AOF Webinar 6-14-11

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Advocates for Ohio's Future
Political and Field Update
June 14, 2011

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  • Medicaid: Long-term reforms will improve health care outcomes and lower costs Without significant reform, growth in the state’s Medicaid program would overwhelm spending in all other state programs.  The Governor’s Office of Health Transformation moves Ohio’s Medicaid program in the right direction through a number of strategies to reduce system costs and improve health outcomes by modernizing the health care payment system, integrating behavioral and physical health care and reducing other fragmentation in the system, and improving the coordination of care. These strategies will better position the state to take advantage of many of the improvements available through federal health care reform.  The proposed changes will particularly help Ohioans with chronic conditions and children with disabilities who will benefit from coordinated care and integrated hospital, physician, and supportive services.  We also commend Governor Kasich for: Preserving Medicaid Eligibility –Ohio’s eligibility limits are already lower than many other states. Reductions to eligibility would have harmed vulnerable populations including more than 1.2 million of Ohio’s 2.9 million children who rely on the Medicaid program for their health care coverage.  Preserving Access to Medicaid’s “Optional Services” –Optional services, which include vision, dental, prescription drugs, hospice care, and community mental health services among other things, provide cost-effective care and enable people to avoid care in more expensive settings.  Elevating Behavioral Health Financing to the State –The decentralization of funding and lack of state investment has brought Ohio’s community behavioral health system to the brink of failure and collapse. In addition, disconnected systems have created perverse incentives to shift patients to more expensive and, often, inappropriate settings. Relieving counties of this responsibility will enable the state to create consistent and comprehensive policies to ensure better care for Medicaid-eligible individuals with behavioral health disorders. Rebalancing Long-Term Care— Ohio’s long-term care system relies too heavily on nursing home placements, which are more expensive than home- or community-based care. The governor’s budget establishes a goal of reducing the nursing home population to 50 percent of the state’s long-term care system.  Reforming the payment system for Large Providers –Since the Medicaid program was delinked from cash assistance in 1996, it has evolved from being a welfare program to a major player in the health care market. As such, its focus has had to shift to ensuring value for spending. Hospitals and nursing homes represent significant areas of Medicaid spending. The governor’s budget modifies Ohio’s out-of-date hospital payment system and moves nursing homes to a price-based reimbursement system that focuses more on quality.
  • Preserving Investments Made in Early Care and Education – Helping children enter school ready to learn is critical to their long-term success. The budget preserves funding in the Department of Education for Early Childhood Education (formerly public preschool) for 5,700 children. The budget maintains some funding for Ohio’s Step Up to Quality program that works to improve the quality of Ohio’s early care and education programs. Funding for the Help Me Grow program was reduced by $3 million each year. We applaud the administration for continuing work begun in the Strickland administration to refinance this program through Medicaid. Refinancing portions of this program will mitigate General Revenue Fund (GRF) reductions.  The Governor’s focus on prenatal care is a common-sense method of promoting healthier children and mothers, and it saves money in the system. Lowering the number of low-birth-weight babies – whose care costs six times more than that of healthy babies – will have positive effects down the line, reducing the need for early intervention, special education in school, and more.  Preservation of the Ohio Housing Trust Fund, TANF Cash Assistance, and emergency food assistance represents more good news in the budget. DYSBoth the RECLAIM program and Youth Services Subsidy line items are funded at FY 2011 levels in both years of the bienniumContinuation of funding for Juvenile Justice Behavioral Health ProgramsOne more Juvenile Detention Center closed
