The legislature and the administration will be revisiting portions of the approved two-year state budget this spring. This “mid-biennium” budget review is sure to mean policy changes that affect health, human services, and early care & education in Ohio.

1. Budget Redux: What the Mid-Biennium
Review Means for Advocates
Featuring:
Gayle Channing Tenenbaum, co-Chair of Advocates for Ohio’s Future and
Director of Policy and Govt Affairs at PCSAO
Larke Recchie, Executive Director of
the Ohio Association of Area Agencies on Aging (o4a)
Lisa Hamler-Fugitt, Executive Director of the Ohio Association of Second
Harvest Foodbanks (OASHF)
Cathy Levine, Executive Director of Universal Health Care Action Network
of Ohio (UHCAN Ohio) and Co-Chair of Ohio Consumers for Health Coverage

2. Today’s Agenda
• 3:00-3:08 Will Petrik - Intro, Purpose, Timeline
• 3:08-3:16 Gayle Channing Tenenbaum – Focus of the Mid-
Biennial Review, Mental health, Child Welfare
• 3:16-3:24 Larke Recchie – Mid-biennial issues for aging
and disability networks
• 3:24-3:32 Lisa Hamler-Fugitt – Mid-biennial issues for the
safety net -- food assistance
• 3:32-3:40 Cathy Levine – Health care, Medicaid Cost
Containment, Care coordination
• 3:40-3:48 Will – Call to Action and other ways to build
support and get involved
• 3:48-4:00 Q and A

3. Gayle Channing
Tenenbaum
Co-Chair of Advocates for
Ohio’s Future (AOF)
Director of Policy and Govt
Affairs at PCSAO
www.pcsao.org

4. Mid-Biennial Budget
Review
• The Kasich Administration to
introduce version of Interim Biennial
Budget shortly after March 6,2012
• Budget will focus on programmatic
change
• Reform, restrain, and reduce where
possible

5. Mid-Biennial Budget
Review
• Administration and legislature will
be looking at Medicaid, Mental
Health and Developmental
Disabilities
• There will be opportunity for
stakeholder input before the budget
is introduced

6. Child Welfare
• Still seeing reduction of children coming
into care
• Adding 10 more counties to Differential
Response
• Working on Plan for an Incentive Fund that
would reward counties who pass levies
• Working closely on several behavioral
health initiatives as they relate to
children, youth and families in the child
protection system

7. Mental Health
• Intensive-Home Based Therapy ( IHBT)
• LAUNCH ( A Substance Abuse and Mental
Health Grant funded by SAMHSA ) working
on “Telehealth Networks” to address the
shortage of mental health practioners in
Ohio
• Medicaid Health Homes, SPA submitted for
seriously chronically mentally ill adults and
children

8. Mental Health
• BEACON (Best Evidence for Advancing Child
Health in Ohio Now) Meeting Feb 3, 2012 to
determine which children’s mental health
issues will be addressed in the next two
years.
• One issue will likely be the over-use of psychotropic
drugs with children in foster care
• Trauma as a Public Health Issue
• Intensive Home Based Visitation

9. Mid-biennial issues for Aging
and Disability Networks
Larke Recchie
Executive Director
Ohio Association of Area
Agencies on Aging

10. Medicaid LTSS Changes
•Single waiver
•Medicaid Medicare Eligible (MME)
waiver
•Medicaid Health Home
•Funding issues

11. Single Waiver
•Take down 5 current waivers PASSPORT, Ohio
Home Care, Choices, Assisted Living, Transitions
(50,000 consumers)
•Replace with single Medicaid Waiver for all adults
(age 21 and over?) who meet NF level of care
•Draft letter to CMS expected within 2 weeks
•Some potential changes to
screening, assessment and case management
•Implement after MME Waiver (January 2013)
•Opportunity to address service needs

12. Medicare Medicaid Eligible
(MME) Waiver
•190,000 MMEs in Ohio
•Straw Man released last week of concept
paper
http://healthtransformation.ohio.gov/Cur
rentInitiatives/IntegrateMedicareMedicai
dbenefits.aspx
•Implementation in Fall 2012
•Likely to start in metropolitan areas with
higher concentration of MMEs.

