MANSFIELD – Another change at the state level could mean the loss of more funding for Richland County operations. This time the change involves the possible loss of federal dollars that pay for transportation to and from medical appointments for county Medicaid recipients.
Job and Family Services director Sharlene Neumann outlined the problem Tuesday as the county commissioners approved the department’s federal funding contracts for fiscal 2018, which starts Oct. 1. Funding for non-emergency medical transportation became an issue when the Ohio Legislature passed the state budget earlier this year and changed responsibility for non-emergency medical transportation from a county-based system to a regional brokerage model that transfers funding from the state Jobs and Family Services to the Ohio Department of Medicaid Services.
Neumann told the board the state is planning to contract for transportation services through regional hubs in large metropolitan communities, with the change scheduled to take effect July 1, 2018. Information on the Department of Medicaid website says the agency will contract with third party transportation brokers to manage non-emergency medical transportation, set standards for consistent response, use existing local transportation resources and streamline the process for Medicaid enrollees to secure reliable transportation.
Neumann said state officials made the change in order to obtain an additional 12 percent in federal funding because the federal government favors regional transportation.
“The administrative money I believe they will pull down will go to the regional hubs and we will not see those funds at the local level and my fear is we’ll see less transportation money at the local level,” she said. “Right now we absorb administrative costs in other pots of (federal) money.”
Richland County Job and Family Services currently contracts with eight transportation providers so Medicaid recipients can get to non-emergency medical services. Officials estimate that around 24,000 trips will be provided at a cost of $575,000 for the current fiscal year, which ends Sept. 30.
Earlier this year, commissioners were concerned that a proposal in the Ohio Legislature to require people convicted of fifth degree felony crimes be held in local jails, along with the failure to reimburse counties for sales tax revenue lost because of a federal ruling involving managed care organizations, could cost the county $1.5 million in 2018. The sentencing change was mostly scrapped but the state has not restored the lost sales tax revenue.
Commissioner Tony Vero said the transportation funding issue is another example of the state moving program financial responsibilities down to the local level. “It’s whatever way the wind blows for the state based on how they can get money or save money,” he said.
Vero and Neumann also recounted a recent conference call with the Medicaid assistant director who will administer the regionalized hubs in which they asked how the state would serve people who already are familiar to local caseworkers. “It was embarrassing for the state,” Vero said. “They said other states are going to this model so I asked which states and they said they didn’t know.”
Commissioners’ chairwoman Marilyn John also was critical of the state after Neumann said state officials have not come out to the local level to see how counties handle the transportation issue.
“So they’re going to do this sitting in an ivory tower in Columbus even though they have no idea how transportation works,” she said. “We found out, working with our (local) transportation committee that transportation looks different in each county.”
Neumann admitted that some Ohio counties that do not have transportation, particularly in Appalachia, want to see if the state hub proposal works because there might be a regional provider that could bring in some service. She added that officials are working with state Rep. Mark Romanchuck and the JFS directors’ association to have a dialogue over the next week or two and gather information so local concerns are heard.