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Direct Support Professional Retention Payments

Client Alert

On December 15, the Ohio Senate and House passed House Bill 45, which authorizes the Department of Developmental Disabilities (DODD), in conjunction with the county boards of developmental disabilities, to launch their initiative to issue retention payments to Direct Support Professionals (DSPs). These retention payments will be distributed quarterly to participating home and community-based waiver providers to address the workforce crisis in the direct provider sector. Governor DeWine needs to sign the Bill to begin the payments, but he is expected to do so by the end of 2022.

Who is eligible?

Agency and independent providers in good standing that have received claim payments for the eligible services during the applicable calendar quarter will be eligible for an automatic retention payment. Eligible services include:

  • Homemaker/Personal Care (HP),
  • HPC-Daily Billing Unit,
  • HPC-Participant-Directed,
  • On-Site/On-Call,
  • Shared Living,
  • Transportation (Medical & Non-Medical),
  • Adult Day Support,
  • Career Planning,
  • Group Employment Support,
  • Vocational Habilitation, and
  • Individual Employment Support.

Independent providers will receive the retention payments automatically and do not need to take any further actions to receive them. Agency providers, conversely, must opt-in via the eMBS application on the DODD website, provide all required data for each quarter, and attest that funds were used in accordance with DODD requirements in order to receive retention funds. Agency providers must ensure that expenditures made using the DODD funds are not claimed in any other program.

When will the payments be made?

The initiative was originally approved by the federal Centers for Medicare and Medicaid Services (CMS) with an effective date of July 1. Therefore, initial payments will be for three quarters of payments (April through December) and will be staggered by provider type. Provider agencies and independent providers will receive their first payments in mid-January. Provider agencies will then distribute payments to their eligible DSP employees. DSPs employed by agency providers will receive payment from their employers in mid-March.

There is no definitive end date for payments at this time but DODD and the county agencies will continue to evaluate the program.

How much will retention payments be?

The retention payments for independent and agency providers will be calculated by multiplying 6.5% by the total amount of claims paid during the applicable calendar quarter for eligible services.

Agency providers will then need to calculate how much to pay each eligible employee based on the funds received. Employees may be allocated payments based on either (1) an equal percentage of their total wages or (2) an equal payment based on the payment divided by the number of employees. Agency providers may withhold up to 18% of the total payment for implementation and other costs, with additional reporting requirements. Agency providers may not use this payment as a way to increase hourly wages.

Generally, independent contractors of agencies will not be eligible for retention payments. However, DODD specifically identifies shared living contractors, where the agency bills for the contractor’s services, as an exception. Shared living contracted staff should be included in the employee payment calculation.

Where can I find the enrollment portal, or more information?

DODD has created a website specifically for these payments, which can be found at: This is also where the enrollment portal will be located from January 3-16.

If you have any questions about the DSP payments or how your agency might apply for them, please contact Ashley Watson at or your local BMD Healthcare Attorney.