Legislative Tidbits by Gail Stelger

What would you like to know?

Here is some brief information on updates from LeadingAge PA. If you would like some more in depth information, please feel free to call me at 717-624-7715 or 610-392-1313 (cell) or e-mail me at gailstelger@hotmail.com. If you want the whole story, contact Anne Henry at anne@leadingagepa.org or 717-790-3949.

COVID-19 (Coronavirus)

3/10/2020 - PARCR Admin

Most of you have probably heard much information about the coronavirus or COVID-19. This notice is being sent to inform you that LeadingAge PA has gathered the most relevant and essential tools to prepare our organizations for the possibility of an outbreak. As LeadingAge PA reports, COVID-19 can pose a significant threat to those who become infected. Should the virus spread within the U.S., as it has in other countries, our senior citizens can be disproportionately impacted. Therefore, we need to take precautions.

This is from the LeadingAge website:

What Are Five Things Everyone Can Do?

Like so many of the easily-transmissible diseases and viruses we prepare for every day in our work with older people, everyone can use a few simple reminders:

  • Wash your hands frequently.
  • Cover your mouth when you sneeze.
  • Maintain “social distances” of a few feet near people who show symptoms.
  • Avoid touching your eyes, nose, and mouth.
  • Stay home and get medical attention if you are sick.

More information from LeadingAge PA about COVID-19 and what we can do can be found here. If you have difficulty accessing the links provided here and below, please let me know.

Information about Act 77 Election Reform will be provided in an upcoming tidbit.

Updated COVID Resources

With the Coronavirus so prominent in the news, there are multiple new and updated resources and tools to share for health care facilities. The Department of Health (DOH) issued a health care alert updating the information for health care professionals regarding COVID-19, for more information please visit their web page. Likewise, the Office of Long Term Living (OLTL), working closely with Managed Care Organizations (MCO) and the DOH to ensure preparedness, shared an update.

The Centers for Disease Control & Prevention (CDC) hosted a webinar “What Clinicians Need to Know to Prepare for COVID-19 in the United States,” on March 5, 2020.

Another informational call on preparedness for COVID-19 was held on March 11, 2020 with the DOH and the Hospital and Healthsystem Association of PA (HAP). This call was specifically for long-term care facilities. It provided status updates and discussed resources, recommendations, and plans.

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Budget Advocacy Update

2/18/2020 - PARCR Admin

LeadingAge PA reported on its proposal for the for 2020-2021 budget. Below is the report detailing the Quality Incentive Program and a 2% rate increase for both nursing homes and LIFE programs. Please note the last paragraph about grassroots advocacy.

In addition there is information on the Older Adult Protective Services Act, the Independent Senior Living Facility Privacy Act (HB2291), and The Centers for Medicare and Medicaid Services Fiscal Accountability Regulation.

LeadingAge PA Advocacy Update

State Budget Advocacy for 2020/2021

Almost as soon as the ink was dry on the 2019/2020 budget, LeadingAge PA began to work on our proposal for the 2020/2021 budget. We spent a number of months developing a Quality Incentive Program that would reward nursing homes for better staffing, better utilization of state Medical Assistance funds and better quality measures. This initiative was presented to the Wolf Administration as a proposed program to be included in the governor's Executive Budget that was announced on February 4, 2020. Unfortunately, for the sixth straight year, the Executive Budget did not include any rate increase for nursing homes.

In the meantime, until the budget is finalized by the legislature and the governor, we are working diligently on strategies to obtain not only $17 million in new state funding for our proposed Quality Incentive Program, but also a 2% rate increase for both nursing homes and LIFE programs. A rate increase for LIFE programs would be a modest return to the rates they were reimbursed prior to 2009 when they were reduced by 5%.

However, if we are to be successful, the General Assembly needs to hear your voice, too. In the upcoming months, please watch for Member Alerts with information on grassroots advocacy efforts.

Older Adult Protective Services Act

Since November 2019, we have been hard at work advocating for changes to the Older Adult Protective Services Act (OAPSA). The changes we are proposing would balance protections for seniors, ensure workers are not subject to numerous new criminal history background checks and prevent providers from being burdened with costly administrative processes.

