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00:00:18ASSOCIATION, REPRESENTING
131,000 TEACHERS, SUPPORT
00:00:22PROFESSIONALS AND HIGHER
EDUCATION FACULTY WHO ARE
00:00:24WORKING FOR GREAT PUBLIC
SCHOOLS FOR EVERY CHILD, ONLINE
00:00:26AT OHEA.ORG.
ADDITIONAL SUPPORT FOR "THE
00:00:32STATE OF OHIO" IS MADE POSSIBLE
BY ETECH OHIO.
00:00:36>> A DEAL TO RESOLVE THE DUELING
TAX CUTS IN THE HOUSE AND SENATE
00:00:42VERSIONS OF THE BUDGET.
AND AS LAWMAKERS APPEAR POISED
00:00:43TO REJECT MEDICAID EXPANSION FOR
NOW, OHIO IS FACING BIG
00:00:46CHALLENGES IN HELPING THE
MENTALLY ILL.
00:00:47ALL THIS WEEK IN "THE STATE OF
OHIO".
00:00:49>> THERE'S A COMPLICATED DEAL ON
THE TABLE TO MAKE BIG CHANGES IN
00:00:56OHIO'S TAX STRUCTURE, TO TRY TO
MELD THE TWO TAX CUT PLANS IN
00:01:00THE HOUSE AND SENATE VERSIONS
OF THE BUDGET.
00:01:01THIS COMES AS THE COMMITTEE
THAT'S WORKING OUT THE BUDGET
00:01:05GOT NEW REVENUE AND MEDICAID
ESTIMATES TO FACTOR INTO THE
00:01:09HOUSE SPEAKER BILL BATCHELDER
AND SENATE PRESIDENT KEITH
00:01:12FABER, AND NOT MEMBERS OF THE
CONFERENCE COMMITTEE DEALING
00:01:15WITH THE BUDGET, ANNOUNCED THE
TAX PROPOSAL THIS WEEK.
00:01:16BUT ALONGSIDE THE LEADERS WERE
REPUBLICAN CONFERENCE COMMITTEE
00:01:20MEMBERS SEN. SCOTT OELSLAGER OF
CANTON AND REP. RON AMSTUTZ,
00:01:23THE CONFERENCE COMMITTEE CHAIR.
THE PLAN PULLS IN ELEMENTS OF
00:01:29GOV. JOHN KASICH'S ORIGINAL
BUDGET PROPOSAL, BUT NOT THE
00:01:32SEVERANCE TAX PLAN ON BIG OIL
AND NATURAL GAS DRILLERS.
00:01:33THE PROPOSAL INCLUDES A NEW
TAKE ON THE 7% INCOME TAX CUT IN
00:01:37THE HOUSE BUDGET THROUGH AN
INCOME TAX CUT PHASED IN OVER
00:01:42THREE YEARS - 8.5% THE FIRST
YEAR, 9% THE SECOND AND 10% IN
00:01:46THE FINAL YEAR.
THE FINAL YEAR WOULD BE IN THE
00:01:51NEXT BUDGET CYCLE.
IT ALSO INCLUDES A 50% INCOME
00:01:54TAX CUT FOR SMALL BUSINESSES UP
TO $250,000 OF THEIR INCOMES --
00:01:59THAT INCOME LEVEL IS REDUCED
FROM THE SENATE BUDGET, AND
00:02:03LAWMAKERS SAY IT WILL COVER
NEARLY ALL OF OHIO'S SMALL
00:02:06BUSINESSES.
THE TOTAL PACKAGE IS SAID TO BE
00:02:08A 2.6 BILLION DOLLAR TAX CUT
OVER THREE YEARS.
00:02:10TO PAY FOR BOTH OF THESE TAX
CUTS, THE STATE SALES TAX WOULD
00:02:15BE INCREASED FROM 5.5 PERCENT
TO 5.75 PERCENT.
00:02:21THAT WOULD BRING IN $800 MILLION
OVER TWO YEARS.
00:02:24THE PROPOSAL ALSO INCLUDES MEANS
TESTING FOR THE STATE'S
00:02:33HOMESTEAD PROPERTY TAX EXEMPTION
AND THE ELIMINATION OF THE
00:02:35PROPERTY TAX ROLLBACK OF 12.5%
ON NEW LEVIES.
00:02:36>> IN THIS BILL WE ARE LEAST
CONCERNED WITH -- WE ARE
00:02:50CONCERNED WITH THE LEAST WEALTHY
ELDERLY.
00:02:52THEY HAVE WORKED HARD THEIR
WHOLE LIFE.
00:02:58ON A FLAT PENSION OR WHATEVER IT
MAY BE -- THAT ALLOWS THEM TO
00:03:09KEEP THEIR HOMES.
>> THE NUMBER ONE THING THIS
00:03:14PLAN DOES THAT FORMER PLANS HAVE
NOT -- THIS IS SUSTAINABLE, IT
00:03:19IS BALANCE, AND IT DOES NOT RELY
ON MONEY.
00:03:21THE NEWS COMES A DAY AFTER
TESTIMONY BEFORE THE CONFERENCE
00:03:25MEDICAID.
BUDGET DIRECTOR TIM KEEN TOLD
00:03:27THERE WILL BE AN ESTIMATED $709
MILLION MORE IN TAX REVENUES
00:03:31ABOVE THE ORIGINAL FORECAST.
