January 26, 2024
Greetings!

Today marks the end of the third week in the 2024 legislative session, with just five weeks until the legislature adjourns. This week, we continued our work to oppose HB 1859, legislation that would adopt federal skilled nursing facility resident rights standards in Washington’s community-based care settings.

We far exceeded our goal of 100 of our members signing in opposition to this bill and your voice continues to be critical on this politically contentious piece of legislation. Thank you to those of you who made it a priority to register your opposition to the legislation. Also, thank you to those who submitted written testimony and testified at the public hearing about the dangerous policy that would further delay discharges from assisted living for individuals who are a danger to themselves or others, or those whose clinical or behavioral care needs exceed reasonable accommodation and cannot be met safely in that environment. The legislation would also legally entitle individuals who discontinue payment for care to remain in care and services for 90 days beyond the date a discharge notice is issued. The bill applies equally to Medicaid and private pay residents. Over 4,000 people registered their position on the bill. This number is akin to highly disputed legislation such as gun rights bills. Thanks to you, the opposition outweighed support on Monday morning, when the legislative record was closed. 

Click here to review the public hearing on this bill. If you have not done so, we encourage you to weigh in to oppose the legislation today.  

In the initial public hearing on this bill, Representative Simmons, the bill sponsor, announced that she will be offering amending language on the legislation, but we have yet to see the proposal. The bill must pass the House Health Care Committee by January 31 to continue moving forward in the legislative process, and we must ensure that the opposition continues to run strong on this proposal. Your assisted living and enhanced facility stories about difficult to discharge individuals that have endangered themselves, other residents, or staff are needed. We also need your stories about financial hardship related to those who stopped making payments but could not be discharged.

Please email Eric Negomir, who is here to provide you comprehensive support and make it easy for you to get your important examples on paper. Your examples are giving lawmakers pause on why community settings are NOT the same as skilled nursing facilities and why this type of policy must consider when a discharge is appropriate for the sake of all the residents and staff in a community setting. Please continue to help inform this discussion. 
PDPM Legislation Advances to Ways and Means 

Yesterday the Senate Health and Long-Term Care Committee passed SB 5802 in executive action. This bill is important-- for over 25 years, Washington’s Medicaid nursing home payment system has tied payment to the complexity and acuity of the resident. The state has relied on federal acuity data for this purpose. Use of this data ensures higher payments are tied to heavier care.

As of October 2023, the federal government retired the data system Washington used for rates setting - the Resource Utilization Group System, or RUGs. In order to continue tying payment to the complexity and acuity of the residents, Washington must switch to the new federal data system- the Patient Driven Payment Model (PDPM). SB 5802 authorizes the state to switch to the new system and to use the new data to set Medicaid rates beginning with the July 1, 2024, rates.

Without this bill, Medicaid rates would be “frozen,” severing the connection between payments and care needs. Freezing the system is bad policy and creates a financial cliff for providers when acuity data is reintroduced into the payment system. SB 5802 now travels to the Ways and Means Committee, where Chair June Robinson noted there will be additional work on the legislation. Please urge your legislators to support this bill.  
Supplemental Budget Development 

We continue to meet with key legislators to encourage support for additional assisted living Medicaid funding. We support the DSHS recommendation to increase funding for labor costs from 79 percent to 95 percent of costs. The DSHS proposal also increases specialized dementia care funding to $60/day, an increase from the current funding level of $43.48. Please send a message to ask your legislators to support this proposal.  
WHCA Winter Conference – 1/30 Legislative Update @1:00 p.m. 

If you have not done so, we strongly encourage you to sign up for the WHCA Winter Conference. This is an outstanding professional development opportunity for your teams, and you can learn more about our work in Olympia.

On Tuesday, January 30, the WHCA Government Relations Team will provide an update about the work of the Washington Legislature this year and will help you understand how to advocate on meaningful and important policies that affect long term care. Register now below.