Posts filed under ‘Ohio Issues’

The American Health Care Act and preserving Medicaid

headshot of claudia smilingLast week we wrote the following letter to Senator Rob Portman, which several of our members signed on to, regarding the American Health Care Act (AHCA).

Dear Senator Portman,

The Philanthropy Ohio Health Initiative began as a member-initiated coalition focused on improving the health of Ohioans. Our membership includes private and community foundations, corporate funders, public charity grantmakers and United Ways. The Health Initiative envisions a future where Ohio communities – including the philanthropic sector and the health care system – support health promotion, disease prevention and patient-centered, quality care accessible by all Ohioans. To do this we also work with other community organizations, government and partners who share our goals, many who have joined us in signing this letter. Like many others who invest in the health and welfare of our communities, we are deeply concerned about the impact on Ohioans of key changes being considered in the American Health Care Act (AHCA).

shutterstock_445553Senator Portman, we appreciate your leadership in directly confronting the impact of Medicaid changes proposed in the House-passed version of the AHCA. As you said in your letter to Senate Majority Leader McConnell (dated March 6, 2017), Medicaid “reform should not come at the cost of disruption in access to health care for our country’s most vulnerable and sickest individuals…and we will not support a plan that does not include stability for Medicaid expansion populations or flexibility for states.” We could not agree more.

We respect the concerns about the cost to the state and federal government of providing Medicaid coverage and want to collaborate with good-faith partners in addressing these concerns. However, we believe the longstanding state-federal financing partnership is not fundamentally broken.

As you indicated with Anthem’s announcement to withdraw from the Obamacare Exchange (the Marketplace), “the status quo is unsustainable.” We agree. The Anthem withdrawal leaves 19,000 Ohioans in 20 Ohio counties without any option to purchase an individual plan on the Marketplace; that is 11% of Ohio’s total Marketplace enrollment. However, despite the need to fix the Marketplace, there is no need to alter the current underlying federal-state financing structure for Medicaid—it works.

Today, Medicaid efficiently provides comprehensive health care for 3.1 million Ohioans, including 723,000 receiving coverage through the Medicaid Expansion. The AHCA’s proposal to shift Medicaid financing to ‘per- capita caps’ will jeopardize Ohio’s ability to provide health care to all Medicaid enrollees, including children, seniors, and people with disabilities, and would have a significant negative economic impact on our state. Consider the following:

Per-Capita Cap, Children & Other Extraordinary Medical Needs

  • Ohio’s child protection system is seeing a dramatic increase in the rate of opioid-exposed babies. The life threatening medical issues these babies face result in immediate and long term needs for care and support. These babies are not covered by the Medicaid Expansion. Their needs require an ongoing, guaranteed federal- state partnership, which cannot be assured with “medical CPI plus 1%.”
  • Ohio spends $2,488 per child on Medicaid, the 11th lowest in the country. With per-capita caps in place, this would become a permanent federal funding ceiling. Can we absorb the short and long-term cost of care for the opioid-exposed babies or other unexpected emerging public health threats? Further, as we work to improve health care quality and efficiency for children, if our spending falls below the federal cap, the recently discussed idea of periodic “rebasing” would further lower our federal funding ceiling, making the per-capita caps even more damaging.
  • We ask: How do we absorb the short and long-term cost of care for the opioid-exposed babies? How would Medicaid financed by per- capita caps support our state’s needs in times of health and economic distress?

A Dedicated Pot to Replace Medicaid Funding for Opiate Treatment

  • $650 million of the $1 billion dollars Ohio spent last year to reduce drug use and overdose fatalities was paid for by Medicaid. More than 50% of all prescriptions in Ohio for Buprenorphine (an opioid recovery medicine) in 2016 were paid for by Medicaid. Our healthcare system and these services are increasingly integrated to serve individuals holistically across the continuum of care, whether the need is identified in primary care, emergency rooms, or specialized services locations.
  • We ask: Will the opiate funding pot that is being contemplated be large enough and grow commensurate with our $650 million need? How would this pot address each individual’s comprehensive needs and be integrated in a system of care? Why would we create a pot of funding for treating opiate addiction? We don’t pay for hip replacements or care for diabetes that way–these are part of holistic healthcare coverage.

