Ohio



The Speaker’s Task Force on Education and Poverty: The Impact of Dropout Recovery Schools


By Brie Lusheck
Public Policy Associate
October 19, 2017

The Speaker’s Task Force on Education and Poverty (STFEP) met on October 12 to discuss the impact dropout recovery schools have on students in poverty. In addition to the testimony from dropout recovery schools, the committee heard testimony from former State Representative Jim Buchy, who presented on the benefits of agricultural education.

By incorporating agri-science and programming, the George Washington Carver STEM School in Cleveland has seen significant achievements made in academic performance. In the last graduating class, for example, the top six graduates were Future Farmers of America (FFA) members.  Other anecdotal successes noted in Representative Buchy’s testimony include an increased eagerness to learn, more involvement by students in after-school activities such as 4-H, exposing children in “food deserts” to new healthy options, and a greater interest by students considering careers in agri-science (Ohio’s number one industry).





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The Speaker’s Task Force on Education and Poverty: The State’s Superintendent Weighs In
By Brie Lusheck
Public Policy Associate
October 3, 2017

On Thursday, September 28, 2017, the Speaker’s Task Force on Education and Poverty heard from the State Superintendent of Public Instruction, Paolo DeMaria.

From the start, Superintendent DeMaria challenged the committee by saying there is “no more important challenge that we must address.” Having set the tone for the remainder of his presentation, the superintendent dug into district, building, and student data from across the state, highlighting the newly released Ohio School Report Card data that were made available September 14.


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Census Update: Ohio’s Uninsured Rates Continue to Decline

By Kate Warren
Research Associate
September 14, 2017 

Looking at Census insurance data is a great example of how policy can truly move the needle on issues facing our communities. The Affordable Care Act and Medicaid Expansion have allowed hundreds of thousands of Ohioans to access the healthcare they need, and the number of people impacted by this policy grows each year.

In the state of Ohio, as in the nation, the number of uninsured people dropped once again in 2016. Between 2015 and 2016, an additional 102,548 Ohioans gained health insurance coverage, a statistically significant change. The number of uninsured people in the state dropped 14 percent. As of 2016, only 5.6 percent of Ohioans lacked health insurance coverage, compared to 6.5 percent in 2016.

Source: U.S. Census Bureau, American Community Survey 1-Year Estimates







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The Speaker’s Task Force on Education and Poverty
By Brie Lusheck
Public Policy Associate
August 25, 2017

The Speaker’s Task Force on Education and Poverty (STFEP) was announced in March in addition to four other committees on topics ranging from the opiate crisis to energy policy. The common goal of the various tasks forces is to better understand the subject each committee is charged with and to make policy recommendations to the House as its session resumes in the 132nd General Assembly.   

The STFEP will focus on an improved understanding of the achievement gap as it relates to education and poverty by focusing on state data and proven outcomes that work to assist in minimizing the gap. This goal will be accomplished by exploring both practical and proven approaches that have worked around the country and have shown significant educational outcomes.



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Ohio General Assembly Considering Implementing 
Multi-System Youth Recommendations 

Gayle Channing Tenenbaum, MSW
Youth and Family Advocate, Medicaid Consultant for Children, The Center for Community Solutions, Policy Fellow, The Voinovich School, Ohio University
May 23, 2017

MULTI-SYSTEM YOUTH (MSY) refers to a child or youth with significant mental health, addiction and/or developmental delays who is involved or at risk of being involved with child protection and/or juvenile justice due to not being able to access the right services or supports to remain stable and in their own home.  Multi-system youth have complex needs that cannot be met by a single system. In some cases, two or more systems are used to fill gaps in services offered single agencies or when the cost of providing services becomes prohibitive for a single agency.



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House-Passed Version of State Budget Includes $170 Million to Address Opiate Crisis and Behavioral Health Needs in the State
Tara Britton
Director of Public Policy
May 17, 2017

The Ohio House of Representatives passed its version of the state budget in early May and, as had been discussed for weeks, included a significant investment in behavioral health-related services to address the growing needs around the state’s opiate crisis and individuals living with mental illness. The funding totals $170.6 million over the biennium, spread across multiple agencies and initiatives. The funding is referred to as Ohio HOPES (Heroin, Opioids, Prevention, Education, Safety). The House shared that the funding is spread across four main areas: workforce, prevention, mental health, and treatment. More details around what is included in each of these categories is the focus of this blog.

