Cleveland Plain Dealer. May 7, 2023.

Editorial: Nursing-home budget largesse should reflect need, not lobbying clout

Nursing home operators seem to be getting a pretty good return on their prior campaign contributions, if the state’s pending two-year budget is any indicator. That’s not a positive.

As the 2023-25 budget now makes its way through the Senate, and then a conference committee to reconcile differences between the Ohio House and Senate, lawmakers must take a more critical look at what the state’s powerful nursing home lobby legitimately needs and what guardrails, including audits, are needed to make sure taxpayer money doesn’t just end up lining the pockets of for-profit nursing home operators.

First came the contributions. Cleveland.com’s Jake Zuckerman reported in November that nursing home “PACs and individual facility operators contributed more than $1.4 million to state races during the 2021-2022 campaign cycle alone, almost entirely to Republicans who rule Ohio.”

Then, the apparent payoff. Zuckerman reported last month that “older Ohioans in nursing homes or receiving home-based care could see a big boost in state funding under an Ohio House framework that significantly changes the governor’s proposed budget” — Substitute House Bill 33, as passed by the House. DeWine’s budget provided extra money to nursing homes, but the House made it bigger.

Zuckerman also noted budget victories on the home health-care side, including new spending for home and community-based care and better wages for direct support professionals who help disabled people stay in their homes rather than in nursing homes.

But overall, Zuckerman wrote, “While some budget lines amount to a victory for home-care patients, few industries won as big as nursing homes in the House budget.”

Key examples of industry wins in the House, which passed its substitute budget bill on a bipartisan 78-19 vote April 26:

— “Rebasing”: Increasing the frequency of how often the nursing home industry can boost nursing home rates in terms of inflation. According to the Legislative Service Commission, the cost of this House amendment is $607 million per fiscal year. Republican Gov. Mike DeWine’s budget proposal didn’t request the rebasing provision.

— High-occupancy premium: The House rewrite “reworks the state’s quality incentive program, rewarding (nursing) homes with higher occupancy rates,” Zuckerman reports. According to the LSC, the cost of this House amendment is $32 million per fiscal year. The governor didn’t request this.

— Adds private-room payouts: The House rewrite “offers an add-on payment to facilities that put Medicaid patients in private rooms.” According to the LSC, the cost of this House amendment is $82 million per fiscal year. The governor didn’t request this, although Zuckerman notes it’s widely supported as a way to improve patient dignity and for infection control.

— Pandemic bonus for six upscale facilities: The retroactive rewrite “would allow some of the $350 million pool in previously appropriated federal coronavirus relief (American Rescue Plan Act) dollars to flow to roughly six nursing homes that aren’t enrolled in Medicaid. Those more upscale facilities cater to people with private insurance.” LSC didn’t estimate the additional cost. The governor didn’t request either the appropriation or the retroactivity.

Netted out with some related Medicaid nursing home provisions, the amendments Zuckerman cited would boost Ohio Medicaid spending over two years by $1.43 billion, the LSC estimated.

It begs the questions: Why do nursing homes get this largesse, and not local governments, still footing the bill after Ohio’s failure to fully restore Local Government Fund spending slashed after the 2008 recession?

And are the guardrails sufficient?

More money is tied into federal quality metrics, Zuckerman reports. But will the state actually audit use of these monies? It should.

And why not use this spending to force improvements in nursing-home deficiencies, such as nonresponsiveness to residents’ needs, that drive a large proportion of complaints in Ohio.

DeWine, who highlighted Ohio nursing homes’ low national rankings his State of the State, needs to turn his concerns about nursing-home quality into real guideposts for state spending.

According to the LSC, Ohio Medicaid “provides health insurance coverage to more than 3.5 million low-income Ohioans, including over 1.3 million children” and “is the largest single state program,” accounting “for nearly 5% of Ohio’s economy.”

By definition, Medicaid is for those in need of health coverage who lack the personal resources to pay for it.

It is not a slush fund for a deep-pocketed lobby. The Ohio Senate, House-Senate conferees and ultimately Gov. DeWine need to take a close look at this spending and pare it back to a reasonable amount that can be justified when balanced against other urgent health care and continuing care needs in Ohio.

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Toledo Blade. May 3, 2023.

Editorial: Another utility scam

The residue of corruption from the FirstEnergy bribery scandal raises significant questions regarding proposed legislation purportedly devoted to encouraging energy efficiency and environmental protection.

House Bill 79, sponsored by Majority Floor Leader Rep. Bill Seitz, a longtime proponent of utility cash flow enrichment legislation, is challenged by opponents who doubt energy efficiency and environmental protection are the motivation for the proposal.

Everyone wants to contribute to reducing consumption of fossil fuel. But there is well-advised, widespread distrust of state government (“Is H.B. 79 meant to promote energy efficiency or generate revenue for utilities,” Tuesday), especially the Public Utility Commission of Ohio, fueling opposition to the proposal.

It is a seemingly minor expense for such a vigorous clash.

