12/14/2022

House Bill includes relief for nursing facilities, expands PACE program, raises concern for affordable housing

House Bill includes relief for nursing facilities, expands PACE program, raises concern for affordable housing

Last night just before 11:00PM, the Ohio Senate Finance committee voted in favor of Sub. House Bill (HB) 45, which includes a number of long-awaited aging and health policy proposals attached to it as part of a massive omnibus amendment valued at $6 billion in total. Sub. HB 45 will now proceed to the Ohio Senate floor today to receive consideration from the entire Senate and will then be sent to the Ohio House of Representatives immediately after for concurrence. If passed in both chambers, the bill will move to the Governor's desk for signature. 

Items included in Sub. HB 45 are:

• $350 million for nursing homes. The bill reduces the amount included in SB 110, which passed in the House last week, from $615M to $350M. While this is a reduction, it was increased from the Senate's original plan to provide $305M. Sub. HB 45 uses ARPA funds to support nursing facilities, with 40 percent going out based on Medicaid days and 60 percent being based on a quality formula derived from the Quality Incentive Payment (QIP). Modifications to the QIP include NOT excluding the bottom quartile of providers from the calculation, and an additional measure that awards 7.5 points to providers with 75% or greater occupancy in calendar year 2021. The package also includes the language expressing the General Assembly’s intent to rebase nursing facility rates, effective July 1, 2023, using 2022 cost report data, requires a plan to convert the capital price to one based on fair rental value by October of 2023, and a proposal for a private room by June 2023.
• $50 million for PACE expansion. The bill includes language from HB 600 to expand the Program for All-Inclusive Care for the Elderly (PACE) to the unserved metro areas of Toledo, Columbus, Dayton, Cincinnati, Akron, Lorain, and allows for PACE proposals in other parts of the state if providers are interested. The amendment removes $4M originally included in the bill that were to go to ODA to expand administratively to support PACE. 
• $40 million for assisted living. Earlier in the day, the Ohio House passed HB 572, which would have expanded the AL Waiver rate using a tier structure based on Medicaid occupancy. Sub. HB 45 includes relief funding for assisted living without any changes to the payment methodology. Providers are prohibited from using funding for contract workers, staffing agencies, executives, administrators or owners.
• $30 million for hospices, $10 million for home health home and community based services. Hospice and HCBS funding has strings attached that prohibit contract workers, staffing agencies, executives, administrators, and owners from receiving any of the funding. 
• $8 million for adult day services. The amendment appropriates $8M in grant funding to support eligible adult day sites. 

LeadingAge Ohio is also tracking language included related to tax valuation of low-income housing properties, continuing the conversation begun with SB 36 during the last General Assembly. LeadingAge Ohio is engaging with other stakeholders on a plan to respond to this proposal.

This bill reflects the negotiated package between both chambers, and is likely to pass as-is today during the afternoon sessions. The proposals reflect the continued commitment of the state to support long-term services and supports and will alleviate some of the financial challenges experienced by LeadingAge Ohio members.

Questions can be sent to Patrick Schwartz, Director of Government Affairs & Communications, at pschwartz@leadingageohio.org, or Susan Wallace, President/CEO, at swallace@leadingageohio.org.