Elevating the Post-Acute and
Long Term Care Profession

June 1, 2021

Senate Releases Substitute Budget Bill. The Senate Finance Committee today adopted a substitute version of the state budget bill, House Bill 110. This was the Senate's first opportunity to place its mark on the budget. Their main focus, as explained by Senate President Matt Huffman (R-Lima) and Finance Chair Matt Dolan (R-Chagrin Falls) in a morning press conference, is on changes to the education funding formula and personal income tax cuts. After adopting the substitute, the committee immediately adjourned, but will hold hearings the next three days as needed. We expect the Senate to complete its work on the budget next Thursday, June 10. Key issues for long-term services and supports were addressed as follows:

  • SNF reimbursement. The substitute adds $81 million to the House-passed version of the bill and shifts most of the dollars into rebasing instead of the quality incentive. The Senate bill comes closer to funding rebasing fully, but establishes a hierarchy of cost centers to cap the cost. Unfortunately, numerous language problems from the House bill remain in the Senate substitute.
  • ICF/IID reimbursement. The substitute retains the Executive's "cap and rollback" methodology but raises the cap by 2% each year, adding $34 million.
  • DD waiver reimbursement. The substitute adds $127 million to provide 2% rate increases in each year of the biennium for all waiver services, starting at the beginning of each fiscal year instead of on January 1. The House provision adding $10 million for adult day services is removed.
  • Waiver and home health reimbursement. The substitute adds $47 million to move the Executive's 4% rate increase up to July 1, 2021, and to provide an additional 2% in the second year of the biennium. Home health therapy services are added to the list of rate increases and the House's $10 million appropriation for senior adult day services is removed.
  • Health orders and Special Focus Facilities. These provisions are removed from the bill and repealed, respectively.
  • Home health licensure. The substitute also removes these provisions, although we believe it is only because the agreed-upon amendments were not submitted in time.
  • Temporary nurse aides. The substitute includes OHCA's legislative language on this issue, which we previously were trying to place in other potential vehicles.
We are working to analyze the substitute bill and to develop amendments for the omnibus amendment that the Senate Finance Committee will consider next week.

Nearly All Green. This week's Centers for Medicare and Medicaid Services positivity ratings came out a day later because of the Memorial Day holiday. The table for Ohio shows continued progress, as 80 of Ohio's 88 counties now are green. Three counties are even below 1% positivity. On the other end of the spectrum, Lawrence County is near 20%, but remains yellow because of low testing numbers. This week's changes:
  • Allen County - yellow to green.
  • Auglaize County - yellow to green.
  • Belmont County - yellow to green.
  • Carroll County - green to yellow.
  • Defiance County - yellow to green.
  • Lucas County - yellow to green.
  • Putnam County - green to yellow.
  • Vinton County - yellow to green.
  • Washington County - green to yellow.

NIOSH, FDA Recommend Only Using N95s. Both the National Institute for Occupational Safety and Health (NIOSH) and the Food and Drug Administration (FDA) now recommend that health care providers move away from using alternatives to approved N95 respirators in situations when N95s are needed. The federal agencies believe there is sufficient supply of N95s to obviate the need for crisis capacity strategies involving use of non-NIOSH-approved respirators. The NIOSH situational update is incorporated at the top of various Centers for Disease Control and Prevention guidelines addressing personal protective equipment, such as "Strategies for Optimizing the Supply of N95 Respirators ," while the FDA recommendation is contained in a recent letter. See this AHCA/NCAL blog post for more information.

ODH Materials for Vaccine Providers. As we reported at the end of last week, the Health Department (ODH) is opening the Vaccine Ordering Management System (VOMS) next week to all enrolled vaccine providers to order vaccine directly. We received confirmation from ODH that this opportunity applies to long-term services and supports providers who have enrolled and are interested in managing their own vaccine administration, including storage and reporting. We recommend all members consider this option because of its added flexibility for vaccinations, including members who have not yet registered as vaccine providers. In the last few days, ODH circulated two communications of interest to anyone who might puruse this option: a memo on maximizing vaccinations while minimizing wasted doses and a second piece on vaccine lot management and expiration dates.