BUT AFTER OBLIGATIONS TO THE
00:03:35FEDERAL GOVERNMENT FOR
UNEMPLOYMENT BENEFITS,
00:03:37TRANSFERS TO THE RAINY DAY FUND
AND OTHER ISSUES ARE PAID, THERE
00:03:42WILL ONLY BE ABOUT $397 MILLION
EXTRA.
00:03:44THERE'S A LITTLE OVER A WEEK
REMAINING FOR THE CONFERENCE
00:03:49COMMITTEE TO MAKE
RECOMMENDATIONS AND FOR THE
00:03:51BUDGET TO PASS BOTH THE HOUSE
AND SENATE AND GO ON TO THE
00:03:54GOVERNOR BEFORE THE END OF THE
FISCAL YEAR.
00:03:55THAT'S ALL EXPECTED TO HAPPEN
NEXT WEEK.
00:03:58REACTION TO THE PROPOSAL WAS
SWIFT, AND THE RESPONSES WERE
00:04:03TOTALLY EXPECTED.
GOV. KASICH, WHO HAD WANTED A
00:04:0520 PERCENT INCOME TAX CUT ALONG
WITH THE SMALL BUSINESSES CUT,
00:04:12SAID, "THIS IS ANOTHER BIG STEP
FORWARD IN OHIO'S COMEBACK.
00:04:14BALANCING BUDGETS,
STRENGTHENING EDUCATION,
00:04:17REFORMING REGULATIONS AND
CUTTING TAXES AN ADDITIONAL $2.6
00:04:19BILLION -- THESE ARE THE KINDS
OF CHANGES OHIO IS MAKING THAT
00:04:21OTHER STATES AREN'T WHICH ARE
HELPING DRIVE OUR STATE FORWARD
00:04:25BETTER AND FASTER."
THE OHIO CHAMBER OF COMMERCE
00:04:29SAID IN A STATEMENT THAT READS
IN PART, "A CUT OF THIS SIZE
00:04:31WILL MAKE OHIO MORE COMPETITIVE
AND FREE UP MORE BUSINESS
00:04:35CAPITAL FOR FUTURE INVESTMENT,
ECONOMIC DEVELOPMENT AND JOBS.
00:04:38THIS WILL MAKE OHIO'S BUSINESS
CLIMATE, ALREADY ONE OF THE
00:04:41MOST IMPROVED IN THE NATION,
EVEN STRONGER."
00:04:43BUT DEMOCRATS BLASTED THE PLAN
AS TAX BREAKS FOR THE WEALTHY.
00:04:48SENATE MINORITY LEADER ERIC
KEARNEY OF CINCINNATI HAD ASKED
00:04:51FOR THE EXTRA MONEY IN THE
BUDGET TO GO TO EARLY CHILDHOOD
00:04:54EDUCATION.
HE WROTE IN A STATEMENT THAT
00:04:57SAYS IN PART:
"THROUGHOUT THIS BUDGET PROCESS,
00:05:00REPUBLICANS HAVE FAILED
MISERABLY AT PROVIDING THE
00:05:01RESOURCES OUR SCHOOLS AND
COMMUNITIES DESPERATELY NEED.
00:05:03INSTEAD OF FIXING THE PROBLEM,
THEY NOW PROPOSE TO MAKE THE
00:05:07SITUATION WORSE.
IF REPUBLICANS FOLLOW THROUGH
00:05:09ON THEIR THREAT TO ELIMINATE THE
PROPERTY TAX ROLLBACK, IT WILL
00:05:12MAKE IT HARDER FOR SCHOOLS AND
COMMUNITIES ACROSS THE STATE TO
00:05:15PASS LEVIES IN THE FUTURE."
ED FITZGERALD, WHO WILL LIKELY
00:05:20FACE GOV. KASICH IN HIS RE-
ELECTION BID NEXT YEAR, ISSUED
00:05:22A STATEMENT THAT INCLUDED THESE
LINES -- "THESE TAX CUTS THAT
00:05:26BENEFIT THE RICH MEAN FEWER
FIREFIGHTERS AND POLICE OFFICERS
00:05:29ON THE STREET AND FEWER
TEACHERS IN OUR CHILDREN'S
00:05:33CLASSROOMS.
THIS IS NOTHING BUT ANOTHER
00:05:36MASSIVE TAX SHIFT THAT WILL PUT
A GREATER BURDEN ON MIDDLE
00:05:38CLASS FAMILIES ACROSS OHIO IN
ORDER TO BENEFIT THOSE AT THE
00:05:41VERY TOP."
MEANWHILE, THOUGH MEDICAID
00:05:45EXPANSION IS NOT IN THE BUDGET,
OHIO LAWMAKERS ARE CONTINUING
00:05:47TO GRAPPLE WITH THE QUESTION OF
WHAT TO DO WITH THE MEDICAID
00:05:50PROGRAM.
THIS WEEK, THE HOUSE FINANCE
00:05:54COMMITTEE HEARD SPONSOR
TESTIMONY ON TWO BILLS. ONE
00:05:57WOULD EXPAND MEDICAID TO AS MANY
AS 366-THOUSAND OHIOANS MAKING
00:06:02UP TO 138 PERCENT OF THE
FEDERAL POVERTY LEVEL. ITS SOLE
00:06:05SPONSOR IS REPUBLICAN
REPRESENTATIVE BARBARA SEARS,
00:06:08WHO SAYS SHE'S PUT SAFEGUARDS IN
PLACE TO MAKE SURE THE FEDERAL
00:06:11GOVERNMENT DOESN'T LEAVE OHIO
HOLDING THE BILL FOR THE
00:06:15EXTENDED COVERAGE IN THE FUTURE.
