Poverty & Safety Net
Article

The Senate budget is out, what does it mean for health and human services?

June 12, 2019
Read time:
Download Fact Sheets
Register now
Share this resource
Subscribe to our Newsletter
By subscribing you agree to with our Privacy Policy.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Download this as a PDF

By:

Loren C. Anthes, MBA, Public Policy Fellow, Medicaid Policy Center

Melissa Federman, Treuhaft Chair for Health Planning

Tara Britton, Director of Public Policy and Advocacy | Edward D. and Dorothy E. Lynde Fellow  

On Tuesday, the Ohio Senate released its version of the state budget, Substitute House Bill 166. We’ll be sharing more about the Senate’s changes in a webinar on Tuesday, June 18, but in the meantime we wanted to share a status update on The Center for Community Solutions’ budget priority areas.

 We’ll be sharing more about the Senate’s changes in a webinar on Tuesday, June 18!

Medicaid expansion

While Medicaid expansion was largely untouched by the Senate Sub Bill, the discussion around waivers that would impact Medicaid coverage are still circling around capitol square. With the last minute action by the House to include and then remove an updated version of the “Healthy Ohio” cost-sharing waiver, the Senate has been discussing policies which may broaden and deepen the impact of the existing work requirement waiver. If both pieces were to become reality, unfortunately, the eligibility conditions would not only affect the expansion population, but could include parents of children covered by Medicaid as well, which would double the number of people required to take additional action (more than one million Ohioans) in order to maintain their Medicaid coverage.

 While Medicaid expansion was largely untouched by the Senate Sub Bill, the discussion around waivers that would impact Medicaid coverage are still circling around capitol square.

Maternal mortality and morbidity

Maternal mortality and severe maternal morbidity have increased nationally and disproportionately impact women of color. Between 60 and 70 percent of maternal deaths are preventable. In Ohio’s most recently reported data on maternal deaths, nearly 408 deaths were reported from 2008 through 2014.

 Between 60 and 70 percent of maternal deaths are preventable.

The Ohio Department of Health (ODH) does not currently receive timely or complete data required for investigations, which hampers efforts to target resources where they are needed most to prevent these deaths. The governor’s as-introduced budget included language for a pregnancy-associated mortality review (PAMR) board and privacy protections for the board and reporting entities. The House-passed version of the budget required the PAMR (changing the legislative language from a permissive “ODH may create…” to the PAMR is “hereby established”). Community Solutions sought to further strengthen this language to include more frequent reporting of the PAMR board’s findings. The Senate-passed version included biennial reporting (an improvement from triennial in the previous versions of the budget), but lacks Community Solutions’ recommendations for 1) accountability for investigations – timelines to request and receive the information related to an investigation, 2) requirements for a representative board and 3) any accounting of severe maternal morbidity, considered ‘near misses.’

 Having timely and complete data on maternal deaths and severe maternal morbidity is a necessary first step toward implementing measures to prevent these deaths and improve the health and wellbeing of Ohio mothers.

Multi-system youth

Community Solutions is working with a coalition of stakeholders committed to achieving the best possible outcomes for multi-system youth (MSY). The House-passed budget included language that develops a MSY action plan that includes implementing the recommendations of the Joint Legislative Committee on Multi-System Youth. This remains in the Senate version. The Senate budget does make some changes to the funding that was allocated in the Medicaid budget to “Multi-system Youth Innovation and Support.” The Senate’s pending budget bill includes $4 million in 2020 and $6 million in 2021, a reduction from $10 million per year in the as-introduced and House-passed budgets for MSY innovation, now targeted to “Multi-System Youth Custody Relinquishment.” Information is still being gathered on how flexible these dollars will be to address the needs of youth and families across income levels, with various types of health coverage and levels of need. We remain uncertain about how far these dollars will go to address the needs of all types of MSY, as well as what services will be lost due to the reduction of this part of the budget.

 The Senate’s pending budget bill includes $4 million in 2020 and $6 million in 2021, a reduction from $10 million per year in the as-introduced and House-passed budgets for MSY innovation.

Older adults

The House-passed budget included an increase to the adult protective services (APS) line item, a move in the right direction to protect Ohio’s older adults. The Senate has retained this increase in its budget. This increase brings the line-item from $2.74 million each year of the biennium to $4.23 million each year of the biennium. The bill, as it stands, would provide about $48,000 per county in Ohio, compared to $31,000 per county per year under the current budget levels. Community Solutions continues to support an increase to at least $5.72 million each year, which would allow an allocation of $65,000 per county, to support one full-time, designated APS caseworker.

 Community Solutions continues to support an increase to at least $5.72 million each year, which would allow an allocation of $65,000 per county, to support one full-time, designated APS caseworker.

The Senate’s substitute bill also has provisions to increase rates for individuals who provide personal care, personal aides and nursing services, including services provided by assisted living and PASSPORT providers. These provisions help bolster a sector challenged by staff recruitment and retention at a time when Ohio’s fastest growing population, the elderly, are seeking out ways to age that center on individual choice. While the bill still provides additional funding for nursing facilities without doing more to address the issues of quality or staffing, these policies will go a long way to bolster the choices of Ohio seniors.

