OHIO
In January 2003, Ohio officials estimated the state's budget gap at $720 million. Although some home and community-based services for people with disabilities were largely spared from budget cuts in the FY 2003 budget, the state's continuing fiscal problems led to spending reduction proposals for these programs in the FY 2004 budget.
The Budget
When a budget balancing plan was enacted in mid-2002 that reduced state spending by $375 milllion for FY 2003, programs for senior citizens and people with disabilities mainly escaped the budget axe. Funding for the Medicaid home and community-based waiver program, PASSPORT, and the Alzheimer's Respite program were exempted from agency-wide cuts. However, the Department of Mental Health took a 1.5 percent cut, and the budget of the Department of Mental Retardation took a 7.5 percent reduction. (Most state agency budgets were reduced by 15 percent.) Appropriations for FY 2002-03 included the following.
- Adding 1,300 slots in FY 2002 and another 1,600 slots in FY 2003 to PASSPORT, which had 24,000 slots before the additions.
- Adding 500 slots in both FY 2002 and FY 2003 to the Home Care Waiver Program, which provides care to disabled people under age 60 or people of any age with a chronic, unstable condition who require nursing care. The program had 8,200 slots before the additions.
- Adding 500 slots in both FY 2002 and FY 2003 to the Individuals Options Waiver program, which serves people who otherwise would require institutionalization in an ICF/MR facility.
As budget problems continued in 2003, however, even the PASSPORT program was not spared from spending reductions. In March 2003, Governor Bob Taft cut $1.8 million from PASSPORT, resulting in a 20 percent reduction in new monthly enrollments statewide. The governor also proposed freezing Medicaid nursing home reimbursement rates for FY 2004.
Nursing Homes
Ohio lawmakers tackled nursing home liability issues during the 2002 legislative session. The bill that was enacted in August amends various definitions, including tort action and medical claim. The following also must be considered when determining punitive damage awards against a nursing home or residential facility:
- The ability of a facility to pay the award of punitive or exemplary damages based on the facility's assets, income and net worth;
- Whether the amount of punitive or exemplary damages is sufficient to deter future tortious conduct; and
- The financial ability of a facility, both currently and in the future, to provide accommodations, personal care services and skilled nursing care.
The law also prohibits the results of nursing home inspections or investigations or the results of any survey of a nursing facility from being used in court. However, any statement of deficiencies and all findings and deficiencies cited in the statement that result from the survey may be used in a criminal investigation or prosecution.
Developmental Disabilities
Ohio received approval from the federal government in June 2002 to provide Medicaid coverage for home-based care to an additional 2,000 people with mental retardation and developmental disabilities. The expansion was the third increase in available slots since January 2000, bringing the total increase during that period to about 4,500 slots.
In December, the state received federal approval for its new Level One Waiver, which would allow an additional 6,000 people with mental retardation and developmental disabilities to receive in-home care. The 6,000 slots will phase in over three years. Ohio developed the Level One Waiver as part of a redesign of its Medicaid program with services such as respite and home modifications designed to help families keep a person with MR/DD at home.
Legislation was enacted in December 2002 to give the state more authority to regulate homes for the mentally retarded if residents are abused, neglected or harmed. The bill does away with lifetime licenses for private homes and replaces them with permits that expire every one to three years. The changes are intended to help state officials focus their manpower on problem facilities, which would be inspected every year until they improve.
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