Protect Family Caregiving in Ohio - Stop HB795

Chairwoman Gross and Members of the House Medicaid Committee,

I am writing in strong and urgent opposition to Section (M) of Substitute House Bill 795.

This amendment would prohibit Medicaid payment for personal care services provided by family members to waiver participants under Ohio’s Home and Community-Based Services (HCBS) waiver system. Its definition of “family member” is broad, encompassing spouses, parents, children, grandparents, siblings, aunts, uncles, nieces, nephews, cousins, and step-relations.

This would devastate Ohio’s HCBS system.

Many waiver participants depend on family caregivers not by preference, but by necessity, because provider agencies failed them, staffing systems collapsed, abuse or neglect occurred in prior placements, rural provider shortages left no alternatives, or no other safe and stable caregiver was available.

These families did not become providers for convenience. They stepped in out of protection, survival, and love when institutional systems failed the people they care for most.

Eliminating payment eligibility for family caregivers would directly threaten continuity of care, free choice of provider, family preservation, community integration, and the ability of disabled Ohioans to remain safely in their homes. The consequences would be immediate and severe: caregiver shortages, loss of trusted support, disruption of medically necessary care, increased hospitalization, and mounting pressure toward institutionalization.

We must continue fighting not only to preserve family caregiving options, but also to protect the rights and independence of people with disabilities. And we must demand that Ohio lift the provider enrollment moratorium so individuals and families can hire the caregivers they need, when they need them.

Our loved ones deserve choices, stability, and the opportunity to live full lives in their communities—not barriers that limit their care and independence. Together, our voices are making a difference. Let’s keep going.

This amendment also raises serious legal concerns under the Americans with Disabilities Act, Section 504 of the Rehabilitation Act, Olmstead v. L.C., and long-established federal person-centered HCBS principles.

The federal RAISE Family Caregivers Act explicitly recognizes family caregivers as the backbone of the long-term care system and warns that removing family caregiving support increases institutionalization risk. Ohio would be moving in the exact opposite direction.