This is the 12th day of the 2022 regular legislative session. There are 48 days until adjournment.
We are continuing to meet with budget and policy leaders regarding the need for intentional investments in Medicaid reimbursement for skilled nursing and assisted living centers providing long term care for state clients. We are working hard to help legislators understand the dire challenges you face as providers and employers—and we are asking you to do the same with your own legislators in the coming days. February 3 marks the deadline for legislators to submit their budget request to budget leaders, so it is very important for your legislators to hear from you about funding priorities.
Assisted Living Medicaid Rates
The assisted living Medicaid priority to increase Medicaid rates to 77 percent of the modeled rate is gaining traction with the Legislature. State Representative Jessica Bateman (D-22) is sponsoring a budget proviso to support that funding level in the House budget and is working to garner support with her colleagues for the proposal. Her Senate colleague Senator Sam Hunt (D-22) is also a proponent of the budget proposal that is designed to address years of chronic underfunding.
Skilled Nursing Facility Budget Priorities
We are working now to advance supplemental budget operating language for “bridge funding” to help close the burgeoning Medicaid shortfall. Since January 2021, SNF entry level wages have grown 8 percent and costs for overtime, bonuses, contracted labor, and hazard pay have grown by 20 percent. Seventy percent of the cost of care is labor related, and there are stringent operating standards that cannot be ignored. Current skilled nursing facility payments are based on 2019 costs and are scheduled to be updated to 2020 costs on July 1, 2022. Our “bridge funding” proposal provides three months of bridge payments beginning April 1 to June 30, to help SNF providers sustain operations while waiting for the July 1 rebase. Waiting until July 1, 2022 for additional funding is not an option. This one-time, temporary bridge funding would be paid for with federal COVID relief dollars.
Your legislators need to hear from you about this proposal. Click here to send a message making the case for this important funding.
We continue to work with Representative Eileen Cody (D-34), chair of the House Health Care Committee on a “wage equity” proposal that would drive state Medicaid dollars to low wage earner paychecks as a pass-through. The devil is always in the details, and we are working hard to ensure this proposal is not burdensome, and that it will actually drive dollars as intended. The current projection is for a $63 million investment.
Emergency COVID Add-Ons
We also support the Governor’s budget proposal to extend the COVID-19 emergency funds for assisted living and skilled nursing facilities through the conclusion of the public health emergency using federal dollars earmarked by Congress for this purpose. While not nearly enough, the additional $8.33 per patient day add-on for skilled nursing facilities, and $4.79 per patient day for assisted living are truly important.
Agency Staffing
On the policy side, we continue to work to advance legislation that would address provider concerns with staffing agency practices that have resulted in extraordinary cost increases, and questionable contracting practices. This is a thorny issue—and we are being told that the short session may not provide adequate time to address the proposal. We will continue to press about the need for oversight and encourage you to email Lauri St. Ours to share any details about your own experiences with agency staffing. We are using these examples to educate legislators about the issue.
Policy Initiatives
As is no surprise, we continue to see legislative proposals related to staffing and labor. This week, we have been active on these policy initiatives:
This week, the House Labor and Workplace Standards Committee held a public hearing on legislation that would create hospital staffing ratios. We expressed great concern with the legislation, arguing that skilled nursing and assisted living providers are already challenged to compete for nurses. The bill has strong Democrat support and appears to have traction.
HB 1872 - Establishing the Care Worker Center to Promote Caregiving Professions
We signed in to support this legislation that would provide stronger support for caregivers. Click here for the details on the legislation.
We anticipate seeing additional workforce initiatives in coming days.
Please know that our actions are fueled by your heroic work during these unprecedented times. We are proud to be your voice in Olympia, and we are committed to helping policymakers and others understand the need for a sustainable, robust long term care system to support the incoming age wave.
Please let me know if you have questions about our work.
