State Budget Update


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  • Senate Finance Chair = Senator Oelslager (R-Canton) Medicaid Subcommittee Chair David Burke (R-Marysville); also subcommittees on general govt and EducationSenate Medicaid, Health and Human Services Committee – Sen Jones, SenCafaro (ranking)House Finance Committee chair – Representative Ron AmstutzHouse HHS subcommittee chair – Rep. Anne Gonzales
  • We have spent months working with people all over the state to develop a list of budget goals and we will measure recommendations made in coming months against those goals for strengthening Ohio.First, we will be looking to see if the budget makes Ohio and Ohioans more competitive. We know critical human services stabilize families so they can compete in the 21st century economy. Second, we will assess whether the budget strengthens the health of our communities. Healthy citizens build strong communities, and healthy workers strengthen Ohio’s economy. A healthy, productive, and educated workforce is vital to position Ohio as a top tier business location. Finally, we will evaluate whether the budget prepares Ohio to create more jobs and better jobs. Good jobs and career opportunities for all Ohioans are critical to our state’s success. With new economic development policy we can strengthen our workforce and ensure that every community has jobs that provide opportunity for all. Ultimately, we’re looking to see if the budget strengthens Ohio’s economy.  When Ohio’s economy thrives, everybody benefits.
  • Long Term Care Seniors and people of all ages with disabilities should be able to live with dignity in the setting they prefer: their home and community. Home and community-based services allow people to remain independent, connected to their community, and avoid costly nursing facilities and institutions. Having just 2,500 people at home instead of in a nursing facility can save more than $100 million per year.
  • Long Term Care Seniors and people of all ages with disabilities should be able to live with dignity in the setting they prefer: their home and community. Home and community-based services allow people to remain independent, connected to their community, and avoid costly nursing facilities and institutions. Having just 2,500 people at home instead of in a nursing facility can save more than $100 million per year.
  • Long Term Care Seniors and people of all ages with disabilities should be able to live with dignity in the setting they prefer: their home and community. Home and community-based services allow people to remain independent, connected to their community, and avoid costly nursing facilities and institutions. Having just 2,500 people at home instead of in a nursing facility can save more than $100 million per year.
  •   “Early Childhood Access” funding in the education funding plan:o   Supposed to be $90.3 million per year, although the district breakdown released shows $96M for 2014o   210 district would receive the ECA funding in the Governor’s plano   Can be used for pre-k to third grade, but not “required” to be used that way- i.e. could be used for any purpose o   Bottom line:  likely that if the proposal moved forward as introduced very few of the districts would use these dollars for pre-k, and many would probably not even use them for pre-k to 3rd grade depending on deficits in other areas
  • TANF PRC Increased – supporting services for primary parents & kin, preventing foster care
  • Ohio’s Hunger Index illustrates that the economic conditions that influence hunger and food insecurity worsened significantly in the aftermath of the recession, with 2009 being the worst year.While economic conditions have improved since 2009, they are still significantly worse than prior to the recession. This means that the needs of those individuals who suffer from the effects of food insecurity and hunger continue to be severe despite recent economic improvements.
  • Total last year (2009): 3,462,181Most recent total (2010): 3,561,514Source: 2006-2010 American Community Survey
  • Talk about what it means to be an endorsing organization.
  • Example: someone who has workforce issues because either they can't get healthy or they don't have health care, or the reverse, some one who is able to work because they were able to get healthy.
  • State Budget Update

    1. 1. State Budget UpdateWhat does the budget mean forfamilies and communities in Ohio?
    2. 2. STATE BUDGET UPDATE Featuring:Larke RecchieExecutive Director, Ohio Association of Area Agencies on AgingTeresa LamplAssociate Director, the Ohio Council of Behavioral Health &Family Service ProvidersLisa Hamler-FugittExecutive Director, Ohio Association of FoodbanksCathy LevineExecutive Director, UHCAN Ohio
    3. 3. TODAY’S AGENDA 3:00 - 3:08 Will Petrik – Intro, agenda and budget overview 3:08 - 3:16 Larke Recchie - Long term care; services for seniors and people with disabilities 3:16 -3:24 Teresa Lampl—behavioral health, families and children and workforce opportunities 3:24 - 3:32 Lisa Hamler-Fugitt—food and housing 3:32 - 3:40 Cathy—Medicaid expansion update; payment reform 3:40 - 3:48 Will Petrik – What can you do to strengthen families and communities in the state budget? 3:48 - 4:00 Q&A
    4. 4. WILL PETRIK State DirectorAdvocates for Ohio’s Future
    5. 5. BUDGET PROCESSExecutive Budget Introduced Feb. 4House (target of April 18 for passage)  Finance & Appropriations Committee  Health & Human Services SubcommitteeSenate Finance Committee: April-May  Subcommittee on Medicaid Conference Committee: June Governor Kasich signs into law by June 30
    6. 6. 14-15 BUDGET ISSUESHealth care reformK-12 educationHigher educationTax StructurePrivatizationHealth and Human Services
    7. 7. GOALS AND POLICY RECOMMENDATIONS• Make Ohioans more competitive .• Improve the health of our communities.• More and better jobs.
