It's Not Too Late: Last State Budget Update

It’s Not Too Late
Last State Budget Update

a statewide coalition of over 475
organizations working together to promote
health and human service budget and policy
solutions so that all Ohioans live better lives.
Advocates for Ohio’s Future is…

Mark Davis
President
Ohio Provider Resource
Association
Col Owens
Senior Attorney
Legal Aid Society of Southwest
Ohio
Bill Sundermeyer
State Director
Advocates for Ohio’s Future

AOF OVERALL POLICY OBJECTIVES
AOF believes all Ohioans should have the opportunity to
participate in the economy, afford the basics, and pursue
higher quality of life.
Work should allow workers to lift themselves out of
poverty, but not all jobs mean a living.
Health & human services can play a critical role in
supporting Ohioans.

BUDGET PROCESS OVERVIEW
Bill Sundermeyer, Advocates for Ohio’s
Future

STATE BUDGET PROCESS
House
• Finance Committee (Rep. Ryan Smith)
• Health and Human Services Subcommittee
(Rep. Sprague)
Senate
• Finance Committee (Sen. Oelslager)
• Others worked in subcommittees
Conference
• 3 members from each chamber
• First meeting occurred last last Friday
• Budget bill is set to pass no later than June 30

OHIO’S AVAILABLE RESOURCES
 Latest Revenue projections by the Director of Budget and
Management show their earlier projections were
understated by $340 million.
 The state can meet the needs of those in need of
assistance and still save for the state’s fiscal future.

JOINT CONFERENCE COMMITTEE
MEMBERS
 Senate:
 LEADERSHIP- President Faber, R- Celina, 614-466-7584 or
sd12@ohiosenate.gov
 Sen. Oelslager, R- N. Canton, 614-466-0626 or oelslager@ohiosenate.gov
 Sen. Coley, R- Liberty Township, 614-466-8072 or coley@ohiosenate.gov
 Sen. Skindell, D- Lakewood, 614-466-5123 or sd23@ohiosenate.gov
 House:
 LEADERSHIP- Speaker Rosenberger, R- Clarksville, 614-466-3506 or
re91@ohiohouse.gov
 Rep. Smith, R- Bidwell, 614-466-1366 or rep93@ohiohouse.gov
 Rep. Schuring, R- Canton, 614-752-2438 or rep48@ohiohouse.gov
 Rep. Driehaus, D- Cincinnati, 614-466-5786 or rep31@ohiohouse.gov

AOF’S BUDGET PRIORITIES
Col Owens, Legal Aid Society of
Southwest Ohio

PERSON-CENTERED WORK PROGRAMS
 Governor’s budget proposed intensive case management
(ICM) program for 16-24 year olds required to work.
 House took proposal out, separate H.B. 196 introduced,
reinstate ICM program with Healthier Buckeye Council
counterpart.
 Senate reinstated Governor’s proposal with modifications,
took out separate Buckeye Council grant program.
 AOF supports the Governor’s/Senate’s approach, but will
monitor implementation closely.

WORK SUPPORT PROGRAMS
 Governor’s budget increased entry level child care eligibility
from 125% to 130% FPL; no change in House or Senate
versions.
 AOF seeks entry level reinstatement to 200% over 4 years,
additional $15 million/year increase.
 Refundable State earned income tax credit (EITC) not
included in any of the three versions of the budget.
 AOF seeks refundable EITC at current level (10% of federal),
with cap removed.

ADULT PROTECTIVE SERVICES (APS)
 2014-2015 state budget included $500,000/year for APS;
some counties got <$550/year.
 Governor’s budget proposed $3.5 million/year, $2.64
million for counties ($30,000 x 88), balance for state
administration; unchanged in House and Senate versions.
 AOF Goal: $20million/year, including the Governor’s $3.5
million to more adequately meet the growing need for
services.

CHILDREN’S PROTECTIVE SERVICES (CPS)
 Ohio is 50th in nation in state share of funding for children’s
protective services (CPS).
 Over $53 million has been lost to CPS since 2009, and CPS
stands to lose another $17 million in 2016-17.
 PCSAO and AOF seek an additional. $20 million/year for
CPS, $8.8 million base funding for all counties ($100,000 x
88), and $11.2 million to counties via formula, for increased
investment in permanency efforts.

OHIO HOUSING TRUST FUND
 Governor’s budget created Housing Trust Reserve Fund to
capture first additional $15 million in fees over $50 million
statutorily granted to the Housing Trust Fund for housing;
House left unchanged.
 Senate mandated that half of amounts collected must go
to County Recorders to be distributed locally; focus on
homeless, low income, people with disabilities, elderly, and
youth.
 COHHIO and AOF seek to restore the previous system, with
all money going out at state level; this eliminates
inefficiency and unnecessary administrative costs.

AOF’S BUDGET PRIORITIES
CONT.
Mark Davis, Ohio Provider Resource
Association

MEDICAID
 Requires additional information to be included in an annual
report that Ohio Department of Medicaid (ODM) must
complete under existing law on the effectiveness of the
Medicaid program in meeting the health care needs of low-
income pregnant women, infants and children.
 Replaces the House provision with a provision that requires
ODM to establish a Medicaid waiver program under which
certain Medicaid recipients must enroll in innovative and
value-based health coverage that is modeled on health
savings accounts and uses premiums, copayments or both
instead of participating in Medicaid's fee-for-service
component or Medicaid managed care.

MEDICAID CONT.
 Enroll children in foster care and children who have been
adopted in managed care.
 Elective enrollment of individuals with IDD in managed care.
 Community health workers in areas of high infant mortality,
paid for by managed care organizations.
 By July 1, 2020 at least 50% of aggregate net payments by ODM
are value-based.
 Hospital provider tax reduced back to 2.66%, resulting in a
significant loss in federal revenue ($452.1 million total, $73
million outside of hospitals).

MEDICAID CONT.
 Independent providers issue in waivers to be studied by
legislature with the intent to resolve the issue by December
31, 2015.
 Requires a report by ODM on clinical care and outcomes of
Medicaid expansion population to the Ohio General
Assembly.

BEHAVIORAL HEALTH
 Same as the Executive, but
 (1) requires ODM to begin to include alcohol, drug
addiction, and mental health services in the care
management system not later than January 1, 2018,
 (2) requires approval by the Joint Medicaid Oversight
Committee (JMOC) before ODM may implement any
proposal to include the services in the system before
January 1, 2018, and
 (3) requires JMOC to monitor ODM’s actions regarding
the inclusion of the services in the system.

DIRECT CARE WORKFORCE
 Home health aide services for non-independent provider,
increased at least 5% in Senate; 10% in House.
 Developmental Disabilities (DD) direct care increase
funding reduced $10.5 million and added funds availability
requirement.
 Rates for ambulette services increased at least 10%.

FOOD AND NUTRITION
 House’s version – added $2.5 million/year to the
Governor’s proposal for a total of $17.25 million/year.
 Senate’s version – added $2.75 million/year to the House’s
proposal for a total of $19.75 million/year; shift from GRF
to TANF as source of funding.
 AOF’s goal was met, but we will continue to monitor the
source of the funding.

STATE BUDGET WRAP-UP
Bill Sundermeyer, Advocates for
Ohio’s Future

YOUR CALLS & EMAILS
INFLUENCE POLICY
Join AOF this week in contacting key
legislators to support health and human
services programs.

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It's Not Too Late: Last State Budget Update

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