Budget Bill Released:
Key Updates for Aging Services

Late Tuesday afternoon, the language for HB 96, the biennial budget for SFY 2026-2027 was posted to the Ohio General Assembly’s website. The bill language is consistent with previous statements by DeWine Administration officials that this biennium will be one of continuing previous priorities vs. launching new objectives. Little new information for aging services providers could be gleaned from the budget language, since the majority of provider payment policy is not in statute. The bill makes no changes to statutes governing hospice nor assisted living, and only small modifications to those governing home care.

One exception to this is nursing home reimbursement, whose reimbursement policy is spelled out in statute. Only two substantive changes are included in the budget, one for payment policy and another pertaining to change of operators:

• The budget changes language referencing the transition to PDPM from RUGS, and sets forth a three-year schedule for making the transition. July 1, 2025 rates will be calculated using one-third of the difference between the direct care rate on January 1, 2025, and the new rate calculated using PDPM, and July 1, 2026 rates will reflect two-thirds of the difference. The bill is silent on what blend of PDPM components or adjustment factor shall be used, noting only that it will be developed in rulemaking.
• The budget language prohibits changes of operator whereby the new owner is a Real Estate Investment Trust (REIT), and requires existing REITs to disclose ownership to the Ohio Department of Health no later than 90 days following the passage of the bill. The bill also removes language that would have prohibited QIP payments when there is a change of operator followed by a subsequent, dramatic increase in the charge for the lease payment to the operator, presumably because this provision would be challenging for Medicaid to implement.

Under HB96, the licensure cost for Licensed Nursing Home Administrators (LNHAs) will increase from $600 to $800, a move seeking to right-size funding for the Bureau of Executives of Long-term Services and Supports (BELTSS). Administrators operating under a temporary license will pay $350.

Changes to home care policy include:

• Temporary law requiring Medicaid, Aging and DoDD to collect wage data annually for direct care workers operating in home- and community-based waivers.
  Removal of language that was inserted in the last budget, that would prohibit requirements for training for home health aides beyond the federal minimum.
• Addition of physicians, physician’s assistants, optometrists, dentists, podiatrists or chiropractors to those that may supervise LPNs supervising personal care aides under the PASSPORT program; current language only notes registered nurses as potential supervisors.

LeadingAge Ohio continues to evaluate the budget language and will include additional provisions in tomorrow’s edition of The Source. We strongly encourage members to plan to join us for Advocacy Day at the Statehouse on April 1. Additional questions may be directed to Eli Faes, Director of Public Policy, at efaes@leadingageohio.org.