Direct care workers in Ohio will receive $300 million in appropriated federal pandemic relief funding, with both legislative bodies passing the bill this week.

The Ohio Senate and House greenlit the nursing home funding on Wednesday and Thursday respectively, as part of $4.18 billion in pandemic relief dollars. The majority of funds are earmarked for schools, health care providers, childcare and law enforcement.

Funds cannot be used for staffing agency labor, executive, owner or administrative pay however, according to the legislation.

Instead, the $300 million is reserved for pay, bonuses and incentives to recruit and retain the state’s direct care workforce.

“We didn’t know this was coming, and we didn’t see the language until it was actually in the committee, so we didn’t have an opportunity to weigh in on [staffing agency exclusions]. We have said a lot to legislators about the problems with staffing agencies and how they’re charging members, so I think this was the reaction to those comments,” said Pete Van Runkle, executive director for the Ohio Health Care Association (OHCA).

Van Runkle said the legislation went from “seeing the light of day” to passing both the Senate and House in a matter of days.

Nursing homes across the country have had to increasingly rely on staffing agencies during the pandemic; the unregulated industry has been charging “astronomical rates” for a service many didn’t use at all pre-pandemic.

About 14% of the nursing home workforce has left since COVID-19 was first detected in nursing homes, which amounts to about 221,000 jobs, according to Bureau of Labor Statistics data released in November.

Still, operators like Ohio Living feel the legislation is a “step in the right direction,” CEO Laurence Gumina told Skilled Nursing News, while also noting “complexities” related to staffing agency usage.

“An uncomfortable majority of providers right now are dependent upon agency staff to continue with their missions, regardless of tax status, for-profit or not-for-profit,” said Gumina, adding that more than half of his facilities rely on staffing agencies. “I hope [state funding support] continues because these team members of ours deserve additional compensation.”

Ohio Living operates 12 continuing care retirement communities (CCRCs) in the state, with 824 beds out of 2,904 dedicated to skilled nursing.

Allison Salopeck, chair of the LeadingAge Ohio board of directors, is curious to learn how the legislature defines direct care workers – it’s unclear if pay will extend beyond registered nurses (RNs), licensed practical nurses (LPNs) and certified nursing assistants (CNAs).

“I would love to be able to include culinary staff, housekeeping, and life enrichment staff, in addition to nursing assistants and nurses,” said Salopeck, who is also CEO of Jennings, which offers skilled nursing and long-term care, among other services along the care continuum. “I know there’s a whole caveat in there about making sure that the dollars aren’t used to do owner executive bonuses or anything like that, which I think is absolutely appropriate.”

Another stipulation of the bill allows funds to be recouped by the state. If an operator receives a portion of the $300 million and then the facility changes ownership, the previous owner would need to send the funds back to the state via proceeds of the sale.

“It’s got some rather odd provisions in there. But, you know, we’ll figure out how to work with those things. We’re just very grateful that the legislature and the governor came together,” said Van Runkle.

Originally introduced as HB 169 but repurposed and introduced on the Senate floor, the bill was sponsored by Republican Reps. Al Cutrona and D.J. Swearingen.

A separate standalone bill introduced in the House by Republican Rep. Sara Carruthers, HB 461, doesn’t have any such stipulations – Carruthers said she’d be willing to add an amendment to her bill blocking nursing homes that mandated the vaccine for its workers, local media outlets have reported.

Ohio currently has a 60.9% staff vaccination rate according to data released by the Centers for Medicare & Medicaid Services (CMS), the third lowest in the country. The state is impacted by a nationwide preliminary injunction against the CMS vaccine mandate, issued by a Louisiana federal judge.