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Less than a week left for the Ohio redistricting commission to approve a congressional map.

Or it goes back to state lawmakers.

The House overwhelmingly passes two property tax bills.

But will they bring real relief?

And as Ohio's population gets grayer, the state is expanding a program that seeks to keep older people with medical needs in their homes longer.

That's this weekend.

The state of Ohio Welcome to the state of Ohio.

I'm Karen Kasler.

The process to create a new 15 district congressional map has moved on from a bipartisan legislative committee to the Ohio Redistricting Commission, which held its first meeting earlier this week.

The deadline for that panel to produce a map with bipartisan support is Friday.

But as state House correspondent Joe Ingles reports, the Republican dominated panel of elected officials met but didn't come out with a map.

And to faithfully discharge and to faithfully discharge the duties of the office.

The duties of the office as a member of the Ohio Redistricting Commission.

As the tension at the first meeting of the Ohio Redistricting Commission was palpable.

Seven members were sworn in, and it quickly became apparent that the Republican majority and the two Democrats on the panel had different ideas about what the rules should be.

At this time, I'd like to suggest we use Mason's Manual of Legislative Procedure.

But Democrats wanted the board to adopt a different set of rules that included Mason's rules plus.

But what we wanted to add were some elements of how many meetings to have.

And there were a couple of other items.

Some items like to have a set number of public hearings or to have a quorum to call a meeting.

Rules that were in place by a previous Ohio redistricting commission meeting in 2022.

Now, while two Democrats voted for Senate Minority Leader Nickie Antonio's proposal, majority Republicans voted to accept Representative Brian Stewart's motion to use Mason's rules.

Then later in the meeting, I feel like this is the part in jeopardy!

Where Alex Trebek comes in and says, we have a small correction.

The able lawyers have alerted me that actually, pursuant to article 11, section 1B2A of the Ohio Constitution, we actually cannot adopt rules without at least one vote for the minority party.

So having not gotten one of those votes, we are proceeding as a commission for now.

Without rules, without rules, and not without controversy.

It's not your job.

On.

Audience members jeered as the commission meeting ended after just a half hour without a map that Republicans would consider.

Antonio said majority Republicans are slow walking it.

I mean, we've all heard the rumors.

We've all heard rumors about taking our congressional seats down from the five that the Democrats hold right now.

Taking them down to two.

Taking them down to three.

We don't know.

Democrats proposed a map last month that would have likely yielded eight Republican districts and seven Democratic ones.

The map currently in use has yielded ten Republican seats and five Democratic ones in the last two elections.

House Minority Leader Danny Isaacson said he thinks there's a reason why Republicans are not putting forward a map now.

And we know what happens if we let this run its course, because we've seen what has happened all over the country that the party in charge, the majority party, has gone for broke.

And in Ohio, what that would look like is a 13 to 2 map in a state that is much closer to 5545 than anything else.

Republican.

Democrat.

And so we cannot afford to let that happen.

But Stewart said the ball is in the Democrats court to decide what deal they're willing or not willing to take.

And he said GOP lawmakers are talking about a map but are not ready to introduce it yet.

If there is a bill, a map that has enough support to pass and that will get introduced and we'll we'll have a debate and take a look at it.

But, you know, we're not going to just, you know, show all of our notes in public while you're trying to have discussions between legislative leaders about what they wouldn't support.

But Stewart did give some hints of congressional districts being talked about behind closed doors.

Well, I think that clearly the Toledo seat, the Akron seat in the Cincinnati seat, are probably the most hotly contested races generally.

And I think that it would it's I don't think I'm giving away any secrets to political reporters that those are probably the seats that are most discussed when we're talking about whether there's going to be a deal.

Those seats are currently occupied by U.S.

Representatives Marcy Kaptur, Amelia Sykes and Greg Landsman, who are all Democrats.

If the commission doesn't pass a map with bipartisan support by next Friday, Republican lawmakers can pass a six year map by November 30th without any Democratic votes.

Joe Ingles, Statehouse News Bureau.

the Ohio House overwhelmingly passed two property tax related bills that backers say will provide more than $2 billion in tax relief over the next three years.

While some lawmakers are praising the bills and the money the state is putting in.

Some lawmakers say they don't go far enough.

House Bill 186 would cap property tax revenue growth for homeowners and around two thirds of districts at what's known as the 20 mill floor.

It would also provide a credit for increases they've paid in the last two years.

The state will kick in $306 million to cover those costs, with the money coming from the fund that would be used to expand the sales tax holiday next year.

House Bill 335 capped increases on the first ten mills of property tax, known as inside millage.

That's a change from the bill's initial goal, which was to eliminate inside millage entirely.

Republicans gathered to celebrate after the session with House Ways and Means Chair Bill Roemer offering high praise.

