Ohio has 86,000+ home care aides with ∼50% PCA turnover and wages near ∼$15–16/hr. ORC 4111.03 incorporates FLSA exemptions, but the constitutional minimum wage amendment (Art. 2, Sec. 34a) may provide broader OT protections per Haight v. Cheap Escape. No DWBOR (SB 14 pending). PASSPORT and MyCare Ohio serve 93.3% of LTSS users in community settings. Independent home care workers lost collective bargaining rights in 2015.
| # | Metric | Ohio | Status |
|---|---|---|---|
| 1.1 | BLS median hourly wage (SOC 31-1120) | ∼$15–$16/hr | Estimated |
| 1.2 | PHI median hourly wage (all DCW, ACS) | TBD | Gap |
| 1.3 | Median annual earnings (DCW) | TBD | Gap |
| 1.4 | MIT living wage (1 adult, 0 children) | ∼$17–$18/hr | Proxy |
| 1.5 | Wage gap (living wage minus BLS median) | ∼$1–$3/hr below living wage | Estimated |
| 1.6 | State minimum wage (2026) | $11.00/hr (eff. Jan 2026) | Public |
| 1.7 | Local minimum wage (highest city) | N/A | Public |
| 1.8 | Low-income household rate (<200% FPL) | TBD | Gap |
| 1.9 | Public assistance reliance (state-specific) | 44% receive public assistance (OH-specific) | Public |
| 1.10 | Housing cost-burdened rate | TBD | Gap |
| 1.11 | Uninsured rate (DCW) | Yes (expanded 2014) | Public |
| 1.12 | PHI Overall State Index ranking | TBD | Gap |
| 1.13 | Wage competitiveness vs. similar jobs | TBD | Gap |
| 1.14 | Genworth median home health aide rate | TBD | Gap |
| 1.15 | Genworth median NF semi-private rate | TBD | Gap |
| 1.16 | Family Care capitation PMPM (NH LOC) | TBD | Gap |
| 1.17 | Blended HCBS avg cost (all acuity) | TBD | Gap |
| 1.18 | NF private pay monthly avg | TBD | Gap |
| 1.19 | HCBS-to-NF cost ratio (state-specific) | TBD | Gap |
| 1.20 | Exemption aggregate savings (national est.) | $500-700M/yr (∼0.2% of HCBS) | Estimated |
| 1.21 | Per-worker OT loss (50hr/wk worker) | TBD | Gap |
| # | Metric | Ohio | Status |
|---|---|---|---|
| 2.1 | Headline caregiver vacancy rate | TBD | Gap |
| 2.2 | Open caregiver positions | TBD | Gap |
| 2.3 | Available job seekers (entire labor market) | TBD | Gap |
| 2.4 | Annual turnover rate | ∼50% PCA / ∼25% HHA (OH-specific) | Public |
| 2.5 | Individuals denied/delayed services | TBD | Gap |
| 2.6 | Agencies unable to staff all hours | TBD | Gap |
| 2.7 | Nursing homes closed since 2016 | TBD | Gap |
| 2.8 | NF beds empty due to staffing | TBD | Gap |
| 2.9 | Total direct care workers | 86,000+ (Policy Matters Ohio) | Public |
| 2.10 | New jobs projected (2022–2032) | TBD | Gap |
| 2.11 | Total openings incl. separations (2022–2032) | TBD | Gap |
| 2.12 | Population 75+ growth projection | TBD | Gap |
| 2.13 | Workforce demographics: % women | ∼85% (national proxy) | Proxy |
| 2.14 | Workforce demographics: % people of color | TBD | Gap |
| 2.15 | Workforce demographics: % immigrants | TBD | Gap |
| 2.16 | Health insurance offered by agencies | TBD | Gap |
| 2.17 | Family caregivers providing 80%+ of all care | TBD | Gap |
| 2.18 | Unpaid caregiver hours/economic value | TBD | Gap |
| # | Metric | Ohio | Status |
|---|---|---|---|
| 3.1 | State companionship/OT exemption status | ORC 4111.03 incorporates FLSA exemptions, but Art. 2, Sec. 34a may override per Haight v. Cheap Escape (2014) | Public |
| 3.2 | State overtime threshold | 40 hrs/wk (federal FLSA; state constitutional issue unresolved) | Public |
| 3.3 | Domestic Workers Bill of Rights | No DWBOR; SB 14 (136th GA) pending — would create domestic worker standards + bargaining feasibility study | Public |
| 3.4 | Paid sick leave law | TBD | Gap |
| 3.5 | Paid family/medical leave | No state paid family/medical leave | Public |
| 3.6 | Primary self-directed Medicaid program | PASSPORT waiver (Age 60+) + MyCare Ohio (dual-eligibles) | Public |
| 3.7 | Self-directed program enrollment | ∼33,000 PASSPORT slots; possible waitlist | Public |
| 3.8 | Primary managed LTC program | Mandatory managed care for dual-eligibles (MyCare); 4 MCOs: Anthem, CareSource, Molina, Buckeye | Public |
| 3.9 | Managed LTC enrollment | TBD | Gap |
| 3.10 | Combined HCBS enrollment | TBD | Gap |
| 3.11 | HCBS share of LTSS spending | 93.3% of LTSS users in HCBS (2023; top tier nationally) | Public |
| 3.12 | HCBS waiting lists status | TBD | Gap |
| 3.13 | Spouses as paid Medicaid caregivers | Yes (C-HCAS + CD-PCS within PASSPORT; family members incl. spouses can be hired) | Public |
