1. Gov. John Kasich’s State Fiscal Year 14-15 Budget Mental Health and Addiction Services Highlights John R. Kasich, Governor Tracy Plouck, Director

2. K-12 Funding – Advancement Everywhere Plan Higher Education – Refocusing on Degree Completion Tax Reform – Cutting Income Taxes, Sales Taxes and Taxes on Small Business Turnpike – Jobs and Transportation Plan Medicaid – Health Care for the Neediest Ohioans

3. 1.Extending Medicaid coverage to 138% of poverty – simplifying and modernizing eligibility 2.Recovery Requires a Community – redirecting individuals with serious and persistent mental illness out of institutions and into the community 3.Consolidating Mental Health and Addiction Services – moving administrative savings into Community Innovations services

4. GRF – Funding for fiscal year 2014 is $315.7 million (or a 0.2% increase from fiscal year 2013). – Funding for fiscal year 2015 is $315.9 million (or a 0.1% increase from fiscal year 2014). All Funds – Funding for fiscal year 2014 is $643.8 million (or a 20.2% decrease from fiscal year 2013). – Funding for fiscal year 2015 is $636.0 million (or a 1.2% decrease from fiscal year 2014). – Note that the all funds numbers decrease is due to the run out of Medicaid claims that are now the responsibility of Ohio Medicaid.

5. Elevation of Medicaid match responsibility to the state level – Created a predictable and sustainable future for local board systems – Focuses local efforts on unmet needs, such as housing and employment supports

6. Create Medicaid health homes for people with severe and persistent mental illness (SPMI) – Ohioans with mental illness represent 10% of Ohio’s Medicaid population, but 26% of the cost – Health homes promote the integration of physical and behavioral health care – Meets the needs of the whole person through case management – Approximately 14,000 clients enrolled in Phase I, scheduled to go statewide July 1, 2013

7. Targeted investments to restore behavioral health funding – Governor Kasich’s Jobs Budget increased state funding for mental health by 5.7% ($26.8 million) over two years, reversing a downward trend since 2008 in which state funding was reduced by 19.5% ($112.4 million). – $10 million investment in community capital projects – largest investment in more than 10 years – Additional investment in both mental health and addiction in the mid-biennium review for a total of $6 million – $5 million investment targeted at youth and young adults with intensive needs

8. Modernizing Ohio’s Medicaid eligibility will reduce costs and improve care quality Offering Medicaid to more Ohioans will keep our federal tax dollars here at home Ohio’s proposal will mitigate spikes in health care premiums caused by Obamacare Serving more Ohioans at no extra cost to Ohio Preventing hospital layoffs and closures by reducing hospital uncompensated care

9. Offering coverage for 366,000 estimated to enroll and avoiding a coverage gap for childless adults – effective Jan. 1, 2014 – Childless adults struggling with substance use and unable to work – NOW COVERED – Transition age youth in danger of losing services when entering adulthood – NOW COVERED – Prisoners re-entering the community after getting treatment in corrections, but needing continued services to find employment and avoid recidivism – NOW COVERED

10. An estimated $70 million annually ($105 million for the FY 14-15 biennium) in local board spending can be redirected to community services such as housing and transportation or addressing waiting lists – Funds paying for 100% of services on the Medicaid service array for individuals who are not currently eligible but will become so 1/1/14 – Redirects state subsidy and county levy funds to address basic needs that ensure a person’s ability to be a contributing member of the community

11. Collective set of initiatives that will assist nursing home residents under age 60 who have a primary diagnosis related to mental illness to move into the community – Provides care in less restrictive settings at lower taxpayer expense – Cost avoided by moving one person into the community is approximately $35,250 per year Goal: Move 1,200 individuals into the community over the course of the biennium

12. Funding follows the person from the institution to the community – Temp law will allow MHAS and Medicaid to transfer assumed savings that would have otherwise been spent on nursing home costs to support community living – Access Success II pilot will utilize $1 million to move individuals residing in non-Medicaid institutions (such as state psychiatric hospitals) into the community

13. Improve care coordination and quality in adult care facilities – Enhanced rate for adult care facilities that connect residents to a Medicaid health home or other appropriate case management – Supports an important housing option for individuals moving out of institutions – Continues support for the Residential State Supplement program (RSS) and commits to future program improvements

14. Recovery Requires Housing – voucher program to assist with rent costs and ensure safe housing options for individuals who are not eligible for other supports Reduce inappropriate admissions into nursing homes – Budget language will eliminate the exemption from a Preadmission Screening and Resident Review (PASRR) prior to admission into a nursing home when coming from psychiatric hospital facility licensed or operated by MHAS

15. In May 2012, Governor Kasich announced plans to consolidate the Ohio Departments of Mental Health (ODMH) and Alcohol and Drug Addiction Services (ODADAS) into a single cabinet agency effective 7/1/13 The two systems have much in common, including a shared local board system, shared providers, shared federal authority and many shared individuals being served The ultimate goal is to provide a system for prevention and treatment of mental illness and addiction with no wrong doors, shared resources, and combined expertise

16. Jobs Budget 2.0 finalizes the consolidation, which is already underway, through permanent law changes and an aligned budget structure An estimated annual administrative cost savings will be redirected to Community Innovations – Focus on partnerships with the criminal justice system – Identify partnerships with sheriffs and DRC which will assist individuals with behavioral health needs and reduce recidivism and support public safety

17. Commitment to continuing the fight against opiate abuse Area of focus for Director Orman Hall Governor’s Cabinet Opiate Action Team (GCOAT) work will continue – Evaluate prescribing practices for opiates – Launch of Southern Ohio Treatment Center – Medication-Assisted Treatment (MAT) Protocols – Addressing Neonatal Abstinence Syndrome (NAS) in babies born to addicted mothers

18. Continued support of the state’s six psychiatric hospital facilities, including a significant planned upgrade to Electronic Medical Records systems through a partnership with The Ohio State University Collaborative work with Ohio for Responsible Gambling (ORG) state agencies to address problem gambling through resources from the problem gambling fund from casinos and racinos

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