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Ohio's 2024-2025 Fiscal Budget - Behavioral Health Updates

Client Alert

Ohio’s 2024-2025 State Budget was signed into law by Governor Mike DeWine on July 3, 2023. Behavioral health is an area that Governor DeWine expressed great interest in supporting and the final version of the Budget does reflect some of those initiatives. The Budget prioritizes growing the behavioral health workforce and increasing research and innovation by building community capacity for care that offers better crisis response services and treatment, increased prevention efforts, and increased provision of residential and outpatient services. Outlined below are notable Budget items geared toward achieving growth and improvement in the behavioral health field as well as some key items that were rejected by Governor DeWine’s veto.

988 Suicide & Crisis Lifeline

988 Lifeline Centers receive 10,000+ calls, chats, and texts each month from Ohioans. Consequently, the Budget has allocated $86.5M across the biennium to crisis centers to ensure Ohioans in need have access to appropriate behavioral health resources close to home and reduce the burden on local law enforcement and emergency departments.

Building the Workforce

In attempting to grow a strong and supportive behavioral health workforce, the Budget provides for increased rates for community behavioral health providers, continued support for Centers of Excellence and Tech Assistance Centers, and investments in pediatric inpatient and residential settings for youth and children. To enhance pediatric behavioral health, $50M in one-time funds have been allocated to enhance the workforce and residential treatment environments.

Building Resiliency through Prevention and Early Identification

Focusing on student mental health, $13.9M across the biennium was allocated for suicide prevention, expansion of the student assistance program, and student wellness and success initiatives including the payment of behavioral wellness coordinators.

Increasing Inpatient Access

$14M across the biennium has been allocated to the growth of state hospital capacity by adding 30 beds and staff support to state psychiatric hospitals in central Ohio. Additionally, these funds will leverage bed availability at private psychiatric hospitals for vulnerable Ohioans without coverage.

Increasing Housing Options and Quality

In distributing a $64.5M allocation across the biennium, the Residential State Supplement (RSS) Program Budget has increased from $16M per year to $24M per year. Further, in providing continued support for community transition programs to help those with mental illness or addiction to successfully re-enter upon prison release, this allocation aids in growing the quality of Recovery Housing across Ohio.

Expanding Jail and Forensic Services

$63.5M across the biennium has been allocated in support of the expansion of jail and forensic services. Specifically, this allocation will aid in enhancing forensic centers’ capacity for court-ordered psychological evaluations and monitoring and support of specialty courts. Additionally, the funds will be used to improve the ability for jails in Ohio to provide addiction services. Lastly, funds will authorize jail-based competency restoration.

Kickstarting Innovation and Research for Wellness and Recovery

$30M across the biennium has been allocated to establish the State of Ohio Action for Resiliency Network (“SOAR”) that will research, establish best practices, and provide funding to implement better mental health and addiction prevention, treatment, and recovery strategies. OhioMHAS will create working groups that incorporate providers, patients, community stakeholders and others to implement this program.  

Relevant Budget Vetoes

House Bill 33 proposed several behavioral health initiatives that did not survive Governor DeWine’s veto. First, HB 33 sought to implement statute-based payment rates for Medicaid components administered by the Department of Developmental Disabilities including personal care services, adult day services, and ICF/IID services. The item was vetoed with DeWine with the reasoning that establishing rates within a statute, rather than a rule, would restrict the Ohio Department of Medicaid, the Ohio Department of Development Disabilities, and the Ohio Department of Aging’s ability to manage the policies and costs of the Medicaid program while being compliant with federal law.

Second, HB 33 sought to require the Ohio Department of Mental Health and Addiction Services and the Ohio Department of Medicaid to develop and implement standards and procedures for the exchange of Medicaid recipient information. Specifically, the proposal would have allowed a board of alcohol, drug addiction, and mental health services to advocate on behalf of Medicaid recipients who have been identified as needing addiction or mental health services. However, DeWine vetoed reasoning that a statute requiring the Department of Medicaid to share sensitive Medicaid information would be unnecessarily risky and in violation of federal privacy laws.

Lastly, a proposal in HB 33 would have exempted federally qualified health centers that provide behavioral healthcare services from certification from the Ohio Department of Mental Health and Addiction Services. The item was vetoed with DeWine reasoning that the public wellbeing is best protected when all healthcare services are properly certified by the appropriate state agency.

Should you have any questions on these recent behavioral health updates or how to get involved in these initiatives, please contact Partner Ashley Watson at abwatson@bmdllc.com.