2024-2025 State Budget Updates- Am. Sub. HB 33

On Wednesday, April 26, 2023, the Ohio House of Representatives voted (77-19) in a bipartisan manner to approve its version of the state operating budget for fiscal years 2024-2025 – Am. Sub. HB 33. The text of the bill along with a comparison document and appropriations spreadsheet can be viewed on the Legislative Service Commission’s website. The Ohio House made significant modifications to Governor DeWine’s proposed budget, including the following high-cost provisions:

Tax cut focusing on middle-income families, costing nearly $ 1 billion over the biennium
Expansion of publicly funded tuition vouchers for K-12 private schools
Funded the Ohio Fair School Funding Formula using updated cost reporting data
Provided $715 million to Nursing Facilities

Leading up to the House’s final passage of the budget bill, members of the House Finance Committee accepted a wide ranging “Omnibus” amendment that included many provisions of varying size, scope, and subject matter – including an amendment clarifying that the direct care payment rate increases for certain Medicaid services also applies to community behavioral health services. Based on discussions with ODM staff, we estimate this amendment will appropriate an additional $75 million beyond the $220 million proposed by the Governor to support the community behavioral health workforce.

Overall, Am. Sub. HB 33 maintains support for community behavioral health services, and includes several of our other priorities, including new appropriations for the behavioral health workforce, preserving the Student Wellness and Success Program Funding and safeguards, and the enhanced quality standards and national accreditation for providers and recovery residences. However, due to the significant amount of resources being directed toward tax cuts; school funding formula investment; teacher pay increases; and nursing facility rate increases – most state agencies experienced some funding reductions from the Governor’s proposal, including OhioMHAS. We are in close communication with OhioMHAS and working in collaboration with stakeholders to develop and implement an effective advocacy strategy in the Senate to support funding increases across the continuum of care.

Here are some quick budget highlights concerning Ohio Council budget priorities.

Medicaid BH Provider Rate Increase: The House maintained the Governor’s proposed 10% community BH provider rate increase and added another $75 million across the biennium as part of the Medicaid Direct Care Payment Rate Increase. However, we will need to work with ODM on how this additional appropriation would be used for community BH services given the budget language ties it to a base payment wage of $17/$18 per hour. Securing additional funding for Medicaid BH rates is the important objective in the House process. We will continue working with ODM and seek additional funding and clarification as needed in the Senate process.
Student Wellness and Success Funds: The House maintained the appropriation and Governor’s proposed guardrails that will require more accountability and transparency on how schools use these funds, including that 50% be used to provide health or behavioral health services.
National Accreditation and OhioMHAS Certification: The House maintained the proposed requirements that support national accreditation as a condition of obtaining OhioMHAS certification, requires providers to be in good standing in any state in which they operate, and extends expectations for OhioMHAS certification for MH and SUD services for any certifiable service.
Recovery Housing: Maintains increased funding and policy changes to support requirements for national accreditation for recovery housing. We are seeking amendments in the Senate to clarify and improve this language.
Mental Health Insurance Assistance Office: Maintains funding for the MHIA ombuds program and increases funding to support market conduct reviews.
988 OhioMHAS Funding: The House maintained the appropriation but moved it from GRF funding to a Dedicated Purpose funding line.
OhioMHAS Prevention Funding (Line Item 406): The House reduced funding to $7 million each year or by almost 50%, which is still a $2.2 million increase over FY23.
OhioMHAS Continuum of Care (Line Item 421): The House reduced the Governor’s proposed funding by 10% or $10.8 million per year, which is still an increase of almost $6 million per year over FY 23. Added some additional earmarks, some without additional funding.
OhioMHAS Criminal Justice Services (Line Item 422): The House reduced the Governor’s proposed funding by 30% or $9 million, which is still an increase of $1.2 million per year over FY23.
OhioMHAS State Hospital Service (Line 421): The House reduced the Governor’s proposed funding by almost 10% or $30 million and $34 million each year, which is still an increase of around $58 million across the biennium. OhioMHAS has indicated this funding level would not sustain current state hospital operating levels and would prevent bringing online additional capacity at three of the state hospitals.
OhioMHAS Residential State Supplement (RSS): The House maintained funding at current levels.
OhioMHAS State of Ohio Action for Resiliency Network (SOAR): The House removed this provision.
OhioMHAS Pediatric Behavioral Health Workforce: The House removed all but $1.2 million of the ARPA funding for this provision.
Department of Children and Youth: The House maintained creation of the new cabinet level agency.

An additional LCS Budget Comparison Document by Agency provides additional insight into the House passed budget, as well as specific appropriations comparisons for Medicaid and OhioMHAS. The Ohio Senate has already begun its examination of the budget bill with OhioMHAS Director Lori Criss set to appear on Tuesday, May 2, 2023, before the Senate Health Committee, and Director Maureen Corcoran before the Senate Medicaid Committee soon thereafter. Ohio Council staff will share more detailed budget information and opportunities for advocacy as the process moves forward.