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The Usual--
Well, it looks like things will warm up a bit this week. That's bitter-sweet as it means that everything will be a grey, slushy, muddy mess as the frozen ground absorbs all the white stuff. Still, it will be nice to see 50 degrees again.
If any of you are letter-writers and/or really good phone call Karens-- Ohio government is voting the next biennium budget soon. CLI and our state wide advocacy group, OPRA (Ohio Provider Resource Association) would really like to see the budget maintain the current DD funding and codify automatic cost of living reimbursement increases into future state budgets for DD providers.
There was a 38% increase in DD reimbursement rates in 2024 because the original reimbursement rates were set in the early 1990's when minimum wage was well under $5 per hour. Fast-forward to 2023 and providers have to pay $15-$20/hour just to keep up with McDonalds-- but we were still being reimbursed at rates that allowed a slim margin at $5/hour. It was terrible and I don't want to repeat that cycle-- and it's a really big pill for governments to swallow a 30%+ budget increase in one year, when it could be avoided if annual inflation were just recognized in the rates. The irony is that government wages recognize the need for annual increases to keep up with inflation for their own employees. It's just common sense and fair that they offer the same to the contractors like CLI that provide the actual direct services to people.
Nationally, Tuesday the US congress is scheduled to vote on the national budget & there's been a lot of talk about cuts to Medicaid, but not clear reports on which Medicaid programs would be cut. Ohio's DD services are funded by Medicaid. We need to pay attention to this as it develops.
I'm scared about how quickly everything that we take for granted will fall apart if the US government were to stop all Medicaid payment for a few weeks as a method of determining what should be kept and what should be thrown out. There are a ton of inefficiencies in the system. I would like to see more of the billions that Ohio spends every year be allocated to direct services for people with DD, and I worry that the path we're on is not sustainable. But-- flawed as it may be-- Ohio has one of the best comprehensive DD service system of all the states. There is lots of room for improvement, but it's really important that our politicians don't knee jerk us into something that throws out everything.
This isn't a philosophic and/or political debate. If Medicaid were to suddenly stop, DD businesses would have to almost immediately stop services, lay off staff, and many would quickly go out of business. Bear in mind that right now individuals and their families don't usually have a ton of choices in providers because there already aren't that many service providers available.
I don't want to be negative. I tend toward cynical optimism if that's a thing. I only want to stress the importance of paying attention to the news, especially in regard to Medicaid. This is a dynamic time both politically and economically. Things are happening very quickly. Obviously there has been a lot of talk about trimming cost among the federal workforce, but the only way to save the trillions that people are talking about is to take it from Medicaid, Medicare, Social Security, and/or the Military. I worry that Medicaid is the most vulnerable.
Enjoy the warmer weather this week. Take the opportunity to get outside. The future to living long & well is to just keep moving!
-John
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