Welcome to the first Capitol Update of the 2024 legislative session! I look forward to embarking on my second legislative session as WHCA CEO. Your WHCA team is honored to represent you at the Washington State Legislature.
I want to reassure you that we stand vigilant, sharp-eyed, and ready to keep you updated and engaged in this work. Legislators must understand your key role in the Washington health care system and the essential delivery of care you provide to our most vulnerable citizens. Even under our most vigilant efforts, we cannot do this without you. You are vital and influential in our ongoing conversation with legislators. The Capitol Update will be one way for you to know when we are calling upon the voice of our members to advocate for our residents, our workforce, and our providers.
Our next issue of Capitol Update will be released on January 12, 2024. Thereafter, we will reach out weekly on Fridays to update you about our work during session. We are strategic and thoughtful on how and when to engage our members, so, thank you in advance for making it a priority to respond to our requests for support and help with legislator meetings, testimony, and email advocacy efforts.
|
|
January 10 – 12:00pm
Please plan to join us on January 10 for a legislative briefing for WHCA members only. This session is designed to update you about our work and to help you engage powerfully as an advocate.
|
|
Here’s a brief overview to help pique your interest.
Session Overview
On Monday January 8, the legislature will meet for the 2024 legislative session. Last year was the 105-day “long” session, where the two-year state operating budget was adopted. This year is a “short” 60-day session where the Legislature must adopt a supplemental budget to update last’s year’s two-year plan. The Legislature will also be asked to consider a myriad of policy proposals during this brief time. The race is fast-paced, and the issues are important.
This session will be the last for Jay Inslee as Governor. He announced earlier this year he would not seek a fourth term as Governor. As the result, several Democrat members of the State Senate have announced their candidacies for higher office. Sen. Mark Mullet (D-Issaquah) is running for Governor, Sen. Manka Dhingra is running for Attorney General, Senators Kevin Van DeWege and Rebecca Saldana are running for Commissioner of Public Lands, Sen. Patty Kuderer is running for Insurance Commissioner, and Sen. Emily Randall is running for Congress for the seat being vacated by Rep. Derek Kilmer. This session promises to be a race for legislators to get out of Olympia and on to the campaign trail.
The state budget has seen revenue growth since the Legislature adjourned in April. The most recent forecast added $679 million to the state general fund. All totaled the state will have $4 billion in reserves before the start of the session. But top budget writers are concerned that six initiatives to the Legislature could affect the budget.
The organization Let’s Go Washington, funded by Brian Heywood, the CEO of the hedge fund Taiyo Pacific Partners, has been circulating petitions on six initiatives that would repeal recent legislation on the Capital Gains Tax, Long-Term Care Trust Act, the Climate Commitment Act, police pursuit policy, and parental rights in schools. Another proposal would ban any state or local income taxes. Two of the proposals have been sent to the Secretary of State’s Office for certification. Initiative proponents have until December 29 to submit signatures. This will be an issue that receives media attention and interest.
|
|
2024 Supplemental Budget
WHCA’s priorities for Medicaid funding remain the same for the 2024 legislative session:
- Fund the assisted living labor rate so that providers can compete for workers.
- Ensure that specialized dementia care funding is improved to address costs.
- Ensure that skilled nursing facility rates are updated annually to address rate shortfalls that threaten operational viability.
One of the core areas of business for the 2024 Legislature is to update the 2023-25 state operating budget. This budget directs Medicaid funding to provide care for low-income Washingtonians. Ultimately, there will be three budget releases considered—the Governor, House of Representatives, and the Senate.
The Governor released his proposed supplemental plan last week in Olympia. Unfortunately, his proposal did not act on the DSHS recommendation to increase funding for the labor costs. DSHS recommended that funding be moved from 79 percent to 95 percent of the cost.
In their September 2023 budget request to the Governor for assisted living funds, DSHS called out the inequitable treatment in funding:
“Although a significant improvement, ALF rates are out of alignment with other residential care settings that have seen higher rate increases...the labor component
for adult family homes rates is now funded at 95 percent. This separation in funding continues to stress the ALF workforce as they struggle to compete with other care providers.”
We will continue to work with the Legislature to address the funding inequity in this sector. The Governor’s proposal did advance limited funding for specialized dementia care in assisted living. The DSHS budget request recommended increasing the rate add-on from $44 to $60/resident day; the Governor’s plan brings the funding level to $55.
Please take a moment now to reach out to the legislators who represent you in Olympia to advocate for fair assisted living Medicaid funding:
|
|
For skilled nursing facilities, the Governor’s proposal provides $6.7 million in funding to mitigate rate swings that could occur in an initial transition to the minimum data set using the Patient Driven Payment Model (PDPM). While the details are unclear, this appears to align with the DSHS proposal to take a first step toward implementing PDPM on July 1, 2024. The DSHS proposal allocates funds for a one-year placeholder that would be followed by stakeholder work to develop a final plan and phase-in schedule for the PDPM. We are engaged in this work and will support DSHS legislation that creates the flexibility needed to implement the program.
Additional funding is also included to implement the July 1, 2024, skilled nursing facility rebase that was funded in the 2023-25 biennial budget. This adjustment to a 2022 cost base was higher than initially expected. Under the Governor’s proposal, providers would expect to see an increase of $35 per patient day on July 1, 2024, in the average daily weighted rate. We are still very appreciative of the Legislature’s work on skilled nursing facility funding in the two-year operating plan.
|
|
Policy Measures
This issue of discharge appeal rights for residents in community-based settings including assisted living, adult family homes, and enhanced services facilities is under consideration in Olympia. Last session, HB 1859 was introduced in the late days of the session as an effort to drive legislative attention to the issue. We have met with key legislators to register our opposition to the bill, which would extend all skilled nursing facility resident rights to residential care settings. There are pronounced differences in the care setting in Washington; the current legislation fails to acknowledge the statutory limitations on the care that can be provided. This issue has been percolating -- the Washington LTC Ombuds Program had petitioned DSHS and the Governor’s Office to engage in rulemaking around this issue. Both declined because of the lack of statutory direction about those rights.
We have been engaged in stakeholder discussions about the Ombuds proposal, but have significant, remaining concerns about HB 1859. We have been at work with other stakeholders and legal counsel to shape legislative language around the proposal and will keep you apprised of our work in this area.
We know there will be more bills introduced in Olympia that will affect our members. We are geared up to track, watch and affect those issues, and will count on your support to help drive the message about the key role of long-term care in the Washington health care system.
Look for Capitol Updates on Fridays during session for updates on our legislative work, and please make it a priority to respond to our Calls to Action that will help bring your voice to legislators in Olympia.
The Legislature is scheduled to adjourn on March 7th.
|
|
|
|
|
|
|
