04/20/2023

House budget boosts waiver funding to $130/day, plus add-ons

This week, the House Finance committee released its draft sub bill for the SFY 2024-2025 biennial budget, which included a proposal for assisted living waiver reform. The language outlines the following: 

• ODM will adopt rules increasing reimbursement for the assisted living waiver to no less than $130 / day effective no later than November 1, 2023; 
• That a memory care add-on would be created of no less than $25 / day, under the following conditions: 
• The resident has been assessed by a practitioner and determined to need the services of a memory care unit; and
• The memory care unit has a ratio of at least 20 percent higher than the other units in the residential care facility. 
• For the purpose of this payment, a memory care unit is defined as a discrete unit or section in a residential care facility or an entire residential care facility that is 1. Designated as a memory care unit, and 2. Operated in compliance with any rules applicable to memory care units. 
• A “critical access” payment of no less than $10 / day for those facilities that, in the previous state fiscal year, averaged at least fifty percent of residents receiving services under the Medicaid assisted living waiver. 
• Finally, the bill directs the Department of Medicaid in consultation with the Department of Aging and other stakeholders to develop a methodology for determining rates for assisted living which provides for adjusting rates annually according to the consumer price index. 

LeadingAge Ohio is grateful to the Ohio House for building upon the DeWine Administration’s proposal to aggressively correct decades-long underfunding of the assisted living waiver. The increase represents an over 70 percent increase in the base rate. Questions regarding the proposal may be directed to Susan Wallace at swallace@leadingageohio.org.