  • Preserving Investments Made in Early Care and Education – Helping children enter school ready to learn is critical to their long-term success. The budget preserves funding in the Department of Education for Early Childhood Education (formerly public preschool) for 5,700 children. The budget maintains some funding for Ohio’s Step Up to Quality program that works to improve the quality of Ohio’s early care and education programs. Funding for the Help Me Grow program was reduced by $3 million each year. We applaud the administration for continuing work begun in the Strickland administration to refinance this program through Medicaid. Refinancing portions of this program will mitigate General Revenue Fund (GRF) reductions.  The Governor’s focus on prenatal care is a common-sense method of promoting healthier children and mothers, and it saves money in the system. Lowering the number of low-birth-weight babies – whose care costs six times more than that of healthy babies – will have positive effects down the line, reducing the need for early intervention, special education in school, and more.  Preservation of the Ohio Housing Trust Fund, TANF Cash Assistance, and emergency food assistance represents more good news in the budget. DYSBoth the RECLAIM program and Youth Services Subsidy line items are funded at FY 2011 levels in both years of the bienniumContinuation of funding for Juvenile Justice Behavioral Health ProgramsOne more Juvenile Detention Center closed
  • AOF Webinar 6-14-11

    1. 1. Advocates for Ohio’s Future Political and Field Call<br />Featuring:<br />Gayle Channing Tenenbaum, co-Chair of Advocates for Ohio’s Future, Senior Policy Associate for Voices for Ohio’s Children, and Director of Policy and Govt Affairs at PCSAO<br />LarkeRecchie, Executive Director of the Ohio Association of Area Agencies on Aging (o4a)<br />Cathy Levine, Executive Director of Universal Health Care Action Network of Ohio and Co-Chair of Ohio Consumers for Health Coverage<br />Nora Nees, Director of Child and Senior Nutrition of the Ohio Association of Second Harvest Foodbanks (OASHF)<br />
    2. 2. HB 153 (State Budget, FY 2012-2013)Cathy LevineCo-Chair of Ohio Consumers for Health Coverage (OCHC), Executive Director of Universal Health Care Action Network of Ohio (UHCAN-OH)<br />
    3. 3. Good Policy in House and Senate versions of HB 153<br />Policy Approach of the Office of Health Tranformation: <br /><ul><li>Promotes better care, better health and lower costs</li></ul>Budget calls for:<br /><ul><li>Improved care coordination
    4. 4. Integration of behavioral and physical health care
    5. 5. Balancing of long term care</li></li></ul><li>More Good Policy in the 2012-13 Budget<br /><ul><li>Preserves Medicaid Eligibility
    6. 6. Preserves Access to Medicaid’s “Optional Services” –dental and vision
    7. 7. Elevates Behavioral Health Financing to the State </li></li></ul><li>Budget doesn’t support the policy<br />Increases or improvements in services accompanied by disinvestments in the “front door” or delivery system<br /><ul><li>Inadequate funding for Passport and AAA’s
    8. 8. Behavioral Health
    9. 9. $15 million needed in mental health community line
    10. 10. $13.5 million needed in addiction services community line in 2012 and 2013 </li></li></ul><li>Budget doesn’t support the policy<br />Good Policy Goal: <br /><ul><li>Calls for modernizing Medicaid payment rules to reward value instead of volume</li></ul>Language Concern:<br /><ul><li>Contrary to modernized payment – caps the % of HMO premiums that can be withheld subject to achieving quality benchmarks.