This is the greatest compilation of property tax reform in the last 50 years, or maybe longer.

When you look at what we're doing, we are limiting the rate of increase for both, both inside millage that that ten mills that are spread and at the 20 mill floor, the thing that we hear most from our constituents is not I don't think I should be paying property taxes at all.

There are definitely people that say that.

But most of what people say is we think that we can't afford those massive spikes that we have seen but House Minority Leader Donny Isaacson said before the vote that many Democrats don't feel the two bills offer meaningful property tax relief.

Our caucus has been clear for the last couple of years now.

Our property taxes are way too high for way too many people.

We should not be taxing people out of their homes, particularly seniors.

And so what we need is meaningful relief.

In the short term, that means cash in people's pockets, funded by the state.

And long term, the state has to step up and pay its fair share of public services.

We cannot keep relying on local communities to shoulder the burden of 6,070% of public education funding for of police and fire.

And so, you know, I think there's some elements that maybe make sense in the bills that we're looking at tomorrow in terms of capping potential future spikes.

But they do not address the two core issues.

Short term relief for people most impacted by high property taxes and long term changes that would take the burden of public services off of the backs of homeowners.

Where it is right now terribly overweighted.

The legislature's research office says the combined statewide average property tax benefit from the two bills is $148.

The bills now move on to the Senate.

Meanwhile, the Committee to Abolish Ohio's Property Taxes is still gathering signatures for an amendment that would get rid of all property taxes if voters approve it.

The group has until next July to turn in 413,446 valid signatures to make next fall's ballot.

Lawmakers also overwhelmingly agreed to a Senate proposal to regulate THC products, like those with Delta eight or others categorized as intoxicating hemp.

This comes after a judge halted governor Mike DeWine 90 day ban on sales of those products, which are not regulated by Ohio's recreational marijuana law.

But Senate President Rob McCauley says the dozens of changes the House made to the bill have raised problems for his supermajority caucus.

Some of it is it's a brand new regulatory scheme for him relative to what we had been talking about.

For us to put that on the floor without talking to our caucus about it.

I'm sure there are going to be members who are going to have some issues with some of that stuff.

So we're going to take a look at that.

Some of the other items in there regarding how they're trading products and everything.

We have some concerns about.

So that's just a very superficial view of some of the initial issues, I'm sure, as we did, excuse me, dig deeper.

Will have more issues to discuss Ohio ranked sixth in the country and population age, according to the Ohio State University's College of Medicine.

The U.S.

Census Bureau, which has full pages and sections that are not accessible or updated because of the federal shutdown, says about 1 in 5 Ohioans are over 65.

The graying of Ohio's population means there's more attention and potentially more money going to programs to help people with complex medical needs who want to stay in their homes longer.

The state is expanding the program of All Inclusive Care for the elderly, or Pace, which started in Cuyahoga County and expects to be operating in ten counties by early next year.

I talked with the Ohio Department of Aging Director Sal McElroy about what pace does.

So let's talk about the program of all inclusive care for the elderly pace.

The goal was to provide all in one care for Ohioans who have complex medical needs and require nursing home care.

Started in Cuyahoga County, plans to expand to ten counties by early next year.

So what does this program actually do and what does it look like in action?

Absolutely.

It is what we call an integrated care model, so that the individual can receive all of their services in one place.

Can you imagine going to one place for all of your therapies, your medical appointments, your medication, and just your socialization?

All of those things can happen in one place for an individual versus having to go to multiple providers.

And the goal, again, is to keep people in their homes and in their communities.

But obviously there are people who are in this program who need care that goes beyond what they could get in their own home from a home based caregiver.

Absolutely.

And so many of these individuals go to what's called one of our pay centers.

And it's a really lovely thing.

You have to see all the individuals receive transportation at no cost.

They arrive at the center, they can have their meals.

Some centers even do things as deep as laundry for individuals.

Again, all of their therapies, all of their counseling, all of their medication, all of their needs are there.

They meet new friends.

And the great thing about it is that those caregivers that perhaps the individuals may live with can go to work, continue to contribute to our economy, and do so knowing that their loved one is safe.

So it's kind of like a senior center, but has other benefits that go well beyond just the socialization and that kind of thing.

Absolutely.

And those individuals who go to those centers have the option to have the full panoply of services often provided through their Medicare benefits.

And in some cases, they're Medicaid as well.

And the facilities that the program is set up.

And what are those facilities?

Are they are they brand new?

Are they, facilities that have been rehab?

Can you tell me a little bit about those?

Right.

I think it varies.

And that's the exciting thing about this year in Ohio.

Not long ago, we had one pace provider in the state, and the Pace model was offered in the Cuyahoga County area and some of the surrounding areas.

But since we've been able to move this program for, we now see that it will take off in greater than nine areas across the state of Ohio.

