The system is confusing. Let's make it less so.
Nobody hands you a manual when a family member becomes eligible for developmental disability services. This page is the plain-language version we wish existed when families first call us. None of it requires choosing Nirvana.
How services actually begin
Roughly this order, though timelines vary a lot by county and by situation.
Call your county board
Every Ohio county has a Board of Developmental Disabilities. This is the front door. You do not need a provider, a lawyer or a diagnosis in hand to call.
Eligibility is determined
The county board assesses whether the person qualifies for services, and if so, which funding may be available.
You are assigned an SSA
A Support Service Administrator becomes your main contact. They coordinate the plan and stay with you long term.
A plan is written
The individual service plan sets out what support is needed, how many hours, and which services are authorized.
Then you choose a provider. This part matters and it is genuinely your choice. Ohio families have the right to select any qualified, willing provider, and to change providers if it is not working out. Your SSA sends the referral to the providers you are interested in.
If there is a waiting list for waiver funding, ask your SSA specifically what the county board can fund in the meantime. The answer is sometimes more than families expect.
The three Ohio waivers
A waiver is how services get paid for. Ohio DODD administers three, and your SSA confirms which one applies.
Individual Options
Often called the I/O waiver. Generally suits people who need a substantial amount of support at home, or several different kinds of service at once. It is the most comprehensive of the three.
Level One
Generally suits people who do not need many paid support staff. Funding is more limited than I/O, and it is often the first waiver a person receives.
SELF
Self-Empowered Life Funding. Built for people who want to direct some of their own services, including choosing and managing their own staff.
DODD publishes a side by side comparison, which is worth reading before an ISP meeting. DODD waiver comparison
What the acronyms mean
The jargon is the single biggest barrier families mention to us.
DODD
The Ohio Department of Developmental Disabilities. The state agency that certifies providers, administers the waivers and sets the rules everyone works under.
County Board of DD, sometimes CBDD
Your local board. Determines eligibility, employs the SSAs, and can fund some services with local dollars. This is who you call first.
SSA, Support Service Administrator
Your coordinator at the county board. They write and maintain the plan, send referrals to providers and are your advocate inside the system. Sometimes called a case manager elsewhere in the country.
ISP, Individual Service Plan
The written plan describing the person's goals, needs and authorized services. It says how many hours of what kind of support are approved. Providers work from it, and it is reviewed at least annually.
HPC, Homemaker Personal Care
The most common waiver service. Hands-on daily support in the person's own home and community: hygiene, meals, household tasks, routines and getting out.
DSP, Direct Support Professional
The person who actually shows up and provides the support. Background-checked and trained. The quality of your services is mostly the quality of your DSP.
Participant-directed services
An arrangement where the individual or family chooses the staff and sets the schedule, while an agency handles payroll, background checks and compliance.
Agency with Choice
A participant-directed arrangement, available on the SELF waiver only, where an agency acts as co-employer while the family still selects the person. On the Individual Options and Level One waivers the individual is the employer directly, which Ohio calls the common law employer arrangement.
EVV, Electronic Visit Verification
The system staff use to clock in and out of shifts, required by Medicaid. If your DSP checks their phone at the start and end of a shift, this is why.
BCI and WebCheck
Ohio's criminal background check process. Every direct support professional must clear it before working with anyone.
Questions worth asking any agency
Including us. If an agency gets uncomfortable answering these, that itself is information.
- Do you currently have staff available in my area, or would you be recruiting for this placement after accepting it?
- Who will actually be in my home, and will it be the same person each week?
- What happens when my regular DSP is sick or quits?
- How quickly do you return a phone call or email?
- Who do I contact if something goes wrong, and who is their manager?
- How do you handle it if the match between my family member and the DSP is not working?
- Are you able to support a family member being hired as the paid caregiver?
- How long have you been certified, and have you had any compliance issues?
Our answer to the first question, since it is the one that matters most: we are a newer agency and we do not keep a large bench of idle staff. We assess honestly whether we can cover a placement before accepting it, and we say no when the answer is no. An agency that accepts everything and then cannot staff it costs you months.
Guides and plain answers
Short, practical pieces answering the questions families ask us most.
Where to go for the real rules
We keep this page plain on purpose. For anything binding, go to the source.
State of Ohio
County boards
Still stuck? Just ask.
Email us a question about waivers, eligibility or providers. We will answer it even if the answer points you somewhere other than Nirvana.