    8. 8. HB 59: Long Term Care LARKE RECCHIE Executive Director
    9. 9. HB 59: SERVICES THAT STRENGTHENOHIOANSHome and Community Based Services• PASSPORT, Assisted Living, Choices, Ohio Home Care, ICDS • Increases to support changing demographics• Balancing Incentive Payment Program
    10. 10. HB 59: SERVICES THAT STRENGTHENOHIOANSHome and Community Based Services• Taking funds used for people under 60 with behavioral health needs and put them into community services• Some provider rate increases: Adult day services, Assisted Living, nursing and some aide services• Medicaid Expansion
    11. 11. HB 59: MORE WORK STILL NEEDS TO BEDONE TO STRENGTHEN COMMUNITIES• Access to Services: • ICDS, • Aging and Disability Resource Networks, • Screening and Assessment Services• Adequate funds for Per Member Per Month• Better provider rates for all personal care providers• Adult Protective Services
    12. 12. HB 59: Behavioral Health, Families and Children,& Workforce Opportunities TERESA LAMPL Associate Director
    13. 13. BEHAVIORAL HEALTHMedicaid Expansion – Impact on Access $105 Million ($35 million in FY 14; $70 million in FY 15) Single largest investment in addiction and mental health “treatment” services Re-invest Resources in Social and Community Supports such as Housing, Employment, and Respite Care to Compliment Clinical Treatment
    14. 14. BEHAVIORAL HEALTHRecovery Requires a Community Builds on Ohio’s HOME Choice Program to Allow 1,200 adults under age 60 transition to less restrictive settings in the community. Invests savings from utilizing community based services over nursing homes, similar to Money Follows the Person, to sustain individuals in transitioning to community living Access Success II - $1 Million
    15. 15. BEHAVIORAL HEALTHRecovery Requires a Community (con’t) Recovery Requires Housing – new voucher program to assist individuals moving out of nursing homes, living in substandard housing, or are homeless. Adult Care Facilities – Better Care Coordination, Enhanced Rates Reduce Inappropriate Admissions to Nursing Homes
    16. 16. BEHAVIORAL HEALTHNew Consolidated Department: Ohio Department of Mental Health and Addiction Services (MHAS)Continuum of Care: $76.4 M per yearCommunity Innovation Fund: $1.5 Million Redirected to Innovative Service Projects
    17. 17. FAMILIES AND CHILDRENEducation Reform – Achievement Everywhere Special Education: $711.2 M and $765.3 M English Language Learners: $17.7 M and $18.8 M Early Childhood Access: $90.3 M each year Poverty: $488.8 M each year Gifted and Talented: $85.2 M each year
    18. 18. FAMILIES AND CHILDRENReduce Infant Mortality: $3.2 M Investment  Prenatal Smoking Prevention Progesterone Supplementation Safe SleepMaintains current funding for Help Me Grow
    19. 19. FAMILIES AND CHILDRENChild Welfare Statewide implementation of Differential Response – Adds 40 remaining counties Maintains Kinship Permanency Incentive Program New Incentives for Permanent Adoption of Children Over Age 9 TANF Prevention, Retention, & Contingency (PRC) increased by $42 M each year
    20. 20. JOBS AND EMPLOYMENTSummer Youth Employment Program $9 M increaseWork Supports Ohio Means Jobs – Rebrand One-Stops Shift to a Responsive On-the-Job Training Program Short-term Model which allows Workers to Learn and Earn
    21. 21. JOBS AND EMPLOYMENTOpportunities for Ohioans with Disabilities (formerly Rehabilitation Service Commission) Funding increased to $15.7 M (20% increase)Maintains Priority for Employment First for Individuals with Developmental Disabilities $1 M each year for Pilot/Demonstration
    22. 22. HEALTH CARE JOBSPrioritize Advanced Primary Care TrainingTarget Scholarship, Training and Loan Repayment ProgramsRe-direct Graduate Medical Education Funds to Primary Care and Physician ShortagesSupport Person Centered Medical HomesEstablish Core Competencies for Direct Care Workforce
    23. 23. HEALTH CARE JOBSRate Increases Primary Care - ACA requirement Home and Community Based CarePayment Innovation Reward Prevention, Coordination of Care, and Management of Chronic Diseases Episode of Care: Public-Private Partnership
    24. 24. STATE BUDGET DECISIONS IN HUMAN SERVICES, FY 2014-2015 LISA HAMLER-FUGITT Executive Director Ohio Association of
    25. 25. OHIO’S HUNGER BILL - $6.97 BILLION • Ohio was in the80% “billion-dollar club;” 78%70% in 201060% • 5th in the nation for50% high cost of hunger40% • $542.00 per Ohioan30% • 33.68% increase since20% 200710% 12% 10%0% Illness costs Education & related Charity costs costs
    26. 26. ECONOMIC INDICATORS INFLUENCING HUNGER IN OHIO, 2007-2011 2007 2008 2009 2010 2011Median Income* $48,385 $47,428 $45,395 $46,275 $45,749 % Poverty 13.1% 13.4% 15.2% 15.8% 16.4%% Unemployment 5.6% 6.5% 10.1% 10.0% 8.6% Hunger Factors 8.95 9.95 13.04 12.65 12.72 Indexᵻ Driscoll & Fleeter, 2012* Median income is adjusted for inflation.ᵻ Index combining Ohio’s economic indicators. An index value of zero would representno poverty, no unemployment and an Ohio median income equal to that of the 2007national average.
