Today is the 5th day of the 2022 legislative session. There are 55 days until the session is scheduled to adjourn. This year, the session will predominantly be conducted virtually – the House will be fully virtual, and the Senate has adopted a hybrid remote session that limits the number of legislators on the floor at any time.
This week, the House Appropriations Committee and the Senate Ways and Means Committee held public hearings about the Governor’s 2022 supplemental budget proposal that was released in December. Unfortunately, the Governor’s plan fails to provide adequate support for skilled nursing and assisted living centers, and we are working with House and Senate budget leaders on funding proposals designed to address our greatest need – additional resources to address years of funding shortfalls that are impacting provider ability to compete for workers, and continued allocation of additional COVID-19 emergency funding made available by the federal government. It is imperative that the Legislature address significant cost growth occurring during this pandemic.
Assisted living providers who serve Medicaid clients are particularly challenged to compete for workforce, given the current state of funding. The new assisted living Medicaid payment methodology adopted in 2018 is only funded at 60 percent of costs and well below minimum wage. Click
here for a briefing.
We are seeking $21.3 million general fund state to bring the assisted living payment model to 77 percent funding level, and for extension of COVID-19 add-on funds throughout the state of emergency. Equally as important, we are also laying the groundwork for additional, stepped-up assisted living funding in the 2023-25 state operating budget with the message that the failure to fund these rates puts the very providers who serve low- and moderate-income seniors at great risk. The current assisted living Medicaid funding level is simply not sustainable and frankly, defies understanding both fiscally and in terms of consumer preference and choice.
For skilled nursing facilities, the July 1, 2022, rebase does not come soon enough for providers who are still reimbursed at 2019 costs (a shortfall of over $100 million annually). We continue to raise the alarm about steep increases in the cost of labor, goods, and services that are impacting care costs. In addition to seeking bridge funding to drive additional dollars into direct care starting on April 1, 2022, we are also stakeholders in developing a wage equity proposal with Representative Eileen Cody. The goal is to drive additional dollars to low-wage workers in skilled nursing facilities, including CNAs, laundry, dietary, and housekeeping personnel. We are focused on ensuring that any proposal going forward does not inadvertently drive additional, uncompensated provider costs.
We continue to monitor, analyze, and respond to legislative proposals that have a direct or related impact for our members:
HB 1124 - The blood glucose monitoring legislation introduced last year passed the House this week. The legislation expands nurse delegation of glucose monitoring and testing to CNAs and home care aides, regardless of health care setting. A registered nurse may delegate glucose monitoring and testing to a registered or certified nursing assistant or a certified home care aide. The specified frequency with which a registered nurse must supervise and evaluate a person to whom the nurse has delegated insulin injections is eliminated. Instead, the supervision and evaluation is governed by requirements to be established by the Nursing Care Quality Assurance Commission in rule. From here, the legislation will travel to the Governor’s office for signature, with rulemaking necessary from the Nursing Care Quality Assurance Commission.
HB 1877 - This bill would extend to five years the timeline for certified nursing assistants and long term care workers with expired credentials to renew certification without additional mandated training requirements. Click
here to register your support for this legislation, which would presumably help bring workers back into the workforce.
We continue to meet with legislators to detail our budget and policy priorities – and urge you to communicate directly with your legislators to update them about your experiences in the current operating environment. Our team is standing by to support you. It’s easy to customize and send a message from
our online advocacy center.
If you have questions or need additional information, please let me know. These are very difficult times, and we strive to bring our members’ important voices to the Governor and the Legislature.
