By Amy Clawson
There are important changes for Ohioans who rely on Home and Community-Based Services (HCBS) and Medicaid waiver programs. Several legislative and administrative actions have moved quickly through the Statehouse, raising both opportunities and concerns for family caregivers, people with disabilities and advocates.
A major focus has been House Bill 795 (HB 795), Ohio’s Medicaid fraud prevention bill. If passed, the legislation would increase oversight of home care services, expand the use of Electronic Visit Verification (EVV), increase provider requirements, and increase penalties for fraud. The original version of the bill would have eliminated paid family caregivers, but thanks to strong advocacy from families, self-advocates, disability organizations and bipartisan lawmakers, that provision was removed.
Senate Bill 315 (SB 315) began as a SNAP card security bill. Lawmakers later amended the bill to add many of the same Medicaid oversight provisions from HB 795 into SB 315. The bill increases the state’s ability to investigate fraud, pause payments to providers with credible fraud allegations, require additional authorizations for some services, and strengthen program oversight.
SB 315 Is Now Law. Signed by Governor DeWine in July 2026, the law takes effect on Oct. 6, 2026. The Ohio Department of Medicaid (ODM) will now begin developing rules and guidance related to fraud prevention, EVV, prior authorizations and provider oversight. Public comment opportunities have not yet been announced on these new rules, but Ohioans can monitor ODM’s Public Notices and Rule-Making website pages for future hearings and comment periods to advocate further.
At the same time, the governor announced a temporary moratorium (a six-month pause) on new Medicaid home care agency providers and independent providers enrolling in the program. The stated goal is to review oversight gaps and prevent fraudulent providers from entering the system while reforms are considered.
While the moratorium is intended to be temporary, many family caregivers are concerned about its impact right now. For many individuals with disabilities, independent providers are not just a preference — they are often the only people available and qualified to provide complex, specialized, overnight or long-term support. Families report that some needs are so unique that traditional provider agencies cannot consistently recruit or retain staff to meet them.
Families are concerned that the moratorium may create a large backlog of new provider applications once enrollment resumes. Because the process for becoming a Medicaid provider is already lengthy and complex, additional delays could further worsen workforce shortages and extend waiting times for families seeking qualified caregivers.
Advocates worry that restricting new independent providers could worsen workforce shortages and leave people and families with few options when services cannot be staffed. Too often, the responsibility falls back on family caregivers, many of whom are aging parents or relatives already providing extensive care.
While advocates were pleased to preserve paid family caregiving, concerns remain about expanded EVV requirements and additional prior authorization rules that could create delays and barriers to needed services.
Another Important Change
Ohioans with developmental disabilities who receive a “DD Waiver” (Level One, SELF, or Individual Options Waiver) — and their families — also should be aware that the Ohio Department of Disabilities (DODD, dodd.ohio.gov/home) is implementing a new assessment tool called InterRAI, which will replace the Ohio Developmental Disabilities Profile (ODDP). This new assessment will be used to help identify support needs and inform service planning for waiver recipients.
Families who would like to learn when their loved one will receive the new assessment should contact their Service and Support Administrator (SSA) at their local County Board of Developmental Disabilities. How exactly this assessment may or may not affect the amount and types of services individuals receive is yet to be determined. As more information becomes available, families may want to make sure their loved one’s current needs, goals and services are accurately reflected in their plans and discussed with their SSA before the new assessment is completed.
A Call to Action for
Ohio Families
Stay informed through multiple sources, including DODD Family Forums
(dodd.ohio.gov/your-family/advocacy/
family-advisory-council); The Arc of Ohio (thearcofohio.org) conferences; Breaking Silences and the Ohio Olmstead Task Force (ohioolmstead.com); and other community meetings, newsletters and town halls.
Contact your legislators. Share your family’s story and explain how or if these proposals could affect your loved one’s care and ability to live safely at home. Personal stories help policymakers understand the real-life impact of decisions affecting Medicaid and waiver services. Your voice can make a difference. To find your state representative and state senator, visit the Ohio Legislature’s “Find Your Legislator” tool at legislature.ohio.gov.
Families can also seek information and support from the Ohio Family to Family Health Information Center at ohiof2f@cchmc.org.
Most importantly, when families, self-advocates, providers and community organizations come together, their collective voice can make a real difference.
Amy Clawson is the program coordinator for the Ohio Family to Family Health Information Center (ucucedd.org/ohio-family-to-family-f2f). With more than 27 years of experience, she supports families of children and adults with special needs as they navigate Ohio’s disability, community and healthcare systems. As the parent of an adult with a disability, Amy brings both professional expertise and personal perspective to her work. She leads statewide trainings and presentations and is actively involved in local and statewide committees.