    27. 27. 3,561,514 Ohioans withincomes below 200% of thefederal poverty level—eligiblefor emergency food.
    28. 28. MAKING OHIOANS MORE COMPETITIVEFood and Nutrition - Invest $34 million over the 2014-15 biennialbudget ($17 million per year) to support the purchase of food andgrocery products, and distribution of this food through the 12foodbanks, representing all of Ohio’s 88 counties and over 3,300local agencies.HB 59 – Proposes level funding on $12.5 M per year or 26.5%shortfall required to meet the current needStable HousingInvest $106M over the 2014-15 biennial budget to the OhioHousing Trust Fund to ensure that children, seniors, veterans, andpeople with disabilities have the housing security necessary toachieve.HB 59 – Proposes level funding of $106 M over 2014-15
    29. 29. OTHER PROGRAMS IN HB 59• Ohio Works First (OWF) cash assistance to approximately 68,896 assistance groups per month in 2014 and 68,349 assistance groups per month in 2015. Ohio Works First: $303.1 m in 14 and $300.4 in 15• County Regular Allocation (to practically support a PRC type program): $97.2 m in each year = $194.4 m• TANF Summer Youth Employment: $35 m in each year = $70 million• Disability Assistance to provide an average of $135 per month to an average of 11,798 persons in 2014/15: $22 m per year = $44 m• Adult Protective Services: to assist/protect at risk seniors: $366,000 per year = $732,000
    30. 30. MEDICAID DIRECTOR – 2/14/13“In a meeting with the CEO of Care Source they shared theirexperience of new shared case management andrequirement to conduct face-to-face visits with patients intheir homes.The nurses reported that when your in a persons house yousee a lot of other things going on in the persons life and thenumber one issue the nurses see are food issues.” Director John McCarty Testimony to the Finance and Appropriations Committee
    31. 31. Medicaid Expansion: Good for Ohio CATHY LEVINE Executive Director
    32. 32. HEALTHY COMMUNITIESHealth Care CoverageExpand Medicaid eligibility to all Ohioans withincome up to 138% of the federal poverty level aspermitted by the Affordable Care Act.Reduce Hospital ReadmissionsOhio can significantly reduce costly patient harm andrealize $44.7 Million per year in savings throughpublic reporting of hospital rates and adjustinghospital reimbursement based on performance.
    33. 33. CONCLUSIONMedicaid Expansion is GOOD DEAL for OhioProvides stimulus to Ohio’s economyKeeps Ohio tax dollars in OhioProvide health care to hundreds of thousands of OhioansProvide fairer payment to health care providers, especially hospitalsMore than pays for itself
    34. 34. TAKE ACTION!Next steps for state budget advocacy.
    35. 35. NEXT STEPS: WHAT YOU CAN DO TODAY?Join the coalition of over 350 organizations.Endorse Advocates for Ohio’s Future today.Like us on FacebookFollow us on Twitter @Advocates4OH
    36. 36. NEXT STEPS: WHAT YOU CAN DO THIS WEEK? Join a statewide day of action this Thursday. Email and call your State Rep. Message: We cant afford not to extend Medicaid in the state budget.
    37. 37. NEXT STEPS: OVER THE NEXT MONTH 1. Meet with your State Representative. 2. Review our “effective legislative visits” webinar here. 3. Ask them: Can we count on you to strengthen families and communities and make Ohioans more competitive?
    38. 38. STEPS FOR MEETING WITH STATE REP 3. Use our 2014-15 State Budget Goals to ask your Representative about issues you are passionate about.  Example ask: Will you expand Medicaid eligibility to all Ohioans with income up to 138% of the federal poverty level to extend health coverage to nearly half a million Ohioans? 4. Send thank you’s and let us know how your visit went.
    39. 39. NEXT STEPS: OVER THE NEXT 5 MONTHSTake action on critical action alertsEducate yourself – participate in Advocates for Ohio’s Future webinarsUse our talking points to talk to your lawmakers about how your work strengthens families in your community.Submit your story to OhioSPEAKS
    40. 40. CONTACTAdvocates for Ohio’s Future510 East Mound Street, Suite 200Columbus, OH 43215www.advocatesforohio.orgWill Petrik | 614-602-2464wpetrik@advocatesforohio.orgGail Clendenin |