Impact on Rural Communities, Veterans, Elderly, and Intellectually Disabled Individuals

  • old_lady_with_drA Medicaid per-capita cap and phasing out the Medicaid Expansion will have a disproportionate impact on rural communities. Roughly 21% of Ohio’s Medicaid Expansion are individuals who live in rural communities. From 2009 to 2015, Ohio had the third largest decline in the number of uninsured adults nationally, as an additional 115,000 adults received Medicaid or Marketplace coverage.
  • The uninsured rate among non-elderly Veterans has dropped 42% since 2014.
  • Medicaid home and community-based services are an optional service. Today Ohio is serving almost 100,000 individuals in community services; that is 65% of our Medicaid long-term services spending. While seniors and people with intellectual and developmental disabilities would have a more generous growth rate in the per-capita cap, from 2000 to 2011 Ohio’s growth rate was higher than most states; 3.5% and 5.1% for aged and disabled, respectively.
  • We ask: Faced with estimated reductions of $22 billion dollars over a ten-year period to Ohio, can we honestly assure families and individuals that these optional home and community based services will be supported at a level commensurate with their changing needs and will not be a prime target for reduced funding? Can Veterans and those in rural Ohio feel secure that there will not be disruption in their access to services, at the expense of others who also have significant needs?

A per-capita cap means that Ohio will have fewer resources over time to address these issues and will not be able to respond effectively to future public health crises. A federal funding cap cannot account for the specific spending pressures, needs and values of Ohio. The current federal matching formula already takes into account changes in each state’s demographic and economic conditions. Ohio’s health transformation is being driven by Governor Kasich and his Medicaid leadership team: the fundamental federal-state partnership doesn’t need to be abandoned, but deliberate progress continued. The President’s new team at HHS has many tools to continue and enhance this progress.

Capitol Hill2With this in mind, we strongly urge you to oppose any health reform bill that would cause Ohioans to lose health care coverage or benefits that they currently have. Specifically, we urge you to vote against any bill that would effectively end the Medicaid expansion, as we know it by completely phasing out the enhanced federal match or end the Medicaid program as we know it by shifting billions in Medicaid costs to states through a per-capita cap.

In closing, we, and the others who have signed on, pledge to work with you in any constructive manner to improve our state’s health care system. We appreciate your continued leadership on these important issues.

Sincerely,

Philanthropy Ohio

June 28, 2017 at 2:35 pm Leave a comment

Philanthropy Ohio ramps up policy work

headshot of claudia smilingWith new federal and state policymakers settling into their jobs in D.C. and Columbus, Philanthropy Ohio is already working to advocate for critical issues of most importance to our members.

Registration has begun for our annual trip to Washington D.C. for Foundations on the Hill, which is open to all Philanthropy Ohio members. We’ll trek to D.C. March 20 – 22 to meet with Ohio’s congressional delegation, attend a policy summit and network with 200 philanthropy leaders from across the country. This year, philanthropy’s voice is more important than ever as so much change is in the wind, including a promise to reform the tax code with provisions that would impact charitable giving as well as efforts to change health and education policies. And, our Tax Reform Working Group will reconvene as part of the Public Policy Committee.

Portman POH

Philanthropy Ohio’s member cohort met with Rep. Portman as part of Foundations on the Hill in 2016.

We’ve convened a new affinity group of members focused on ensuring a full and accurate 2020 U.S. Census, to learn more about the policy decisions being made in coming months and to add philanthropy’s voice to policy discussions. The group, Ohio Funders for the Census, has formed as part of a Midwest project funded by the Joyce Foundation through the Forum of Regional Associations of Grantmakers. Notes from its first meeting in January are online and the next meeting is set for late February.

Here in Ohio, while we await Governor Kasich’s budget proposal, our Health and Education Initiatives are poised to continue their policy work. The Health Initiative coalition will meet in mid-February and the Education Initiative coalition is presenting a briefing on college affordability on February 9 in conjunction with the release of its report on the topic. The affordability brief is the latest in a series of papers Philanthropy Ohio has published and provided to state policymakers to inform critical decisions, particularly related to the state’s Every Student Succeeds Act state plan.

education-policy-briefs

Philanthropy Ohio developed a series of targeted education briefing papers aimed at helping the state’s elected officials and education leaders plot a clear direction for the future of education and student success.

