Ohio Senate Finance Committee Chairman DolanMay 25, 2023
Tara Britton, Director of Public Policy and Advocacy
Chairman Dolan, Vice Chair Cirino, Ranking Member Sykes and members of the Senate Finance Committee, thank you for the opportunity to provide interested party testimony on House Bill 33. The Center for Community Solutions (CCS) is a nonprofit, nonpartisan think tank that aims to improve health, social and economic conditions through research, policy analysis and communication. I will address a few areas of House Bill 33 in my testimony, all pertaining to health and human services.
Medicaid coverage
We support the Governor’s proposal to increase Medicaid eligibility to 300% of the federal poverty level for children and pregnant women. This policy will go a long way in ensuring continuity of coverage and access to care. This will also build upon the work done in the last state budget that expanded coverage for pregnant women from 60 days to 12 months postpartum.
To further build upon these beneficial coverage expansions, we are grateful to the House for its inclusion of continuous coverage for kids on Medicaid up to their 4th birthday. We encourage the Senate to maintain this provision. Continuous coverages means that once a child in this age range is enrolled in Medicaid, they would stay enrolled without an annual redetermination, until the age the continuous coverage ends. Our research shows that when parents lose Medicaid coverage, for whatever reason, there are significant rates of coverage loss for their kids too, even though these children may still be eligible. This is because we cover kids up to a higher income range than adults. Other states have adopted or are exploring policies that would provide continuous coverage to young children and we know what a difference this will make for continuity of care and access for Ohio’s kids.
Maternal health
We continue to support ongoing work across the legislative and executive branches that would create a certification process for doulas and provide Medicaid reimbursement for doula services. We are supportive of achieving this through the budget process, as this would kickstart the development of rules and a payment mechanism through Medicaid and are in communication across both chambers to move this work forward. We are grateful for bipartisan support of this issue in the House to add this into House Bill 33 and the bipartisan support in the Senate with the introduction of Senate Bill 93 to certify and provide Medicaid support for doulas. We are eager to work with everyone in the Senate to reconcile the language across legislation to move this policy forward in the budget.
Increasing access to doula services has been proven to improve maternal and infant health outcomes, especially for Black moms and babies. The involvement of doulas into the normal course of care before, during and after childbirth has proven to provide better birth outcomes for mothers and infants compared to those that are without. Doula assisted mothers are four times less likely to have a low-birth-weight baby (one of the leading drivers of infant mortality), two times less likely to experience a birth complication involving themselves or their baby and significantly more likely to initiate breastfeeding.
Older Ohioans
Earlier this year, The Center for Community Solutions released its latest edition of data-based profiles of every state legislative district in Ohio. We noticed that for the first time, Ohio has districts where the number of persons over age 65 outnumbered the population of persons 17 or younger.[1] At the same time, poverty rates for those older than 65 have steadily increased over the past 20 years.
We are grateful to the Governor, for proposing, and to the House, for maintaining, support for adult protective services so that older Ohioans can live safely in their communities, but there is more we can do. Community Solutions urges full support of the Department of Aging’s Healthy Aging Grants proposal. These grants will be administered through local partners and can be used to help older Ohioans live safely in homes, which often only need minor modifications as folks age. Supports could include retrofitting the homes of older residents to address challenges with utilizing stairs, installing bathtub rails and providing other supports, like nutrition services and transportation. As the department points out, these grants can also help to delay entry into Medicaid, preserve their personal assets, and promote a healthy, independent, active lifestyle.
In addition to the Healthy Aging grants, we support the work of our partners at the Ohio Association of Foodbanks and the Area Agencies on Aging to secure a state funded minimum benefit of at least $50 for older adults on SNAP. We know that people are struggling across this state, more so since the end of emergency allotments, to afford to feed themselves and their families.[2] With poverty rates amongst older Ohioans increasing, now is the time to provide this support.
Wellbeing of Ohio’s kids
The Governor and his team proposed a robust package of support for Ohio’s kids, to be mostly coordinated through the new Department of Children and Youth. We support this effort and would like to highlight a few things in this space:
- Support for pediatric behavioral health in line item 336648 within the Department of Mental Health and Addiction Services was cut significantly from the introduced budget. We understand these one-time dollars were intended to support some one-time costs associated with building up the infrastructure of pediatric behavioral health services in Ohio, which are desperately needed and building capacity for OhioRISE, Ohio’s program to better serve multi-system youth. We would support a restoration of this line item
- From the introduced budget, there was a cut to the infant vitality line item. Our understanding is that this cut could impact Ohio’s ability to more fully engage in the Alliance for Innovation on Maternal Health or AIM patient safety bundles which we know will help to address Ohio’s dismal infant and maternal mortality rates.
Additional provisions
The dedicated line item for Harm Reduction (line item 440529) in the Ohio Department of Health budget was cut entirely. This funding has been maintained since its inception two budget cycles ago (through a bipartisan effort in the Senate) and is providing vital, yet modest, support to small syringe service programs across the state, often in areas that have been particularly hard hit by the opioid crisis. We encourage the Senate to restore this line item back to $50,000 each year.
Conclusion
We thank you for the time you’re taking to hear from stakeholders on the budget. I am happy to answer any questions or provide follow up information. You can reach me at tbritton@communitysolutions.com.
[1]Since our data source tends to lag behind rapid demographic changes, there are probably even more districts that fall into this category.
[2] https://comsolutionst.wpengine.com/what-does-our-new-research-tell-us-about-food-insecurity/
