June 3, 2021
Dear Chairman Matt Dolan, Vice Chairwoman Theresa Gavarone and Ranking Member Vernon Sykes,
Thank you for your work ushering the budget through these last few weeks and taking our feedback into account. The Center for Community Solutions is a nonprofit, nonpartisan think tank that aims to improve health, social and economic conditions through research, policy analysis and communication.
The inclusion of Medicaid coverage for women who earn up to 200 percent of the federal poverty level in the postpartum period for 12 full months is a significant step toward improving maternal health in the State of Ohio and we commend the Senate for including this policy and its associated funding. Coverage is critical to maintain access to services that can decrease the incidence of maternal deaths and complications.
We continue to support ongoing work across the legislative and executive branches that would provide Medicaid reimbursement for doula services. We are supportive of achieving this through the budget process, as this would kickstart the development of rules and a payment mechanism through Medicaid. Increasing access to doula services has been proven to improve maternal health outcomes, especially for Black women.
We are grateful that Substitute House Bill 110 maintains an increase in funding for adult protective services. Community Solutions has a long history of advocating for a strong adult protective services system in Ohio. Prior to the pandemic, older Ohioans were more susceptible to unjust circumstances such as financial exploitation from scam artists friends or family; as well as physical, sexual or emotional abuse. The pandemic restrictions, including social-distancing guidelines, non-visitor policies and capacity mandates meant older adults, like all of us, have had less interaction with society, reducing the likelihood that mandatory reporters of elder abuse were able to recognize and report it. We are concerned in the coming months there will be a caseload uptick in each county as restrictions are lifted and vaccines becomes more widely available. The increase included in the substitute bill will bring each county to $65,000, enough to support at least one full-time dedicated APS caseworker per county.
We are pleased to see an expansion of the Program for All Inclusive Care for the Elderly (PACE) program included the budget. In a recent report that our team authored, we highlighted the benefits of the PACE program and look forward to the possibility of expanding the program to more eligible Ohioans.
We are excited to see the maintained inclusion of the Elderly/Disabled Simplified Application Project (EDSAP) that aims to increase access to and retention in the SNAP program for older adults and disabled Ohioans in this substitute bill. This waiver package is crucial in an increasingly aging state where a large population is eligible for SNAP but faces numerous barriers in remaining consistently enrolled in the program. Additionally, this waiver package will reduce county workloads and allow caseworkers to dedicate more time to more difficult SNAP cases.
We continue to support the recommendations of the Multi-System Youth (MSY) Action Plan and current state efforts and funding to develop a program that can provide more comprehensive care for children with complex needs through OhioRISE (Resilience through Integrated Systems and Excellence). State support, across the board for MSY, is needed for families navigating a complex network of care for their children. OhioRISE will go a long way to provide coordinated services for MSY and to work toward eliminating forced custody relinquishment and out-of-state residential placement.
Relatedly, we are concerned about the inclusion of language that would terminate the procurement process for Medicaid managed care plans in Ohio. While perhaps unintended, this language would impact the numerous existing improvement efforts of the state including OhioRISE and the nearly 60,000 children it would serve; the new pharmacy benefit management system; the streamlined provider credentialing; and billing mechanisms of the state. With more than $416 million in administrative savings produced by these reforms, the General Assembly would add to the program’s overhead and need to find additional revenue to support the existing program. Additionally, given our state’s current underperformance in achieving value, we are significantly concerned this effort will diminish the benefits of market competition in managed care, possibly running afoul of federal standards in procurement.
Thank you for your time and attention to vital programs for Ohioans. We are happy to provide additional information or answer any questions at firstname.lastname@example.org.
Director of Public Policy and Advocacy
The Center for Community Solutions
175 S. Third Street, Suite 350
Columbus, OH 43215
CC: Senate Finance committee members