13. Medicaid Health Homes
 Focus on severe and persistently mentally ill
 State Plan Amendment sent to CMS
 Implement July 2012

14. Not to be confused with …
Rebidding of Medicaid Managed Care –
•RFA released last week
•Applications by March 2012
•Awards in April 2012
•3 regions with up to 4 providers
•Combines CFC & ABD populations
•Implement January 2013

15. How do these initiatives relate?
• 1.6 million Ohioans enrolled in Managed Care
•190,000 Ohioans eligible for Medicaid and
Medicare (MME)
•50,000 Medicaid Nursing facility level of care
waiver consumers
The MME waiver will pull some people from
Medicaid Managed Care and some people from
waiver (85% of PASSPORT consumers are
MMEs)

16. Consumer Input Sessions on the
Single Waiver and MME Waiver
Dates and locations:
January 24, 2012 Toledo
January 31, 2012 Dayton or Columbus
February 3, 2012 Columbus or Dayton
February 7, 2012 Cleveland
February 14, 2012 Athens
Olmstead Task Force funding Lewin Group to
help facilitate.
Watch OHT website for details
http://healthtransformation.ohio.gov/
•Likely 1:00 – 4:30pm
•More like focus groups, less like hearings

17. Our Concerns:
• Don’t tear down or destroy what is
working – Build on Ohio’s strengths
•Make sure new services are responsive to
wide range of consumers.
•Make sure funding is available to provide
real choice for home and community
options

18. Thank you.
Larke Recchie
recchie@ohioaging.org
Ohio Association
of Area Agencies on Aging

19. Lisa Hamler-Fugitt
Executive Director
Ohio Association of
Second Harvest Foodbanks
(614) 221-4336
www.oashf.org

20. Cathy Levine, UHCAN Ohio
clevine@uhcanohio.org
www.uhcanohio.org

21. Three-Year Framework from Governor’s
Office of Health Transformation
 2011: Modernize Medicaid
 2012: Streamline Health and Human Services
 2013: Improve Health System Performance
 Payment and delivery reform (see AOF doc)
 AOF Cost Containment Agenda aligned
What does this mean for
advocates?

22. 2011: Modernize Medicaid
 Administration priorities (using ACA)
 Improve care coordination – new models
 Integrate behavioral and physical health care
 Rebalance long term care
 AOF Consumer Friendly Cost Containment Agenda
aligned – Devil is in Details

23. 2012: Opportunities for Advocates
 Input into new models of care
 Medicaid Health Homes – starting with SPMI
 New Models for People who are Dually Eligible
 Regional Consumer Input Meetings
 coming your way!
 Mid Biennial Review (MBR) – watchful waiting

24. 2011: FY 2012-13 BUDGET –
Advances
 Almost no cuts to Medicaid eligibility/benefits
 Spending shifted from institutional to home and
community based long term care
 Policies enacted and investment made in care
coordination for most vulnerable patients
 Launched Patient Centered Primary Care Collaborative

25. FY 2012-13 Budget: Weaknesses:
Policies not always supported by $
 Continued inadequate funding for behavioral health
 Limits put on certain BH treatment
 Home and community based services for people with
disabilities < 60 inadequate
 Gutting of public health programs
 County funding cuts: inadequate JFS staff

26. 2012: Streamline Health and Human
Services
Streamline governance, efficient operations and funding
 Single waiver
 Modernizing eligibility determination systems
 Easier to enroll and reenroll in all programs
 Getting ready for “Health Exchange” in 2014

27. Coalitions Working on
Implementing ACA
 Ohio Consumers for Health Coverage
 www.ohioconsumersforhealth.org
 Ohio Campaign for Better Care: building a voice for
older adults in achieving better care and better
coordination for older adults and family caregivers.
 www.uhcanohio.org/ohiocampaignforbettercare

28. Take Action:
Will you meet with one of your local lawmakers
before Mar 6th?
• Prioritize meeting with members on the House and Senate
Finance Committee
If you don’t know who your lawmakers are, you are not
alone! Find out here:
• http://go.advocatesforohio.org/getLocal.jsp
If you’ve never met with a lawmaker before (or it’s been a
while since your last visit), use this guide to set up and
execute your meeting with lawmakers:
• http://advocatesforohio.org/perch/resources/Invite.Legislators.
to.Tour.Your.Program.or.Facility.pdf

29. Share this map with your
lawmakers
• highlight the growing need in
your county and in Ohio
• Download and print the map
here:
http://www.advocatesforohio.o
rg/perch/resources/PovertyMap
.pdf

30. The Ask
Can we count on you to
stand up for health, human
services, safety net services
and early care & education
in your Caucus?

31. Follow Up: Report back
and send a Thank You
Let us know:
• how your meetings went
• who you visited with
• Report Back Document:
https://docs.google.com/spreadsheet/
viewform?formkey=dHFYQTNNMVJ5Vm
9mVi04M081N1lkVWc6MQ
• Don’t forget to send a Thank You
note!

32. How Organizations
Can Help
• Endorse Advocates for Ohio’s
Future
• Educate your
board, staff, volunteers, and
clients
• Recruit other agencies and
organizations to endorse

33. Contact Us
Advocates for Ohio’s Future
www.advocatesforohio.org
510 East Mound Street, Suite 200
Columbus, OH 43215
Fax: (614) 228-5150
Will Petrik Scott Britton
Outreach Director Coordinator
wpetrik@advocatesforohio.org sbritton@advocatesforohio.org
614-602-2464 614-602-2463