The discussion focused on how supporters in Ohio can communicate with conference committee members to strengthen families and communities in the final process of Ohio's 2014-15 budget. Advocates focused on early learning, long term care, developmental disabilities, and food assistance. Speakers also talked about a possible pathway to expand healthcare coverage to Ohioans through two new Medicaid reform bills in the House and the Senate.

1. State Budget &
Medicaid Expansion
Update
Phone Number: 213-416-1560
Guest Access Code: 198 678 477

2. STATE BUDGET & MEDICAID UPDATE
Featuring:
Katie Kelly
Director of groundWork
Larke Recchie
Executive Director, Ohio Association of Area Agencies on Aging
Mark Davis
President of the Ohio Provider Resource Association (OPRA)
and Co-Chair of Advocates for Ohio’s Future
Lisa Hamler-Fugitt
Executive Director, Ohio Association of Foodbanks
Col Owens
Co-Chair of Ohio Consumers for Health Coverage (OCHC) and
Senior Attorney at Legal Aid of SW Ohio

3. WILL PETRIK
State Director
Advocates for Ohio’s Future

4. BUDGET TIMELINE
Feb 4 – Executive Budget released
April 18 – House version of the HB 59 (state budget) passes Ohio
House
June 6 – Senate passes it’s version of the budget
June 12 – House rejects Senate version of the budget – budget
goes to Conference Committee
t
We have less than three weeks left to
strengthen Ohio in the state budget
Late June – House and Senate pass Conference Committee bill
June 30 – Governor signs budget into law – has line- item veto
authority

5. CHANGES SINCE THE EXECUTIVE VERSION
OF THE BUDGET

6. Katie Kelly
Director of Ohio groundWork Campaign
Early Education
www.groundWorkOhio.org

7. Early Education in the Governor’s
Budget and House Budget
Governor’s Budget:
•Flat-funded most programs, $2 million increase in
Public Preschool
•“Early Childhood Access” funds in school funding
formula not tied to Pre-K
House Budget:
•Included amendment for “Ready To Learn”, $5
million per year
•Changed “Early Childhood Access” funds to K-3rd
grade funding

8. Early Education in the Senate
Budget
• Maintained $10 million for early education from
the House budget, and added $20 million
additional
• House “Ready to Learn” line item
removed, funding transferred to existing Public
Preschool line item
• Funding for high-quality, part-day preschool slots
low-income 3, 4, and 5 year olds.
• Expands eligible providers to include high-quality
child care centers and non-public schools.

9. Early Education in the Conference
Committee
• Leadership has indicated that there may be
additional dollars for early education in the
conference committee
• Message to legislators: thank you for the $30
million investment to support kindergarten
readiness and third grade success. Please
support additional funding in the conference
committee to support high-quality early
education.

10. Columbus, OH
June 13, 2013
Budget Advocacy for Aging and
Long-term Care Issues
Larke Recchie
recchie@ohioaging.org
(614) 481-3511
Ohio Association of
Area Agencies on Aging
www.ohioaging.org
Keeping the front door open,
Restoring funds to rebalance Medicaid
Facebook: o4aadvocacy
Twitter: @o4aadvocacy

11. Budget Priorities
While the Governor’s budget continues to support home
and community services, additional help is needed in the
legislature.
1.Restore the 10% cuts ($1.8 million/year GRF) for
PASSPORT screening and assessment
2.Increase all PASSPORT provider rates by 3% ($5
million/year GRF)
3.Fully fund Adult Protective Services across the state
($11 million/year GRF)

12. 1. Restore front door funding
• PASSPORT assessors are the front door to link older adults
to cost-effective in-home and community programs
• PASSPORT enrollment has stalled since July 2011 when 10%
cuts to front door funding went into effect, forcing AAAs to
lay off screeners and assessors
• HB 59 proposes only fractional increases to front door
funding
• Not only is PASSPORT cost-effective, it also has 99.3%
consumer satisfaction rate statewide

13. 2. Restore provider rates
• While rates for assisted living and adult day care
services are increasing, all other PASSPORT providers
are flat-funded after sustaining a 3% cut from the last
budget
• Providers who have earned a Medicare-Medicaid
certification get a higher Medicaid reimbursement rate
than PASSPORT’s and thus many of them choose not to
provide the PASSPORT service
• ALL provider rates need to be restored to ensure that
seniors receive quality services without delay

14. 3. Fully fund Adult Protective Services
• 39 counties do not have enough funding to have fulltime adult protective workers
• Older Ohioans deserve protection from abuse,
neglect, and exploitation
• o4a has testified in support of the Ohio Elder Justice
Act
– This bill would expand the definition of “elder abuse” to
include financial harm and make permanent the Elder
Abuse Commission, among other provisions that
strengthen Adult Protective Services Law