Policy work – like politics – depends on local relationships and doesn’t happen once every four years when we elect a new president or governor. Policymakers need to hear from philanthropy throughout every year, with messages that include what philanthropy can and can’t do – while philanthropy is a co-investor with government, it can’t come close to filling the gaps after budget cuts – as well as stories of impact, information on promising programs addressing critical issues and suggestions for policy reform. Add your voice, get engaged.

Claudia Y.W. Herrold

January 25, 2017 at 4:36 pm Leave a comment

Pass SB 332 to reduce infant mortality

headshot of claudia smilingThe number of Ohio babies who die before their first birthday is simply unacceptable and that is why Philanthropy Ohio supports SB 332. We urge the Ohio House of Representatives to follow the lead of the Ohio Senate and pass SB 332 when it returns to its scheduled sessions after the November election. The bill passed the Senate with broad, bipartisan support as seen by its 29-1 vote.

Consider just a few facts about infant mortality, deaths before age 1 per 1,000 live births:

  • Ohio ranks 45th in the nation in overall infant mortality rates;
  • 7 of every 1,000 babies born in Ohio died before their first birthday in 2014;
  • The rate of black babies who died in Ohio is twice that – 14.3 – and actually increased from previous years; and
  • The national rate was 6.05.

Philanthropy has worked with government and community partners to develop and implement various initiatives to address this crisis in their local regions. For example, Interact for Health and United Way of Greater Cincinnati support Cradle Cincinnati, a collective impact initiative that focuses on three aspects of reducing infant mortality: preventing premature births, reducing tobacco and other substance use during pregnancy and promoting safe sleep. Hamilton County’s infant mortality rate in 2014 was 8.8, two points higher than the national rate. Fifth Third Bank also supports efforts through its funding of Cincinnati Children’s Center for Prevention of Preterm Birth, a partner in Cradle Cincinnati.

At Home with Newborn Baby

At the other end of the state, the Toledo Community Foundation has been deeply committed to the cause of saving infants. The foundation is an active partner with the Hospital Council of Northwest Ohio’s Northwest Ohio Pathways HUB program.

Pathways HUB is a system designed to find at-risk pregnant women and link them to services that contribute to positive birth outcomes. The program was created to address the high number of preterm infants born to African American women living in Lucas County. Since its founding in 2007, 1,400 at-risk African American pregnant women (2,772 all races) enrolled in the Pathways HUB and the program has shown positive results: from 2013-2015, African American women enrolled in Pathways at least 90 days had a much better birth weight rate (8.2%) than the overall rates for African Americans in Lucas County (14.7% in 2014).

These are just a few examples of philanthropy’s engagement across the state: there are also collaborations in Cleveland (First Year Cleveland) and Columbus (CelebrateOne) that our members support.

But these efforts, along with the state’s policy efforts to combat the high infant mortality rate, are not enough. SB 332 is a statewide, coordinated approach – critical if not sufficient – to reduce the number of infants who die each year.

The bill is innovative and deliberate in its focus on the social determinants of health, a focus that is critical to preventing the death of our youngest residents. By addressing housing issues and increasing the number of qualified community hubs providing services to at-risk populations the bill can go a long way toward saving babies and keeping them out of hospital NICUs. Its other provisions are also important, from tobacco cessation efforts to birth spacing and safe sleep education, to keep babies alive. These are interventions that work – we have proof of that – and strengthening these provisions will help our state move the needle on infant mortality.

Call your representative in the Ohio House to urge their support for the bill, moving it through committee and to the House floor before the end of this session.

Claudia Y.W. Herrold

October 24, 2016 at 3:17 pm Leave a comment

The Big Table at Philanthropy Ohio

2016-jessica-blog-photoTwo weeks ago, more than 5,000 individuals participated in The Big Table conversations across our community, including 20 of our members convening at our Central Ohio office. Deborah Aubert Thomas and I led the conversations, splitting into two groups to better facilitate conversation and interaction.

The Columbus Foundation invited people and organizations to host conversations and participate in discussions, and we took the opportunity to convene our members to hear about the issues close to their hearts. The conversations lasted just over an hour and spanned topics from emotional intelligence and equity to mental health and millennials.

To see notes from the two conversations we hosted, please visit our website.

