If this latest round of cuts, totaling $17 million or 11 percent of the DC budget, is implemented the state will have eliminated 25 percent of its total program in just five years.

• SERVICE CAPACITY - The notion that ODMRDD can move individuals from the DCs into other settings is a mirage. There is no capacity or place for these individuals to move to. In many rural areas, for example, ICF/MR beds are unavailable or extremely limited. Already, individuals in need of residential services languish on waiting lists that some estimate to be as long as 16,000.

• FAMILY SUPPORT - In areas such as Gallipolis, Mount Vernon and Cambridge, where as many as 100 residents are targeted to move, there are virtually no providers to take these individuals. The only option would be to move them far away from families, surrogate families and staff, a proposition that would be devastating to everyone involved

• SKILLED STAFF - All stakeholders believe the ability to recruit and retain qualified direct care staff is the single most prominent health and safety concern in Ohio’s MRDD system today. Turnover is as high as 80 percent annually in the private sector, typically because of low wage rates. Meanwhile, researchers and professionals are desperately trying to raise the caliber, skills and retention of direct care staff in the system. In fact, persistent cutting of career MRDD employees, who make a living wage with benefits and a retirement plan, flies in the face of every recommendation currently being made in the field.

• FUNDING FORFEIT - Why would the State of Ohio leave $6 million on the table? Decreasing capacity in the MR system also does not make good business sense for the State of Ohio. Developmental Centers, like other federal Medicaid programs, generate federal reimbursement. But these facilities are in a unique position among those revenue producers. For every dollar the DCs spend, 58 cents is reimbursed by the federal government in the form of Medicaid reimbursement. Because individuals needing DC services have the most profound needs in the system, Developmental Centers draw down more federal reimbursement than any other service provider in the system. A rough estimate of the federal Medicaid money that the state would lose by closing 191 beds is at minimum $6 million. These reimbursements cannot be received in any other way.