    11. 11. We can’t afford to pay without receiving quality measures. </li></li></ul><li>Food: Adequate access is a critical health issue<br /><ul><li>Inadequate access to nutritious food is connected to rising diabetes and obesity
    12. 12. Malnutrition is a risk factor for poor health
    13. 13. Food insecurity is a stressor leading to other health problems</li></li></ul><li>Additional Revenue Should be prioritized for…<br /><ul><li>Health Homes Initiative
    14. 14. Food and Housing
    15. 15. Long term care for the elderly and people with disabilities
    16. 16. Mental health
    17. 17. Drug and addiction services
    18. 18. Early Care & Education
    19. 19. Child Welfare</li></li></ul><li>HB 153 (State Budget, FY 2012-2013)Gayle Channing TenenbaumCo-Chair of Advocates for Ohio’s Future, Senior Policy Associate for Voices for Ohio’s Children, and Director of Policy and Govt Affairs at PCSAO <br />
    20. 20. Meeting withGovernor Kasich<br /><ul><li>Emergency Food
    21. 21. Ohio Housing Trust Fund
    22. 22. Mental Health</li></li></ul><li>Senate Supported Several Areas<br /><ul><li>Ohio Housing Trust Fund
    23. 23. Help Me Grow
    24. 24. Adoption subsidies, kinship programs
    25. 25. Home and Community based care</li></li></ul><li>Recent News and Opinion<br />Editorial: “Does budget proposal address Ohio's needs? No: By slashing services, it makes Ohio less desirable for businesses”<br />http://www.dispatch.com/live/content/editorials/stories/2011/06/12/fejes-0911-art-g07d09o1-1.html<br />“Budget Plan Spares Rich of the Worst”<br />http://www.dispatchpolitics.com/live/content/local_news/stories/2011/06/13/budget-plan-spares-rich-of-the-worst.html?adsec=politics&sid=101<br />“Cuyahoga County will lay off 14 of its Alcohol, Drug Addiction, and Mental Health Services Board.”<br />http://www.cleveland.com/cuyahoga-county/index.ssf/2011/06/cuyahoga_county_will_lay_off_14_from_its_alcohol_drug_addiction_and_mental_health_services_board.html<br />
    26. 26. Invest New Revenue in Safety Net Services<br /><ul><li>Emergency Food
    27. 27. Mental health and addiction services
    28. 28. Early Childhood Programs
    29. 29. Local Government Social Services
    30. 30. Home-based care for seniors and people with disabilities</li></li></ul><li>The Aging Network: <br />HB 153 for Aging <br />LarkeRecchie, <br />Executive Directorof the <br />Ohio Association of Area Agency on Aging (o4a)<br />
    31. 31. PASSPORT and Aging waivers:<br />Progress:<br /><ul><li>Senate added $15 M to PASSPORT
    32. 32. Represents a $30 M increase including the $15 M from the House budget</li></ul>Not there yet:<br /><ul><li>$42 million still needed from Conference Committee to restore funding levels for:
    33. 33. service utilization
    34. 34. provider rate cuts
    35. 35. PASSPORT agency operating costs</li></li></ul><li>Home First for Ohio Home Care<br />Is an under 60 JFS NF waiver and a future combined waiver<br /><ul><li>Allows people at imminent risk of nursing home placement get onto programs from a waiting list
    36. 36. Added in Senate amendments, hang on in conference committee</li></li></ul><li>Challenges<br /><ul><li>Adequate funding to meet diversion and transition goals
    37. 37. Adequate funding for Adult Protective Service (APS) providers
    38. 38. Funding cuts for non-Medicaid services Alzheimer’s programs and Senior Community Services (meals, transportation, ect…)
    39. 39. How will a combined waiver affect senior and disabled consumers?