| 3.14 | Parents of minors as paid caregivers | Yes (Choices HCAS — participant sets hourly rate within budget) | Public |
| 3.15 | COVID family caregiver relaxations permanent? | SB 14 (DWBOR pending); HB 34 (min wage increase pending); Next Gen MyCare rollout 2026 | Pending |
| 3.16 | SDPC maximum wage (self-directed) | TBD | Gap |
| 3.17 | OT rate cap in self-directed programs | TBD | Gap |
| 3.18 | IRIS/SDPC weekly hour cap | TBD | Gap |
| 3.19 | Minimum fee schedule for HCBS | TBD | Gap |
| 3.20 | Wage pass-through requirement | Up to 12% of home care workers work 40+ hrs/wk without OT (Policy Matters OH) | Public |
| 3.21 | MCO contract wage floor provisions | TBD | Gap |
| 3.22 | Union representation (home care workers) | Independent home care workers lost bargaining rights in 2015 (Kasich EO); SEIU 1199 represents ∼25K state employees but not independent home care | Public |
| # | Metric | Ohio | Status |
|---|---|---|---|
| 4.1 | Travel time/mileage reimbursement mandate | TBD | Gap |
| 4.2 | Caregiver-to-senior ratio by county | NOT COMPILED | FOIA |
| 4.3 | Counties with zero/limited home care agencies | NOT COMPILED | FOIA |
| 4.4 | Rural broadband coverage (for EVV compliance) | TBD | Gap |
| 4.5 | EVV system & vendor | TBD | Gap |
| 4.6 | EVV offline/low-connectivity accommodation | TBD | Gap |
| 4.7 | EVV hard launch date (personal care) | TBD | Gap |
| 4.8 | Rural vs. urban NF admission rates | NOT COMPILED | FOIA |
| 4.9 | Rural nursing home closures since 2016 | TBD | Gap |
| 4.10 | Rural HCBS alternatives (adult day, ALF) | TBD | Gap |
| 4.11 | Projected NF bed shortage (statewide) | TBD | Gap |
| # | Metric | Ohio | Status |
|---|---|---|---|
| 5.1 | Medicaid rate-setting authority model | PASSPORT + MyCare Ohio (Next Gen launching 2026) + Ohio Home Care + Individual Options waivers | Public |
| 5.2 | Minimum fee schedule exists? | TBD | Gap |
| 5.3 | Fee schedule codified in statute or budget? | TBD | Gap |
| 5.4 | Wage pass-through % requirement | TBD | Gap |
| 5.5 | State-level 80/20 compensation rule? | No (federal CMS rule faces rescission) | Public |
| 5.6 | MCO contract cycle & next renewal | No wage pass-through requirement | Public |
| 5.7 | MCO workforce adequacy reporting required? | TBD | Gap |
| 5.8 | IRIS IBA formula inputs reflect market wages? | TBD | Gap |
| 5.9 | Premium pay structure for extended hours? | Structured Family Caregiving: up to $392/wk ($1,680/mo) tax-free stipend | Public |
| 5.10 | State domestic service OT exemption status | Complex — ORC incorporates FLSA exemptions but constitutional amendment may override (Haight) | Public |
| 5.11 | Legislative path to eliminate state OT exemption? | Haight precedent creates potential state constitutional OT floor; needs higher court resolution | Analysis |
| 5.12 | Federal Medicaid loss projection (10yr) | TBD | Gap |
| 5.13 | Annual new cost to state taxpayers | TBD | Gap |
| 5.14 | State-directed payment limit impact (eff. 2028) | 110% Medicare cap; exact impact TBD | Pending |
| 5.15 | Provider tax moratorium status | TBD | Gap |
| 5.16 | NF staffing rule moratorium (10yr) | Applies (est. 13,000 add'l deaths/yr nationally) | Public |
| 5.17 | Work requirements effective date | Dec 31, 2026 (childless adults) | Public |
| # | Metric | Ohio | Status |
|---|---|---|---|
| 6.1 | 2013 DOL rule status (as of March 2026) | Technically in effect; enforcement suspended July 25, 2025 (FAB 2025-4) | Public |
| 6.2 | Proposed rescission rule published? | Yes — July 2, 2025 (90 FR 28976) | Public |
| 6.3 | Final rescission rule published? | No (as of March 2026) | Monitor |
| 6.4 | Chevron deference status | Eliminated — Loper Bright v. Raimondo (2024) | Public |
| 6.5 | Private litigation still viable? | Yes — 2013 rule provisions still invocable by private parties | Public |
| 6.6 | DOL estimated annual transfer (2013 RIA) | .8M (medium scenario, 7% discount) | Public |
| 6.7 | Adjusted current estimate | -700M annually | Estimated |
| 6.8 | GAO post-implementation finding | Hour caps, not cost absorption; pay did not increase; workforce declined 11.6% | Public |
| 6.9 | Familial caregiver % in self-directed programs | 50-78% nationally; CA IHSS >70% | Public |
| 6.10 | Disparate impact demographics | 85% female; 67% POC; 27% Black; 26% Hispanic | Public |
| 6.11 | CMS 80/20 Access Rule status | Finalized May 2024; faces likely rescission/non-enforcement | Public |