AOF has compiled a run-down of the major health and human services provisions in the final version of the state operating budget. Check out our review below:
Tax Cuts
$1.7 billion income tax cut over the next two years
Across the board 3% income tax cut for most Ohioans
Eliminates the top two tax brackets and replaces them with a 3.99% tax rate
This means that the wealthiest 1% of Ohioans will receive more than a 16% cut in taxes while most Ohioans only have a 3% cut
Medicaid
Requires Medicaid coverage for pregnant women for the maximum postpartum period permitted under federal law, instead of for 60 days after giving birth
Redeterminations: Sets the amount of time in which ODM must conduct and act on any redetermination of a Medicaid recipient at 90 days after receiving approval from the U.S. Centers for Medicare and Medicaid Services to conduct such redeterminations.
Authorizes a county department of job and family services assisting ODM with conducting and acting on redeterminations to request from ODJFS, in consultation with the Department of Medicaid, up to 30 additional days to act on redeterminations
Delays the effective date of this provision until January 1, 2022
Removes requirement that ODM suspend its current procurement process and, during FY 2022, complete a new procurement process.
DeWine Veto: Removes following requirements from current and future procurements:
Requires ODM to, to the extent permitted by federal law, when contracting with Medicaid MCOs, include contracts with organizations that:
(1) Are domiciled in Ohio, including their parent entities;
(2) Are currently Medicaid MCOs; and
(3) Have a proven history of quality and customer satisfaction, as reported by ODM's Medicaid Managed Care Plans Report Card and NCQA Medicaid health insurance plan ratings.
Requires the contracted organizations to participate, at minimum, in the areas of Ohio where they are providing services as of the bill's effective date.
Exempts from the reprocurement requirements a behavioral health managed care plan selected to assist with implementing the Ohio Resilience through Integrated Systems and Excellence (OhioRISE) Program.
SNAP Eligibility
Requires the ODJFS Director to submit an application to the U.S. Department of Agriculture for participation in the Elderly Simplified Application Project within the Supplemental Nutrition Assistance Program (SNAP)
All Removed (SB17 Provisions)
Prohibits SNAP income and asset limits from exceeding the types and allowable amounts permitted by the Secretary of the U.S. Department of Agriculture.
Requires ODJFS to conduct an asset test for each SNAP recipient
30 Day Change Reporting up to $500
Requires ODJFS to prepare and submit baseline and subsequent quarterly reports detailing certain information regarding SNAP.
Requires SNAP recipients to cooperate with the child support enforcement program
Public Assistance Programs
Creates the Public Assistance Benefits Accountability Task Force
Establishes the Public Assistance Benefits Accountability Task Force consisting of 15 members
Requires the Task Force to review all of the following
(1) The State Auditor's report of Ohio's Medicaid Eligibility Determination Process to determine to what extent the recommendations have been adopted.
(2) Past and present welfare to work county programs and their effectiveness on assisting individuals in achieving employment.
(3) Existing fraud prevention efforts at the state and county levels to determine best practices for fraud prevention in the SNAP, Medicaid, Ohio Works First, and publicly funded child care programs.
(4) Best practices on how overpayments in the SNAP, Medicaid, and publicly funded child care programs can be prevented at the state and county level.
(5) Best practices in public assistance case processing that create efficiencies and reduce errors through the use of technology.
(6) The length of time that individuals receive public assistance benefits in the state and ways to return individuals to the workforce.
(7) Existing efforts to ensure compliance with child support enforcement across public assistance benefit programs and recommend additional ways compliance could be improved.
(8) The costs and benefits associated with implementing a requirement that each SNAP debit card include a color photograph of at least one adult member of the household.
Requires the task force to prepare and submit a report to the General Assembly
Broadband
Removes Senate-added provision to restrict government-owned broadband networks
Provides $250 million cash from the GRF for Ohio Residential Broadband Expansion Grant Program
Provides $230.0 million in FY 2022 and $20.0 million in FY 2023 for the program under Fund 5GTO line item 195550, Broadband Development Grants.
TANF
Kinship Caregiver Program: Restores $10 million in each fiscal year from FED Fund 3V60 line item 600689, TANF Block Grant, to support kinship care.
Requires funds to be allocated via formula and requires PCSAs to use funds to provide reasonable and necessary relief of child caring functions so kinship caregivers can provide and maintain a home for a child
K-12 School Funding
“Almost entirely” restores the House’s Fair School Funding Plan
Intent language speaking to how the House plan would go into effect beyond this coming biennium was deleted.
Proposed and previously authorized cost studies on various elements of the formula were also removed
Grants Senate-proposed increases to funding for school choice programs
Maintains the policy of direct state funding of choice programs that was included in both the House and Senate versions.
Housing
Removed proposal that jeopardized the continued viability of one-third of Ohio’s affordable housing properties
Instead of increasing taxes on affordable housing developments, the final state budget would create a 16-member study committee charged with making recommendations about the valuation process of federally subsidized rental properties
Child Care & Step Up to Quality
PFCC eligibility increased to 142% FPL for SFY22-23 (150%FPL for families of children with special needs)
Step Up to Quality (SUTQ) mandate for PFCC providers to be one-star rated is restored; requirement for PFCC providers to be highly rated by 2025 is eliminated
Further defines scope of the child care & SUTQ legislative study committee (first included in House, required to report by 12/31/21) is required to evaluate access, eligibility, administrative requirements, rate setting, funding and sustainability, as well as consideration of an alternative pathway to obtaining a one-star rating for programs “with a low census of children receiving PFCC”
Requires ODJFS to use any additional federal resources (specifies the December 2020 CRSA) for stabilizing and sustaining the child care system, improve workforce recruitment and retention, and increase access for families.
Home & Community Based Services
DeWine Veto Removes the 6% (4% in 2022 and 2% in 2023) increase in provider rates for PASSPORT/MyCare/Ohio Home Care personal care and assisted living and other home care rates.
**Rate increases intended to be enacted via rule rather than statue ASAP
Older Adults
An increase of $1 million per year in the Senior Community Services line item, not earmarked.
Adult Protective Services – the House added $1.5 million per year increase ($65,000 per county per year) was maintained- $5.7 million appropriated per year is the largest amount of state funding for APS ever
Additional Items of Interest-AOF Veto Request Items
Establishes a new joint legislative committee appointed every two years to examine if a new entity should be designated as the state’s Protection and Advocacy system (P&A) charged with investigating instances of abuse and neglect and protecting the rights of people with disabilities.
Allows medical practitioners or health care institutions to decline to perform any health care service that violates their conscience as informed by their moral, ethical, or religious beliefs or principles.
**Veto attempts sadly failed