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Impact of the state budget on older adults and direct care workers

Natasha Takyi-Micah
Treuhaft Fellow for Health Planning
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September 18, 2023
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Now that fiscal year 2024-25 is underway, state departments are anticipating the funding commitments laid out in the state budget. Much of that funding will help Ohioans that need assistance in health, food, housing, etc. Agency allocations in the health and human services sector will be especially helpful for special populations like older adults and workers in this field. Programs in the Departments of Medicaid and Aging maintained funding as introduced in the beginning of budget season.

 Some programs from the Departments of Aging and Medicaid were positively impacted in the state budget.

Some programs from the Departments of Aging and Medicaid were positively impacted in the state budget.

Outcomes of the state budget for the Department of Aging

Funding for the Department of Aging (ODA) has increased by 53.13 percent between FY 2023 and FY 2024. The state government appropriated nearly $113 million in funds for ODA in FY 2023, is giving roughly $173 million in FY 2024 and will administer $115.6 million in FY 2025. Healthy Aging Grants were drawn back into the budget after the Senate omitted them. Local partners will receive Healthy Aging Grants to enhance the quality of life for older adults so they can delay entry into Medicaid, live in their homes, maintain their personal assets, and promote an independent, healthy, and active lifestyle. Likewise, AGE Home and Community-Based Services will have the same funding as introduced at the beginning of the budget season.  

The Nursing Home Quality Initiative, which is part of the Ombudsman Support line item, will actually obtain more funding than requested. ODA asked for around $1.6 million each year for FY 2024 and FY 2024. However, the government will provide around $6.5 million in FY 2024 and $10.8 million in FY 2025. Under the Nursing Home Quality Initiative, ODA will arrange “infection prevention and control services as a quality initiative improvement project.”  

Medicaid funding: nursing homes, home and community-based services, and direct care workers

The Department of Medicaid (ODM) will receive more funding over the next two years. The state will appropriate around $36.1 billion for FY 2024, an 11.54 percent increase from FY 2023 at $32.4 billion. ODM will obtain roughly $39.3 billion in FY 2025. Medicaid will still have up to $415 million for nursing homes for both FY 2024 and FY 2025. Long-term care workers in nursing homes will receive an increase in pay through rebasing. There will be a 40 percent limit increase in direct care cost and ancillary and support within the rebasing calculation.

 Direct care workers in HCBS will receive pay raises over the next biennium.

Also beginning in FY 2024, rebasing will be limited to only direct care and tax cost centers. Some home and community-based services (HCBS) rate increases will occur during this biennium. The funding for HCBS from the state will mainly be derived from the American Rescue Plan Act (ARPA) for FY 2024 and ODM will divide funding of HBCS rate increases between the state share and Medicaid general revenue fund (GRF) spending for FY 2025. The federal government will also fund HCBS rate increases.

Under ODM, direct care workers in HCBS will receive pay raises over the next biennium. Governor DeWine vetoed the specific amount of the base payment rates in FY 2024 ($17 an hour) and FY 2025 ($18 an hour) and included in his veto message a commitment to raising rates, but without tying ODM to a specific rate in statute as the language would have done. This means that ODM does not have to limit how much they can increase wages to now or in the future.

The state budget will positively impact older adult Ohioans and direct care workers

Funding that comes from the state budget will positively impact the living experiences of older adults in Ohio. If they prefer to live independently, they will be able to age in their homes while getting the assistance they need to live to their full potential. Other older adults who live in nursing homes will hopefully experience better living conditions due to increased funding and enhanced quality nursing home initiative projects. Moreover, direct care workers will get paid more that could help with their living expenses. The final budget shows there are plans to ensure that the lifestyles of older adults and direct care workers will be addressed. Overall, the effect of the budget positively helps older adults and direct care workers.

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