House Committee Hearings - Aging & Long Term Care

From Gongwer News Service, Inc. March 9, 2017

The Ohio House Aging and Long Term Care Committee heard testimony on its first bill, and also testimony from the Director of the Joint Medicaid Oversight Committee and Director of Medicaid.

HB 78 ADULT PROTECTIVE SERVICES (Retherford, W.) To revise the laws governing the provision of adult protective services. (1st Hearing-Sponsor)

Rep. Wes Retherford (R-Hamilton) provided sponsor testimony on the bill, which makes several changes to protective services laws, including the modification and expansion of the list of people required to report suspected elderly abuse, neglect or exploitation to county departments of job and family services. (LSC analysis)

The proposal is similar to legislation (HB24) that cleared the House last year but not the Senate, and the latest version includes changes that bill picked up in the Senate, the sponsor said.

"Elder abuse can happen to anyone - a family member or friend; Elder abuse can happen anywhere, next door, or at your local nursing home. Across the state of Ohio, older Ohioans are being victimized through violence, manipulation and fraud. That is why I have joined Ohio Attorney General Mike DeWine in supporting HB 78," Rep. Retherford said.

The sponsor cited statistics on what he described as an "invisible" problem that often occurs behind closed doors. "Many victims of elder abuse are reluctant to report abuse because of fear of abuser or denial; and tragically, some victims are unable to speak out due to dementia or other physical impairments," he said.

Recent studies show that about 11% of U.S. elders surveyed had experienced some type of abuse or potential neglect, and the National Council of Aging estimates that 5 million older adults suffer abuse annually, he said. Yet the incidents are often under-identified and under-reported, research shows, and as few as 1 in 14 cases of elder abuse come to the attention of authorities.

"As we continue to care for the 'greatest generation' and as 'baby boomer' generation reaches 65, it is imperative that we promote awareness of elder abuse and establish safeguards that protect our loved ones," Rep. Retherford said.

The sponsor said the bill addresses "significantly outdated" definitions in state law pertaining to elder abuse, which when originally crafted focused on physical abuse. Changes in the bill include a definition of financial harm "to ensure our seniors life savings and homes are protected," he said.

"Second, we acknowledged the state lacks the proper reporting requirements to accurately track elder abuse and identify patterns of abuse, as well as provide support to the individuals on the front lines who are charged with protecting our seniors. Our legislation will create a registry to help identify reported patterns of elder abuse," Rep. Retherford said.

The bill also codifies the Attorney General's Elder Abuse Commission, which was established in 2009. The sponsor said the new commission "will increase awareness and research of elder abuse, work to improve public policy, funding and programming, and improve the judicial response to elder abuse victims."

Responding to questions from members, the sponsor said there are still some details to work out with ODJFS in order to achieve the maximum amount of reporters while avoiding too many and being "out of control."

He told Rep. Stephanie Howse (D-Cleveland) that the AG has started developing training for reporters. The training will be made available to banks, financial institutions and other groups, he said, and the bill would leave some rules details up to the elder abuse commission and AG's office. He referred the lawmaker to the AG's office for answers regarding training costs.

Rep. Scott Wiggam (R-Wooster) asked why the bill eliminates some mandatory reporters. The sponsor said that change stems from concerns raised during Senate deliberations on the bill last session.

Rep. Retherford told Chairman Rep. Steven Arndt (R-Port Clinton) that the goal is to have one adult protective services agent in every county, and that a prior $10 million appropriation was for startup costs for the program. The sponsor said the cost of maintaining the program moving forward is an ongoing matter of discussion with the administration.

Medicaid Presentations: The panel fielded presentations from Medicaid Director Barbara Sears (Presentation) and Joint Medicaid Oversight Committee Executive Director Susan Ackerman (Presentation).

Chairman Arndt cut Ms. Sears's presentation short, saying he would have preferred a focus on aging issues versus the broader overview of the Medicaid program. Ms. Sears said she would be happy to return to the committee in the future with a more focused approach.

Rep. Dorothy Pelanda (R-Marysville) remarked, "I'm not sure what the purpose of the presentation is other than to completely overload us."

The Medicaid director said she assumed the panel wanted the more comprehensive overview of the program.

Part of Ms. Sears's testimony focused on the continued expansion of Medicaid managed care to include long-term care services, which prompted Rep. Pelanda to request more Ohio-specific "evidence-based data" on how MCOs have performed in the Medicaid arena.

"Just give us some basic evidence to support" the administration's plans, she said.

Ms. Sears said the latest progress report, which is also fairly dense with specifics, indicates that Medicaid recipients served under managed care are seeing improved outcomes. She added that in getting federal approval for the MyCare pilot program for managed care the state had to demonstrate it would be cost-effective.

Responding to a question from Rep. Janine Boyd (D-Cleveland Hts.), the Medicaid director said the administration is proposing to spend an additional $53.4 million in the budget to reimburse providers on the behavioral health side.

Ms. Sears told Rep. Wiggam that a component of personal responsibility in health care could be the purchase of long-term care insurance that serves to protect assets as citizens age and become dependent on more care.