AND SHE SAYS HER PLAN WOULD
00:06:18ALLOW THE STATE TO MAKE
IMPROVEMENTS TO THE MEDICAID
00:06:20PROGRAM.
>> "THIS IS A ONCE IN A
00:06:23LIFETIME OPPORTUNITY TO REFOCUS
OUR ELIGIBILITY GUIDELINES AND
00:06:25OUR MEDICAID PROGRAM TO ALLOW US
TO LOOK AT OHIOANS, WORKING
00:06:29POOR AND PROVIDE HOPE FOR A
MORE SUCCESSFUL OHIO."
00:06:31>> THE OTHER BILL IS SPONSORED
BY A QUARTET OF HIGH-PROFILE
00:06:37LAWMAKERS REPS. RON AMSTUTZ, A
REPUBLICAN OF WOOSTER, AND
00:06:40VERNON SYKES, A DEMOCRAT OF
AKRON, WHO ARE THEIR PARTIES'
00:06:43LEADERS ON THE HOUSE FINANCE
COMMITTEE AND THE CONFERENCE
00:06:45COMMITTEE. THE OTHER SPONSORS
ARE SENS. DAVE BURKE, A
00:06:49REPUBLICAN OF MARYSVILLE AND
CAPRI CAFARO, A DEMOCRAT OF
00:06:52HUBBARD NEAR YOUNGSTOWN. THE
GROUP SAYS THIS BILL IS ABOUT
00:06:55MEDICAID REFORM AND DOES NOT
EXPAND THE PROGRAM, BUT AMSTUTZ
00:06:59SAYS IT'S A WORK IN PROGRESS.
>> IT'S A GOOD BILL. IT
00:07:03LITERALLY HAS PIECES AND PARTS
THAT CAME FROM MEMBERS OF THE
00:07:06WORKING GROUP I BELIEVE.)
>> WITH THE BIG NAMES INVOLVED
00:07:08IN THE BIPARTISAN REFORM BILL,
AND WITH THE MINDSET OF MANY
00:07:12REPUBLICANS AGAINST MEDICAID
EXPANSION, IT APPEARS THAT
00:07:15REFORM IS THE PATH FOR MEDICAID
IN OHIO RIGHT NOW. AND SPEAKER
00:07:20BILL BATCHELDER SAID THIS WEEK
THAT THE WORK THAT'S NEEDED TO
00:07:23BE DONE ON MEDICAID CAN'T BE
COMPLETED BY THE END OF THIS
00:07:26MONTH. BUT GOV. JOHN KASICH
TOLD REPORTERS THIS WEEK HE'S
00:07:28NOT GIVING UP.
>> "IT WILL EITHER BE IN THE
00:07:32BUDGET OR IT WILL BE LATER BUT
I WANT TO MAKE THIS CLEAR, I
00:07:34WILL NOT GIVE UP THIS FIGHT
UNTIL WE GET THIS DONE.
00:07:37PERIOD.EXCLAMATION POINT.
I'VE PLEADED, ARGUED, PRESENTED
00:07:49-- IT IS WHAT IT IS IN THIS
BUSINESS.
00:07:51SO I'M NOT GOING TO GIVE THIS
UP. I WILL NOT. I DON'T CARE HOW
00:07:55LONG THIS TAKES.
HOPEFULLY IT WILL BE SOONER
00:07:59RATHER THAN LONGER.
I'M GOING TO DO MY BEST."
00:08:00>> SPEAKING OF MEDICAID, AN
ESTIMATED ONE IN FOUR PEOPLE,
00:08:05INCLUDING ONE IN FIVE CHILDREN,
HAVE SOME SORT OF MENTAL
00:08:08ILLNESS.
THAT COVERS DEPRESSION AND
00:08:10ANXIETY DISORDERS, AS WELL AS
SOMETIMES MISUNDERSTOOD
00:08:13DISORDERS SUCH AS BIPOLAR
DISORDER AND SCHIZOPHRENIA, AND
00:08:17ADDICTION TO DRUGS AND/OR
ALCOHOL.
00:08:20THE STATE IS HOPING TO BRING ALL
THOSE CONCERNS TOGETHER BY
00:08:23MERGING TWO AGENCIES, THE
DEPARTMENT OF MENTAL HEALTH WITH
00:08:25THE DEPARTMENT OF ALCOHOL AND
DRUG ADDICTION SERVICES.
00:08:26AND WHILE MENTAL ILLNESSES ARE
OFTEN PHYSIOLOGICAL IN NATURE
00:08:32AND CAN BE MANAGED, SERVICES TO
HELP PEOPLE GET TREATED, GET
00:08:34STABILIZED AND GET BACK TO WORK
AND LIFE ARE SPOTTY THROUGHOUT
00:08:39OHIO. AND WITH MEDICAID
EXPANSION UNLIKELY TO BE
00:08:41CONSIDERED BEFORE THE HOUSE AND
SENATE GO INTO RECESS, IT'S
00:08:44UNLIKELY THAT THOSE SERVICES
WILL BE DRAMATICALLY IMPROVED
00:08:46OR CHANGED.
