"Building a Cost-effective, Consumer-friendly Long-term Services and Supports System: Final Report of the Unified Long-Term Care Budget Workgroup"  

In his first biennium budget, Governor Ted Strickland instructed the Department of Aging to lead the charge in determining the steps necessary to establish a unified budget for long-term services and supports, as well as to determine what that budget will look like and how it will be managed. This will start with the formation of a Unified Long-term Care Planning Committee and several appropriate subcommittees. On Wednesday, June 11, the Joint Legislative Committee on Medicaid Technology and Reform (JLCMTR) heard from experts who reported that, using current laws and methods, Ohio cannot continue to provide long-term care for those who will need it in the coming decades.  Robert Applebaum and Shahla Mehdizadeh, researchers at the Scripps Gerontology Center, Miami University, warned that Ohio's fragmented long-term care system would consume 32% of the state's General Revenue Funds (GRF) budget in Medicaid costs by 2020, compared with 24% in 2006.  If Medicaid inflation continues at 11.5%, as it did from 2000 to 2006, and if the state budget grows at 3.5%, Medicaid would account for 68% of the total GRF budget by 2020.
 
Preliminary planning to address the challenge is the recently completed Final Report of the Unified Long-Term Care Budget Workgroup.  The report, required by the biennial budget bill, H.B. 119, is the product of a ten-month effort by the workgroup, chaired by Barbara Riley, Director, Ohio Department of Aging, and its five subcommittees.  The group included more than 300 participants, including legislators, consumers, service providers, advocates, representatives from state agencies and local entities, and interested stakeholders.  The full report is available at http://goldenbuckeye.com/ultcb
 
As Chairperson of the Workgroup, Director Riley presented the JLCMTR with plans that address streamlining Ohio's long-term care delivery system.  The report details a multi-year plan to phase in a coordinated budgeting system in which each agency would begin by combining all its long-term care appropriations in one line item.  Eventually, all long-term care appropriations would appear in one line item within the Department of Job and Family Services budget.  This plan would provide the transparency, cost-effectiveness, and financial accountability for policymakers and consistent rates for service providers that lawmakers asked for in HB 119.  In addition, the plan calls for less nursing facility based care and more care provided through home- and community based services (HCBS).  Currently, about 63% of Ohioans receive Medicaid-covered long-term care services in nursing facilities, 38% through HCBS.  If the services were delivered 50-50%, Ohio would save $114 million based on fiscal year 2007 costs.
 
Director Riley named other goals, such as providing a "no wrong door" policy to access information or services through coordinated regional collaborations, expanding housing and service options, and establishing incentives for facilities to adapt to the new service delivery system.  Director Riley noted that the success of the plan would depend on an Information Technology capacity and residential and transportation options that do not exist yet.

Portions of this article provided by Ohio Assoc. of Area Agencies on Aging