We're really excited.

In fact, I think it's perhaps close to ten.

And many of these sites, some have been new builds, but others have been rehabbed, facilities or structures that we were able to repurpose.

How?

Who qualifies?

Who qualifies for this program?

How many people do you expect will be served once it's expanded to the ten counties?

And how do you qualify?

Can your caregiver qualify?

Make sure that you're qualified or check to see if you're qualified?

Absolutely.

So if an individual is 55 years and older, if they have nursing facility level of care, you can qualify by a variety of different ways.

One, there must be a pace site, obviously within that area.

But in addition to that, you can pay privately.

You can pay through Medicare.

And also you can pay through Medicare and Medicaid.

So it is a very, I would say, diverse, opportunity for people to take advantage of.

And so I wouldn't make the assumption that I didn't qualify.

Again, it's more so if you're 55, if there's a pay site in your area and you have that nursing facility level of care, how do you know the difference between you could qualify for pace because it's near and it's intercounty versus you really need to be considering going to an institutional setting, a nursing home.

Absolutely.

I think that's a question that many individuals and family members grapple with.

And I always say, try to start with the least restrictive option or the option that most suits that person's needs and or preferences.

And so oftentimes there's what's called a level of care assessment done.

And with those assessments, the options for that family should be provided.

And so based upon that assessment, if it is determined that you can be safely served at a pay site, that's an option you might want to consider.

There may be circumstances where in fact may be a different type of care option is more suitable, but we certainly want to be sure that that assessment is done, that you have your questions answered and that you're in the most appropriate setting.

Certainly, you do have people who are going to need the longer term institutional care.

Is this a more cost effective option for the state, for the federal government, for individuals to seek out Pace if it's available versus going to that institutional care, that nursing home?

Right.

That's a good question.

This is what we call one of those integrated care models.

And with these models, the idea is that if an individual say, for instance, has both Medicare and Medicaid, how can we maximize those benefits at the most affordable cost?

Oftentimes there is a capitated payment model, whereas we know that only up to a certain point will we have to pay, when in fact there are public investments in this model.

So again, I think it depends on the person's needs, what that care plan will look like.

But this is a model where we do have some control of the costs because of the capitated payment structure.

And it is integrated.

So we have the opportunity to have, I think, a more cost effective model than perhaps some others.

Now, with the expansion, it pays to be in the most populous counties in the state, which which makes sense.

But you have need throughout the state, especially in rural counties and Appalachian counties where you have an older population.

How did you decide to go to these ten counties, and how do you broaden from there?

Absolutely.

So there were a few things.

Number one, we had a market analysis done.

So we worked, in fact, with Scripps Gerontology Center to help us determine where is the market most saturated and where will the needs be.

And so we looked at a variety of factors to help us come up with that.

And then the General Assembly, also had great interest in this model.

And so we were given guidance from the General Assembly by which counties we want to start with.

But we were pleased with is not only did that guidance align really well with, the market analysis, it also gave us opportunity to emphasize, a rural pace.

And rural pay centers are perhaps one of the most challenging places to have a pay center.

But the interesting thing is, they're probably one of the places that have one of the greatest needs for it.

And so we're very interested to see how one of our providers is able to thrive in some of our rural settings.

And when you're talking about rural settings, obviously you're talking about transportation issues, you're talking about maybe technology.

There's lots of things, but I guess you have to consider absolutely, particularly the transportation.

And I think that's it.

Making sure one, that we have enough people in a concentrated area and being able to transport them back and forth within a reasonable amount of time to do it safely.

And you've got a workforce issue there as well.

When you're trying to get make sure that enough people are there to serve the population.

Absolutely.

But it's interesting you bring up workforce because that's again why the pace model is so amazing.

Because if you have most people come into this setting where they can, one have the ability to socialize with people, be able to thrive and have all their needs met, we can do it with a lower overhead cost, because everyone and everything you need is in one place to kind of an economy of scale.

Absolutely, absolutely.

Oh, I want to talk about cost again here.

I mean, this is a federally funded program through Medicare and Medicaid.

It's available around the country.

If the federal shutdown happens and continues, well, it's happened if it continues, what does that do to your expansion plans?

Do you have plans in place to try to deal with that?

We absolutely do.

I believe at this point we're on track with pretty much everything to open and go, as I think, to continue to move smoothly.

At this point, the department feels really confident.

We've looked at our cash flow.

We looked at things that are continuing to happen, and certainly we're keeping our eye on things.

But at this point, we have no reason to tell people to panic, no reason to feel that we'll have to discontinue or to disrupt any services.

And how much is this cost the state?

I mean, again, you talked about the different the funding model here.

How much does this cost the state.

Absolutely.

So I think the first thing to point out is the Pace model.