HERE TO TALK ABOUT THE STATE OF
00:08:50MENTAL HEALTH IN OHIO IS TRACY
PLOUCK, THE DIRECTOR OF THE
00:08:53OHIO DEPARTMENT OF HEALTH, WHO
IS THE FORMER STATE MEDICAID
00:08:55DIRECTOR.
THE NATIONAL ALLIANCE ON MENTAL
00:09:04ILLNESS IS THAT OHIO IS
SPENDING $74.26 PER CAPITA ON
00:09:10MENTAL HEALTH SERVICES BUT WE
RANK WAY DOWN THE LIST IN TERMS
00:09:13OF HOW MUCH MONEY WE ARE
SPENDING.
00:09:15I HEARD AT THE METROPOLITAN CLUB
THIS WEEK, YOU WERE ON A PANEL
00:09:20TALKING ABOUT A SOCIETAL CLASS
OF MENTAL-HEALTH, THAT WE ARE
00:09:24ACTUALLY IN A SITUATION WHERE
THERE HAS BEEN MORE DISCUSSION
00:09:28ABOUT MENTAL-HEALTH THAN EVER
BEFORE.
00:09:29HOW ARE THESE TWO THINGS
WORKING, MAYBE WE ARE SPENDING
00:09:33LESS IN OTHER STATES BUT TALKING
ABOUT THIS ISSUE MORE?
00:09:36>> PART OF THE PROBLEM IS WE DO
NOT HAVE THE SERVICES, THE SORT
00:09:43OF SERVICES WITH A NEED TO BE.
-- THE SORT OF SERVICES WHERE
00:09:49THEY NEED TO BE.
I WOULD JUST LIKE TO START THERE
00:09:53FOR A MOMENT.
THERE ARE MANY PEOPLE WHO
00:09:56STRUGGLE WITH ADDICTION AND
MENTAL ILLNESS, MANY WHOM ARE
00:10:00WORKING.
THEY LACK ACCESS TO INSURANCE
00:10:03BECAUSE THEY CANNOT AFFORD IT OR
BECAUSE THEIR EMPLOYER DOES NOT
00:10:07OFFER IT OR BECAUSE THEIR
EMPLOYER SIMPLY DOES NOT HAVE
00:10:08ANY.
THEY HAVE ACCESS TO SAFETY NET
00:10:14SERVICES IF IT IS AVAILABLE.
GIVEN THESE SHORTAGE OF
00:10:17RESOURCES IN SOME AREAS OF THE
STATE, IF YOU ARE NOT IN AN
00:10:23ACUTE CRISIS WITH MENTAL HEALTH
OR ADDICTION YOU OFTENTIMES MAY
00:10:27BE TURNED AWAY FOR SERVICES.
THAT IS CREATING A GAP WHERE
00:10:32FOLKS WHO ARE NOT AT THE ACUTE
CRISIS LEVEL -- IT IS JUST NOT
00:10:40AVAILABLE.
THEY MAY CONTINUE TO COMPENSATE
00:10:45AND WHEN THEY ARE AT EIGHT.
OF CRISIS IT MAY BE WORSE FOR
00:10:49THEM.
THEN YOU ARE TALKING ABOUT
00:10:54HOSPITALIZATION, JAIL TIME,
EMERGENCY DEPARTMENT VISITS .S
00:11:01BY MAKING BEHAVIORAL DEVELOPMENT
AVAILABLE --
00:11:08THE SECOND THING IS THE GOVERNOR
IS PROPOSING THE EXPANSION OF
00:11:12MEDICARE TO INCLUDE PHYSICAL
HEALTH CARE FOR THESE
00:11:14INDIVIDUALS.
MANY TIMES IF A MEDICATION IS
00:11:18PRESCRIBED RELATING TO MENTAL
ILLNESS THERE ARE SIDE EFFECTS
00:11:22THAT CAUSE PHYSICAL HEALTH
CHALLENGES, ME BE AN INCREASE
00:11:26GAIN IN WEIGHT OR OTHER SORTS
OF COMPLICATIONS.
00:11:30HAVING ACCESS TO FISCAL HEALTH
HERE MAY HELP STAVE OFF OR
00:11:34MANAGE CHRONIC CONDITIONS THAT
MAY RESULT.
00:11:39IF YOU CAN AVOID NEGATIVE
CIRCUMSTANCES RELATED TO
00:11:45UNCHECKED DIABETES -- PEOPLE ARE
HEALTHIER AND TAXPAYERS ARE
00:11:50SPENDING LESS.
THE THIRD POINT I WANTED TO MAKE
00:11:53RELATED TO EXPANSION WAS TODAY
WE HAVE 50 LOCAL BOARDS OF -- 53
00:11:58LOCAL BOARDS OF MENTAL HEALTH
AND RECOVERY SERVICES AROUND THE
00:12:02STATE.
TO THE EXTENT THAT THESE PORTS
00:12:04CAN AFFORD TO PURCHASE CLINICAL
SERVICES TODAY, COUNSELING,
00:12:09DETOXIFICATION, THOSE KINDS OF
THINGS, THAT WILL BE FUNDED BY
00:12:15MEDICAID IN THE FUTURE.
THOSE ENTITIES CAN TAKE THOSE
00:12:18RESOURCES AND REROUTE THEM INTO
THINGS LIKE HOUSING AND
00:12:21EMPLOYMENT SERVICES AND PREVENT
MEANT PARTNERSHIP.
00:12:23THERE ARE MANY POSITIVE ELEMENTS
OF THE GOVERNMENT'S PLAN AS IT
00:12:31RELATES TO INDIVIDUALS WHO ARE
STRUGGLING WITH ADDICTION AND
00:12:34MENTAL ILLNESS.
