How Senate-Passed Version of State Budget Alters House HOPES Plan to Address the Opioid Crisis

When the Ohio House of Representatives passed its version of the state budget (H.B. 49) in early May, the bill featured a $170.6 million investment toward combatting Ohio’s opioid crisis through a plan titled Ohio HOPES (Heroin, Opioids, Prevention, Education, and Safety). The House’s HOPES plan targeted funding toward four broad areas: $9 million for workforce development, $12.2 million for prevention, $19.4 million for mental health, and $130 million for treatment and child services. In a previous blog post, The Center for Community Solutions broke down the allocations to specific programs within each of the four HOPES focus areas.

Having passed the Ohio Senate on Wednesday, June 21, H.B. 49 now includes nearly $180 million, depending on how it is counted, in funding for combatting substance abuse. However, a close examination of the details of the Senate-passed funding package shows significant changes were made to the House’s HOPES plan to reach this higher total. Among these changes were the funding reductions and elimination of numerous House proposals, greater utilization of federal funds, and the shifting of funding from the General Revenue Fund (GRF) to dedicated purpose funds (DPFs), drawing from the Local Government Fund (LGF) to cover some of the costs. The Senate also added several new proposals of its own.

The table below provides a comprehensive view of the changes in funding made in the Senate to the original HOPES plan, including new funding added by the Senate relating to opioids and behavioral health.

Source: Legislative Service Commission’s “Budget in Detail” and “Comparison Document.”

Hopes Proposals Preserved by the Senate
The Senate maintained funding in some form for the following HOPES proposals made by the House:

  • $5 million in FY 2019 for the Department of Higher Education to award need-based financial aid under the Ohio College Opportunity Grant program for students to earn certificates or industry credentials for in-demand jobs (shifted from GRF to a dedicated purpose fund);
  • $4 million in FY 2018 for forensic laboratory work related to opioid cases;
  • $30 million over the biennium in federal Temporary Assistance for Needy Families (TANF) funding earmarked for kinship caregivers caring for children who could not safely stay with their parents (an increase from the $20 million in earmarks made by the House);
  • $30 million over the biennium for child welfare services;
  • $6 million over the biennium to expand medication assisted treatment (MAT) to 18 additional counties;
  • Up to $20 million in capital funds through the Mental Health Facilities Improvement fund to expand treatment facilities.

HOPES Proposals Eliminated or Reduced by the Senate
The Senate eliminated a total of $73.6 million in HOPES programs proposed in the House plan, most of which was to be funded with GRF dollars. The HOPES proposals eliminated in the Senate’s budget include:

  • $4 million over the biennium in state matching funds for the federal Supplemental Nutrition Assistance Program (SNAP) Employment and Training Programs (SNAP E&T). This funding was to be used to assist SNAP recipients become more competitive in the workforce by obtaining short-term non-degree certificates. This funding was eliminated by the Senate;
  • $2.2 million in FY 2018 for each county to create an “Opioid Addiction Hub” that would be responsible for coordinating and organizing each county’s efforts to combat the opioid epidemic;
  • $10 million over the biennium from a new Drug Addiction Prevention line item that was meant to fund a website with resources regarding opioid addiction treatment services, along with a 24-hour hotline and other materials;
  • $2 million over the biennium for the Residential State Supplement program, which would have supported individuals with mental illnesses residing in supportive living facilities, as well as the facilities themselves;
  • $1.4 million over the biennium for a pilot program that would have provided mental health services and recovery supports to offenders in the criminal justice system who are participating in certified mental health court programs in Cuyahoga, Franklin, and Warren Counties;
  • $12 million over the biennium that would have been allocated from the Housing Trust Fund (if the fund exceeded $60 million each year) to advance housing opportunities for individuals exiting residential opiate treatment;
  • A net $42 million over the biennium in earmarks from the Continuum of Care Services line item, including:
    • $24 million which was to be distributed across county ADAMH boards;
    • $12 million for ADAMH boards to establish and administer a mental health crisis stabilization center in each of the six state psychiatric hospital regions;
    • A net $6 million for ADAMH boards to establish and administer an acute substance use disorder stabilization center in each of the six state psychiatric hospital regions ($18 million in GRF funds were eliminated, but the Senate earmarked $12 million in a dedicated purpose fund for this purpose).

Additional Funds Added in the Senate
To offset the cuts made in GRF appropriations, the Senate invested large sums toward fighting the opioid crisis by using non-GRF funds and federal funds, including excess TANF dollars. Notably, the Senate has proposed to redirect over $35 million that would have otherwise been paid directly to municipal governments through the Local Government Fund (LGF) to a new “Targeting Addiction Assistance Fund.” Over the biennium, this fund will appropriate:

  • $2 million to reimburse county coroners in counties where coroners have performed toxicology screenings on victims of drug overdoses;
  • $20 million for Probation Improvement and Incentive grants, which would help felony offenders receive drug treatment;
  • $12 million for substance use disorder stabilization centers, or detox facilities, in each of the state’s six psychiatric hospital regions (described above);
  • $1 million for a pilot program to treat infants with neonatal abstinence syndrome in a nonhospital, community facility.

The shift from GRF dollars to LGF dollars is part of a broader effort by the Senate to close a $1 billion revenue shortfall in the budget while still investing heavily in combating the state’s addiction crisis. However, by redirecting this investment from the LGF, some say the Senate’s decision may negatively impact the ability of municipalities to respond to the opioid epidemic at the local level, especially in the context of lost dollars from the Managed Care Tax.

Other new investments proposed by the Senate over the biennium include:

  • $10 million in TANF funds to provide services for children with complex needs whose parents are at risk of relinquishing custody;
  • $11 million out of the $26 million awarded to Ohio through the federal 21st Century Cures Act, to be used pursuant to the State Targeted Response to the Opioid Crisis Grant provision in the act;
  • $5 million in GRF funding for the Attorney General to establish the Drug Abuse Response Team (DART) Grant Program for the purpose of replicating or expanding successful programs, such as Lucas County’s DART program;
  • $5 million in GRF funding to develop a program to help teachers identify students who are struggling with addiction;
  • $2 million to provide substance abuse treatment services to individuals incarcerated in state institutions through a new dedicated purpose fund using funds transferred from the Indigent Drivers Alcohol Treatment Fund;
  • $4.2 million (mostly federal dollars) for upgrades to the Ohio Automated Rx Reporting System (OARRS) to continue tracking prescriptions statewide and combat prescription abuse;
  • $8 million to reimburse county jails for psychotropic drugs dispensed to inmates;
  • $2 million to support drug task forces in combatting trafficking.

While the total dollar figure on the Senate’s funding package for addressing the opioid crisis exceeds that of the House’s HOPES plan, the contents of the two plans have stark differences. In an effort to close the state’s revenue gap, the Senate has made significant cuts in the HOPES target areas of workforce development and prevention, and transformed the scope of programs funded in the treatment and mental health categories by leveraging mostly federal and LGF dollars rather than committing more general revenue or utilizing the state’s rainy day fund to address the growing addiction crisis. Legislators from both the House and Senate are now working out the differences between the two chambers’ budget plans in Conference Committee, with a final budget bill to be ready for the Governor’s signature by June 30.