Montgomery County Board of Developmental Disabilities Services Declares Fiscal Emergency

DAYTON — Rise in cost and loss of revenue caused Montgomery County Board of Developmental Disabilities Services to declare a fiscal emergency.

The Montgomery County Board of Developmental Disabilities Services (MCBDDS) is working with Montgomery County Administration to address the financial shortfall beginning in 2024.

Dr. Pamela Combs, the superintendent of MCBDDS, said, “We’ve seen this coming, so it’s no surprise. We’ve managed around it and tried to hold it off as long as possible.”

Combs noted several factors contributing to this financial need. These factors include:

• A doubling in demand for DDS services since 2009, eligibility for which is dictated by the State of Ohio.
• A continual loss of revenue since 2009 which has resulted in a $13 million loss on an annual basis since 2017, including a loss of $7 million in day services and transportation revenue annually when the agency was forced to privatize these services due to a federal mandate.
• Increase in payments to the State of Ohio of $773,000 annually to cover the costs of services to individuals with developmental disabilities between 2011 and 2022. Previously, the county was required to pay 27 cents on the dollar for each waiver; now, that cost is 37 cents on the dollar. These costs will continue to increase as the federal government rolls back COVID-related subsidies.
• A 6.5% increase in waiver costs implemented by the state that all counties are expected to implement retention payments for direct care professionals. The board previously said this was to cover wage increases for professions but Wednesday clarified it was for retention payments. This increase will be retroactive to April 2022 and is expected to cost approximately $2 million in State Fiscal Year 2023, and more thereafter.
• An increase in the cost of care for difficult-to-serve individuals due to the closure of state Developmental Centers.

Several cost-reduction measures have been implemented to leverage funds more efficiently, such as reductions in staffing costs, the closure of four service facilities and one administrative office, a move to full-time agency teleworking, and the implementation of just-in-time payment of services.

The five-year budget revealed the deficit and showed multi-million-dollar shortfalls through 2028 if the board did not take immediate action. The current five-year average deficit is $18.7 million per year. The Board of County Commissioners is providing $17 million in funds from the American Rescue Plan Act with additional funding from the Human Services Levy Council.

“The $17 million in ARPA funds we are utilizing for this deficit is for expenses we know are directly tied to the pandemic,” said Montgomery County Administrator Michael Colbert. “We know those expenses meet the requirements the federal government has in place governing the use of ARPA funds. The funding from ARPA and funding received from the Human Services Levy Council may fluctuate over the next two years, but that is our initial plan,” he said.

Combs said “several other initiatives are projected to lead to cost savings in the future, including an increase in billing for Medicaid mental health services; secure federally funded housing vouchers; seek additional state waiver-enhanced Medicaid match funds and request the state cover the recently imposed 6.7% DDS match increase in 2024; utilize community-based resources and needs-based waivers; and reduce DDS administrative costs, hiring will be mission critical and liquidation of the Southview facility.”

The Northview facility will remain open at 8114 North Main Street in Dayton.

Combs noted, “We are facing the challenges this shortfall presents, and believe these actions will have minimal impact on those who require services.”

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