>> IT SOUNDS LIKE THIS IDEA OF
00:12:36IS SOCIETAL CONFLICT WITH MENTAL
ILLNESS CAN BE QUANTIFIED.
00:12:40I READ A STATISTIC THAT SAID
OHIOANS WITH MENTAL ILLNESS DIE
00:12:49AS A RESULT -- DIE EARLIER AS A
RESULT.
00:12:54>> NOT MANY PEOPLE ARE DYING
FROM MENTAL ILLNESS EXACTLY BUT
00:12:58THEY ARE DYING FROM THE COMIC
CONDITIONS THAT ARE UNTREATED
00:13:00RELATED TO THEIR -- THE CHRONIC
CONDITIONS THAT ARE ON TREATED
00:13:05RELATED TO THEIR INABILITY TO
ACCESS CARE.
00:13:08>> DO YOU FEEL LIKE SOMETIMES WE
IGNORE THAT CROSS AND FOCUS ON
00:13:17THE BIG THINGS?
THE TRAGEDY'S WITH THE SCHOOL
00:13:19SHOOTINGS, THE PAIN KILLER
EPIDEMIC IN SOUTHERN OHIO, THESE
00:13:23KINDS OF THINGS?
>> THERE ARE CHALLENGES.
00:13:26I THINK ON MANY FRONTS WE ARE
TRYING TO ADDRESS GAP AREAS THAT
00:13:32WE KNOW EXIST.
IN THE LAST YEAR WE HAVE
00:13:35UNDERTAKEN A DIALOGUE WITH THE
SHARE ASSOCIATION DID MANY
00:13:39PEOPLE SERVED IN JAIL BECAUSE
-- SHARE ASSOCIATION.
00:13:44MANY PEOPLE SERVE IN JAIL
BECAUSE OF CIRCUMSTANCES THAT
00:13:50COULD BE AVOIDED.
WE SAT DOWN WITH SOME SHERIFFS
00:13:58AND SAID, "LET US TALK ABOUT OUR
COLLECTIVE CHALLENGE AS."
00:14:02AS A RESULT OF THE CAN LUCK --
OF THE CONSOLIDATION WE WILL BE
00:14:06SPENDING LESS ADMINISTRATION AND
COST NEXT YEAR.
00:14:10WE WANT TO TAKE THAT $1.5
MILLION AND INVESTMENT IN
00:14:13DEMONSTRATION PROJECTS WITH
COUNTY JAILS.
00:14:15IF WE USE JUST A LITTLE BIT OF
RESOURCE HERE TO CONNECT PEOPLE
00:14:20WHO MIGHT BE READY TO LEAVE THE
JAIL WITH HOUSING, OR PROVIDE
00:14:24SOME MANAGEMENT SERVICES, OR
MAYBE CONNECTING THEM WITH A
00:14:30PROVIDER THAT IS OUT OF THE
COUNTY.
00:14:31THE DEPUTY DOES NOT HAVE TO
DRIVE THAN TO GET AN ASSESSMENT,
00:14:35THEY CAN DO ONE ELECTRONICALLY.
THAT IS REDUCING COSTS WITHIN
00:14:39THE JAIL, AND IS ACTUALLY
CONNECTING PEOPLE BETTER WITH
00:14:42SERVICES THAT MIGHT HELP THEM.
WE ARE LOOKING FOR OPPORTUNITIES
00:14:46LIKE THAT.
AS A CONSOLIDATED AGENCY WE CAN
00:14:51REALLY PUT FOCUS ON BOTH MENTAL-
HEALTH AND ADDICTION IN THIS
00:14:55WAY, THAT WE MIGHT APPROACH A
SILO.
00:14:59>> I WAS ONE TO ASK ABOUT THE
CONSOLIDATION OF THE TWO
00:15:02AGENCIES.
HOW YOU AVOID GETTING INTO THIS
00:15:07MEGA-AGENCY PROBLEM WHERE THERE
IS A LOT OF ADMINISTRATION AND
00:15:10BUREAUCRACY COMING FROM THE TOP
AND YOU STILL HAVE LOCAL
00:15:14COMMUNITIES THAT CANNOT ACCESS
THE SERVICES THAT THEIR PEOPLE
00:15:16NEED?
>> WE ARE NOT ADDING STAFF AS A
00:15:19RESULT OF THIS COSTS -- AS A
RESULT OF THIS CONSOLIDATION.
00:15:22WE ARE PROUD OF THE FACT THAT WE
DO NOT HAVE TO DO ANY LAYOFFS.
00:15:30AS FAR AS THE RELATIONSHIPS
LOCALLY, WE STILL HAVE THE THREE
00:15:40COMMUNITIES TODAY -- BUTLER,
LORENA -- JUST BECAUSE WE ARE
00:15:48CONSOLIDATING DOES NOT MEAN WE
ARE NOT GOING TO REQUIRE OR EVEN
00:15:51ENCOURAGE ANY CHANGES THERE.
THAT IS A LOCALLY-LED DECISION.
00:15:54WHAT WE HOPE WILL BE
ACCOMPLISHED HERE IS WE CAN WORK
00:15:59MORE EFFECTIVELY AS A SINGLE
AGENCY BECAUSE LOCAL BOARDS,
00:16:03PROVIDERS, CLIENTS WILL DEAL
WITH A SINGLE STATE ENTITY
00:16:07RATHER THAN TWO.
