Ohio House Finance Subcommittee on Health and Human Services Chairwoman Carruthers March 23, 2023
Tara Britton, Director of Public Policy and Advocacy
Chairwoman Carruthers, Ranking Member Liston and members of the House Finance Subcommittee on Health and Human Services, thank you for the opportunity to provide interested party testimony on House Bill 33. The Center for Community Solutions (CCS) is a nonprofit, nonpartisan think tank that aims to improve health, social and economic conditions through research, policy analysis and communication. We will address several areas of House Bill 33 in our written testimony, all pertaining to health and human services.
Medicaid
We support the Governor’s proposal to increase Medicaid eligibility to 300% of the federal poverty level for children and pregnant women. This policy will go a long way in ensuring continuity of coverage and access to care. This will also build upon the work done in the last state budget that expanded coverage for pregnant women from 60 days to 12 months postpartum.
To further build upon these beneficial coverage expansions, we ask the General Assembly to explore a policy of continuous coverage for kids on Medicaid. Our research[1] shows that when parents lose Medicaid coverage, for whatever reason, there are significant rates of coverage loss for their kids too, even though these children may still be eligible. This is because we cover kids up to a higher income range than adults. Other states have adopted or are exploring policies that would provide continuous coverage to young children (under the age of 6, for example). This would mean that once a child in this age range is enrolled in Medicaid, they would stay enrolled without an annual redetermination, until the age the continuous coverage ends. We understand this is a significant policy change, but know that it will make a positive impact on Ohio kids’ health and wellbeing.
Maternal health
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, but also recognize that there is bipartisan, bicameral support for this issue in standalone legislation. We stand ready to do whatever we can to move this policy forward. Increasing access to doula services has been proven to improve maternal and infant health outcomes, especially for women and babies of color.
In prior state budgets, we worked with the General Assembly and the executive branch to improve data collection in the maternal health space by strengthening the Pregnancy Associated Mortality Review (PAMR) Board at the Department of Health, however, we maintain that data collection and oversight remain a concern. We are still not seeing consistent data reporting in Ohio around maternal mortality and morbidity. Improvements to coverage and benefits and care delivery transformation rely upon valid and up to date data. In addition to advocating for more frequent public reporting on maternal deaths in the state, from biannually to annually, we also believe that public annual disaggregated reporting of maternal morbidity data is crucial to identifying gaps in care and services, studying the racial disparities gap between Black and white mothers and determining evidence based-solutions for both the community and organizational levels throughout Ohio.
Harm reduction
The 2020-21 state budget included an initial commitment to providing support to Ohio’s local health departments, or a partner agency, to operate harm reduction services, including syringe services programs (SSPs), through a dedicated line item (Harm Reduction, 440529) in the Department of Health’s budget. Since its inception, the amount in this line item has not increased from $50,000 per year, at the same time that overdose deaths have increased and the state’s challenges with substance use disorders remain. Doubling this line item to $100,000 per year could go a long way to helping locally run, often financially-limited syringe services programs across the state. What we know[2] is that dollars are stretched thin at most of Ohio’s SSPs and any increased funding will be fully leveraged. The state’s SSPs have shown how far these dollars can go to reduce incidence of infectious disease and increase access to other supportive services and connections to substance use treatment.
Multi-System Youth (MSY)
The Center for Community Solutions has been focused on the needs of multi-system youth over many budget cycles. We are the proud home of the Multi-System Youth Coalition (the Coalition’s budget priorities are attached), a multi-sector stakeholder group, including parents of children who are MSY, working together to improve the lives of MSY. Community Solutions supports the continued implementation of OhioRISE (Resilience through Integrated Systems and Excellence). As these programs are fully implemented, the state must ensure support continues to be available to work toward eliminating forced custody relinquishment for families and connecting Ohio’s children in need through dedicated funding for MSY in the budgets of the Departments of Medicaid, Developmental Disabilities and Job and Family Services. These funding sources were established in the 2020-2021 state budget and have shown that with dedicated resources and a cross-agency/cross-systems effort, children and families can access needed services, often closer to home, and with more support from communities. Undoubtedly, many of these children and families would have been forced into custody relinquishment had it not been for this funding. We are grateful to Governor DeWine and his administration and the many champions for multi-system youth across the legislature who have made this progress possible.
Older Adults
We want to thank the Governor and General Assembly for supporting the expansion of the PACE program in Ohio and we stand ready to help in the implementation process in any way. This is an area that we have researched[3] thoroughly and are excited about the benefits that an expanded PACE program can bring to Ohio.
The Center for Community Solutions has a long history of advocating for a strong adult protective services system in Ohio. Even before the pandemic, older Ohioans could face the prospect of unjust circumstances such as financial exploitation from scam artists, friends or family and physical, sexual or emotional abuse. Older adults may find themselves in situations of neglect, or self-neglect, which can result in deterioration of physical and mental health. Individuals who experience these situations are four times more likely to be admitted to a nursing home and three times more likely to be admitted to a hospital. For these and many other reasons, Community Solutions is grateful to Governor DeWine for the increased funding for adult protective services (line item 600534) from $5.72 million each year of the biennium to $9.72 million each year of the biennium. This was built upon the foundation that the General Assembly provided in the last budget to increase this line item to $5.72 million each year. We thank you.
Supporting our partners
Community Solutions is a member of the steering committee of Advocates for Ohio’s Future (AOF), a nonprofit, nonpartisan coalition of over 500 state and local health and human services policy, advocacy and provider organizations that strive to strengthen families and communities through public funding for health, human services, and early care & education. We support the initiatives that AOF is advancing through the state budget process.
Thank you for your time and attention to these important issues. We appreciate the attention devoted to health and human services throughout the subcommittee process.
Please reach out for any additional information or follow up questions.
Tara Britton Director of Public Policy and Advocacy 614-586-6324tbritton@communitysolutions.com
[1] https://comsolutionst.wpengine.com/research/childrens-medicaid-eligibility-ohio/
[2] https://comsolutionst.wpengine.com/research/profiles-ohio-syringe-service-programs-ssps-doubled-since-2016/
[3] https://comsolutionst.wpengine.com/research/mcgregor-pace-program-demonstrates-success-community-based-alternative-older-ohioans-greater-risk-contracting-covid-19/
