2. STATE BUDGET UPDATE
Featuring:
Larke Recchie
Executive Director, Ohio Association of Area Agencies on Aging
Teresa Lampl
Associate Director, the Ohio Council of Behavioral Health &
Family Service Providers
Lisa Hamler-Fugitt
Executive Director, Ohio Association of Foodbanks
Cathy Levine
Executive Director, UHCAN Ohio
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. WILL PETRIK
State Director
Advocates for Ohio’s Future
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. 14-15 BUDGET ISSUES
Health care reform
K-12 education
Higher education
Tax Structure
Privatization
Health and Human Services
7. GOALS AND POLICY RECOMMENDATIONS
• Make Ohioans more
competitive .
• Improve the health of our
communities.
• More and better jobs.
8. HB 59: Long Term Care
LARKE RECCHIE
Executive Director
9. HB 59: SERVICES THAT STRENGTHEN
OHIOANS
Home and Community Based Services
• PASSPORT, Assisted Living, Choices, Ohio Home
Care, ICDS
• Increases to support changing demographics
• Balancing Incentive Payment Program
10. HB 59: SERVICES THAT STRENGTHEN
OHIOANS
Home 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. HB 59: MORE WORK STILL NEEDS TO BE
DONE 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. HB 59: Behavioral Health,
Families and Children,
& Workforce Opportunities
TERESA LAMPL
Associate Director
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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. STATE BUDGET DECISIONS IN HUMAN
SERVICES, FY 2014-2015
LISA HAMLER-FUGITT
Executive Director
Ohio Association of Foodbanks
www.ohiofoodbanks.org
www.ohiobenefits.org
25. OHIO’S HUNGER BILL - $6.97 BILLION
• Ohio was in the
80%
“billion-dollar club;”
78%
70%
in 2010
60%
• 5th in the nation for
50% high cost of hunger
40% • $542.00 per Ohioan
30% • 33.68% increase since
20% 2007
10%
12% 10%
0%
Illness costs Education & related Charity costs
costs
26. ECONOMIC INDICATORS INFLUENCING
HUNGER IN OHIO, 2007-2011
2007 2008 2009 2010 2011
Median 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 represent
no poverty, no unemployment and an Ohio median income equal to that of the 2007
national average.
28. MAKING OHIOANS MORE COMPETITIVE
Food and Nutrition - Invest $34 million over the 2014-15 biennial
budget ($17 million per year) to support the purchase of food and
grocery products, and distribution of this food through the 12
foodbanks, representing all of Ohio’s 88 counties and over 3,300
local agencies.
HB 59 – Proposes level funding on $12.5 M per year or 26.5%
shortfall required to meet the current need
Stable Housing
Invest $106M over the 2014-15 biennial budget to the Ohio
Housing Trust Fund to ensure that children, seniors, veterans, and
people with disabilities have the housing security necessary to
achieve.
HB 59 – Proposes level funding of $106 M over 2014-15
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. MEDICAID DIRECTOR – 2/14/13
“In a meeting with the CEO of Care Source they shared their
experience of new shared case management and
requirement to conduct face-to-face visits with patients in
their homes.
The nurses reported that when your in a persons house you
see a lot of other things going on in the persons life and the
number one issue the nurses see are food issues.”
Director John McCarty
Testimony to the Finance and Appropriations Committee
32. HEALTHY COMMUNITIES
Health Care Coverage
Expand Medicaid eligibility to all Ohioans with
income up to 138% of the federal poverty level as
permitted by the Affordable Care Act.
Reduce Hospital Readmissions
Ohio can significantly reduce costly patient harm and
realize $44.7 Million per year in savings through
public reporting of hospital rates and adjusting
hospital reimbursement based on performance.
33.
34.
35.
36.
37. 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
39. 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
40. NEXT STEPS: WHAT YOU CAN DO THIS WEEK?
Join a statewide day of action
this Thursday.
Email and call your State Rep.
Message: We can't afford not
to extend Medicaid in the state
budget.
41. 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?
42. 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.
43. 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
44.
45. CONTACT
Advocates for Ohio’s Future
510 East Mound Street, Suite 200
Columbus, OH 43215
www.advocatesforohio.org
Will Petrik | 614-602-2464
wpetrik@advocatesforohio.org
Gail Clendenin | 614-602-2463
gclendenin@advocatesforohio.org
Editor's Notes
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.
