Understanding HB 795, SB 315, and What Families Need to Know
By Troy Hunter, President & CEO, ElevateDD
Over the past two weeks, House Bill 795 and Senate Bill 315 have raised important questions for people with disabilities, families, caregivers, providers, and advocates across Ohio.
Because these issues touch daily life for so many families, it is important to understand both the legislative process and the practical impact of the language being considered. Medicaid, home- and community-based services, electronic visit verification, GPS-based verification, transportation, and family caregiving all shape how people access care, remain in their homes, and participate in their communities.
Two things can be true at the same time:
Ohio can and should be serious about Medicaid program integrity, fraud prevention, and responsible use of taxpayer dollars;
and those efforts must be designed and implemented in ways that protect access to essential services and supports for people with disabilities and their families.
For many Ohioans with developmental disabilities, family caregivers are not a loophole in the system. They are often part of the care network that helps people remain safe, supported, and connected to their homes and communities.
What happened?
House Bill 795 was introduced as the SHIELD Act, a Medicaid program integrity bill sponsored by Representative Josh Williams. Senate Bill 315 was introduced as the Enhanced Cybersecurity for SNAP Act, sponsored by Senators Tim Schaffer and Hearcel Craig.
HB 795 received several hearings in the House Medicaid Committee over the last two weeks. On Wednesday, June 3, the committee adopted a substitute version of HB 795 that included language that would have prohibited family members from being paid providers for their loved ones under certain Medicaid home- and community-based services.
That language raised serious concerns across the disability community. The concern was not opposition to Medicaid integrity. The concern was that a broad restriction on family caregivers could unintentionally destabilize care for people who already face barriers to accessing services.
On Monday, June 8, families, caregivers, people with disabilities, providers, and advocates shared testimony with the House Medicaid Committee. The message was clear: Ohio can be serious about fraud prevention while also protecting families, preserving choice, supporting local care solutions, and keeping people with developmental disabilities in their homes and communities.
That same day, the committee introduced another substitute version of HB 795 that removed the family caregiver prohibition. On Tuesday, June 9, the committee took recess and did not hold an additional hearing on HB 795.
After that, components of HB 795 were added to SB 315 through a substitute bill in the House Finance Committee. Substitute SB 315 then passed out of the House Finance Committee, passed the House floor by a vote of 85-10, and the Senate later concurred with the House changes. SB 315 is now on the Governor’s desk. SB 315 is now on the Governor’s desk. If signed and not vetoed, the bill will generally take effect 90 days after the Governor’s signature.
What is still in SB 315?
The final House-passed language does not include the earlier provision that would have prohibited family caregivers from serving as paid providers for their loved ones.
Family members often help piece together care for services their loved ones are already approved to receive. Many families use family caregiving to fill hours that are difficult, and sometimes impossible, to cover through the existing provider network.
While the family caregiver prohibition was removed, SB 315 still includes several Medicaid program integrity provisions that may impact people with disabilities, families, caregivers, and providers. Much of the practical impact will depend on implementation, rulemaking, agency guidance, technical assistance, exemptions, and how state agencies apply these requirements.
Key provisions include:
Family caregiver oversight: The bill allows the Department of Medicaid to establish family caregiver oversight mechanisms, which may include audits, enhanced check-in review, annual Medicaid provider recertification, case manager verification, limits on compensated care hours without documented medical necessity, forensic review triggers, and background check monitoring. This does not prohibit family caregivers from being paid providers, but it does create additional oversight authority.
EVV and GPS-based verification: The bill expands electronic visit verification and GPS-based verification provisions for certain services. Importantly, it includes an exemption from GPS-based clock-in and clock-out verification for in-home care services provided by a family caregiver who lives at the same residence as the person receiving services.
Prior authorization for personal care services: The bill includes prior authorization language for personal care services when requested services exceed the amount or scope described in a written plan of care or individual service plan. However, the bill states that this section does not apply to personal care services provided under a Medicaid waiver component administered by the Department of Developmental Disabilities.
Nonemergency medical transportation: The bill includes new electronic verification requirements for nonemergency medical transportation providers, including GPS-based verification of pickup, transport, drop-off, timestamps, route data, and distance traveled. Implementation will matter to ensure these requirements do not create new barriers to reliable and accessible transportation.
Broader Medicaid program integrity: SB 315 also includes provisions related to provider screening, ownership disclosure, address review, fraud reporting, provider education, audits, payment reviews, managed care program integrity, high-risk provider verification, EVV reporting, and legislative review of Medicaid waiver components.
What does this mean for the disability community?
The removal of the family caregiver prohibition shows that advocacy matters. Families, caregivers, people with disabilities, providers, and advocates shared their experiences, and that advocacy helped make clear that broad restrictions on family caregiving could have unintended consequences.
At the same time, SB 315 still includes significant Medicaid oversight, EVV, GPS verification, transportation verification, family caregiver oversight, and provider accountability provisions.
The central question moving forward is how Ohio protects Medicaid program integrity while also protecting access to services, family choice, privacy, provider capacity, and continuity of care.
Throughout this process, members of the House committees and House leadership shared that they heard the concerns from families, caregivers, providers, and advocates loud and clear. They reported the testimony and outreach from the disability community helped improve the bill by removing language that could have unintentionally harmed families and disrupted access to care.
ElevateDD will continue to monitor final bill language, agency guidance, rulemaking, implementation timelines, and opportunities for public input. We will keep working with families, advocates, providers, policymakers, and partners to better understand the impact of these changes and share updates as more information becomes available.
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