill affords law enforcement officers critical information prior to approaching a vehicle that the driver or passenger may have a communication challenge. The proposed database will be administered by the Ohio Bureau of Motor Vehicles and visible to officers through the Law Enforcement Agencies Data System (LEADS). Individuals may opt out of the database at any time and all information will be private.

Fact: HB 115 has been sent to Governor Kasich for his signature.