Long-Term Care, Direct Support Staff Rates In Focus For House Health Budget Panel Members

This year's budget hearings by the House Finance Subcommittee on Health & Human Services differed in one major way from the past two biennial processes, according to Chairman Rep. Mark Romanchuk.

Witnesses tended to like this budget package, the Mansfield Republican said.

"There didn't appear to be any hot-button issues in this proposed budget," he said in an interview. "In the past we've had budgets come to us that resulted in a lot of people coming out upset. We didn't see that in this budget. That was an absolute big change from the last two budgets."

That's likely due to Gov. Mike DeWine following through on a promise of no surprises or major policy changes in his first two-year spending plan. Conversely, his predecessor was known to continuously push the legislature to enact sweeping tax changes and other volatile budget initiatives.

This year the subcommittee heard from more than 200 witnesses over the past three weeks of hearings on the budget (HB 166).

Rep. Romanchuk said it's still too early to say just what amendments might make it into the House's version of the budget, but that several issues raised by witnesses to the subcommittee are under consideration.

One of those issues centers on Medicaid reimbursement rates for long-term care providers, including the "market basket" rate increase for skilled nursing facilities, the assisted living waiver and the PASSPORT program. (See Gongwer Ohio Report, March 25, 2019)

"We're fighting to get those increases back in," Rep. Romanchuk said. "That's going to be difficult, but we're going to turn over every stone we can to beef up that system."

Another concern the subcommittee heard repeatedly centered on reimbursement rates for direct service professionals that care for people with disabilities. The budget proposed an 11% increase over the biennium to $12.38 per hour. (See Gongwer Ohio Report, April 8, 2019)

Rep. Romanchuk said members are working to see if that total can be pushed even higher, but the House hopes to keep the increase to at least $12.38.

"It's an 11% increase over the biennium," he said. "That's kind of a big deal."

Rep. Thomas West (D-Canton), the ranking Democrat on the subcommittee, said increasing wages for direct care workers, in developmental disabilities and in areas such as aging through the PASSPORT program, is a priority.

"Their wages are not high enough and their turnover seems to be more rapid than usual," he said in an interview. "We've heard an overarching theme that we need to have higher wages among direct care service providers."

One long-term concern for the panel is the DeWine Administration's plan to spend down the state's balance of federal Temporary Assistance for Needy Families funds. (See Gongwer Ohio Report, April 3, 2019)

That plan could pose problems beyond this two-year budget, Rep. Romanchuk said.

"I think that's an issue long-term," he said. "It's going to be an issue for the sustainability for the publicly funded child care."

Rep. West said some of his main takeaways from the subcommittee's work centered around the need to promote policies that help families.

"The one thing that stood out under this whole budget is really that Ohio needs to invest in our mothers, our fathers and our children," he said.

Infant mortality is another area the state needs to continue to invest in, he said. The budget should also emphasize ways to address health disparities, such as rates of chronic disease among black Ohioans. Both of those issues can be helped by ensuring the Commission on Minority Health can focus on them.

"We have a huge opportunity to close that gap," he said. "We all know it exists, and to me that should be a crisis unto itself."

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