Ohio House Prioritizes Opioid Epidemic; Provider Cuts Remain

This morning, the Ohio House released its version of the budget, Sub HB 49 for SFY 18 and 19.  The House had to address the continuing decline in revenues in response to the Governor’s request to decrease General Revenue Fund (GRF) spending by $800 million, $400 million per FY.  The House removed any increases in provider rates that were included in the executive budget, and provided an across the board 1.5% cut to non-Medicaid GRF.  The House demonstrated its commitment to fighting the opioid epidemic by providing an additional $170 million. Primary and secondary education also received an additional $80 million, though few districts will see significant increases.

The following are provisions of interest to LeadingAge Ohio members. The sub bill:

• Establishes a study committee to examine the merits of moving nursing facility services and home and community-based waiver services to Medicaid managed care.  Requires the study committee to complete a report by June 30, 2020 thereby, prohibiting the move to Medicaid managed care before January 1, 2021.  LeadingAge Ohio is named to this committee. This prohibition does not impact those in MyCare Ohio.
  
  
• Retains the seven (7) percent reduction to nursing facility Medicaid payment rates for direct care costs introduced in the Executive Budget as well as the inclusion of the low resource utilization (PA1/PA2) residents in a facility’s quarterly case-mix score.
  
  
• Prohibits the establishment of a new rate-setting methodology for the assisted living waiver (ALW) program during the biennium (FY2018-FY2019) and removes the flexibility in the settings in which ALW can be provided.  Creates a workgroup to review the ALW program and specifies membership, which includes LeadingAge Ohio.  Requires the workgroup to identify potential barriers to enrollment and participation however, stipulates that the workgroup cannot recommend that ALW be offered in settings beyond residential care.  Encourages making community-based services that are similar to AL services available under other programs that the Ohio Department of Aging currently administers, or under a new program.  Requires the workgroup to complete a report by July 1, 2018.
  
  
• Prohibits the rates for personal care aide services under PASSPORT, Ohio Home Care or State Plan from being restructured or exceeding the rates in effect on June 30, 2017.
  
  
• Creates a nursing facility bed conversion pilot in Cuyahoga County that allows a nursing facility the opportunity to voluntarily convert NF beds for use for substance use disorder treatment services.  Requires ODM to complete a report on the pilot by October 1, 2019.
  
  
• Removes the penalties for residential care facility (RCF) violations permitted to be imposed by the Director of Health and similarly eliminates the immediate action order authority given to the Director of Health for nursing facilities and RCFs introduced in the Executive Budget.
  
  
• Directs Medicaid to seek federal waiver to require a Group VIII Medicaid recipient to be one of the following: over 55, medically fragile, employed, in an education or workforce training program or in a recovery program.
  
  
• Prohibits the Department of Medicaid from increasing provider rates or rolling new populations into managed care without the approval of the Joint Medicaid Oversight Committee (JMOC), subject to full General Assembly veto.  Returns Medicaid eligibility determination to the General Assembly.
  
  
• States that it is the intent of the General Assembly to create a Healthy Ohio or similar program if the federal government makes Medicaid a block grant system.
  
  
• Corrects an error from HB 470 from the 131^st GA that inadvertently enacted a palliative care license.

The House Finance Committee will be accepting public testimony this week on the sub bill and will accept an omnibus amendment on Monday. The House Finance Committee will likely report the bill out on Tuesday or Wednesday with a floor vote the following day.

Currently the Senate is holding informal hearings on the bill. The Senate will conclude its process in approximately six weeks and the bill will move to conference committee. The Senate will continue to monitor final revenue collections for April and May prior to the conference committee.

LeadingAge Ohio encourages members to invite their legislators to their organization. For support in this process, contact Nisha Hammel, Director of Advocacy, at nhammel@leadingageohio.org.

LeadingAge Ohio will release a detailed analysis of the sub bill in the coming week. Stay tuned to alerts and the LeadingAge Ohio newsletter, the Source, for updates.