TODAY WE HAVE TWO SEPARATE
00:16:11CERTIFICATION PROCESSES FOR
THESE PROVIDERS.
00:16:13WE HAVE MANY DIFFERENT
APPROACHES THAT HAVE BEEN
00:16:17REPORTED, OUT COMES OF
INFORMATION.
00:16:20THERE IS AN OPPORTUNITY TO MAKE
THIS EASIER FOR THE STATE.
00:16:23ONE WAY I WANT TO BE JUDGED
WITHIN A YEAR IS TO GO OUT AND
00:16:29ASK A CLIENT AND PROVIDER IT IS
EASIER IN TERMS OF BUREAUCRACY
00:16:34AND ACCESS TO SERVICE.
>> WHAT IS IT LIKE FOR LOCAL
00:16:39COMMUNITIES WHERE THEY CANNOT
PASS THE LEVEE.
00:16:43A LOT OF COMMUNITIES CANNOT
AFFORD IT.
00:16:49THEIR POPULATIONS ARE NOT VOTING
FOR THESE LEVIES.
00:16:50A>> WE HAVE HAD QUITE A BIT OF
TESTIMONY IN BOTH THE HOUSE AND
00:17:01SENATE IN RECENT MONTHS.
WE HEARD HER HEART WRENCHING
00:17:05TESTIMONY -- HEARD HEART
WRENCHING TESTIMONY FROM LOCAL
00:17:10PEOPLE WHO SAY THEY HAVE TO TURN
PEOPLE AWAY BECAUSE THEY DID NOT
00:17:13HAVE THE FUNDS.
AT ONE POINT THERE WAS A BOARD
00:17:16DIRECTOR THAT SHARED A STORE
WITH THE LEGISLATIVE PANEL THAT
00:17:19SHE WAS APPROACHED AT A
COMMUNITY EVENT AND A MOTHER
00:17:22MADE THE POINT THAT HER SON
WOULD BE ALIVE TODAY BUT FOR THE
00:17:25FACT THAT TREATMENT HAS NOT BEEN
AVAILABLE.
00:17:28IF RESOURCES HAD BEEN AVAILABLE
-- EVERYBODY WOULD HAVE WANTED
00:17:34TO OFFER THAT TREATMENT BUT IT
DID NOT EXIST BECAUSE THERE WERE
00:17:37NO FUNDS TO AFFORD IT.
AND IS REALLY A LIFE AND DEATH
00:17:43TO IT AND TO MANY COMMUNITIES.
IF YOU HAVE ACCESS TO MEDICAID
00:17:48-- IT OFFERS A FUNDING SOURCE SO
IF RESOURCES ARE A VERY SCARCE
00:17:54IN AN AREA THERE CAN BE
REIMBURSEMENT PROVIDED.
00:17:59I WAS IN SOUTHEAST OHIO ONE
MONTH AGO AND I MET WITH A
00:18:04COMMUNITY-BASED PROVIDER.
THEY WERE TALKING ABOUT FREE
00:18:07COUNSELING THEY GIVE AWAY
BECAUSE THERE WAS NO RESOURCES
00:18:10TO PAY FOR IT BUT COMMUNITY
DESPERATELY NEEDED.
00:18:13YOU CANNOT SUSTAIN A BUSINESS IN
THAT WAY.
00:18:15WE REALLY NEED TO THINK ABOUT
THIS AS THE SMALL BUSINESSES
00:18:19THAT ARE RENDERING SERVICES TO
OHIO, YOU CANNOT JUST SAY "DO
00:18:25MORE FOR FREE."
AT SOME POINT YOU COULD NOT
00:18:28AFFORD THE STAFF.
THIS IS AN ECONOMIC SITUATION
00:18:32FROM THE BUSINESS PERSPECTIVE,
AS WELL, NOT AS THE NEED TO
00:18:35CONNECT FOLKS WITH SERVICES.
>> YOU MENTIONED THERE IS A
00:18:38SHORTAGE OF PEOPLE WHO COULD SEE
PEOPLE -- A SHORTAGE OF
00:18:44SERVICES, IN A WAY.
HOW WILL MEDICAID HELP IF WHEN
00:18:47YOU'RE GOING TO BE -- MEDICAID
HELP WHEN YOU'RE GOING TO BE
00:18:52ADDING MORE PEOPLE?
DO YOU THROW ALL THESE PEOPLE
00:18:54INTO THE SYSTEM -- HOW DOES THIS
WORK THAT THEY WOULD GET BETTER
00:18:58HEALTH?
>> THEY ARE FUNDED THROUGH THE
00:19:04SAFETY NET.
IF LOCAL LEVEE DOLLARS ARE
00:19:06AVAILABLE OR THEY ARE IN A
PARTICULAR PART OF THE STATE
00:19:09THAT IT CAN BE AVAILABLE, IT CAN
BE PURCHASED.
00:19:12THE FEDERAL GOVERNMENT ACTS AS A
PEER FOR THOSE SERVICES AND
00:19:19INCREASES MORE REVENUE INTO THE
SYSTEM.
00:19:21YOU CAN -- DEMAND FAR OUTSTRIPS
THE SUPPLY IN SOME AREAS OF THE
00:19:29STATE.
CLEARLY CAPACITY LIKE CHILD
00:19:34PSYCHIATRY IS NOT GOING TO
MATERIALIZE OVERNIGHT.
