The intense debate in Washington over the future of our health care system has been largely focused on two central issues.

First is how to give more Americans access to quality health coverage and how to accomplish this goal while also tackling the spiraling cost of health care not only for families and businesses, but local, state and federal governments.

While the U.S. House recently approved a health care reform bill, the final vote on the proposal — 220 for and 215 against, including 39 Democrats — is evidence that there is still much more work to do to address some serious concerns that members on both sides of the aisle have with the plan.

As this discussion continues in our nation’s capitol, there is an important, bipartisan effort underway in Ohio to help reduce our state’s health expenditures and give hundreds of Ohioans greater choice in the care they receive.

In the coming days, I plan to introduce legislation with State Senator Dale Miller (D-Cleveland) that would expand eligibility for Ohio’s Home First program, which allows individuals in nursing facilities, who are Medicaid-eligible, to bypass any waiting lists for home and community-based care services.

In 2005, I worked to establish the Home First program through passage of House Bill 66 to give Ohio seniors in nursing homes the ability to enroll in PASSPORT and receive the care they need in the comfort of their own homes.

PASSPORT is a Medicaid waiver program that pays for services such as adult day care, emergency response, medical equipment and supplies, independent living assistance and medical transportation.

Then, last year, the General Assembly approved legislation to expand eligibility for Home First to include individuals in nursing homes who are on a waiting list for Ohio’s Assisted Living Waiver Program.

Soon, Sen. Miller and I will unveil a bill to further increase opportunities under the Home First law by making Ohioans, who are at-risk of imminent admission to a nursing facility, immediately eligible for either PASSPORT or the Assisted Living program.

Physicians and community advocates, including local Area Agencies on Aging and Adult Protective Services, would work together to establish if an individual meets this criteria and determine the level of care they need.

By helping more Ohioans enter home and community-based care settings, the Home First program not only creates greater choice in our state’s health care system, but works to save Ohio taxpayers millions of dollars per year.

According to data from the Ohio Department of Aging, it costs the state $560 per month for an individual receiving PASSPORT assistance and $842 for Assisted Living.

But the state spends nearly $1,700 per patient, per month for nursing home care.

While Ohio’s nursing facilities provide critical care for many Ohioans, it just makes long-term fiscal sense for the state to invest in home and community-based care, particularly as the Legislature and Governor face the prospect of having to fill a multi-billion dollar budget hole in two years when Ohio’s federal stimulus money has dried up.

The Ohio Business Roundtable has said that if Ohio simply achieved the national average on spending for home and community-based care—we currently rank 39th in the nation—the state could save $900 million a year in Medicaid costs.

Not to mention, a recent AARP survey found that 94 percent of Ohioans would prefer to receive care in their home.

The Home First program has already helped hundreds of Ohioans access the care they need in the setting they prefer.

Between July 20 and October 31 of this year, there were 521 Home First enrollments, according to the Ohio Department of Aging.

By expanding eligibility for the program, we would not only create greater choice in Ohio’s health care system for consumers, but help significantly reduce state government spending and put Ohio on more solid financial ground moving forward.

John A. Carey is a member of the Ohio Senate and represents the 17th District. He can be reached at Ohio Senate, Statehouse, Columbus, Ohio 43215 or by phone at (614) 466-8156.