Workforce
In order to draw down federal dollars for Supplemental Nutrition Assistance Program (SNAP) employment and training programs (SNAP E&T), the House budget commits $2 million per year of state resources through the Job and Family Services (JFS) budget. SNAP E&T programs help SNAP recipients gain skills, training, and job experience. The House budget specifically directs the money to be used for programs that produce short-term non-degree certificates. In addition, the budget commits $5 million in 2019 to the Department of Higher Education. This money will also be used for short-term certificate programs associated with in-demand jobs. JFS and the Department of Higher Education are tasked with establishing a committee to develop a plan to draw down additional federal resources to support similar initiatives in the future.






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State Budget Update: Medicaid Changes in House Substitute Bill
By Loren Anthes
Public Policy Fellow
April 26, 2017 

With the budget in full swing, the Ohio House has offered its first amendments to the governor’s proposed budget. This action is the first in a multi-step process that will soon include another round of consolidated amendments (Omnibus) before it is voted on by the full House and sent to the Senate. Even though we are early in the process, there have been a number of dramatic changes proposed. To assist policy analysts and advocates with learning more about each of these initiatives, the Legislative Service Commission’s Comparison Document (“Comp Doc”) code will be cited to make the information on the changes easier to find.


Deviating from the Administration
CPC Eliminated – MCDCD60
Since the beginning of the Kasich Administration, the Office of Health Transformation (OHT) has focused on value-based payment as a key element of its reform efforts. These policies have included two main activities in the construction of episodic-based payments and the proliferation of patient-centered medical homes (PCMH) through the Comprehensive Primary Care Initiative (CPC). With CPC, OHT is working to enroll primary care practices into a system built on the clinical coordination of care, with the transparency of cost and quality being a mechanism through which enhanced reimbursement would be attached and incented. Now, the Medicaid director, and by proxy OHT, would no longer be permitted to implement this system, but would also lose authority in establishing PCMH services for the developmentally disabled.








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Earned Income Tax Credit Lifts Families Out of Poverty
By Joseph Ahern
Research Fellow
April 12, 2017

Enacted in 1975, the federal Earned Income Tax Credit (EITC) has encouraged and rewarded work over welfare by supplementing working-poor families’ income through the tax system. The amount of the credit is graduated according to family income and composition. For example, a married couple filing jointly with two children and an earned income of $15,000 in 2016 would receive a tax credit of $5,572. Working-poor childless adults are also eligible for an EITC of a maximum of $506.


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Governor’s DODD Budget Includes Investments in Waiver Spending and Rate Increases
By Rose Frech 
Guest Author
March 6, 2017

Governor Kasich’s recently released executive budget includes several noteworthy adjustments to funding within the state’s developmental disabilities system. Touted as an extension of the state’s “historic” investments of the previous budget cycle, the proposal includes increased funding on several important initiatives.[i] However, the budget includes some notable cuts as well. Overall, the budget proposes a small increase in overall spending; a 5 percent increase for FY 2018 and an additional 4 percent increase into FY 2019.[ii] The combination of cuts and investments is likely to draw a mixture of support and criticism. While some will likely laud the governor’s commitment to sustained funding in an otherwise tight budget cycle, others may find fault in what they perceive as an ongoing underinvestment in needed community-based services and supports.

The budget proposal includes $122 million in new spending, which includes both state and federal contributions, primarily focused on efforts to expand community living options for individuals with developmental disabilities. This comes in the form of funding for approximately 1,300 new home-and-community based service (HCBS) waivers, which allow individuals to waive their right to institutional care in favor of receiving services in a home or community-based setting. These waivers are aimed at both continuing to assist individuals living in institutions who may want to leave, and addressing the state’s lengthy waiting list to access waiver services. State funding for waivers created during the past budget cycle will remain, however due to excessive demand, thousands will continue to wait.