The Columbus Foundation was hoping to engage 1,000 people and on August 30, more than 5,000 people participated in over 450 conversations—gathering around tables to listen, share and learn about what strengthens and challenges our community – far exceeding their original hopes.

gok_infographicAnd as a thoughtful gesture of thanks, The Columbus Foundation made a contribution to the Gifts of Kindness Fund in honor of each person who participated. The fund provides one-time emergency grants through local nonprofits to help lift up individuals and families who experience an unexpected setback.

We’re grateful for The Columbus Foundation for giving us the opportunity to hold the community conversations. Our members really appreciated the candid discussion and outlet to talk about Columbus’ assets, opportunities and ways we can collaborate.

big-tableIn addition, The Columbus Foundation created a follow-up survey and will release the results at the end of the month. We’re excited for what may grow out of The Big Table and what The Columbus Foundation has in store.

If you’d like to see what other Big Table conversations looked like, check out the Twitter hashtag #TheBigTable. For more information and next steps to The Big Table conversations, check back on our website for updates.

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Jessica Howard

September 12, 2016 at 4:26 pm Leave a comment

Hit the pause button on Head Start funding change

headshot of claudia smilingHead Start programs that asked for clarification about their ability to continue “layering” federal dollars to provide more services to their young students were told by the Kasich administration that the practice would not be allowed as of September 6. The change will result in Head Start providers in Ohio losing $12 million in federal funding.

The rule promulgated by the Ohio Department of Job and Family Services in June makes Ohio an “extended hours” state. This means that federal funds for early childhood education and Head Start programs can’t be used to provide additional or enhanced services but only to serve these students for additional hours. The rule changes the practice that has been in place for the last 15 years.

girl_reading education.jpgSenator Lehner, chair of the Senate Education Committee and with whom Philanthropy Ohio has worked on a number of education policy reform issues in recent years, explained “It’s going to have a significant impact. It’s actually going to cause a number of children to be dropped from programs, a number of high-quality teachers that are more expensive than others to be let go and I can’t begin to overplay the impact that this decision is going to have on the quality of programs for us in the state of Ohio.”

child plays with cubes 1

We sent the following letter to Governor Kasich last week, as part of our ongoing Education Initiative’s focus on increasing access and quality in early childhood education.

Dear Governor Kasich,

For over a decade, Philanthropy Ohio has been steadfast in its commitment to ensuring all of Ohio’s children have access to high-quality education opportunities. As the state’s only association that provides the network, tools and knowledge to help people engaged in philanthropy become more effective, powerful change agents in their communities, we have worked with members of our Education Advisory Committee to advocate for policies that positively impact Ohio’s youngest, most vulnerable learners and improve early childhood education.

I am writing to you to express Philanthropy Ohio’s concern regarding the Ohio Department of Job and Family Services’ recent decision to prohibit the layering of federal and state funds for early childhood education programs in Ohio. While we are not taking a position on whether the layering of Head Start funds on top of Child Care funds is an appropriate practice, we strongly encourage you to pause the administration’s decision and more fully study the potential impacts before the current proposed changes take effect on September 6, 2016.

Given the profound impact this decision will have on the lives of our teachers, children and families in Ohio, potentially leading to less access to high-quality programs for those most needing such services – and given your passionate support for early education – I urge you to devote the time necessary to collaborate with stakeholders and come to an informed decision about what is best for our children and families.

Claudia Y.W. Herrold

September 1, 2016 at 9:37 am Leave a comment

Passage of IRA Charitable Rollover heralded

headshot of JessicaDecember was a celebrated month for charitable giving. In the last week in session before the December break, Congress made the IRA Charitable Rollover a permanent incentive for charitable giving in the federal tax code. On behalf of our members, we are very thankful for the U.S. Congress’ action that will impact community foundations, nonprofits and donors for years to come.

“We are so excited at this major accomplishment for the nonprofit sector,” said Dr. Suzanne T. Allen, president and CEO of Philanthropy Ohio. “And, we are equally pleased that Ohio’s congressional delegation voted overwhelmingly for its passage.”

The House passed the PATH Act 318 – 109; all of Ohio’s representatives except Rep. Marcia Fudge (voting no) and Rep. David Joyce (not voting as he was attending his daughter’s graduation) supported the bill. In the Senate, the vote was similarly positive, 65 – 33, with Senator Brown voting yes and Senator Portman voting no.

Capitol Hill1The IRA Charitable Rollover, which allows tax-free donations to qualified charities from IRA accounts, has been an important source of donations for Ohio’s community foundations, which have used the funds to support critical local needs.

