New and existing home and community-based services initiatives proposed by the Ohio Department of Aging during the state budget season

On February 23, 2023, Director Ursel J. McElroy of the Ohio Department of Aging (ODA) testified her department’s state budget requests. Coincidentally, the Ohio Legislative Service Commission released ODA’s redbook to the public on the same day. During her testimony, Director McElroy stated that Ohio is now the sixth state with the largest population of age 65 and over. As the older adult population is growing, ODA is requesting $171.1 million for fiscal year (FY) 2024 and $108.4 million for FY2025. Some of the funds will go to ombudsmen services and Federal Aging Grants. However, Director McElroy and her colleague, Dr. John Weigand, medical director for the Ohio Departments of Aging and Health, spent much of their time explaining how the state government should appropriate some funds to home and community-based services (HCBS) to ensure older adults will healthily age in place. The following initiatives are HCBS programs that Director McElroy and Dr. Weigand explained during her testimony or is described in the redbook.

ODA is requesting $171.1 million for fiscal year (FY) 2024 and $108.4 million for FY2025.

Program for All-Inclusive Care for the Elderly (PACE)

One of the major HCBS programs that ODA is operating is the Program for All-Inclusive Care for the Elderly (PACE), a managed care program. PACE offers older adults medical care, health care and ancillary services. Deemed as a successful program, PACE served an average 607 consumers each month in FY2022. As mentioned in our previous blog about state budget highlights, the budget can expand PACE from one county to seven counties. The counties that will possibly obtain a PACE center are Franklin, Hamilton, Lorain, Lucas, Montgomery and Summit counties. If approved by the Ohio Legislature, ODA must divide funding for administrative expenses between PACE, PASSPORT and Assisted Living Programs from both state and federal funding.

FundALI NameFY2023FY2024FY2025
GRFLong Term Care Budget- State$5,323,163$5,66,859$4,762,174
3C40 Federal Fund GroupLong Term Care Budget- Federal$7,467,610$5,670,000$5,000,000


PASSPORT is a popular HCBS Medicaid waiver program. This program provides various services such as home-delivered meals, social work counseling, medical transportation, nutritional counseling, medical equipment and supplies, and other activities in homes and communities. In FY2022, PASSPORT served an average of 18,802 individuals each month. PASSPORT receives funding from both state and federal governments. Funding for PASSPORT can be referred to the previous table.

In FY2022, about 11,930 persons received many in-home services.

Senior Community Services

The Senior Community Services line item will also help older adults live independently. The funds are for older adults, who are in high need, low income and/or cognitively impaired and at least 60 years old. In FY2022, about 11,930 persons received many in-home services. Some services include home maintenance and chores, care coordination service, disease prevention and health promotion and home-delivered and congregate meals. The following is the amount of funding requested for the upcoming fiscal years.

FundALI NameFY2023FY2024FY2025
GRFSenior Community Services$9,763,779$12,832,194$12,832,323

Healthy Aging Grants

A large portion of Director McElroy’s testimony focused on Healthy Aging Grants. These one-time grants are for local partners to help enhance the quality of life for older adults so they can stay in their homes, remain connected with their communities, delay enrollment into Medicaid, keep their personal assets and promote healthy and active lifestyles. Dr. Weigand described the grants promote factors that will be the best way to maintain all dimensions of wellness—physical, emotional, intellectual, spiritual, and financial wellness—for older adults. According to Director McElroy, Healthy Aging Grants are needed because:

  • Federal support has not kept up. The Older Americans Act (OAA) did not increase with inflation or with the growing older adult population. Moreover, federal support is usually for low-income families who experience long waiting lists.
  • Families are often called upon to provide needed care and support when services are not accessible or financially available. AARP stated that in 2017, 41 million family caregivers completed 34 billion hours of care; that equates to $470 billion of unpaid contribution across the country.
  • State and locally funded initiatives have become more important than ever to fill a gap in long-term services and supports for older adults. There are local initiatives that fund aging services at different levels of the state. Some initiatives are funded through property taxes to raise monies for levies or through private foundations.

Some in-home services that will be provided from Healthy Aging Grants are chronic disease management, nutrition services, respite and health promotion.

FundALI NameFY2023FY2024FY2025
5CV3Healthy Aging Grants to Local Partners$0$40,000,000$0

Many organizations testified as well, agreeing the urgent need for Healthy Aging Grants. Organizations include Benjamin Rose Institute on Aging, McGregor- Pace and LeadingAge Ohio.

Increasing Wages for HCBS employees

Besides programs, Director McElroy expresses the need for the Ohio Legislature to increase wages for frontline workers. ODA, the Ohio Department of Developmental Disabilities (DODD) and the Ohio Department of Health (ODM) proposed that the hourly rates should be increased to $25 per hour. According to LeadingAge Ohio’s testimony the workforce has been flat-funded for a long period of time. Due to low wages, many organizations have experienced high staff turnover.

The Center for Community Solutions will continue to monitor the outcome of the ODA budget requests throughout the state budget season.