Bipartisan legislation was introduced in the Ohio General Assembly last week to expand eligibility for Ohio's Home First program, which would revise the waiting list provisions of the PASSPORT and Assisted Living programs for Ohio's senior citizens.

Senate Bill 214 also would require the director of Budget and Management to make certain cash transfers and expenditure authorizations regarding long-term care budget services, revise the law governing the collection of long-term care facilities' Medicaid debts, and revise the law governing the reasons for denying a certificate of need application.

Sen. John Carey, R-Wellston, one of the bill's sponsors, said SB 214 would allow Medicaid-eligible Ohioans who are at risk for imminent nursing home admission to immediately begin receiving services through the PASSPORT or Assisted Living programs.

Physicians and community advocates would work together to decide whether an individual meets this criteria and determine their necessary level of care, he added.

“The Home First program has already helped hundreds of Ohioans access the care they need in the setting they prefer,” Carey said, noting that according to the Ohio Department of Aging, between July 20 and Oct. 3 there were 521 Home First enrollments in the state.

“By expanding eligibility for the program, we would not only create greater choice in Ohio's health-care system for consumers, but help reduce state government spending.”

Carey said funding for SB 214 will come from state Medical funds initially targeted for nursing home expenditures.

Sen. Dale Miller, D-Cleveland, also a sponsor of SB 214, said the legislature established the Home First program in 2005 with House Bill 66 to give nursing home residents the ability to enroll in PASSPORT and receive necessary medical care in their own homes.

He added that in 2008, legislators approved legislation to expand eligibility for Home First to include residents living in nursing facilities, who are on the Ohio's Assisted Living Waiver Program waiting list.

“(SB 214) is a win-win; it will help senior citizens to get good care and stay more independent, and will help the state save money on health-care costs,” said Miller.

He added that home and community-based care is not only preferred by a large majority of Ohioans, but has the potential to save Ohio taxpayers millions of dollars annually.

According to the Ohio Department of Aging, it costs the state $560 per month for an individual receiving PASSPORT assistance and $842 for assisted living, and the state spends nearly $1,700 per patient for nursing home care each month.

Carey said when the Home First program was first enacted in 2005, it saved the state $60 million, and he believes SB 214 could save nearly the same amount.

“While Ohio's nursing facilities provide critical care for many Ohioans, it just makes long-term fiscal sense for our state to invest in home and community-based care,” Carey said. “SB 214 represents an important step toward this goal, while working to give more Ohioans important options to decide where and how they receive the care they need.”

Under SB 214, a patient would be considered at risk of imminent admission to a nursing home if it is medically determined that a person has a medical condition that, unless enrolled in home and community-based services, would require him or her to be admitted to a nursing facility within 30 days; an individual who has been hospitalized should be transported directly to a nursing home unless enrolled in home and community-based services; or an abused, neglected or exploited person should be admitted to a nursing facility, unless the person is able to receive care in a home or community-based care setting.

Bill Sundermeyer, associate state director for advocacy for AARP Ohio, said 3,000 people have been placed on waiting lists before enrolled in PASSPORT and assisted living programs that pay for services that allow them to stay at home, due to state budget cuts in Medicaid funding.

“In addition to offering more options for elderly Ohioans, the proposed improvements to the Home First option will help reduce state spending on health care by allowing more Ohioans to receive the right care, in the right setting, at the right price,” Sundermeyer said, adding that Ohio ranks among the 10 worst states nationwide for disproportionate nursing facility spending.

Sundermeyer said 94 percent of Ohioans prefer to receive care at home, according to an AARP survey, and research studies conducted by Scripps Gerontology found that the longer an older adult remains in a nursing facility, the more unlikely it is that he or she will return home.

“Allowing older adults to stay in their homes, where they want to be, eliminates the trauma of transition and decreases depression. (SB 214) is a significant step in making this possible for more Ohioans,” Sundermeyer said, adding that the AARP is in support of the bill.

Carey said SB 214 has also received support from the nursing home industry, several local Area Agencies on Aging and the Ohio Assisted Living Association.

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