With a budget deficit of $4 billion facing the State of Ohio in July, the Governor will be proposing cuts in optional Medicaid services and a freeze on provider reimbursement. At the Governor’s Press Conference on the Medicaid budget on January 23, 2003, the following services were listed in the Governor’s cost management initiative: freeze hospital physician and other provider rates ($47 million reduction for biennium); eliminate dental, vision, podiatry, chiropractic and psychologist services for adults ($46 million reduction); reduce eligibility for parents to the federal minimum, 70 – 90 % of poverty based on family size ($33 million reduction); freeze reimbursement rates for nursing homes, intermediate care facilities for mentally retarded and community long-term care providers (estimated $223 million reduction); and limit the number of hours per week of nursing and daily living services for adults through the state plan (estimated $17 million reduction when combines with home care waiver reform). The Governor’s strategies to slow the growth of Medicaid over time include the following: provide more care management for high cost populations; reform the Disability Assistance Medical program (estimated $61 million reduction); complete implementation of the preferred drug list and supplemental rebate program (estimated $64 million reduction); and require co-payment for non-preferred prescription drugs for non-pregnant adults (estimated $7 million reduction).
In Taft’s State of the State Address on Wednesday, January 22, 2003, he said that he had signed an Executive Order to reduce State spending immediately by $121 million through ordering Departments to trim their budgets; by reducing payments to local governments by $30 million; and by requiring businesses that electronically submit sales tax receipts to pay within seven days after collecting the taxes, rather than waiting to the end of the month, which should raise $288 million. To also assist with the current deficit, the Governor plans to bring through another budget corrections bill will which call for an increase in the sales taxes on cigarettes, beer, wine and liquor ($160 million); tap rainy-day savings accounts ($65 million); use $35 million from the unclaimed funds; and raid fines and fees collected and used by state agencies for $21 million. Taft would like the short-term budget corrections bill to pass by the end of February.
The regular budget proposal affecting Medicaid should be unveiled some time in February and must be effective by July 1, 2003. An increase in the gas tax is planned to be included in the regular budget bill of two cents for 2003, 2 cents for 2004 and 2 cents for 2005. Money raised from the gas tax may only be used for transportation-related purposes and will not help alleviate the problems with the general revenue fund deficit.
Two bills pertaining to homeland security have been introduced in the Ohio legislature, Senate Bill 6 and House Bill 6. Senate Bill 6 has been referred to the Senate Finance and Financial Institutions Committee and House Bill 6 will probably be referred to the Homeland Security, Engineering & Architectural Design Committee.
House Bill 6 is sponsored by new State Representative Jimmy Stewart ( R – Athens ) and would direct the Ohio General Assembly in its deliberations regarding bioterrorism. House Bill 6 provides that in recognition of the potential use of biological agents to cause the spread of disease among the citizens of Ohio, the Ohio General Assembly is to conduct deliberations on measures to protect the health and safety of the public during events of bioterrorism and to enhance the ability of state and local government entities to provide timely and appropriate responses. In conducting its deliberations, the Ohio General Assembly may consider any of the following:
1. The extent to which existing statutes enable state and local public health agencies and officials to prepare for and respond swiftly to bioterrorism;
2. The division, consolidation, and coordination of jurisdictions among the state and local government entities that may be involved in responding to bioterrorism, including such entities as public health agencies, law enforcement agencies, emergency management agencies, and agencies with jurisdiction over agriculture and the environment;
3. The authority of state and local government entities to cooperate and share information in their response to bioterrorism;
4. The modification and creation of disease reporting systems that aid in the rapid identification of bioterrorism;
5. The standards and procedures to be followed in maintaining the confidentiality of personally identifiable health information that may be obtained by government entities involved in responding to bioterrorism;
6. The modification and creation of programs to assess the preparedness of health care facilities and practitioners to respond to bioterrorism;
7. The modification and creation of programs for the maintenance and distribution of vaccines, immunizing agents, or other health care supplies;
8. The relationship between the rights of individuals and the emergency health powers that state and local government entities may possess or be granted; and
9. Other matters the Ohio General Assembly considers relevant to the prevention, detection, and management of public health emergencies resulting from bioterrorism.
Senate Bill 6, sponsored by new State Senator Steve Stivers ( R – Columbus ), is patterned after Senate Bill 296 from last session and will enhance the authority of the Director of the Ohio Department of Health, as well as the Ohio Department of Health’s authority to step up surveillance of diseases in Ohio and will do the following:
1. Provides that any person who has custody or control over a document or other record the Director or authorized person considers to be necessary for entering, examining, or surveying any grounds, vehicles, dwellings, or places are to make the document or record available to the Director or person.
2. Requires the Public Health Council to adopt rules under which a trauma center is required to report to the Director of the Ohio Department of Health information describing the trauma center’s preparedness and capacity to respond to disasters, mass casualties, and bioterrorism; the Council’s rules may require the reporting of any information the Council considers necessary for the Director to obtain a proper description of a trauma center’s preparedness and capacity to respond to disasters, mass casualties, and bioterrorism.
3. Gives the Department the supreme authority in matters of isolation; the Department currently has supreme authority in matters of quarantine.
4. Requires pharmacists to report medication-related events that might be caused by bioterrorism, epidemic or pandemic disease, or established or novel infectious agents or biological toxins posing a risk of human fatality or disability.
5. Provide the Director may conduct investigations or inquiries at any time the Director considers a matter to be a threat to the public’s health.
6. Requires laboratories outside the State of Ohio to report specified diseases in Ohioans to the Ohio Department of Health.
7. Protects “personal health information” reported to the Ohio Department of Health and avoids premature disclosure of pending public health investigations, with limited exceptions.
8. Gives the Ohio Department of Health the ability to sell its services not only to other state agencies, but to local boards of health, other states and the federal government.
9. Authorizes the Ohio Department of Health to collect information from trauma centers describing their preparedness to respond to bioterrorism and other catastrophic events.
10. Allows the Ohio Department of Health to purchase and store vaccines, serums, antibiotics, etc.
11. Prohibits any person from failing to comply with any reporting requirement established in rules by the Ohio Department of Health;
12. Establishes that the Director of Health may impose fines for violations of items to be reported with the fines being deposited to the credit of the general operations fund of the Department. Such violations are considered either a minor misdemeanor or a misdemeanor of the first degree.