Friday, May 01, 2009


State Budget Update

As the state budget officially moved from the House to the Senate this week, human service advocates were partially successful at shoring up funding needed for many critical services.

We are pleased that the House made a number of needed changes, and we hope that the Senate will continue working toward full restoration of funding for human service programs. Some of the key changes included:

  • Adding $50 million per year for child and adult protective services; These programs are still $12 million short of full restoration;Boosting funding for the Second Harvest Food Banks to $12 million per year, leaving the program $5 million per year below the requested level;
  • Adding $1 million per year for behavioral health services for children under the age of 7;
  • Increasing the Medicaid rate ceiling for behavioral health providers by ½ of 1% in each year of the biennium; and
  • Increasing home and community based options for long term care by creating a “superwaiver” in the Department of Aging and ending limitations such as the number of slots in the assisted living program and regional limits for the self-directed Choices waiver.

We are disappointed that the House chose not to restore full funding to county job and family service departments even though more Ohioans are requesting assistance. The House also removed some executive proposals and added other provisions that will increase costs and make it more difficult to keep the budget in balance. In the long run these choices will add to the already substantial FY 2012-2013 structural deficit. Several of these items include:

  • Elimination of a provision that limited reimbursements to hospitals from Medicaid managed care plans to rates paid for Medicaid fee for service. The removal of this proposal will increase Medicaid managed care costs by $35.1 million in FY 2010 and $110.5 million in FY 2011 and by even more in the next biennium;
  • Increasing state support for nursing facilities – an industry where the supply of beds exceeds demand; and
  • Elimination of proposed sentencing reforms that would substantially reduce the number of low-level, non-violent offenders in prisons.
We remain concerned about state revenues. April’s monthly report will be released soon, and there is no reason to expect that state revenues will look much better than they did in March. The continued erosion of FY 2009 tax receipts will lower the base for the updated estimate currently being prepared for next month’s conference committee.

Let’s hope that the forecast specialists at the Department of Taxation and Legislative Service Commission are adding foil to the antennae on their crystal balls to improve the signal and rubbing lucky pennies as they update their estimates.

Advocates need to stay alert, engaged, and informed. The ride is just getting started.

The money and support sought by the owners and operators of nursing homes was and is vital to our daily operations. The states belief that we should cut nursing home spending and invest in at home programs such as Passport and home nursing companies to eliminate or lessen the need for long term care is absurd. It puts elderly patients at a higher risk and fails to inform that programs such as Passport only provides 4 hours a day and no weekend services to the elderly currently utilizing its services. Home nursing care has shown that it can provide care for the "typical" elderly person overlooking the patient that needs extensive care and ancillary services that they are unable to do themselves. Meals on Wheels is only a 1 meal a day program if you qualify (some still have to pay out of pocket for this service). What are they to do for the rest of the day? Who will provide housekeeping, meal preparation and medical needs? Families? I see personally fewer families participating in their parents care daily. I see more and more citizens having to work till later in life due to the recession and not being able to provide support to their parents due to schedule conflicts and such. Also, you failed to mention that home care is where someone is scheduled to come into your home, what happens if no one shows up for their shift? What if the at home provider fails to schedule someone? Should we then ignore the loopholes in the theory that more elderly patients should be cared for at home and ignore the risks of falls, malnurishment, neglect and over all poor conditions. Nursing homes are vital and have a very important role in todays society. Lots of misleading information is out there that citizens still believe that we are profiting greatly from the patients that reside in our homes. When the reality is we are just managing to survive and give the adequate care needed with increased budget cuts over the last 5 years. A general patient who recieves Medicaid (the majority of patient payee) pays generally $175.00 a day. This must cover nursing, nourishment 3 meals a day, laundry, housekeeping, activities and many other services. Furthermore, Nursing Homes are not the institutions that get portrayed on televisions we are highly functioning advanced settings then years past. Feel free to come to the Nursing Home that I work at and do a "secret shopper" session. I feel that you will change your thoughts and maybe report honestly what the States dollars are paying for. I think if investigated responsibily you would find out just how much revenue we are not making to ensure a "pleasant, caring, loving environment" for our patients. I think it will also further expand your knowledge to learn about some of the tragic stories and patients we have seen come from a home setting where they were being "cared" for.
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