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Published: Thursday, 4/14/2005

House budget plan eyes single unit to manage Medicaid

BY JIM PROVANCE
BLADE COLUMBUS BUREAU

COLUMBUS - Five years after Gov. Bob Taft merged two agencies to form one massive Ohio Department of Job and Family Services, lawmakers are looking at dividing it again.

The $51.3 billion, two-year budget bill that passed the House this week calls for creation of a stand-alone Department of Medicaid, merging various operations from several agencies involved with the $10 billion-a-year health insurance of last resort for 1.7 million poor, disabled, and infirm Ohioans.

Medicaid represents 64 percent of Job and Family Services' $16 billion annual budget, not counting dollars it passes through for Medicaid functions in the Departments of Aging; Health; Mental Retardation and Developmental Disabilities, and Alcohol and Drug Addiction Services.

"We have Medicaid issues distributed through a number of different agencies in the state, and we have no coordinating mechanism for all of those expenditures," House Speaker Jon Husted (R., Kettering) said. "It's the largest single line item in the budget. We need to give that the priority focus it deserves."

A council would be created to develop an implementation plan and report back to Mr. Taft by Dec. 31, 2006, with the goal of having the new department in place by July 1, 2007.

In 2000, the former Department of Human Services and the Bureau of Employment Services were merged to create the new Department of Job and Family Services, a recognition of the link between welfare reform and jobs. The result was a department with a current budget of $16.3 billion and 3,795 employees involved in health care, welfare, foster care, nursing homes, child support, food stamps, unemployment, and job training.

The transition was not seamless, as the new department was soon embroiled in a number of problems involving failed computer programs, improperly withheld child support payments, and unbid consulting contracts.

"It was a mistake, and the chickens have come home to roost," House Minority Leader Chris Redfern (D., Catawba Island) said. "It led to an unseemly, out-of-control bureaucracy that has afforded little in the way of accountability. It needs to be reined in."

The Ohio Commission to Reform Medicaid, created two years ago with appointments by the governor and legislature, recommended the new department. The idea flies in the face of the general consolidation trend of the budget Mr. Taft proposed and the one the House sent to the Senate.

"The governor's budget proposal focuses on immediate steps to reduce growth in Medicaid costs," Taft spokesman Mark Rickel said. "We appreciate the work of the Commission to Reform Medicaid and the House of Representatives in considering a different government structure, and we're willing to participate in discussions about long-term savings."

The current budget plan restrains Medicaid growth below inflation over the next two years after experiencing 12 percent growth last year. The House version removes 25,000 working poor adults from the general Medicaid insurance rolls, eliminates routine dental checkups for adults who remain, and greatly expands managed care.

Contact Jim Provance at:

jprovance@theblade.com

or 614-221-0496.



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