Among the many roles that you will play as governor, perhaps the most challenging responsibility that you could undertake is to articulate and live out, in your administrative and fiscal priorities, a vision that includes all Ohioans. How you see the role of government in relationship to its citizens will certainly be a key element in uniting and leading us into the future.

There are over 1.6 million Ohioans with disabilities, many of whom encounter significant barriers to full participation in society because they lack the support necessary to be independent and self-sufficient. Some of these barriers include lack of basic civil rights, benefits, community life, education, health care, employment, technology, housing, and transportation.

What would help these individuals obtain greater access, and what can you do as governor to create a more inclusive society? The first thing is to realize that persons with disabilities want access to the same opportunities that most of us want for ourselves and our families—quality education, employment that provides a living wage, and the right to choose with whom and where to live, in accessible and affordable housing, with transportation that facilitates overall participation in society. As you address these issues for all Ohioans, the quality of life for persons with disabilities will also improve.

Obtaining a greater degree of self-sufficiency requires an intentional commitment on the part of the larger community and our government to remove barriers faced by persons with disabilities, and to provide necessary individual support, thereby leveling the playing field for all citizens. It is obvious that such an inclusive society would benefit persons with disabilities.

But I also believe that all of Ohio benefits when state dollars are utilized to promote independence and self-sufficiency. No where is this more clearly demonstrated than in the area of long-term health care and supportive services for persons who have a disability, are chronically ill, or are aging. Let me give you just three examples where your administration can make a significant difference: Long-Term Care, Personal Care Assistance and Medicaid Buy-In.

There has never been a better time than the present to rebalance how Ohio provides its citizens longterm care and how it provides support for persons with disabilities. A combined shift in federal public policy plus an actual financial incentive in enhanced federal Medicaid dollars (Money Follows the Person—MFP) will give your administration an opportunity to take a giant step forward in addressing Ohio’s continuing institutional bias as reflected in the way it spends its long-term care (LTC) dollars.

While Ohio has had success in serving persons 60 and older through PASSPORT and by a new state law which allows Medicaid dollars to follow PASSPORT eligible persons from the nursing home to the community, younger persons with disabilities face waiting lists for waiver services or remain in nursing homes. In 2005, the federal government listed Ohio as third among the 50 states in the percentage of total Medicaid LTC dollars it spends on nursing homes and on institutions serving persons with cognitive disabilities. In the same year, Ohio spent only 22.8 percent of its LTC dollars on community-based services. On the other hand, Texas, a state which already has an MFP program, has moved about 10,000 persons out of nursing homes, saving the state approximately 20 percent of what it had been spending on institutionalized care, and making it 14th in the nation in the percentage of LTC dollars (42.8 percent) spent on community-based care. MFP is good for persons with disabilities because it gives individuals more choice over the location and type of services that they receive and doesn’t institutionalize persons unnecessarily. It is good for Ohio because it incorporates into state policy the philosophy of self-determination and has the potential to save the state money.

Workers with disabilities are an underutilized wealth of talent. A Medicaid Buy-In Program (MBI) would give these individuals the opportunity to find meaningful employment without the threat of losing their health care coverage. One of the major barriers to employment is the absolute necessity that an individual with a disability know that they will have ongoing health care that meets their specific needs.

Private insurance is not an option as it is unavailable, unaffordable, or inadequate for persons with disabilities. And, there are a growing number of employers who do not offer employer-based coverage. An MBI program allows persons with disabilities to continue to qualify for Medicaid while earning a greater amount of income and retaining more assets. At least 32 states have enacted an MBI program to assist their citizens with disabilities to become more self-sufficient.

An actuarial study for the Ohio Developmental Disabilities Council shows that 7,000 people in Ohio are potentially eligible for MBI at a projected cost to the state of $14 million per year. This is an investment in human capital worth making.

Implementing just these three initiatives would open doors of opportunity for thousands of Ohioans with disabilities, providing them independence, choice, dignity, and control of their lives—basic tenets that too many of us take for granted.

Sincerely,