Gongwer Staff
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By Gongwer Staff
Posted: May 1, 2023 8:41 AM
Ahead of a final report from the governor's task force, the House decided to invest $504.6 million more state dollars into nursing homes over the next two years compared to the executive version, budget documents show.
That change was the most expensive Medicaid-related amendment included in the House-approved Fiscal Year 2024-2025 spending plan (HB 33). The latest version also expanded several of Gov. Mike DeWine's initiatives, increasing the state share by about $617 million. (See Gongwer Ohio Report, April 26, 2023)
The Medicaid portion of the executive budget, discussed this week by a Senate panel, included $11.2 billion in state general revenue funds over the biennium, as well as $29.4 billion in federal dollars.
Adding in the House changes, the program is now at $11.8 billion in state share and $30.4 billion federal.
The size of the nursing home price tag compared to other changes is due in large part to the fact that they received no funding boost in the governor's plan, whereas most other changes build upon already proposed increases.
Gov. DeWine instead convened the Nursing Home Task Quality and Accountability Task Force. It is set to issue a report at the end of May to be considered by the Senate in its own budget deliberations.
The House's version incorporates all recommendations agreed upon by the state's three nursing home associations, including increasing funding for facilities using 2022 costs, implementing a private room add-on, using fair rental value methodology for capital costs and distributing funding with 40% going toward base payments and 60% to quality-related measures. (See Gongwer Ohio Report, March 27, 2023)
The most heavily discussed amendment was increasing the Medicaid reimbursement rate for direct support professionals from the governor's $16 an hour.
The House's plan calls for $17 in FY24 and $18 in FY25. Community behavioral health would also benefit from those rate increases, for a total cost of $104.1 million to the state. The federal share would increase $185 million.
Senate Medicaid Committee Chair Sen. Mark Romanchuk (R-Ontario), has said rates could increase with financial assistance from county boards of developmental disabilities. (See Gongwer Ohio Report, April 27, 2023)
The House also increased state funding for:
On the other side of the ledger, the House set a 2% spending reduction, cutting $224.5 million over the biennium.
Some of those cuts included decreases in Gov. DeWine's mental health investments; but funding remains above current levels. (See Gongwer Ohio Report, April 24, 2023)
The House-approved plan further provides on-going coverage for Medicaid-eligible babies from birth to 3 years old, adds coverage for doula services and obesity care, and adds lodging as an administrative service for families and children with special health care needs.
As requested by the Ohio Chamber of Commerce, it also requires Medicaid to explore expanding the Medicaid Buy-In for workers with disabilities up to age 65. (See Gongwer Ohio Report, April 21, 2023)
Separately, the lower chamber eliminated a $1 billion deposit in the Health and Human Services reserve fund that was intended to provide a cushion in case the state is off in its projections of how the Medicaid rolls will decrease through the redetermination process. (See Gongwer Ohio Report, March 16, 2023)
Sen. Romanchuk said in an interview it is too soon to say whether that was a good or bad idea.
"We have to work through all the changes in the House and the potential changes in the Senate and decide if that's going to be needed or not," he said. "It's too early to say with any certainty."
Sen. Romanchuk also said he will soon begin the process of "looking at every single thing that they've changed and go from there."