WHCA takes seriously the important role in briefing legislators and their staff about the budget and policy matters that impact you, and this year is no exception. We only have 82 days left before the Legislature passes a state operating budget that sets rates and policies around Medicaid funding for two years, and there are other immediate and near-term policy issues that must be solved in that plan, including development of the long term care workforce. We’ve been working hard to gain traction on your issues.
Failed Medicaid funding policies fuel hospital patient backlogs and worker shortages.
Major themes keep emerging in legislative hearings, meetings, and briefings regarding long term care. Legislators and their staff want to know about the role of long term care in addressing hospital backlogs, and they want to learn more about the long term care workforce crisis. Our message is that both are related to Medicaid funding shortfalls. Nursing facilities provided over $620 million in uncompensated Medicaid care to Washington’s low-income patients during the past five years, and because of that shortfall in funding, are unable to compete for qualified staff. Assisted living providers serving low-income clients are equally as challenged because funding for labor is discounted to 68 percent of the cost.
The status of our workforce is somber and unsettling. The safety net for our low-income elderly is seriously strained by Medicaid funding policies that have failed to keep up with Washington’s operating costs required for care, including labor, food, nursing supplies, equipment, and utilities. Many COVID expenses were unanticipated and are unreimbursed. The long term care workforce has been battered by a three-year public health emergency that has seen a worker exodus from this sector because there are easier jobs that pay more. The disruptions are significant both to seniors needing long term care and to the remaining workers delivering those services. Seniors who are medically ready to discharge are stuck in hospitals because there is no long term placement to discharge to, and people with emergent medical needs can’t get a hospital bed when they need one. There is a great human cost to patients, families, and caregivers.
Both DSHS and the Governor have acknowledged that funding is necessary. Both advanced funding proposals designed to address these problems. We are urging legislative budget writers to adopt the DSHS-level of funding for base skilled nursing, assisted living, and enhanced services facility Medicaid rates, and we are advocating for additional funding for specialized services that will help with the hospital capacity crisis.
Take action: It's easy to advocate with your legislators through WHCA’s electronic advocacy system. You can send a personalized message to your legislators in less than three minutes.
Nursing facility policy legislation drives sustainable funding.
SB 5526/HB 1571: While funding in the two-year budget is important, it is even more critical to advance policy solutions to ensure that Washington has a sustainable system of long term care available to the growing population who will require services. WHCA has been working with key legislators and stakeholders on introduction of legislation to address funding challenges. Read our press release on the legislation. This bill is a top priority and aims to update funding more frequently and targets investments in the workforce.
Special thanks to legislative champions Senators Kevin Van De Wege (D-24) and Ron Muzzall (R-10) and Representatives Steve Tharinger (D-24) and Paul Harris (R-17), prime sponsors. Additional Senate sponsors include Senators Cleveland, Hunt, Keiser, Liias, Pedersen, Salomon, Shewmake, Valdez and Warnick. House sponsors include Representatives Schmick, Leavitt, Caldier, Bateman, Taylor, Stokesbary, Lekanoff, Chapman, Pollet and Macri.
Assisted living is a housing and personal care solution for low-income elderly but steeply discounted Medicaid rates means there is no access.
The lack of funding support for assisted living care is baffling. Assisted living is a housing solution for poor, elderly people who would thrive in this environment. It includes a private or semi-private apartment and a 24/7 care package that includes assistance with personal care, medications management, limited nursing services, activities, meals, housekeeping, and laundry. Current assisted living rates are only funded at 68 percent of costs—including labor, food, utilities, and other goods. This is particularly problematic for the assisted living centers that predominantly provide care to low-income people. Assisted living provides a choice for many who are ready for discharge from skilled nursing facilities and hospitals, and we are asking the Legislature to fully fund the labor component of the Medicaid rate. Representative Jessica Bateman (D-22) is a champion for this funding in the House operating budget.
“Difficult to discharge” hospital backlogs policy is thorny; policy and budget solutions are necessary.
