March 1, 2024

Greetings! There are six days remaining in the 2024 legislative session. Today marks the deadline for bills of the opposite house to pass unless they are budget related. All week, the House and Senate have been on the floor moving the bills that will become law once passed and signed by the Governor.

Supplemental Budget Update  The Governor released his supplemental proposed budget in December. Now the House and the Senate are modifying that proposal and must reach agreement before returning the budget back to the Governor for final approval and signature. Here is a comparison of all three budget proposals. The supplemental budget will affect Medicaid funding from July 1, 2024, through June 30, 2025. We are glad to see that skilled nursing and assisted living Medicaid rates are rebased in each proposal, but the House plan provides additional funding for assisted living and is the best for our members.  Medicaid Funding in the House Budget Proposal: Provides funding to increase reimbursement for the labor component from 79 to 84 percent.  Increases the specialized dementia care add-on from $44.38 to $55 per resident day  Extends one-time bridge funding of $20.99 per day to providers serving 70 percent or greater Medicaid census from the current level of 90 percent.  We are asking our members to make a strong push to support the House proposal for assisted living with their legislators.

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Patient Driven Payment Model (PDPM) Implementation   The House budget proposal specifically details the work on implementation of PDPM for skilled nursing facilities. The proposal is specific regarding stakeholder work and accountability to address this change. Reports about implementation must be submitted in December 2025 and again in December 2026.   These reports must include the following information:   An analysis of the potential impact of the new case mix classification methodology on nursing facility payment rates;   Proposed payment adjustments for capturing specific client needs that may not be clearly captured in the data available from the centers for CMS; and   A plan to continuously monitor the effects of the new methodologies on each facility to ensure certain client populations or needs are not unintentionally negatively impacted.  SSB 5802 is also still in play and provides the statutory authority to DSHS to use the PDPM to set rates beginning July 1, 2024. The legislation passed the House Rules Committee last night and is now eligible for a floor vote in the House of Representatives. The legislation must pass the House floor to advance to the Governor’s desk for signature.

Policy Legislation  HB 1859 – Residents Rights Legislation: This legislation would have imposed federal nursing home regulations onto community-based settings. We defeated the legislation this year, but we expect it to return. The dealbreakers were the 90-day timeline for appealing discharge notices and the lack of resources for focused case management. DSHS did work to draft alternate language, but thanks to your support and collaborative lobbying efforts with the Adult Family Home Council and LeadingAge Washington, this bill did not advance out of committee. Nearly 5000 people registered their positions on the bill – 70 percent were opposed to the legislation.   HB 2114 - Rent Caps Legislation: This legislation impacts independent residents in mixed AL/AL seniors housing. The bill is very controversial – the Senate version of the bill died, and the House version is now in the Ways and Means Committee where it has not yet advanced to executive action. The legislation limits rent and fee increases to 7 percent during any 12-month period and prohibits rent and fee increases during the first 12 months of a tenancy for tenants subject to the Residential Landlord-Tenant Act regardless of the length of their lease, with certain exemptions. The legislation establishes fee increase notice requirements, tenant lease termination provisions, limits on move-in fees, security deposits, and late fees, and requires parity in terms between month-to-month and longer-term rental agreements. There are remedies and enforcement mechanisms under the Consumer Protection Act and through private cause of action.   SB 5640 – Work Group on Independent Residents Rights in Assisted Living: The legislation establishes a living residents' rights work group to recommend a bill of rights for nonresidents residing in an assisted living facility. The legislation passed the Senate but did not move in the House, however the bill is referenced, and funding is provided in the Senate budget, so this could be classified as “Necessary to Implement the Budget” and may still be alive. WHCA is a referenced stakeholder in the work.

Session adjourns next Thursday. We will update you about outcomes in the March 8 Capitol Update. Thank you for staying engaged.   As the clock winds down on the 2024 session, the team at WHCA would like to acknowledge the efforts of our members in this important work. From committee testimony to letters to the editor, email messages and direct outreach to legislators, your efforts are a most important asset.

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