15. Budget Initiatives in HB 59
Budget Priority
Amount of the
cuts in
2012/2013
Governor’s
budget
House budget
Senate budget
PASSPORT
screening and
assessment
(other operating)
10% which is $3.6
million per year
$1.8 million per
year of this is
GRF, and $1.8
million is federal
match
3% which is $5
million each year
in GRF plus
federal match
Less than ½%
added in 2014
and less than 1%
in 2015
Added 5% =
$900,000 GRF
each year with
$900,000 federal
match
Kept House 5%,
no additional
funds
None except
Adult Day Care
and Assisted
Living
Added 1.5% =
$2.5 million GRF
each year with
federal match
PASSPORT
Provider Rates
Adult Protective
Services
$133,997 per
year in GRF
What is needed
from Conference
Committee to
make PASSPORT
whole
Keep House 5%,
Add another 5%
$900,000 GRF
each year with
federal match
Kept House 1.5%, Keep House 1.5%,
no additional
Add $2.5 million
funds
GRF each year
with federal
match
Maintains current Maintains current Added $133,997 Keep Senate
funding level
funding level
GRF in each fiscal $133,997, Add
($366,003)
($366,003)
year
$10.5 million

16. Budget Initiatives in HB 59
Support Medicaid Expansion, Extension,
Reform (by whatever name)!
• Assist people in getting health care that prevents or
delays long-term care needs
• Assists HCBS providers in meeting the health care
requirements of the ACA

17. Developmental
Disabilities (DD) Updates
Mark Davis, President
Ohio Provider Resource
Assocation (OPRA)
www.opra.org

18. Developmental
Disabilities (DD) Updates
• Pending outcome of conference committee and
Governor Kasich’s discretionary pen
• Primary issues
• Extension of Medicaid coverage to low-wage
workers
• Waiver rates and direct care staff
• Intermediate Care Facility for Individuals with
Intellectual Disabilities (ICF/IID) system reform
• Direct care staff certification
• IDD-Specific health homes

19. Extension of Medicaid
coverage to low-wage workers
• On average, our direct care staff would be eligible
for extended health care coverage
• Wells Fargo, Brady and Ware, Barry & Associates
and Ohio Provider Resource Association (OPRA)
estimate a cost of $20 million per year to member
employers without Medicaid coverage extended
to low-wage workers
• Jackson Hewitt estimated $58 million to $88
million lost for Ohio’s businesses every year

20. Waiver rates and direct care staff
• Unsustainable system
•
•
•
•
•
DSP wages below poverty
Staff on public assistance
Turnover over 40%
Rates frozen since 2005
Inflationary pressures – Medicaid funded
• $5.4 million in additional funding in FY14 and $16.2
million in FY15 for waiver provider rate increases in
the Individual Option waiver reimbursement
system

21. ICF/IID Reform
• An OPRA-led compromise, in the
provisions that govern reform for intermediate
care facilities for individuals with intellectual
disabilities (ICF/IID)
• Elimination of the rollback
• Elimination of the flat rate for RAC-4
• Retention of the ICF reimbursement formulary in
statute
• Targets for downsizing of larger ICFs to smaller
ones, and conversion of ICFs to waivers

22. Direct Care Certification
• Removal of provisions that would have
created a DSP (direct support professional)
certification program
• New language now calls for the establishment
of a workgroup to recommend to the
legislature, by December 31st, potential policy
changes in the area of core competencies for
direct care workers

23. IDD-Specific health homes
• Authorization of the Directors of Medicaid and
Developmental Disabilities to establish a
“health home” system that may provide
coordinated care for people with chronic
health conditions and developmental
disabilities

24. HB 59 – Update
Opportunities to build healthy communities in
the 2014-15 state budget
Lisa Hamler-Fugitt
Executive Director
Ohio Association of Foodbanks
www.ohiofoodbanks.org
www.ohiobenefits.org

25. Update - Food and Nutrition
• Hunger continues to be an urgent problem in Ohio
• The food pantry network has been battling a combination
of factors:
• Rising food and fuel costs
• Rising health care costs
• Stagnant incomes,
• High poverty rates,
• Lingering underemployment, and
• An aging population
• These factors have led to a “perfect storm” in Ohio.

26. Update - Food and Nutrition
• Since the recession hit in December 2007:
• the cost of basic needs has increased 23 percent,
• the median income in Ohio has increased only 2
percent,
• Between 1999 and 2011 poverty increased by 57.7%
• The working poor are still facing the effects of the Great
Recession
• The Fiscal Year 2013 (ending on June 30, 2013)
appropriation of $12.5 million was exhausted by February,
as demand climbed and donations declined.

