Complete Story
02/02/2023
DeWine critiques nursing home quality in State of the State, releases budget proposal
The following includes a correction from the previously distributed version of this write up. The previous version of this alert cited increases to home- and community-based provider rates which have not been confirmed. Please join the LeadingAge Ohio Advocacy in Action call on Monday, February 13 to hear the latest on the Governor’s executive budget.
Following Governor DeWine's State of the State address on Tuesday, the Governor's office released the executive budget proposal ("the Blue Book") for SFY 2024-2025 early Wednesday morning. It is now available on the Office of Budget & Management's website.
This represents the first step in Ohio's biennial budget process. The Blue Book offers high-level summaries of proposals by administrative department, but lacks important detail on budget assumptions and projections, including Medicaid reimbursement rates. Medicaid does state, “The Department will prioritize provider rate changes approved through the budget process and their impacts on workforce and service provision,” but providers will likely wait until the Director of Medicaid’s testimony before the House Finance Committee later this month for additional detail.
The executive budget proposal includes:
Items addressed in the executive budget proposal that pertain to LeadingAge Ohio members include the following:
- PACE. The Program for All-Inclusive Care for the Elderly (PACE) was called out specifically in the Budget Recommendations (Book One) as the Ohio Department of Aging’s top highlight: The budget expands the Program of All-Inclusive Care for the Elderly (PACE) from one county to seven counties. This program is a managed care model that provides participants with needed health care, medical care, and ancillary services.
- Affordable housing. The executive budget proposes several tax policy changes to address administration priorities, including the creation of a state low-income housing tax credit (LIHTC). One proposal involves a new tax credit for the development and rehabilitation of low-income multifamily rental housing in this state. The program would be administered by the Ohio Housing Finance Agency and would reserve up to $100 million per year to developers of qualifying projects, over a total of four years. Total credits allowed under the program would amount to $400 million. Taxpayers receiving tax credit allocations would claim 10 percent of their full credit annually over 10 years. The credit would support developers to increase the supply of safe, high-quality, and affordable housing to lower-income Ohioans.
Another proposal involves a tax credit for the development of affordable single-family housing. A total of $50 million in annual credits would be reserved for developers of qualifying projects, provided over four years. This amounts to $200 million in total credits awarded by this program. Credit recipients would take these credits over 10 years.
- Aging services grants. The executive budget proposal also names the Administration's intention to provide grants to home- and community-based services providers. Specifically, the Blue Book suggests $40M in Healthy Aging Grants to Local Partners and $6M to support home and community-based services.
- Dementia care. The proposal increases resources and caregiver supports by investing in the Alzheimer’s Disease and Other Dementia Respite Line, increasing access to dementia education by 100 percent and personal care services by 50 percent. Funding will also support the establishment of a statewide dementia coordinator to ensure greater continuity of resources for all impacted by dementia.
- Improving nutrition, social connectedness, and transportation. Over 55 local partners will have the opportunity to receive grants and implement projects including at least 10 nutrition projects and 12 social connectedness projects. The Department wants to invest in the Senior Community Services Line to more effectively target and prioritize the most in-need populations and reduce waiting lists for services. The number of overall consumers served would be increased by 50 percent (10,800 to 15,800), with an emphasis on increasing nutrition and transportation priority services by 40 percent and 70 percent respectively.
- At home technology pilot program. The proposal suggests $250K may be allocated to support an at home technology pilot program, which follows a suggestion by LeadingAge Ohio to explore artificial intelligence (AI) pilots in home care.
DeWine also took aim at Ohio's nursing facilities, first noting that most of Ohio’s 960 facilities are “very good” staffed by “wonderful and compassionate workers caring for residents,” before sharing that Ohio ranks 39th among states in nursing homes five-star rankings, and sharing that he hears about “horror stories” and “preventable tragedies” that take place in nursing facilities. While acknowledging that it is important for nursing facilities to be adequately funded, he clearly stated that “any discussion about rebasing must also include a discussion of quality” in Ohio nursing facilities. DeWine stated his intent to appoint a Commission to study nursing facility quality issues; the Commission will travel around the state to hear from residents and families and help drive solutions.
The legislature now begins its work to craft their version of the budget bill, beginning in the Ohio House of Representatives. LeadingAge Ohio will continue to share information on the executive budget proposal, including specific rate proposals, when the legislative language is released in the coming weeks. For questions on the executive budget proposal, please reach out to Susan Wallace at swallace@leadingageohio.org.