Harm reduction

Community Solutions produced a report earlier this year on the syringe service programs (SSPs) that have emerged in many Ohio communities response to the opiate crisis. The Centers for Disease Control and Prevention (CDC) has cited 220 counties that are at risk for HIV and Hepatitis C outbreaks. Eleven of these counties are in Ohio and only four operate SSPs. The underutilized and cost-effective programs reduce the spread of infectious disease and leverage other community-based services to reduce and reverse overdoses and connect clients to treatment and recovery services.

 The Centers for Disease Control and Prevention (CDC) has cited 220 counties that are at risk for HIV and Hepatitis C outbreaks. Eleven of these counties are in Ohio and only four operate SSPs.

All of the programs interviewed for the Community Solutions report expressed budget concerns – some operate for as few as two to four hours a week. Without operating support, the public health benefits of these programs cannot be realized. The Senate added a harm reduction line to the ODH budget for the first time. Given the unmet need for services in Ohio, the AIDS Finding Collaborative, housed at Community Solutions, encourages the Senate to increase the funding in this line (440529, DOH) from $50,000 each in 2020 and 2021 to $250,000 in each year of the biennium to support both new and existing programs for Ohioans dealing with addiction and the communities working to keep them alive and on a path toward recovery.

Next steps

The Senate Finance committee is in the midst of hearing public testimony on this version of the budget. Sometime during the week of June 17, we will see the omnibus amendment to the budget and then the Senate will report the bill out of Finance Committee. This will then be followed by a vote in the Senate on the budget. Community Solutions’ budget webinar on Tuesday, June 18 will provide a broader look at the health and human services changes in the Senate’s version of the budget. We will have additional posts and other updates as the budget heads to Conference Committee, where the differences between the House and Senate versions of the budget will be deliberated. Ultimately, it needs to get to Governor Mike DeWine’s desk by June 30.

Download Fact Sheets

Lake County

Download

Geauga County

Download

Cuyahoga County

Download

All Municipalities Geauga County

Download

All Municipalities Lake County

Download

All Municipalities Cuyahoga County

Download

Thompson

Download

South Russell

Download

Russell

Download

Parkman

Download

Newbury

Download

Munson

Download

Montville

Download

Middlefield Township

Download

Middlefield Village

Download

Huntsburg

Download

Hambden

Download

Claridon

Download

Chester

Download

Chardon Township

Download

Chardon City

Download

Burton

Download

Bainbridge

Download

Auburn

Download

Willowick

Download

Willoughby Hills

Download

Willoughby

Download

Wickliffe

Download

Waite Hill

Download

Timberlake

Download

Painesville City

Download

Mentor-on-the-Lake

Download

Mentor

Download

Madison

Download

Lakeline

Download

Kirtland Hills

Download

Kirtland

Download

Eastlake

Download

Concord

Download

Highland Heights 2018

Download

Garfield Heights 2018

Download

Fairview Park 2018

Download

Euclid 2018

Download

East Cleveland 2018

Download

Cleveland 2018

Download

Cleveland Heights 2018

Download

Cities in Cuyahoga County Combined 2018

Download

Brooklyn 2018

Download

Brook Park 2018

Download

Broadview Heights 2018

Download

Brecksville 2018

Download

Berea 2018

Download

Bedford 2018

Download

Bedford Heights 2018

Download

Beachwood 2018

Download

Bay Village 2018

Download

Westlake 2018

Download

Warrensville Heights 2018

Download

University Heights 2018

Download

Strongsville 2018

Download

South Euclid 2018

Download

Solon 2018

Download

Shaker Heights 2018

Download

Seven Hills 2018

Download

Rocky River 2018

Download

Richmond Heights 2018

Download

Pepper Pike 2018

Download

Parma 2018

Download

Parma Heights 2018

Download

Olmsted Falls 2018

Download

North Royalton 2018

Download

North Olmsted 2018

Download

Middleburg Heights 2018

Download

Mayfield Heights 2018

Download

Maple Heights 2018

Download

Lyndhurst 2018

Download

Lakewood 2018

Download

Independence 2018

Download

Woodmere

Download

Westlake

Download

Warrensville Heights

Download

Walton Hills

Download

Valley View

Download

University Heights

Download

Strongsville

Download

South Euclid

Download

Shaker Heights

Download

Seven Hills

Download

Rocky River

Download

Richmond Heights

Download

Pepper Pike

Download

Parma Heights

Download

Orange

Download

Olmsted Falls

Download

Olmsted

Download
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Download report

Subscribe to our newsletter

5 Things you need to know arrives on Mondays with the latest articles, events, and advocacy developments in Ohio

Explore the fact sheets

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Suspendisse varius enim in eros elementum tristique.

No Related Fact Sheets

Explore Topics

Browse articles, research, and testimony.

Poverty & Safety Net
Article

From lead-safe to lead abatement: tackling lead-based properties in Cleveland

Natasha Takyi-Micah
December 9, 2024
Poverty & Safety Net
Article

5 Things to know about Census Hardship Data for Ohio

John R. Corlett
December 9, 2024
Poverty & Safety Net
Article

Data to go...literally on wheels!

Emily Muttillo
December 9, 2024
Poverty & Safety Net
Article

Barriers and Access to Resources in the Union-Miles Neighborhood 

Tamikka James-Haygood
November 24, 2024
Poverty & Safety Net
Article

ARPA 3 Years later: Lessons learned in Ohio

Dylan Armstrong
November 18, 2024
Poverty & Safety Net
Article

New Human Services Chamber launching in December

Emily Campbell
November 17, 2024