Showing Our Support for House Bill 33

April 25, 2023

On behalf of ISBH and the individuals we serve, our CEO, Sam Shafer, has shared her support for House Bill 33 with the Ohio House of Representatives as they consider the SFY 2024-2025 Operating Budget. Governor DeWine's budget includes a historic investment in Ohio's Medicaid community behavioral health services, which provides a 10% rate increase for community behavioral health services ($220 million), investment in mental health peer support services ($30 million), and a 6% rate increase for inpatient psychiatric services ($130.1 million).  Sam's letter emphasizes the importance of HB 33 and its potential impact on workforce stabilization and enhanced service support.

My name is Samantha Shafer, and I am the President/CEO of Integrated Services for Behavioral Health. ISBH is a home and community-based behavioral health provider serving 21 counties in southeast and central Ohio. Our services include psychotherapy, psychiatry, addiction care, case management, youth residential services, housing, and crisis services.  ISBH believes that social determinants of health such as access to healthy foods, housing, healthcare, and employment are key to the health of our communities. That is why all of our programs focus on a holistic approach to supporting those we serve.

ISBH also answered the call from Governor DeWine to be a leader and provider of Ohio RISE Care Coordination. ISBH serves as the Care Management Entity for 19 counties in Regions H and I.

I am writing to you today in regard to HB 33, both to express my support for the legislation and to thank you for prioritizing the behavioral health needs of the people of Ohio. I share the same concerns around workforce development, provision of services, and expanding services to all those in need of them. To that end, the increase in rates paid for Medicaid services is very desperately needed. Since the beginning of the COVID-19 pandemic, ISBH has, along with many other BH providers, struggled to maintain full staffing. This has had measurable effects on our ability to provide services to clients, including requiring us to limit the number of high-need youth we have been able to admit at our Mary Hill Center for Youth.

Our organization is passionate about meeting the needs of Ohioans, and we have been making great strides in expanding access to services since the beginning of the pandemic. However, while we are receiving a historic number of referrals for mental health and substance use disorder services, we are facing unprecedented challenges both in hiring and retaining staff to provide these needed services. While we have increased our recruitment and retention efforts, we have largely been unable to hire and retain enough qualified staff to meet the needs of the people we, and you, are charged with serving. Because of this, we are faced with having to turn down referrals for services, discharge clients, and we have seen our waiting periods for services soar to weeks and sometimes months—far longer than prior to the pandemic.  

This unprecedented need for services and challenges in hiring have contributed to the impacts that we are seeing on children and families statewide. Some studies and estimates show that children in Ohio diagnosed with anxiety and/or depression has increased 42%, which is 10th highest in the United States over the same period of time. Additionally, another national survey showed that suicide is now the second leading cause of death for youth between 10 and 14 years of age.

Parents and families are desperate for additional help, greater access to services, and adequate staffing to meet their needs. In 2021, Nationwide Children’s Hospital conducted a survey of parents and discovered that 53% of working parents have missed at least one day per month of work due to their child’s mental health and that their work performance was impacted by their child’s needs.

These are tangible and serious effects on the citizens of Ohio, and the legislation pending before the Ohio Assembly today is an incredibly important step in addressing those impacts. The state budget for FY 24-25 is making historic investments in behavioral health and is a major step forward in getting desperately needed help for families, providers, and communities in addressing mental health needs. These investments are embedded in the ODM 525 line item and include:

  • A 10% rate increase for community behavioral health services for a total of $220 million.
  • $30 million for Mental Health Peer Recovery support services.
  • A 6% rate increase for inpatient services in free standing.

I am asking that ISBH, all BH providers, and all Ohioans can count on your vote for this legislation. However, the workforce crisis has reached critical levels and many service providers are seeing their ability to meet the needs of Ohioans greatly diminished. Because of this, and because of the increased demand for services, increased mental health needs of Ohioans, and unprecedented turnover rates, more investment is needed in Ohio’s behavioral health programs.

That additional investment would allow us to stabilize our current workforce and attract and retain high-quality candidates for community behavioral health jobs within the challenges presented by today’s labor markets and also lay the foundation for successfully building the behavioral health workforce that we desperately need to provide for Ohio’s future. In consideration of the need for that additional investment, I am respectfully asking for your support of amendment HC0294 that would increase funding for Medicaid payment rates for community behavioral health services by an additional 10% ($220 million) to stabilize and strengthen our workforce and support the needs of Ohioans.

In support of this and anticipating that you may have questions about our experiences working in this field or why this additional financial support is so critical, it would be my hope that we could schedule a time to sit down and discuss this legislation and the state of behavioral health care in Ohio. I will be happy to schedule this at your convenience, and I can be reached at

Thank you so much for your time, your support, and your consideration of this immensely important legislation. I look forward to working with you on supporting Ohio’s behavioral health infrastructure and improving the quality of care for all Ohioans.


Samantha Shafer, CEO

Integrated Services for Behavioral Health

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