OHIO BUDGET Compromise presents struggle for diverse committee members

Effective ideas are not put on the table because of too many views.
COLUMBUS (AP) -- Lawmakers struggling with Ohio's tight two-year budget last year created a committee to study one of the state's fastest growing health-care expenses -- nursing homes -- and gave the panel until the end of July to recommend ways to change the way Medicaid pays for them.
Last week, the group made its report early: They're not done because members can't agree.
Such an impasse is the risk for state-made study groups representing diverse interests and grappling with complex, chronic problems. Public school superintendents have said they're losing patience with a group created by the governor 18 months ago to fix public education funding.
"Many people are frustrated by these commissions not realizing their potential more often," said Sam Staley, president of the Buckeye Institute, a Columbus think tank that advocates smaller government.
Playing nice
"The results of bringing lots of interest groups to the table is more compromise, and more compromise means more lukewarm recommendations. If you've got a big problem, moderate recommendations often won't solve it."
Some study panels have had success, Staley and others said, with recommendations that showed up in later laws to change teacher licensing, classroom standards, school vouchers and bills now being debated on tax reform.
But the groups generally are better at analyzing and describing problems than getting their ideas enacted, Staley said.
The 17 members of the nursing home committee represent the industry, lawmakers, as well as separate state agencies that oversee the homes, the Medicaid insurance program that funds them and aging Ohioans who use them. They were instructed to suggest changes to the formula in state law that sets funding rates for the homes.
The committee divided into smaller groups that came up with proposals to reduce expenses or help homes make up lost revenue, such as providing state backing to encourage more people to buy long-term care insurance or allowing homes to convert empty space to alternative uses such as adult day care.
The subgroup on the formula so far has come up with plans that diverge by $6 per day per nursing home resident -- a more than $560,000 difference in daily expenses for the state's 94,000 licensed nursing home beds.
State influence
Members say they hope to agree on a compromise by the end of the year. Gov. Bob Taft makes his budget recommendation in January to the Legislature, which has until July to set the next two-year budget.
Taft will take the committee's work into account, spokesman Orest Holubec said, but still intends to fight again for one change the committee declined to discuss: taking the funding formula out of state law and giving control instead to the Department of Job and Family Services. Ohio is one of a few states with legal protection for the amount of funding.
"The reimbursement needs to be made based on the market," Holubec said.
Mary Butler, who represented nursing home residents on the committee, said removing the protection of law would be the fastest way to control costs. The nursing home industry has prevented such a move every time the governor or lawmakers tried, saying an agency could cut payment rates without getting opinions from all those affected.
Lawmakers want to keep control over changing the formula, said Rep. Shawn Webster, the Hamilton Republican who leads the committee.
"If the main issue was taking it out of statute or putting it in [an agency's] rules, I wouldn't have anybody at the table," Webster said. "This study council would have been over with in the first meeting.
"There's a reason why it's so complicated. It's an attempt to make it fair."