Today is the 26^th day of the 2022 legislative session. There are 34 days remaining until the Legislature is scheduled to adjourn.

This week, there were two major deadlines in Olympia. Unless necessary to implement the budget, all policy bills had to pass the house of origin by February 3 to remain under consideration. Supplemental budget proposals were also due to budget leaders by February 3.

There are several issues at play in the budget for assisted living and skilled nursing facilities serving state Medicaid clients. While we have worked with intent and focus on advancing these policy initiatives, ultimately the House and Senate Democrat budget writers will determine the state supplemental operating budget for 2022. Each House will release a budget in the coming weeks. The Senate will lead, and the House will follow. We expect to see those proposals following the February 17 state economic forecast. Budget negotiations will begin in earnest as we work to the consensus budget and legislative adjournment on March 10. All the members of the House and half the members of the Senate are up for re-election this year, so there will be little interest in extending into special session.

Assisted Living Medicaid Rates: Representatives Jessica Bateman (D-22) and Joe Schmick (R-9) are sponsors of a budget request that would fund the assisted living Medicaid rates methodology at 77 percent, up from the current 60 percent funding level. Senator Sam Hunt (D-22) has advanced the same proposal for the Senate budget. The cost for the proposal is $27.9 million general fund state.

SNF Budget Priorities: Last night, WHCA and SEIU 775 co-hosted a legislative briefing on the status of the skilled nursing facility sector in Washington. Special thanks to Nadine deaKlerk, Chief Operating Officer for Regency Pacific Management, and Brent Weil, Chief Operating Officer for EmpRes Healthcare Management, for their impassioned advocacy. Click here to see Carma Matti-Jackson’s presentation detailing current fiscal and operational challenges. Special thanks to Carma, Bill Ulrich, and other contributors for their work. This information will be further distributed to Washington legislators, and we strongly encourage you to continue to make the case for funding with your own legislators.

Agency Staffing Study: Providers have experienced tremendous growth in agency staffing costs. Senator Ann Rivers (R-18) has submitted a budget request to require the Department of Health and DSHS to convene a stakeholder process to review pricing and regulatory structures governing these nursing pools. We will be asking Senate budget writers to support this work, focusing on the inadequate oversight regarding contracting and operating standards for these providers.

We have been alerted that there is problematic ergonomics legislation at play in Olympia. House Bill 1837 reverses Initiative 841 which repealed WAC 296-62-051 (the “ergonomics rule”) and essentially prohibited L&I from issuing new rules except to comply with federal law. One of the reasons why this initiative passed was because of how onerous WAC 296-62-051 was. As we interpreted it, the regulation required:

After the promulgation of the rule, but before the initiative passed, Employer Resources Northwest (ERNWest), WHCA’s third party administrator, created and published a manual that, if followed, would bring all skilled nursing and assisted living buildings in compliance with the rule. The 300+ page manual is an example of what all Washington employers would have had to do to comply with the rule.

HB 1837 itself does not reinstate this rule but allows L&I to again take a swipe at regulating ergonomics in the workplace. John Meier, President of ERNWest, notes that the problem with regulating “overexertion” type injuries is the regulations in this area are too broad and overly burdensome. “In fact, what we have done in evaluating workplace safety for many of our clients is not focus on ‘overexertion’ as a whole, because it is too burdensome to do effectively, but focus on the areas specific to each business that cause the majority of the overexertion type injuries. This has proven to be cost effective and effective in practice as evidenced by the rapid decrease in workers’ compensation premiums in the long-term care industry over the past five years.” HB 1837 passed House Labor & Workplace Standards and is in Rules, awaiting a floor vote. From here, the legislation must pass the House and cross over to the Senate for consideration. We expect there will be much pushback from the business community on this legislation and we will continue to work with John Meier and the Retro Community to oppose this ill-timed, cumbersome legislation.

HB 1872 – Care Workforce Center: Legislation sponsored by Rep. Tana Senn (D-41) passed the House Committee on College and Workforce Development this week, and has been referred to the Appropriations Committee. The legislation requires the Health Care Workforce Education Board to establish the Care Worker Center as a central access point of knowledge, research, resources, and best practices for care workers, employers, career counselors, education and training providers, policymakers, and others. Initially, the Care Worker Center must focus on three caregiving professions: childcare and early learning, long term care, and caregivers working with people with disabilities, including personal care attendants and direct service professionals. During the first two years, the Workforce Board must set up the Care Worker Center with staff, conduct an introductory marketing campaign, and work with relevant stakeholders to fulfill the duties of the Care Worker Center. We continue to support the legislation to create pathways for workers interested in care professions.

HB 1868 – Hospital Staffing and Patient Safety Legislation: While this legislation will pertain solely to hospitals, we continue to have concern with the staffing requirements that may have downstream effects for long term care providers who struggle to compete with hospitals for staff. We will continue to monitor and express our concerns about the bill.

We want to commend those of you who have worked so diligently with your teams to communicate about the urgency of our funding requests. Shout out to these teams: Prestige Care, EmpRes Healthcare Management, Life Care Centers of America, Avamere, Avventura, Ensign Services, and Caldera Care.

If you have questions or need support in connecting with your legislators, please contact Sam Sullivan of our team. She’s standing by to help you advocate.

We continue to meet with key legislators and make the case for your challenges. Thank you for working with us to amplify your concerns.