Making this provision permanent is something we at Philanthropy Ohio have been working on since its creation as a two-year provision in the Pension Protection Act of 2006. Having to reauthorize it every year or two has created great uncertainty for donors and nonprofits. Making it permanent strengthens its role in encouraging charitable giving here in Ohio and across the country.

Special thanks to all, including our members, who urged their representatives to vote yes on the legislation!

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Jessica Howard

December 29, 2015 at 11:56 am Leave a comment

Ohio Gives 2015 report released

headshot of JessicaOur annual Ohio Gives report is now out, highlighting a slight reduction in overall Ohio giving. In 2013, the most recent year IRS data is available, Ohio giving fell 5 percent. Individual giving, which was down 8 percent, helped fuel the overall decline, while foundation giving was up 5 percent.

Ohio Gives 2015

Click here to see the infographic.

Click here to see the full report.

Individual giving makes up 75 percent of Ohio giving, with foundations making up 18 percent, United Ways making up 2 percent and other giving at 5 percent.

INDIVIDUAL GIVING

Individuals gave less to their favorite charities in 2013, due to decreases in both the number and dollar amount of bequests as well as a decrease in charitable contributions listed on federal tax returns. Over the past six years, 2012 was the peak of individual giving.

Who gives

Middle-income earners gave $2.7 billion, which is 1.5 times more than high-income earners.

Of the 22 percent of taxpayers who claimed deductions for charitable gifts on their federal tax returns, middle income earners – individuals/joint tax filers earning $50,000 to $200,000 – make up 68 percent of individual giving. Religion is still the top category individuals give to, with those gifts making up 32 percent.

Foundations make up 18 percent of Ohio giving, and strong asset growth pushed foundation giving up 5 percent, just below the 2008 peak of giving. Foundation assets grew 11 percent, despite the number of private and corporate foundations decreasing.

COMMUNITY FOUNDATION GIVING

Top 10 Community Foundations

Community foundations in the three Cs top the list of foundation giving for 2014 with The Columbus Foundation giving $142.9 million, followed by the Cleveland Foundation at $98.2 million and the Greater Cincinnati Foundation giving $72.2 million.

Total Foundation Giving chartThough community foundations make up only 2 percent of all Ohio foundations, their giving makes up 27 percent of all foundation giving.

 

PRIVATE FOUNDATION GIVING

Nine out of 10 foundations in Ohio are private foundations and have been the fastest growing segment of the philanthropic landscape. Most of these foundations are small foundations managed by family boards.

Number of FoundationsOhio’s 3,638 private foundations held 65 percent of the state’s charitable assets and awarded 59 percent of all grant dollars in 2013. Private foundation assets grew by $1.5 billion, or 11 percent, and giving was up a modest 4 percent.

Ohio’s private foundations have recovered from the 2008 Great Recession, with asset and grant totals surpassing the previous high marks of 2007 when assets were $12 billion and grants were $762 million.

Top 10 Private Foundations

CORPORATE FOUNDATION GIVING

While the number of corporate foundations in the state has decreased by 19 percent since 2008, both the assets and grants of corporate foundations grew in 2013.

Corporate foundations comprised only 3 percent of the state’s foundations, yet provided 13 percent of the state’s grant dollars.

Though assets are now at pre-recession rates, giving has yet to reach the 2008 peak of $212 million.

Top 10 Corporate FoundationsThe key component of corporate philanthropy not captured from these numbers is in-kind product contributions, volunteer engagement or similar charitable contributions.

 UNITED WAY GIVING

Ohio’s 75 United Ways are a diverse group of funders spread across the state. Together, they provided $181 million to nonprofit organizations in their communities and are a vital part of the state’s philanthropic network.

Top 10 United Ways

Ohio Gives portrays philanthropy’s value and impact, drawing on 2013 and 2014 data from a variety of sources. Our analysis presents data from the most recent available year, which is 2013 for IRS data. Other sources used for the report include Foundation Center, Foundation Directory Online, Guidestar and Giving USA as well as our own research.

We offer custom research to Philanthropy Ohio members, among other resources. Please contact us if you’re looking for a specific piece of information or data. Learn more about Ohio Gives at www.philanthropyohio.org/ohiogives.

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Jessica Howard

December 16, 2015 at 9:17 am Leave a comment

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