00:19:38THAT IS TRUE FOR MANY AREAS OF
HEALTH CARE.
00:19:41ONE THING WE HAVE BEEN TRYING TO
DO IS LOOK AT SOME CREATIVE WAYS
00:19:44TO EXTEND SHORTAGES BUT, ADDRESS
THOSE OVER A GREATER DISTANCE.
00:19:50WE HAVE INITIATIVE UNDER WAY
WITH THE DEPARTMENT OF
00:19:54DEVELOPMENTAL DISABILITIES WHERE
THERE IS A SPECIALTY PSYCHIATRY
00:19:57PRACTICE THAT SPECIALIZES IN
PSYCHIATRY FOR DIFFICULT AND
00:20:05DISTURBED INDIVIDUALS WHO ARE
BOTH MENTALLY ILL AND
00:20:07INTELLECTUALLY DISABLED.
WHAT WE SAID IS WE NEED AN
00:20:11INVESTMENT OF $100,000 TO
BASICALLY USE TELE-MEDICINE.
00:20:16THEY DO NOT HAVE THE SPECIAL
PSYCHIATRY AVAILABLE WITHIN
00:20:24DRIVING DISTANCE THEY CAN
CONNECT TO, AND RECEIVE ONGOING
00:20:28CONSULTATION FROM THIS SPECIALTY
AREA.
00:20:29THAT IS ONE WAY WE ARE NOT GOING
TO SHORE UP ALL OF THE GAP
00:20:35AREAS.
THERE ARE SOME STEPS WE CAN TAKE
00:20:37TO HELP IN SOME REGARDS.
>> WITH THE MEDICAID EXPANSION
00:20:41QUESTION THERE IS A LOT OF
ISSUES.
00:20:43LAWMAKERS ARE CONCERNED ABOUT
THE FEDERAL GOVERNMENT BEEN
00:20:47THERE OVER TIME TO PAY THE
BILLS.
00:20:48THERE IS ALSO THE QUESTION OF
MENTAL HEALTH AS BEING PART OF
00:20:51THE OVERALL PHYSICAL HEALTH.
IT SEEMS LIKE IT IS IN THERE BUT
00:20:56NOT ALWAYS COUNTED AS AN
ELEMENT OF PHYSICAL HEALTH.
00:20:59WE TALK ABOUT BEING ILL WITH
CANCER, WE DO NOT NECESSARILY
00:21:04TALK ABOUT MENTAL ILLNESS AS A
PART OF THAT.
00:21:05>> IN MY 18TH YEAR OF STATE
GOVERNMENT RIGHT NOW -- ONE OF
00:21:11MY EARLIEST JOBS WAS BUDGET
ANALYST AT THE STATE OFFICE.
00:21:15IF YOU WOULD HAVE ASKED ME BACK
THEN HOW MUCH OF MEDICAID IS
00:21:22RELATED TO MENTAL HEALTH I WOULD
HAVE GIVEN YOU THE PARTS THAT
00:21:25ARE FUNDED THROUGH THE COMMUNITY
MENTAL HEALTH SERVICES AT OUR
00:21:28DEPARTMENT.
REALLY WHAT YOU HAVE TO LOOK AT
00:21:30IS THE OVERALL MEDICAID PLOT
RELATED TO INDIVIDUALS RELEASED
00:21:34-- RELATED TO INDIVIDUALS
RECEIVING THOSE SERVICES.
00:21:37WE TOOK THAT ANALYSIS.
APPROXIMATELY 10% OF ALL PEOPLE
00:21:42ENROLLED IN MEDICAID IN OHIO HAD
SERIOUS AND PERSISTENT MENTAL
00:21:48ILLNESS.
THEY ACCOUNTED FOR 26% OF
00:21:52MEDICAID SPENDING.
NOT LOOKING AT THIS AS FAR AS
00:21:55THE WHOLE PERSON -- IT IS GOING
TO INCREASE OUR COSTS DOWN
00:21:58STREAM BECAUSE IT YOU HAVE
SOMEBODY COMING REGULARLY TO
00:22:05INTERACT FOR COUNSELING AND
STUFF, BUT THEY ARE AFRAID
00:22:11TO GO TO THE DOCTOR BECAUSE THEY
DID NOT DEAL POOR THEY ARE
00:22:15APPREHENSIVE ABOUT THAT, THEY
PROBABLY HAVE MORE PHYSICAL
00:22:19HEALTH CONDITIONS THAT ARE
SPIRALING OUT OF CONTROL.
00:22:21WE INTRODUCE THE HOME CONCEPT,
WE HAVE 14,000 PEOPLE ENROLLED
00:22:26IN FIVE COUNTIES.
WE WILL BE STATEWIDE IN OCTOBER.
00:22:30IT IS AN ATTEMPT TO COORDINATE
BETTER THE PHYSICAL HEALTH AND
00:22:34MENTAL HEALTH AND ADDICTION
NEEDS OF AN INDIVIDUAL SO THAT
00:22:37YOU ARE LOOKING AT THE WHOLE
PERSON, THEIR OVERALL NEED,
00:22:41RATHER THAN THE SILENCE THAT
EXISTED PREVIOUSLY.
00:22:43>> THE SILOS HAVE FLIPPED THERE.
IS THAT RELATED TO THE STIGMA
00:22:48BUILT AROUND MENTAL ILLNESS AND
THE WHOLE IDEA THAT YOU CAN DO
00:22:53SOMETHING ABOUT IT, ESPECIALLY
IF IT WAS AN ADDICTION.