27. Update - Food and Nutrition
• Governor Kasich has responded by issuing Executive Orders in
response to increasing demand and declining food and
donations.
• Executive Budget include flat funding at $12.5 million/year
• House added an additional $2 million per year.
• Senate rejected more than a dozen amendments offered by
majority and minority members to increase funding.
• “Senate declines to boost food-bank aid”
“We’d all like to give $100 million to food banks, but we were
dealing with the reality that of the $175 million we had available to
allocate, we put $171 million into K-12 education. If we wanted to
do another $2.5 million for food-bank requests, do we take that out
of education?”
President Keith Faber, June 7, 2013 in the Columbus Dispatch

28. The Conference Committee ASK
Message to legislators:
• Thank you for your investment of $29 million to
feed children, families, and seniors in Ohio. Will
you provide an additional $2.5 million per year in
State fiscal Year 2014 and 2015 to strengthen
families and communities in Ohio?
• This is a modest request representing $1 per
person, per month served by the emergency
food assistance network.

29. 3,561,514
Ohioans with
incomes below
200% of the
federal poverty
level—eligible
for emergency
food.

30. MEDICAID EXPANSION:
TIME IS RUNNING OUT
Col Owens
Senior Attorney
Legal Aid Society of Southwest Ohio
Co-Chair
Ohio Consumers for Health Coverage
www.lasswo.org
www.ohioconsumersforhealth.org

31. REVIEW OF CURRENT SITUATION
•
•
•
•
•
Governor introduced expansion in budget
House took out of budget
Senate did not include in its budget
Not likely to be in Conference Committee
House ad-hoc committee from Finance
Committee to hear further testimony
• “Gang of 6” established, bi-partisan, bicameral, to develop consensus approach

32. FOCUS: REFORM, NOT EXPANSION,
AND PERSONAL RESPONSIBILITY
• Expansion opponents want Medicaid to be
short-term, focused on getting recipients to
work and out of eligibility
• Ideas that have surfaced include workforce
referrals, testing for addiction and need for
treatment, time limit
• Members of both caucuses seeking ideas to
build consensus

33. CURRENT WORK AND FINAL PUSH
• Constant input into members re: importance,
time running out, need for flexibility
• Two-dimensional messaging: expansion good for
everyone, should be adopted; coupled with,
willingness to seek appropriate ways to
accomplish some personal responsibility goals
• Managed care provides opportunity to address
goals: workforce referrals, addiction assessment
and treatment
• Time limit not possible under national program

34. CONCLUSION
• Next few weeks will determine outcome –
time for all hands on deck! Time running out
• Communication with members key – need to
urge broadest possible mobilization
• Particular focus: Gang of 6: Sens. Burke,
Cafaro, Coley, Reps. Amstutz, Sykes, McClain
• Goal: get accomplished by June 30

35. TAKE ACTION!
Help us strengthen families and
communities in Ohio.

36. CALL CONFERENCE COMMITTEE
MEMBERS AND LEADERSHIP
House of Representatives
Speaker Bill Batchelder (R-Medina)
614-466-8140
rep69@ohiohouse.gov
Rep. Ron Amstutz (R-Wooster)
614-466-1474
rep01@ohiohouse.gov
Rep. Vernon Sykes (D-Akron)
614-466-3100
rep34@ohiohouse.gov
Rep. Jeffrey McClain (R-Upper Sandusky) 614-644-6265 rep87@ohiohouse.gov
Senators
Senate President Keith Faber (R-Celina) 614-466-7584
sd12@ohiosenate.gov
Sen. Bill Coley (R-West Chester)
614-466-8072
sd04@ohiosenate.gov
Sen. Scott Oelslager (R-Canton)
614-466-0626
sd29@ohiosenate.gov
Sen. Tom Sawyer (D-Akron)
614-466-7041
sd28@ohiosenate.gov

37. TELL THEM:
Any new revenue must be prioritized to strengthen families
and communities in Ohio.
•
Food Assistance: Will you provide an additional $5 million (over the
biennium) to feed hungry Ohioans and strengthen families and
communities in Ohio? This request represents $1 per person, per
month served by the emergency food assistance network.
•
Early Education: Please support an additional funding for highquality early education to support kindergarten readiness and third
grade success.
•
Long Term Care: Please support $13.6 million for PASSPORT (over
the biennium). This would restore PASSPORT screening and
assessment and increase PASSPORT provider rates by 3%.
•
Adult Protective Services: 39 counties do not have enough funding
to protect older Ohioans from abuse, neglect, and exploitation. Will
you fully fund Adult Protective Services across the state at $11
million per year?

38. JOIN A STAACTIONS TO EXTEND HEALTH
COVERAGE TO 275,000 OHIOANS
June 20
• Statewide day of action with a message of:
Please Take the Vote – Bipartisan Leadership
Works

39. QUESTIONS?
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