02/09/2023

Big boost for assisted living waiver, workforce in Governor’s budget

Yesterday morning, the Directors of Ohio’s health and human services departments (Medicaid, Developmental Disabilities, Mental Health & Addiction Services and Aging) provided testimony before the House Finance Committee in a marathon 4-hour hearing. This was the second hearing of the full finance committee on the executive budget, following Tuesday’s testimony by Office of Budget & Management Director Kim Murnieks. In testimony, Directors shared details that built upon the blue book proposals particularly as they relate to reimbursement.

• Director McElroy shared that the executive budget includes a proposal that would collapse the three payment tiers under the assisted living waiver and add a payment for dementia care. Taken in total, the proposal would increase funding to the assisted living waiver by 48%.
  
  
• Directors Corcoran and McElroy shared additional details related to the Task Force to be appointed to study the quality of life and quality of care in Ohio’s nursing homes, to be chaired by Director McElroy. Beginning this month, the task force will travel the state holding public town hall events, working cooperatively with nursing home sector & key stakeholders. This task force will report back to the GA their recommendations, with a target of completing the work by May.
  
  
• While the Department of Developmental Disabilities shared that it would raise rates to direct service providers to $16 per hour, Medicaid Director Corcoran said that across agencies, including services serving older adults (PASSPORT, Ohio Home Care Waiver, state plan home health), direct service increases were in the 18-20% range. ODM is prioritizing those services most susceptible to wage growth, including personal care services, homemaker services, home-delivered meals, and adult day services.
  
  
• When pressed regarding nursing facility reimbursement, Directors Corcoran and McElroy referenced the forthcoming recommendations of the nursing facility commission; Director Corcoran stated her desire to work with the General Assembly in implementing the legislature’s intent stated in HB45, which is to complete rebasing for the SFY 2024-2025 ratesetting.
  
  
• Director McElroy provided more insight into the $40 million in healthy aging grants, stating that they envision these to be distributed in partnership with county commissioners and Area Agencies on Aging. McElroy described a payment calculation consisting of a “base rate” and a per-capita rate, according to each area’s population of older adults.
  
  
• The budget also includes an increase to the Senior Services Block Grant, which funds community-based supports and services, often reaching older adults who are not yet eligible for Medicaid.
  
  
• Corcoran confirmed that Medicaid services would expand to include  telemonitoring services, citing the importance of this service as a workforce-extender.

LeadingAge Ohio will be meeting with each Department in the coming days to gain more insight on the outstanding questions, including more definitive information on the nursing facility and home- and community-based services proposals. Members are encouraged to join Monday’s Advocacy in Action call for a complete overview of the hearing as well as next steps for members. Questions regarding budget advocacy may be directed to Susan Wallace at swallace@leadingageohio.org.