Kasich administration considers delaying proposed shift away from independent health providers



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COLUMBUS, Ohio — Gov. John Kasich's administration on Friday said it's open to delaying a proposal that has sparked hours of legislative testimony from people with disabilities who fear it could limit their choice in picking the workers who help them bathe, get dressed and tend to their basic needs at home.

The proposal in Kasich's two-year budget would shift Ohio away from directly paying independent health aides, nurses or other providers.

The move would affect more than 13,000 independent workers who help care for about 16,000 people.

Under the plan, Ohio Medicaid would not take claims for support services from any new independent providers starting in July 2016. By July 2019, the state would only accept billings submitted through certified agencies, except in certain circumstances.

The governor's Office of Health Transformation said Friday it would consider moving the 2019 date back two years, to July 2021, based on feedback it's gotten.

The office released the potential cutoff date in a budget-related document on its website. It also provided additional details about how those getting at-home care could continue to pick their providers.

Ohioans could keep their support workers if they apply to "self-direct" their care, administration officials said.

The option allows individuals, their guardians or authorized representatives to become the workers' employer or make arrangements with an agency that employs workers on the individual's behalf.

Less than 1 percent of Ohioans receiving Medicaid home- and community-based services are enrolled in self-direction. But state officials hope to expand it.

John Martin, the director of Ohio's developmental disabilities department, said the state is considering the longer timeline to gather input from providers, consumers, advocates and others about whether the option could work for more people.

"We want to make sure that folks are comfortable with what we are proposing," Martin said in an interview Friday.

Individuals and families shouldn't see a disruption of services, should they choose the option, he said. They could continue to recruit, hire, fire and train their support workers to meet their needs.

"We're committing that we're not eliminating providers, but rather transitioning them to a new model," Martin said. "We want to do that in a very planful way that continues to respect the individual's right to select and hire people providing services to them."

A state legislative panel reviewing the governor's $72.3 billion state budget braced for slew of proposed revisions on Friday, which was a deadline for amendments.

House Finance Chairman Ryan Smith has said he expects a revised budget to come before the committee by mid-April, with the full House voting on the measure during the third full week of April.

The Senate would then review the bill. The budget must be in place by June 30.

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