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The Gift of the MAGI?
Sweating the Details of Obamacare Repeal
By Loren Anthes
Fellow, Center for Medicaid Policy
December 16, 2016

Medicaid is big and complicated. As I have written about before, the intertangled state and federal monies, processes, and policies that comprise the Medicaid program vary greatly from state to state and, as the saying goes, if you’ve seen one state Medicaid program, you’ve seen one state Medicaid program. With that said, Medicaid occupies a greater share of state and federal budgets, and it is a target of reform on both levels of government. Indeed, with an emboldened Congress and a new administration, changes are coming, and those changes create opportunities and challenges for policymakers. Given this complex relationship, federal policy cannot remain agnostic to the variation of state design.



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Prevention in Ohio:
Examining Ohio’s Efforts to Curb the State’s Drug Epidemic through Prevention Education
By Brie Lusheck, Public Policy Associate

and
Adam White, Graduate Assistant
October 20, 2016

In August, the Ohio Attorney General’s Office announced[1] the formation of a study committee to examine drug use prevention education in Ohio schools.




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Annual Checkup: Digging into Ohio Medicaid’s SFY16 Report
By Loren Anthes
Fellow, Center for Medicaid Policy
August 31, 2016
 

This month, the Ohio Department of Medicaid (ODM) submitted its Annual Report to the governor. The document, which has been released each year since State Fiscal Year (SFY) 2014, provides an overview of the initiatives (and the related messaging) behind some of the work of ODM. As we wait for the final budget from Governor Kasich’s administration, and as we contemplate what that may mean for the Medicaid program, I thought it would be good to dig a bit deeper into this report to garner some insights.


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Preparing for the 2018-2019 State Operating Budget
The Ohio Office of Budget Management Releases Guidance
By Brie Lusheck
Public Policy Associate
August 16, 2016

 

On July 20, 2016, the Ohio Office of Budget and Management (OBM) released guidance for the Fiscal Years 2018-2019 Operating Budget.



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A COLLABORATIVE REPORT ON THE UNINSURED IN NORTHEAST OHIO 

By

Loren Anthes, Fellow, Center for Medicaid Policy | The Center for Community Solutions
Tony Gutowski, Manager | Center for Health Affairs

Marketplace Take-Up Rates in Northeast Ohio:
Coverage Growth and Coverage Gaps






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Healthy Ohio Waiver Released
Loren Anthes, Fellow, Center for Medicaid Policy
July 8, 2016

On June 30, the Ohio Department of Medicaid (ODM) submitted its application for the legislatively required 1115 Demonstration Waiver known as “Healthy Ohio” to the U.S. Department of Health and Human Services (HHS). Throughout the state development process, we have written and posted about Healthy Ohio in order to address our concerns and questions regarding the potentially negative effects of the waiver on the Medicaid program. Now, as the state has its application reviewed by the federal government, we want to revisit the process associated with applying and discuss the potential next steps.

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County Profiles: What’s New, and What Can We Learn?
Kate Warren, Policy & Planning Associate 
July 8, 2016

This week, we’re pleased to introduce updated county profile factsheets. Our hope is that you’ll find them to be a useful resource for better understanding the needs in your community and advocating for programs and policies that can improve health and social conditions around the state. The factsheets focus on data related to health and human services around the state, and are available for each of Ohio’s 88 counties here.

What’s New This Year?



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JMOC: Redesign Update and Panel Discussion
Loren Anthes, Fellow, Center for Medicaid Policy
June 3, 2016

The Joint Medicaid Oversight Committee (JMOC) had a lengthy discussion on May 26th regarding alcohol and drug addiction. During the meeting, which featured a panel of experts in the field, there were two main points of conversation. First, there was a “status update” by Dr. Mark Hurst, Medical Director of the Ohio Department of Mental Health & Addiction Services (ODMHAS), on the Behavioral Health Medicaid Redesign. Second, there were presentations from a number of guests representing providers and the county ADAMHS Boards.


