"COVID is not over for our members. Costs continue to climb. Workers are fleeing long term care. There are barriers to the pipeline of new workers. Nursing pools are not the solution to the ongoing crisis—agency staffing is expensive, unregulated and lacks consistency. Medicaid funding lags by nearly three years in nursing homes, and is dialed back to 68 percent of the costs of care in assisted living. There is a direct nexus between Medicaid funding and access to workers who deliver care, and without the necessary resources, people receiving long term care will have their needs go unmet."
|
|
Washington Legislature Returns to Work for 2023
Last week, Washington’s 149 elected legislators from 49 legislative districts convened in Olympia for the 105-day 2023 legislative session. The difficult transition period from the three-year public health emergency continues, and our work with the Legislature has never been as important.
This is the long session, where a two-year operating budget will be adopted. This budget determines Medicaid rates for the July 1, 2023 - June 30, 2025, period. This is also a session where policy bills that affect your work as providers and as employers are already being introduced. Our mission is to represent your interests in both budget and policy initiatives.
Our strategy is twofold— educate and work with the Legislature at every possible step in the legislative process, including work sessions, public hearings, and meetings, and elevate your stories with the Legislature, the media, and the public. You work and live in districts where one Senator and two Representatives will be asked to make decisions that affect your work. Our goal is to directly engage you in advocacy, and we’ve targeted resources to support this work. In January, we welcomed Eric Negomir to the team; email Eric for advocacy support. His job is to help you connect powerfully with your legislators so they understand why their support is so critical to our workforce, clients and families.
Funding for Long Term Care
Our work to develop and refine legislative proposals has been ongoing—we helped shape the DSHS budget proposal that was submitted to the Governor’s Office of Financial Management in August and saw the results of our work in the Governor’s December budget proposal for LTC.
While that budget did include important Medicaid funding, we are asking the Legislature to do more to address the unprecedented inflation that is driving operating costs, and the dramatic increases in labor expenses that currently go unreimbursed. There will be two more budget proposals— one from the House and one from the Senate— and each will be subject to a prescribed, time-sensitive legislative process. The final budget must be adopted by April 23, when the Legislature is scheduled to adjourn.
The Workforce Crisis Must Be Addressed
COVID is not over for our members. Costs continue to climb. Workers are fleeing long term care. There are barriers to the pipeline of new workers. Nursing pools are not the solution to the ongoing crisis—agency staffing is expensive, unregulated and lacks consistency. Medicaid funding lags by nearly three years in nursing homes; in assisted living, Medicaid is only funded at 68 percent of the cost of care. There is a direct nexus between Medicaid funding and access to workers who deliver care, and without the necessary resources, people receiving long term care will have their needs go unmet. These issues are a critical part of the story, and we continue to stress this with legislators and the public.
On January 12, I testified in a work session of the Senate Health and LTC Committee, along with ALTSA Secretary Bea Rector and Maddie Foutch of SEIU 775. Our messages were aligned: Medicaid funding levels have clear and direct relationship to quality of care for residents and patients, and quality of life for patients, residents, and caregivers who have been pressed to the limit during these unprecedented times. The current workforce cannot and will not be able to address care needs of Washington’s aging and disabled, and that’s a real issue for Washington’s budget writers who are charged with ensuring a sustainable system of long term care.
Here’s a link to a joint legislator briefing on January 4 with SEIU 775 and LeadingAge Washington. Again, data and numbers are important and tell a story that is particularly relatable for budget writers, but caregiver stories were the most compelling. There are unacceptable human costs when care goes unfunded.
Policy Round Up
On the policy front, over the course of this Legislative session, there will be many legislative proposals (bills) that we prioritize and manage. It’s early in session, and many proposals are still subject to work. Here’s a quick update.
-
Skilled Nursing Facility Medicaid Funding: Our work on skilled nursing facility legislation that would update Medicaid rates annually, address census penalties, and continue last year’s “wage equity” funding is a high priority. To that end, this week I met with my own legislators in the 24th legislative district, Senator Kevin Van De Wege (Health Care and Ways and Means Committees) and his seatmate and chair of the Joint Legislative and Executive Committee on Aging and Disability Issues, Representative Steve Tharinger. Rep. Tharinger is a member of the House Health Care and Appropriations Committees. Both have agreed to prime sponsor the WHCA-priority legislation—and we are working to iron out the details of the proposal and to identify other legislative sponsors for the bill that will be introduced in both the House and the Senate in coming days.
-
Ergonomics legislation (SB 5217): Twenty years ago, Washington voters approved an initiative that prohibited Washington’s Department of Labor and Industries (L&I) from issuing regulations related to ergonomics standards. Business and industry pushed back on onerous and expensive standards L&I adopted. For providers, the impact on costs is significant. The past two years have seen a big push to permit L&I to regulate ergonomics standards. Last year there was a large opposition campaign mounted predominantly by business advocates. Ironically, effective workers compensation claims management has resulted in declining injury rates. This year’s legislation is also likely to draw strong opposition.
In the Works
-
Nursing Pool Transparency: Senator June Robinson, (D-38) has agreed to prime sponsor legislation that will establish standards, including cost reporting requirements, for temporary staffing agencies. We continue our work with WSHA and LAW to advance the legislation.
-
Temporary Guardianships: WHCA is involved in stakeholder discussions on legislation that would facilitate expedited LTC placement decisions for individuals engaged in the court guardianship process.
-
Hospital Staffing Requirements (SB 5236): The Senate Labor & Commerce Committee is holding a public hearing on legislation that would establish hospital staffing ratios this week. The legislation would likely increase competition for nursing and direct care staff. WHCA will sign in to oppose the bill.
-
Difficult-to-Discharge Hospital Residents: Today, on January 17, the Senate Health and LTC Committee held a work session on difficult-to-discharge residents that predominantly featured the perspective of hospitals. The need for LTC funding was a strong message in the work session. We continue to advance support for specialized funding for programs that support care for these clients, including additional resources for enhanced services facilities and for programs that support care for people with traumatic brain injuries, bariatrics, and behavioral health needs.
-
Legislator Briefings: During the next couple of weeks, legislative committees will continue to be briefed about key areas of jurisdiction. Here is the link to DSHS assistant secretary Bea Rector’s briefing on long term care in the House Health Care Committee on January 13. (Bea’s remarks start 30 minutes into the session.) ALTSA is responsible for regulatory oversight and Medicaid services delivery in the long term care setting. Here is the slide deck used in the briefing. We will continue to work with key legislators and staff to advance our priorities in both budget and policy committees.
Have A Heart for Seniors: February 14 Day of Advocacy and Action
Please join us, in whatever capacity you are able, for the February 14 day of advocacy and action. The Have A Heart for Seniors campaign is intended to raise legislator awareness. You can meet with legislators in person or via ZOOM, you can work with your teams to make and deliver Valentines in person or by mail, and you can contribute to the awareness of this event by sending us your photos that can be used in our communications work. We’ll release a detailed toolkit on the campaign soon.
|
|
|
|
|
|
|
