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Sponsors tell House Health Committee PPEC centers would expand childcare options for children with complex medical needs
Summary
House Bill 141 would authorize prescribed pediatric extended care (PPEC) centers—community-based, licensed childcare for children with complex medical needs—and establish a Medicaid waiver to pay a daily rate; sponsors say the centers expand options and could cut costs compared with 1:1 home nursing, but waiver rate details are pending.
Representatives Baker and Abrams told the Ohio House Health Committee that House Bill 141 would create prescribed pediatric extended care (PPEC) centers—nonresidential, community-based early childhood and before/after-school programs that care for children with complex medical needs under medical oversight and licensed by the Department of Health. Sponsor Representative Baker said centers would include medical directors, nurses for routine and emergency care, and classroom teachers to deliver individualized lessons and socialization.
"These centers would offer daycare for infants and preschool-aged children and before- and after-school and summer services for school-aged children," Representative Baker said, noting that children who attend PPEC centers and live at home saw higher quality-of-life outcomes in states that already use the model. Baker cited a March 2023 Southwest Ohio task force survey in which 89% of childcare resource and referral agencies reported poor access for children with complex medical needs.
The bill sets up a licensure process through the Department of Health and proposes a Medicaid waiver to pay a daily rate to participating centers. Sponsors acknowledged the waiver's daily rate and fiscal analysis remain under development with the Ohio Department of Medicaid (ODM) and that staff are working to estimate cost implications; they argued the model can reduce reliance on 1:1 in-home nursing, which is often more expensive. Representative Baker said staffing ratios were modeled on other states and adjusted to combine childcare ratios with medical needs.
Committee members asked for more specifics on projected savings, staffing ratios, and waiver mechanics; sponsors said they will provide detailed analysis when available and that centers are designed to be inclusive, allowing both typically developing children and those with medical complexity to attend.
The first hearing concluded without a committee vote; sponsors requested further review and follow-up fiscal information from ODM.