    40. 40. Stakeholder and legislative input</li></li></ul><li>THANK YOU!<br />www.faircareohio.org<br />www.advocatesforohio.org<br />Ohio Association<br /> of Area Agencies on Aging<br />
    41. 41. Nora NeesDirector of Child & Senior NutritionOhio Association of Second Harvest Foodbanks(614) 221-4336, ext230www.oashf.org<br />
    42. 42. Hunger Doesn’t Take a Vacation<br /><ul><li>44% of Ohio’s children live in households that are eligible for free and reduced price school meals
    43. 43. Only 12% of potentially eligible children participate in the SFSP
    44. 44. Nationally 43% of emergency kitchens report they are serving many more children during the summer.</li></li></ul><li>TEFAP & WIC cuts<br />WIC<br />The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) serves 297,000 vulnerable Ohioans each year.<br />Cuts to the program could affect between 10,000 to 15,000 program participants already struggling to stretch formula and food vouchers the entire month.<br />Federal Fiscal Year 2012 Budget and Agriculture Appropriations<br />The House Appropriations Committee approved its fiscal year 2012 Agriculture Appropriations bill on May 31, 2011 and the full House was expected to vote today. <br />August 2nd<br />Deadline issued by Treasury Department to raise $14.3 trillion dollar federal debt ceiling without further borrowing<br /> <br />TEFAP<br />The Emergency Food Assistance Program (TEFAP) provided 22% of all food distributed by the emergency food assistance network last year.<br />Potential cuts to the TEFAP entitlement and the loss of TEFAP bonus foods could cost Ohio at least 12 million poundsof food while cuts to TEFAP Administration dollars will result in the loss of $410,354.00.<br />
    45. 45. CSFP Cuts<br />CSFP<br />The USDA’s Commodity Supplemental Food Program (CSFP) provides a monthly box of food to 20,463 low income older adults in Ohio. <br />Cuts to the program contained in the House Agriculture Appropriations Committee bill could leave 4,205of Ohio’s vulnerable elderly without their monthly box of food.<br />
    46. 46. Need for Emergency Food <br /><ul><li>2.1 million Ohioans served last quarter
    47. 47. 30% of the State’s population income eligible
    48. 48. Inflation in food, fuel, housing costs will send more to our lines
    49. 49. Cuts to critical federal nutrition programs will send more to our lines</li></li></ul><li>How You Can Help<br />Call the Governor and House and Senate Leadership:<br />Ask that they support our request for an additional $4.5 million per year ($9 million over 2012/2013 biennium).<br />This is a modest and humble request representing $1 per person, per month served by the emergency food assistance network.<br />Call Senator Brown and Senator Portman and ask that they vote AGAINST the House FY2012 Agriculture Appropriations legislation, which cuts funding for TEFAP commodities, CSFP, WIC and SNAP reserve funds. Cutting safety net programs is the wrong way to balance the budget. <br />
    50. 50. Learn More andStay Involved<br /><ul><li>HHS news and Information: http://www.advocatesforohio.org/health-human-services-news
    51. 51. Read our partners testimony: http://www.advocatesforohio.org/post?s=2011-05-18-senate-committee-testimony-calls-for-action
    52. 52. Next Field and Political Webinar: Tues, June 28 10-11:00 a.m. </li></ul>Register Here:<br /><ul><li>http://www.anymeeting.com/PIID=E952D989864B</li></li></ul><li>Take Action: <br />Please send the following message to members of the Conference Committee, House Speaker Batchelder, Senate President Niehaus, and the Governor’s Office:<br /><ul><li>Any new revenue must be prioritized for health, human services, and early care & education programs
    53. 53. Send an email to the Conference Committee through Advocates for Ohio’s Future’s action alert:
    54. 54. http://go.advocatesforohio.org/p/dia/action/public/?action_KEY=7188</li></li></ul><li>Take Action: <br />Sen. Chris Widener Email: SD10@senate.state.oh.us Phone: 614.466.3780<br /> <br />Sen. Shannon Jones Email: SD07@senate.state.oh.us Phone: 614.466.9737<br />Sen. Mike Skindell Email: SD23@maild.sen.state.oh.usPhone: 614.466.5123<br /> <br />Rep. Ron Amstutz Email: district03@ohr.state.oh.usPhone: 614.466.1474<br /> <br />Rep. John Carey Email: district87@ohr.state.oh.usPhone: 614.466.1366<br /> <br />Rep. Vern Sykes Email: district44@ohr.state.oh.usPhone: 614.466.3100<br />
    55. 55. Questions?Contact Us Advocates for Ohio’s Futurewww.advocatesforohio.org510 East Mound Street, Suite 200Columbus, OH 43215Fax: (614) 228-5150<br />Will Petrik<br />Outreach Director<br />wpetrik@advocatesforohio.org<br />614-602-2464<br />Scott Britton<br />Coordinator<br />sbritton@advocatesforohio.org<br />614-602-2463<br />

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