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State budget process: health and human services and the House sub bill

May 1, 2023
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It’s been a busy few weeks (months…years….?) in the Ohio legislature. Last we checked in, the Governor’s version of the state budget—House Bill (HB) 33—was making its way through the House of Representatives. The House Finance Subcommittee on Health and Human Services, along with the other issue area subcommittees, heard testimony from a diverse set of stakeholders (including from Community Solutions) before the budget moved back to the full House Finance Committee where the bill was amended to include the House’s priorities. HB33 was subsequently voted out of the committee on April 25.

A high-level view of the House-passed bill

The House passed HB33 with a vote of 78-19 on April 26 (we covered the overall budget process earlier this year, if you need a refresher). This was a significant vote, not only because it is the state budget, but also because Speaker Jason Stephens pulled together a majority of Republicans and Democrats to vote in favor to the bill. You’ll recall from our look at the budget process earlier this year that there have been challenging politics happening within the Republican caucus. This budget vote was expected to be a sign of how things are shaking out.  

Health and human services are a major element of the state budget, and we will dig in deeper over the next few weeks. However, we can offer a high-level look at the House passed budget right now.  

On the whole, we’re still looking at the major funding changes between the Governor’s budget and the House-passed version. One obvious theme is that many of the cuts from the Governor’s budget to the House-passed budget are still increases from the current fiscal year (FY2023), but this warrants further analysis. Areas that Community Solutions have identified as budget priorities are indicated throughout with an asterisk. Complete budget resources are linked at the end of this blog, so you can read more in detail about these provisions.

Health and human services safety net

A new benefit bridge pilot program  

The House added A HAND UP (Actionable Help and New Dignity for Upward Progression) program that is a new iteration of a benefit bridge pilot that the Ohio Department of Job and Family Services is tasked with creating. Generally, a benefit bridge seeks to minimize the “cliff” that happens when an individual or family enrolled in public assistance program experiences when they lose eligibility for one or several of the programs. Community Solutions has written about benefit cliffs and will track this budget provision as it moves into the Senate.

 $15 million each year ($30 million total) of the biennium to the Ohio Association of Foodbanks and $10 million in FY2024 to the Greater Cleveland Foodbank.

Support for Ohio’s foodbanks  

In the aftermath of the end of SNAP emergency allotments, and even in the lead up to it, Ohio’s foodbanks have experienced record demand for nutrition support. The House responded with an increase of $15 million each year ($30 million total) of the biennium to the Ohio Association of Foodbanks and $10 million in FY2024 to the Greater Cleveland Foodbank.  

Department of Children and Youth  

The House maintained the creation of the Governor’s proposed new agency, the Department of Children and Youth, but with an overall reduction to the agency’s budget of about $24 million each year. The new department aims to reduce duplication and create better coordination for child-serving programs. The budget reduction, compared to the Governor’s introduced budget, is focused in the family and children services line. This will be a focus of advocacy in the Senate budget process.

Medicaid

House maintains expanded Medicaid coverage for pregnant women and children*  

The House maintained the Governor’s proposal to expand Medicaid coverage up to 300 percent of the federal poverty level for pregnant women and children, up from the current 200 percent for pregnant women and 206 percent for children.  

Continuous Medicaid coverage for children*  

The House added a provision that would provide continuous Medicaid coverage for kids from birth to their fourth birthday (through age 3). This is an important policy change that would eliminate the need to annually recertify kids for Medicaid in early childhood. This will improve continuity of care and coverage at this key stage of life.

Healthy moms and babies

Doula certification and Medicaid coverage*  

There was language included in the House version of the budget to create a certification process and doulas and require Medicaid to cover doula services. A doula is a labor professional trained to provide non-medical, emotional and physical support throughout a woman’s pregnancy, childbirth and postpartum period. The language included matches that of House Bill 142 from the last General Assembly, which was passed by the House but ran out of time for passage in the Senate. This provision will go a long way in providing support for moms to be and new moms as they adjust to life with a new baby.

 The line item dedicated to harm reduction in the Ohio Department of Health budget was zeroed out.

Mental health and substance use disorders

Dedicated harm reduction* support cut  

The line item dedicated to harm reduction in the Ohio Department of Health budget was zeroed out. While meager, the $50,000 going to support syringe services programs around the state provided a bit of a backbone to programs that are often run on a shoestring budget to begin with. Given the ongoing opioid crisis in this state, Community Solutions encourages restoration, and hopefully increase, of this funding in the Senate.  

Department of Mental Health and Addiction Services  

This agency received an overall decrease compared to the Governor’s introduced budget of $246 million. These reductions stem primarily from federal funding sources. Community Solutions will be further examining what this means for the Governor’s overall plan to boost behavioral health services in our state.

Support for aging and older Ohioans

The Department of Aging’s budget remains largely intact through the House process compared the Governor’s introduced budget, save for Senior Community Services* which received a $1.2 million reduction in FY2024 and a $1.5 million reduction in FY2025. While this is an increase over FY2023 figures, Ohio’s population is aging, so any reduction in allocations warrants careful consideration.  

Home and community-based services  

After impactful testimony from people with lived experience and caregivers, the House included rate increases for direct care providers in the disability and aging communities of $17 per hour in FY2024 starting on January 1, 2024, and $18 per hour in FY2025. This is a move in the right direction, although not yet at the $20 per hour level that was requested.

 Stay tuned for upcoming blogs looking closer at elements of the House-passed budget, as well as a look at the schedule for the Senate budget process, which has already begun.

If you want to dig in further…

You can find the text of and associated documents from Amended Substitute Bill 33 on the legislature’s website.  

To compare the changes from the Governor’s version of the budget to the House passed version, you’ll need the comparison document from the Ohio Legislative Service Commission. This is also where you’ll find the detailed spreadsheet that spells out each line item and the amount appropriated for each.  

Stay tuned for upcoming blogs looking closer at elements of the House-passed budget, as well as a look at the schedule for the Senate budget process, which has already begun.

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