We're preventing people from going into the most expensive level of care in every way that we can.

Most older Americans do not financially qualify for Medicaid and support provided through the Older Americans Act is quite limited. In response, Ohio has generated funds for services for older adults through the use of local county tax levy programs. Ohio currently leads the nation in the utilization and support of local levy funding, generating more than US$200 million annually. This study conducted qualitative descriptive interviews with 15 locally funded programs across the state. Thematic analysis revealed that local programs encounter an array of implementation barriers, including increased state and federal eligibility requirements, staffing issues, lack of access to services in rural locations, and low reimbursement rates. These barriers are coupled with added pressure from county officials to move individuals onto state-funded programs, rather than locally funded programs. This paper also provides recommendations for how these programs can be better supported to ensure their sustainability for the future.

Aims

The goal of this qualitative section was to gain a detailed, in-depth understanding of these levy programs; including barriers and recommendations to providing services with local levy funding.

Dates

January 2022 – March 2023

Funder

The author(s) disclosed receipt of the following financial support for the research for this article. This work was supported by the Ohio Department of Aging (ODA) for the Ohio Long-Term Care Research Project.
Acknowledgements

We wish to extend our sincere gratitude to Dr. Jennifer Kinney1,2 and Dr. Katy Abbott1,2 for their insightful suggestions and comments, which led to an improved manuscript.

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Bailee Brekke
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Updated: May 20, 2025 1:42 pm
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