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An Update on the Extension of Medicaid
Loren Anthes, Fellow, Center for Medicaid Policy
May 18, 2016 

Ohio’s Medicaid extension has received a lot of scrutiny from the media, policymakers, and policy experts since its implementation in 2014. This scrutiny has only increased in the past few months during Governor Kasich’s Presidential run and as the Ohio Department of Medicaid (ODM) finalizes its statutorily required 1115 demonstration waiver, Healthy Ohio. While many have been extolling the value of the program, including the Governor, some have claimed that the costs associated with the extension are exorbitant, resulting in overspending in the Medicaid program. This post, then, tries to give a sense of where we are today by examining the performance of the extension geographically and in terms of enrollment and expenditures.

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Update on Disability Determination Redesign (DDR) 
Tara Britton, Fellow
May 13, 2016

As the state prepares to transition to a unified disability determination system, thus ending the Medicaid spend-down program, additional information about who will be affected by the transition, and the impact of these changes, has been released. The Governor’s Office of Health Transformation (OHT) published an overview of the changes. The impact of the state’s transition from a 209(b) state to a 1634 state (this means the state is implementing Section 1634 of the Social Security Act, rather than using Section 209(b)) will vary depending on an individual’s current eligibility status and income. Under the new eligibility criteria, those who meet disability under Supplemental Security Income (SSI) will also qualify for Medicaid. Medicaid income and asset limits will increase to match current SSI eligibility criteria at 75 percent of the Federal Poverty Level (FPL) or $743 of income and a $2,000 asset limit. The Center for Community Solutions has been following the implementation of these changes as part of a group of interested stakeholders working closely together, and with the Ohio Department of Medicaid (ODM) to help people who are impacted by these changes have accurate, timely, and clear information.

ODM has stated that all current Medicaid aged, blind, and disabled (ABD) enrollees will be automatically moved over to the new system and retain full Medicaid benefits, without spend-down. This automatic transition also applies to anyone who spent-down to Medicaid eligibility levels between July 1, 2015, and June 30, 2016, even if they do not fall into one of the previously mentioned ABD categories. This transition to the new system is planned for July, 2016. ODM is awaiting a response from the federal Centers for Medicare and Medicaid Services (CMS) to allow a waiver of ABD Medicaid renewals for July 1 – December 31, 2016. This will allow time to adjust to the new disability determination system. If approved, annual renewals will commence January 1, 2017, and the new eligibility criteria will apply moving forward. The new eligibility criteria will apply to anyone seeking new Medicaid coverage as of July 1, 2016.



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State Hard at Work on Integrated HIV Prevention and Care Plan

Tara Britton, Fellow
May 2, 2016

As mandated by the Health Resources and Services Administration, HIV/AIDS Bureau (HRSA/HAB) and the Centers for Disease Control, Division of HIV/AIDS Prevention (CDC/DHAP), the State of Ohio has begun working on a five-year plan on HIV prevention and care needs, existing resources, barriers and gaps within jurisdictions, and how it plans to address them for 2017-2021. The plan is due to the federal government by the end of September, 2016, so there will be a full schedule to achieve this goal in the coming months. Traditionally, HIV care and HIV prevention produced separate plans and submitted them to their respective federal agencies. This is a great opportunity to think about integrated care and prevention and set goals for the state.

Presented with this opportunity to develop an integrated plan, the Integrated Plan Steering Committee (The Center for Community Solutions is a member) is looking at the big picture and assessing the barriers, gaps, and needs of all people living with HIV/AIDS in Ohio. In other words, the committee is looking beyond just people served by the Ohio Department of Health care (Ryan White Part B HIV/AIDS Program) and prevention programs to develop a plan that will improve services and target investments that provide the greatest impact. The committee has representation from the Governor’s Office of Health Transformation, and the Ohio departments of Health, Medicaid, Aging, and Mental Health and Addiction Services, the Joint Medicaid Oversight Committee (JMOC), the Cleveland and Columbus Ryan White Part A programs, AIDS service organizations, Medicaid managed care organizations, and many other stakeholders in order to take this broader look.     




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