For a long time, historically, when it came on the scene back in the 70s and it was formalized in the 90s, was pretty much pretty much taken up by just not for profit entities.

And now, I would say, like in 2016, the federal government allowed some of the for profit entities to now come into this market.

With that, we've seen some interesting things.

I think first, one of the things we found with Pace centers is that you really must have the capital investment to be able to open these centers at the beginning.

And so having that mixture, I think will help us balance that out a bit here in the state of Ohio.

Also, we were able to have a one time investment upfront of $50 million, right before the 2425 biennium budget, which really helps support these particular providers in making the decision to open up in our state.

And I can tell you it has caught on.

There are providers from all over and certainly our Ohio providers, but even outside that are interested in breaking into this market.

So I think we're going to be just fine in that regard.

There's been a lot of criticism over the years of nursing homes in the how.

Nobody wants to have to seek out that option, though it is necessary for some folks, certainly.

Do you think we are close to this idea of you can choose whether you can.

You're going to go to a nursing home or whether you have other options.

I mean, staying at home is really what most people say they want to do.

Absolutely, absolutely.

I think what's been important to me, and I think the entire ag network is that no matter where you are on that continuum, that we have high quality service.

And for us that means both quality of life and quality of care.

So it is both clinical and those other things that really make living enjoyable.

What you eat, having people around you, the things that you want to do.

And so I dream of a of a place where in Ohio, if your desire is to stay home and receive care, you will be able to do that and do that safely and with high quality care.

If in fact your situation is one, by maybe having an institution, or maybe having a facility setting where you can have that 24 hour around the clock is what you need.

We still want that to be of high quality, both in care and quality of life.

For those individuals, the cost of all this, obviously, is I mean, the cost of aging in general is is immense.

And your your agency got an increase in the two year budget, but you're addressing issues that have a lot of cost.

And let's just for example, Alzheimer's.

Yes.

Estimated to cost $360 billion nationwide last year, projected to exceed $1 trillion by 2050, which is only 25 years away.

Do you as Ohio's population gets older, the age 65 and older is the fastest growing portion of Ohio's demographics.

Do people have to just kind of be prepared for this is going to be expensive.

This is going to be a part of the state budget that is going to need a lot of attention.

I am so glad you brought that up.

So it's interesting when I came into this role and I had a chance to see where the Department of Aging sat, within the entire HHS infrastructure.

And I think that perhaps its size is a little misleading.

I think that it is a very agile organization.

I believe that it has run on very, thin margins and has done so successfully.

However, I think it is really important that if we are going to be strategic and look at the large demographic shift that not only Ohio is facing, not only the US, but the entire world is facing a huge demographic shift that we must appreciate what that means for our economy and our health care, amongst other things.

And so I think the question is, how can we provide what we know, will be needed, but do it at the lower cost?

A lot of this does mean doing things sooner.

It is my observation that many of the things we've done, while effective, have been later.

If we can do things upstream, if we can pay for lower cost services that help people to stay independent sooner, if we could do things in a manner that don't necessarily wait until you are your sickest and sometimes your poorest, I think that is going to be key because the population, in fact, is growing.

I mean, it is aging up.

And that's not anything at this point.

That's going to change anytime soon.

But our strategies, our planning and making sure that we're prepared, those are things that we can control.

And I really would love to see us really take a really hard look at that and see that as a very strategic, effort in line of business within our state budget.

I mean, we all say we want to get older and live the longest life possible.

There is there's a lot to consider on that.

Absolutely, absolutely.

We do have I would point out to you, there is a state plan on aging.

Every state must have.

And we must submit it to the federal government.

And within our state plan, we do contemplate these things.

We contemplate things that individuals can do themselves to begin to prepare.

We also look at the things that we can do as a state, to prepare for this large population that's just continuing to grow.

And along that growth, I do want to make one last point.

It's not just about those who are 60 or 65 and older.

It's also looking at within that group, there are a large number of individuals who are 85 and older.

And with that brings another level of complexity, because there's increased disability.

So it is not just that number, it is also within that number what we should be concerned with, and even the number below that the people who are providing the care, the caregivers, family members, all those folks are part of this whole discussion.

Well, absolutely.

And that is it for this week for my colleagues at the statehouse.

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Support for the Statehouse News Bureau comes from Medical Mutual, dedicated to the health and well-being of Ohioans, offering health insurance plans, as well as dental, vision and wellness programs to help people achieve their goals and remain healthy.

More at Med mutual.com.

The law offices of Porter, right, Morris and Arthur LLP.

Porter, right, is dedicated to bringing inspired legal outcomes to the Ohio business community.

More at Porter.

Right.

Com Porter Wright inspired every day.

You know, Ohio Education Association representing 120,000 educators who are united in their mission to create the excellent public schools.

Every child deserves more at o h e talk.