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Yesterday, the Ohio Senate released its version of the biennium budget Sub HB49 (R. Smith). The Senate took into consideration the recent revenue projections of the Office of Budget and Management (OBM) and the assumption that Medicaid caseloads would increase more than the executive budget predicted. In a press conference, Senate President Larry Obhof stated, “The bill maintains tax cuts and reforms from previous budget cycles and does not dip into the Rainy Day Fund .” The Senate looked to close the gap of what they believe is a projected budget shortfall of over $1 billion. The Senate Finance Committee accepted the sub bill for consideration.
In spite of the constrained numbers, thanks to the advocacy of LeadingAge Ohio and its members, rates to nursing facilities were maintained as proposed by the House version. Additionally, home- and community-based services did not receive any reductions, though Money Follows the Person demonstration program funding was eliminated.
LeadingAge Ohio offers its members the following summary of the Senate sub bill budget provisions impacting long term care and hospice providers:
- Retains the nursing facility funding of $100 million as introduced by the House, as requested by LeadingAge Ohio;
- Retains changes to the nursing facility rate formula as introduced in the House with one change to the quality indicators; the quality indicator related to receiving antipsychotics would exclude residents who receive the meds in conjunction with hospice care, as requested by LeadingAge Ohio;
- Retains the study committee to review nursing facilities and MLTSS and retains the prohibition on nursing facilities from being added to Medicaid managed care (MLTSS) before January 1, 2021. This does not apply to the MyCare Ohio program;
- Replaces the Executive provision on the alternative purchasing model for nursing facilities with a provision that sets the rate at 30%, instead of 60%, of the statewide average of the per Medicaid day payment rate for long-term acute care hospital services. This is applicable to the ventilator program;
- Retains the extension of a Medicaid demonstration project in Lucas County under which recipients receive nursing facility services instead of hospital services in a free-standing long-term care hospital, but provides for one of the additional facilities that is to participate to be located in Sandusky rather than Seneca County and Brown County is retained.
- Removes the prohibition, instituted by the House, on the Department of Medicaid to restructure rates for Assisted Living and personal care aides;
- Abolishes the Money Follows the Person Demonstration and eliminates the opportunity for the Director of ODM in operating the Helping Ohioans Move, Expanding (HOME) Choice Program, to use state funds if no funds are available under a Money Follows the Person (MFP) demonstration project or integrate the component into a Medicaid waiver program;
- Retains the prohibition on home- and community-based waiver services from being added to Medicaid managed care (MLTSS) before January 1, 2021. This does not apply to the MyCare Ohio program;
- Retains the proposal from the Executive Budget that requires that the portions of civil money penalties that are imposed against home health agencies under a federal regulation and disbursed to ODM be deposited into the Residents Protection Fund, but specifies that these funds are to be used to improve the quality of Medicaid services provided by Medicare-certified home health agencies, instead of for the existing purposes of the Residents Protection Fund.
- Removes the investment made by the House to strengthen the Ohio Housing Trust Fund/Recorder Fee proposal and the $6 million to the Department of Mental Health and Addiction Services (MHA) to advance housing opportunities for individuals exiting residential opiate treatment.
- Retains the House language that a nursing facility does not need to be inspected before the ODH Director increases its licensed capacity but specifies that the exemption applies if the resident rooms to which the beds will be added were inspected (as part of the nursing home's most recent inspection) for the same number of residents proposed to be placed in a room after the capacity increase.
- Removes the language that prohibits the Ohio Department of Medicaid from increasing provider rates without the approval of the Joint Medicaid Oversight Committee (JMOC), subject to full General Assembly veto;
- Retains the House language that abolishes the patient-centered medical home program (Comprehensive Primary Care, CPC);
- The House version for the state share of the funding for the Medicaid expansion population to be approved by Controlling Board remains in the sub bill. However Senate President Larry Obhof publicly stated that this is still under discussion, with likely changes that continue to put the state share of the dollars in a separate health and human services fund with safeguards.
The Senate will hold three days of public testimony on the latest version of the budget bill before an omnibus amendment is accepted on Monday, June 20 at which time the bill is reported out of Committee. The bill will move to the Senate floor for a full vote expected on Wednesday, June 21. Thereafter, the bill will be sent to the House, where the House will refuse to concur with the Senate amendments. Leadership in the House and Senate will appoint a Conference Committee which will consist of three members from each chamber. The conference committee will reconcile any differences between the House and Senate version and prepare a committee report to submit to the House and Senate. If both houses agree to the conference committee report, the act is quickly enrolled so that it can be reviewed by the appropriate executive agencies. The final version of the budget must be sent to the Governor’s desk no later than June 30 for his signature.
To review the LeadingAge Ohio summary of the executive (“As Introduced”) and House versions of the budget, please click the links below.
If you have a question about the budget or about grassroots advocacy, contact Nisha Hammel, Director of advocacy, at nhammel@leadingageohio.org.
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