There are several proposals that could help with the hundreds of Washington’s Medicaid clients languishing in hospitals who face limited discharge options. These are often people who have significant behavioral health needs which hospitals are not staffed to treat. The DSHS recommendation to increase funding for Enhanced Services Facilities by $2.6 million in state funds is one potential solution, but case management barriers must also be addressed if this sector is to be effectively utilized. Providers have beds available and are staffed to treat the most complex, but beds are underutilized. For nursing homes, DSHS recommended funding specialty care, including rate add-ons for serving people with traumatic brain injuries and those who need vent/trach services. In assisted living, DSHS recommended additional funding for specialized dementia care and community behavior supports. We support all of these proposals and are advancing a budget recommendation to key budget leaders. Additionally, legislation is being shepherded by the Governor’s Office that would implement interim “guardians” when petitions are underway but unresolved by the courts.
Weighing in on workforce issues: bold change is needed.
Given today’s workforce crisis, Washington cannot continue to function as it has in the past with the system that supports the training, testing, and certification standards for the long term care workforce. Delays in testing times and the lack of testing locations and opportunities are reported throughout the state. It is time for bold change to address the barriers and bureaucracy that dissuade potential candidates and bog down entry to the workforce. A staggering number of people will require long term care in coming years, and it will take a qualified workforce to deliver the care. That requires funding and focus. It’s important to get it right.
-
Working students deserve streamlined processes. Last week our team had the opportunity to provide public comment on Senate Bill 5278, a bill sponsored by Senator Lynda Wilson’s (R-17) to address the significant and problematic barriers to home care aide certification in our state. While WHCA is a strong proponent for worker training and certification regardless of setting, we do believe that there is an immediate opportunity to address difficult and expensive home care aide certification requirements that are exacerbating the challenges to providing care and services to our aging population. Specifically, we are seeking provisions in SB 5278 that would direct DSHS to permit licensed home and community-based employers to attest to successful completion of home care aide skills demonstrations, with additional standards regarding the qualifications for those who may conduct the testing.
-
Increasing the supply of nurses. SB 5582, legislation sponsored by Senator Jeff Holy (R-6), aims to increase the supply of nurses in Washington and will be subject to public hearing February 1 in the Senate Committee on Higher Education & Workforce Development. The WHCA team has reviewed the legislation and believes there is much to be excited about in this bipartisan proposal. I look forward to testifying about the bill, and will keep you apprised.
It's time to end the tax on independent senior meals.
On February 2, HB 1431, the legislation that clarifies that senior meals are not subject to taxation in care communities serving independent and assisted living residents, is scheduled for a public hearing in the House Finance Committee. We are working with advocates to advance the policy, which addresses a recent revision of the Department of Revenue position, that these meals are free of taxation. Rep. Joe Timmons (D-42) is prime sponsor, and he is joined by 36 other legislators from both sides of the aisle who support clarifying that independent senior meals should not be subject to tax.
Rent control measures dominate Housing Committee work.
Measures to address the state’s homeless problem are a priority for many policymakers in Olympia. Post-pandemic rent increases are historic; a number of rent stabilization measures are currently under consideration. There is an impact for independent seniors housing providers regulated under the Residential Landlord Tenant Act in these measures:
-
House Bill 1124 is on the move in the House. The legislation prohibits, with certain exemptions, a landlord from increasing the rent for a tenancy subject to the Residential Landlord-Tenant Act during the first 12 months after a tenancy begins, and during any 12-month period in an amount greater than the rate of inflation as measured by the consumer price index or 3 percent, whichever is greater, up to a maximum of 7 percent above the existing rent, as required to be calculated and published annually by the Department of Commerce.
|
|
Have a Heart for Seniors
We are designating February as a month of advocacy and action for our members. Our goal is to help legislators put a human face to our work, and we are relying on you to help. This week, we are distributing a toolkit that makes it easy for you to participate. There are two easy ways to support our legislative priorities:
- Start working now with you residents and staff to design Valentines to send directly to your legislators, or to send to the WHCA office for distribution on Valentine’s Day. Pull out the glue and glitter, and work with us on this nostalgic reminder for legislators to “Have A Heart” for our residents and our caregivers.
-
Connect with your legislators. Write a letter, send an email, make a phone call, or schedule a meeting with lawmakers, either in person or virtually. Include other members of your care teams, and spend 15 minutes briefing key policymakers and/or their staff. Email Eric Negomir at WHCA for information and support.
|
|
|
|
|
|
|