H.B. 79 proposes to add $1.50 a month to electric bills to fund ratepayers’ conversions to more energy efficient appliances or weatherization upgrades to cut consumption. Consumers could opt out of the fee — if they can navigate the system. But most of the 4.9 million ratepayers will simply pay the fee at a cost of $90 over the five year life of the program.

That would add more than $400 million to the electric utilities bottom-line and assuming a price-earnings multiple of 15, less than their current multiples to be conservative, it supports $6.6 billion of market capitalization.

A far bigger bonanza is the “lost distribution revenue,” which reimburses the utility for the diminished cash flow caused by energy efficiency.

No Ohioan should trust the PUCO will adequately monitor that expense after watching them perform concierge service for the racketeers convicted of conspiring to provide a corrupt $1.3 billion benefit to FirstEnergy. H.B. 79 is likely headed to the same defeat that a version in the last session of the General Assembly suffered.

But the scandalous H.B. 6 didn’t pass the first time, either, so we must remain eternally vigilant to continuous state government attempts to afflict consumers in order to comfort campaign contributors. Ohio utilities are at the very top of that list.

Lawmakers who were actually working for citizens would make opt-in requirements mandatory for so-called “voluntary” programs. They would enact a provision to refund unlawful utility charges.

Since 2008 the PUCO has approved more than $1 billion in electric rate increases ruled unlawful by the Ohio Supreme Court. There is nothing in Ohio law that requires refunds, so the utilities kept the money and enjoyed the same multiple boosting benefit to their stock value as described above.

H.B. 79 is smoking gun evidence that the Republican House caucus has not learned any lessons from the worst scandal in the history of Ohio and is intent upon a return to business as usual enabling utilities to plunder ratepayers.

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Youngstown Vindicator. May 5, 2023.

Editorial: Ohio counties must get ready now for growth

Buckeye State residents may find hope in the wave of technology companies looking to establish themselves here, as Google announces plans to build two more data centers in Columbus and Lancaster. That region is already home to data centers for Facebook and Amazon, and an established Google facility. The three data centers would bring Google’s total investment in Ohio to more than $2 billion.

Those are in addition to the $20 billion Intel chip factory near New Albany, and the planned $3.5 billion Honda / LG Energy Solutions of South Korea battery plant between Columbus and Cincinnati.

“Ohio is a growing technology hub and data center market, and we welcome these two new Google projects in Columbus and Lancaster to complement the one already in New Albany,” Gov. Mike DeWine said.

It is wonderful news, indeed, but residents of the state’s perimeter counties will note none of that development is within DeWine’s hoped-for one-hour commute for them.

Facilities such as the data centers in question require a large amount of electricity and high-voltage transmission lines. They can generate so much heat that in parts of the country complaints have grown mostly about the constant noise from fans needed to cool the computers and servers.

There is work to be done for communities to accommodate these kinds of employers.

But it appears Ohio is in a chicken-and-egg situation when it comes to economic development that serves the entire state. Companies do not want to build in areas that don’t have good infrastructure, broadband, site readiness, housing, etc. But those communities outside the one-hour range of the development-ready areas don’t have the revenue to become appealing to large employers.

State lawmakers and officials in those rural, Appalachian and otherwise outlying counties will have to focus on a “Field of Dreams” approach to economic development, and build what is needed to thrive in a 21st century economy in the hope that large employers will come. Our current approach — waiting for them to say they want to be here and then figuring out how to build for them — isn’t doing the job.

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Sandusky Register. May 2, 2023.

Editorial: Altogether: Welcome birders

Get ready, set, go — or get ready to go.

Thousands of bird enthusiasts and nature lovers worldwide will soon gather on Ohio’s shores to celebrate the Biggest Week in American Birding. Welcome, welcome and welcome, are the three most important words for our community to make everyone who visits feel right at home.

We’re good at that, welcoming tourists to our area is what we do.

The annual 10-day festival is scheduled from May 5-14 and is sponsored by the Black Swamp Bird Observatory in Oak Harbor. Co-hosts of the event are the Maumee Bay Lodge and Conference Center, Shores & Islands Ohio and Destination Toledo.

Kim Kaufman, the observatory’s executive director, expects 90,000 human visitors to fly, or drive, into the area.

“It is an incredibly immersive experience that brings people from all over the world to northwest Ohio,” Kaufman said.

The annual festival occurs the first week of May, as it coincides with the peak of songbird migration, allowing guests to see many different species of these birds up close — more than 30 — at about a dozen different locations.

Kaufman said that the northwest Ohio region is ideal for seeing these birds. Their three main migratory routes converge over Northwest Ohio and act as a barrier that the birds are reluctant to cross. This hesitation causes a funneling effect, as the birds will refuel in the surrounding marshland before they cross Lake Erie.

It’s a rare opportunity that birders should not pass up on, Kaufman said.

“This is really the only time people can see these birds in our region. Most warblers are neotropical migrants meaning they spend winters in South America,” Kaufman said.

“Our ultimate goal is for people to fall in love with birds and ensure their habitats remain safe and clean,” Kaufman said.

That is, in our view, a worthy goal.