00:22:56DO YOU STILL FIND PEOPLE HAVE
THIS ATTITUDE ON MENTAL ILLNESS?
00:23:01>> THERE ARE A COUPLE OF THINGS
HERE.
00:23:05HISTORIC PLEA HISTOR -
HISTORICALLY THERE HAVE BEEN
00:23:16COMMUNITY HEALTH CENTERS BUILT.
THERE WAS PRIDE IN THE FACT
00:23:18THERE WAS SEPARATION.
FROM A BUREAUCRACY STANDPOINT
00:23:22THIS IS SORT OF THE WAY THAT THE
PRACTICE OF MEDICINE HAD
00:23:27EVOLVED.
I THINK FROM THE STIGMA
00:23:29PERSPECTIVE THERE IS STILL A LOT
OUT THERE.
00:23:34I MET WITH QUITE A FEW
LEGISLATORS OVER THE LAST PERIOD
00:23:38OF MONTHS.
A LOT OF MY COLLEAGUES BELIEVED
00:23:50THAT ADDICTION IS LIMITED TO
YOUNG MEN, AGE 29, WHO ARE TOO
00:23:53LAZY TO GO TO WORK, WHO ARE
SMOKING POT ON MOM'S COUCH.
00:23:57THERE ARE MANY PROFESSIONAL
FIGURES WITH SIX-FIGURE INCOME
00:24:03AS THAT STRUGGLE WITH ADDICTION.
UNTIL WE REALLY EMBRACE THIS IN
00:24:11A WAY -- IT IS NOT THEIR FAULT
THEY GET CANCER.
00:24:16IT HAPPENS.
THE MORE WE CAN DO TO ELIMINATE
00:24:22STIGMA, I THINK THAT WILL HELP
OVER TIME.
00:24:25I THINK WE HAVE A LONG WAY TO
GO.
00:24:26>> IF MEDICAID EXPANSION DOES
NOT HAPPEN, WHAT HAPPENS GOING
00:24:30FORWARD FOR YOUR TWO AGENCIES
AND FOR THE PEOPLE YOU SERVE?
00:24:34>> WE WILL CONTINUE, CLEARLY.
WE ARE GOING TO BE GRAPPLING
00:24:39WITH MANY OF THE SAME PROBLEMS
THAT WE HAVE HAD FOR DECADES.
00:24:44CANDIDLY, I THINK THIS IS AN
OPPORTUNITY THAT MIGHT BE A ONCE
00:24:48IN A LIFETIME OPPORTUNITY, TO
REALLY TAKE ADVANTAGE OF THE
00:24:55ABILITY TO EXTEND HEALTH CARE TO
PEOPLE WHO DO NOT HAVE ACCESS
00:25:02TODAY.
YOU ARE NOT ONLY HELPING
00:25:04INDIVIDUALS BUT YOUR FAMILIES,
YOUR EMPLOYERS, IT IS ABOUT
00:25:07MAKING OHIO STRONGER.
I WOULD HATE TO SEE US MISS THIS
00:25:11OPPORTUNITY.
>> ONE OF THE CRITICISMS ABOUT
00:25:14MEDICAID IS IT IS A BROKEN
SYSTEM.
00:25:16YOU ARE CONFIDENT THAT IT CAN
HELP PEOPLE?
00:25:19>> WE HAVE MEDICAID RUNNING
THROUGH OUR SYSTEM TODAY.
00:25:22PEOPLE RECEIVE TREATMENT AND
RECOVERY IS POSSIBLE.
00:25:29I THINK THAT CONTINUING TO NOT
ENABLE ACCESS TO BASIC SUPPORT
00:25:38THAT WOULD HELP A PERSON GET ON
THE BACK -- HELPERS AND GET BACK
00:25:43ON THE RIGHT PATH, IS
UNCONSCIONABLE.
00:25:45>> AND THAT'S IT FOR THIS WEEK.
FOR MY COLLEAGUES AT OHIO PUBLIC
00:25:49RADIO AND TELEVISION, THANKS FOR
WATCHING.
00:25:50IF YOU'D LIKE TO ASK QUESTIONS,
MAKE COMMENTS, OR WATCH THIS
00:25:52WEEK'S SHOW OR EARLIER EPISODES,
PLEASE VISIT OUR WEBSITE AT
00:25:54STATENEWS.ORG.
YOU CAN ALSO CHECK US OUT ON
00:25:56FACEBOOK, AND YOU CAN FOLLOW JO
INGLES AND ME ON TWITTER.
00:25:58AND PLEASE JOIN US AGAIN NEXT
TIME FOR "THE STATE OF OHIO".
00:26:01CAPTIONED BY THE
NATIONAL CAPTIONING INSTITUTE
00:26:07--WWW.NCICAP.ORG--
>> SUPPORT FOR "THE STATE OF
00:26:12OHIO" COMES FROM THE LAW OFFICES
OF PORTER, WRIGHT, MORRIS &
00:26:14ARTHUR LLP., HELPING BUSINESSES
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00:26:16LEGAL PROBLEMS THROUGHOUT OHIO,
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00:26:21THE WORLD ON THE WEB AT
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00:26:22AND FROM THE OHIO EDUCATION
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00:26:27131,000 TEACHERS, SUPPORT
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00:26:35ADDITIONAL SUPPORT FOR "THE
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Note : Transcripts are compiled from uncorrected captions