Ohio is moving toward changes in how the needs of individuals with developmental disabilities are assessed and how funding for their services is determined. Through the Ohio Department of Developmental Disabilities (DODD) Waiver Modernization initiative, the state is introducing the interRAI assessment, a standardized tool intended to provide a more comprehensive picture of each individual’s support needs.
For individuals and families, this change could affect service planning, individual budgets, and how providers are reimbursed for delivering care. Understanding what is changing—and what questions remain—is an important step in preparing for the transition.
Looking Beyond Basic Support Needs
The interRAI assessment is designed to look at more than an individual's ability to complete daily activities. It considers a broader range of factors, including personal strengths, preferences, health, behavioral support needs, and social circumstances.
The goal is to develop a more complete understanding of each person and the supports necessary for them to live safely, participate in their community, and maintain the greatest possible independence.
A comprehensive assessment can help inform person-centered planning, but an assessment should never replace the individual's voice or the family's knowledge of what works best for that person. Individuals and their supporters should have meaningful opportunities to explain their needs, routines, goals, and circumstances.
How Could Assessments Affect Individual Budgets?
One of the most significant questions for families is how assessment results will affect funding.
Ohio intends to use standardized support levels to help inform individual budgets under the Individual Options (IO) waiver and the payment structures used for providers. The broader objective is to better align funding with the complexity and intensity of care an individual requires.
If implemented effectively, this approach could help recognize differences in support needs and connect resources more closely to the services required.
However, families will understandably want to know:
Will an individual's budget increase, decrease, or remain the same?
How will complex medical, behavioral, and supervision needs be considered?
Will families be able to understand how assessment results translate into funding decisions?
What process will be available to question an assessment or appeal a decision?
How will Ohio ensure that individuals continue receiving necessary supports during the transition?
The answers will be critical to understanding the real impact of waiver modernization.
Privacy, Transparency, and Individual Rights
The introduction of a new assessment system has also raised questions among advocates regarding privacy, data sharing, and transparency.
Because interRAI operates under a licensing framework that includes data-related requirements, families have raised concerns about what information may be collected, how it may be shared, and what protections apply. Questions have also been raised about the use of scoring methodologies and how assessment results influence funding decisions.
These concerns deserve clear answers. Individuals and families should receive understandable information about what data is collected, who can access it, how it is protected, and how it is used. They should also be informed of their rights and any available review or appeal procedures.
The assessment process must respect individual rights while providing the information necessary to plan appropriate services.
What About Individuals Living With Their Families?
Another important issue is how the assessment accounts for living arrangements.
Families who provide substantial daily care often worry that an individual living at home may be viewed as needing fewer paid supports simply because family members are available to help. This concern is sometimes described as the “parent penalty.”
A fair assessment should distinguish between the supports an individual actually needs and the assistance a family voluntarily provides. Living with parents or other relatives should not prevent an individual's genuine support needs from being recognized.
As Ohio implements its new system, families will want reassurance that funding decisions reflect individual circumstances rather than assumptions about the availability of unpaid family care.
The Role of Providers and Families
At Resident Home Association (RHA), we recognize that every individual has unique strengths, goals, and support needs. An assessment is only one part of understanding a person. The daily knowledge of direct support professionals, families, guardians, and the individuals themselves is also essential.
Successful implementation will require clear communication, appropriate training, consistent assessments, and a transparent process for addressing concerns. Providers must be able to understand how funding decisions affect their ability to staff services and maintain quality care.
Moving Forward: Questions Matter
Ohio's transition to interRAI represents a significant change in how developmental disability services may be assessed and funded. Its long-term impact will depend on how the system is implemented, how accurately individual needs are captured, and how funding decisions are communicated and reviewed.
For individuals and families, now is the time to ask questions, participate in planning, and seek clear explanations from their county board and service team.
The ultimate measure of waiver modernization should be whether it helps individuals receive the right supports, at the right time, to live the lives they choose. A standardized assessment may provide useful information, but person-centered planning, individual rights, transparency, and access to appropriate services must remain at the heart of Ohio's developmental disabilities system.
