May 3, 2019
Dear Chairman Oelslager,
Thank you for accepting the following as written testimony.
My name is Tara Britton and I am the Director of Public Policy and Advocacy at The Center for Community Solutions, a nonprofit, nonpartisan think tank that aims to improve health, social and economic conditions through research, policy analysis and communication. I am here today to offer testimony on proposals in the budget regarding adult protective services (APS), and maternal mortality, and to recommend the inclusion of proposals developed by the multi-system youth joint study committee.
In the United States, women are dying from complications related to pregnancy and childbirth at a higher rate than other industrialized nations, and the rate is increasing. Approximately 700 women die each year in the U.S., and thousands more experience complications, often viewed as “near misses” of a maternal death. Non-Hispanic black women are dying at a rate 3 to 4 times that of non-Hispanic white women. The most recent data available for Ohio shows that between 2008 and 2014 there were 408 pregnancy-associated deaths. This data, from 2014, is also the most recent data available on maternal deaths in Ohio. Over the last 18 months Community Solutions has worked to improve awareness and knowledge of maternal mortality in Ohio. Language was included in the as-introduced budget that intended to move us toward strengthening data and reporting on this issue. This language was removed in the substitute bill and we recommend restating it through the omnibus amendment, with some changes that would codify Ohio’s Pregnancy Associated Mortality Review (PAMR) committee and require more frequent reporting of the committee’s overall findings.
There is time sensitivity to including this language in the budget bill. An open federal funding opportunity, made available through the Preventing Maternal Deaths Act, is eligible only to states with maternal mortality review committees. Ohio is eligible to apply for federal funds to support the state’s PAMR, situated at the Ohio Department of Health and the proposed legislative language includes elements that are required to be in place in states that apply for funding.
Currently, this committee is not in state statute and does not have any parameters by which it operates specifically included in state law. We recommend formally establishing this committee (the as-introduced budget language makes the creation permissive) and giving it the tools it needs to pull in timely and high-quality data on maternal deaths. This is key to understanding our Ohio maternal mortality rate. We also recommend that the language requiring reporting frequency to be changed from triennial reports on maternal deaths in Ohio to either annual or biennial reports.
Having timely and complete data on this issue is an important first step toward implementing measures to improve maternal health and wellbeing and will ensure Ohio is able to submit a strong application for federal funding. Community Solutions is committed to working alongside the General Assembly and the administration to carry this issue forward now, and beyond this budget, and to work to support implementation of on-the-ground changes to prevent maternal deaths.
Adult Protective Services
Community Solutions has a long history of advocating for a strong adult protective services system in Ohio. In recent research we covered the rollout of statewide APS changes, enacted legislation that increases the categories of mandatory reporters of suspected APS cases, and senior levies in place across Ohio. Ohio now has a common statewide data system for adult protective services and indications from 2018 data show that more calls are coming into counties. We are supportive of making aggregate-level data from this system publicly available on a routine basis to better inform our discussions on the topic.
The substitute budget bill includes an increase to the APS line item (line item 600534), a strong move in the right direction to protect senior Ohioans. This increase brings the line item from $2.74 million each year of the biennium to $4.23 million each year of the biennium. At current budget levels, each county receives around $31,000 for APS. The substitute bill increase would provide about $48,000 per county in Ohio. Community Solutions continues to support an increase to at least $5.72 million each year, which would allow an allocation of $65,000 per Ohio county, to support one full-time, designated APS caseworker. With a system long overdue for increased support, we want to continue to discuss an overall increase in the line item to $10 million per year, which would provide support for a full-time worker and wraparound supports to help older adults remain safe in their communities.
Community Solutions supports inclusion of the recommendations of the Joint Legislative Committee on Multi-System Youth, including the need for a dedicated, flexible funding source to address the tragic circumstance of custody relinquishment.
Thank you for the opportunity to weigh in on Sub HB 166. The Center for Community Solutions is committed to working with the General Assembly as members deliberate the budget. Please reach out to us with any questions.