Revisions to OAPSA are needed since multiple appellate court decisions have rendered parts of the existing law unconstitutional. Currently, there are two bills in the General Assembly aimed at fixing the law.

In the Senate, Senator Robert Mensch (R-Lehigh) has introduced SB819, while in the House, Representative Tim Hennessey (R-Montgomery) has introduced HB1930. Both bills contain provisions for prohibited offenses and time frames under which an applicant cannot be hired.

SB819 has passed the Senate and now sits in the House Aging and Older Adult Services Committee. LeadingAge PA opposes this bill and has asked the House to not take it up. HB1930 is more favorable, in its current form. However, in November and December 2019, the bill was scheduled for a vote out of the House Aging and Older Adult Services Committee with amendments that would have been disadvantageous for our members. Working in coalition with other long-term care and service provider associations, we were able to stop this bill from being voted on both times. We continue to work with the House Aging Committee, the Governor's Office, and the Department of Aging on language that we can agree upon.

Independent Senior Living Facility Privacy Act

The need for this legislation arose from an incident when representatives from the Department of Human Services canvased independent living apartments and questioned residents about their care needs. LeadingAge PA is actively working with Representative Eric Nelson (R-Westmoreland) to revise the language of House Bill 2291 from the last legislative session. The new language is intended to offer some protections for both independent living providers and residents. Once the co-sponsor memo is available, we will ask LeadingAge PA members to contact your members of the State House and request they sign on as co-sponsors of this legislation.

The Centers for Medicare and Medicaid Services Medicaid Fiscal Accountability Regulation

In November 2019, the Centers for Medicare and Medicaid Services (CMS) released a proposed regulation, the Medicaid Fiscal Accountability Regulation (MFAR) that could structurally alter Pennsylvania's already underfunded Medicaid program. Not only does this regulation have the potential to affect our nursing home members, it could also have devastating effects for our Continuing Care Retirement Community / Life Plan members. If this regulation was to be implemented as it is currently proposed, the process for approval of provider taxes, such as the Nursing Facility Assessment Program, would be significantly more subjective and unpredictable, the consequences of which CMS admits are unknown.

Not only has LeadingAge PA recognized the lack of clarity in the current proposed regulation, the unknown consequences to the Medicaid program, and the potential disruptions to the already tenuous system supporting the commonwealth's most vulnerable citizens, but we have already begun taking action on behalf of our members! We have submitted comments to CMS, written letters to the Pennsylvania Congressional Delegation, and drafted talking points for you, our members, to use when contacting CMS and our elected officials in Washington, D.C. Additionally, we are providing education on the CMS proposal to not only our members, but also our state officials who have received comment letters from many CCRC residents.

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Leading Age PA Alert and Information

2/16/2020 - PARCR Admin

PARCR Members,

Copied below is a Member Alert by LeadingAge PA in response to Governor Wolf”s announcement on Tuesday, February 4, 2020 of his proposed budget for state fiscal year 2020-21. The Alert, at this point, appears to be an Alert of information because the Alert ends with “Please watch for calls to action in the near future.”

Also below are statements from Adam Marles, CEO and President of LeadingAge PA, along with information about LeadingAge PA. Mr. Marles expresses disappointment over this new budget proposal.

Please feel free to contact me if you have questions or wish to make comments.

Gail Stelger

Vulnerable Seniors Ignored by Governor Wolf for the Sixth Year

Yesterday, Governor Wolf shared his executive budget for state fiscal year 2020-21. This announcement was like Groundhog Day all over again, as shared by LeadingAge PA’s President and CEO Adam Marles. While the governor formed a Council on Reform to ensure vulnerable populations have access to needed services, he chose to not increase funding for Medical Assistance senior services yet again. LeadingAge PA’s initial review of the Governor’s Executive Budget identified the following points of interest to LeadingAge PA members:

  • No Medical Assistance rate increases for nursing homes, LIFE providers, adult day programs or home health care.
  • An increase in the minimum wage to $12 per hour.
  • $5 million in state funds to grow the LIFE program by an additional 430 participants.
  • $1.4 million to expand access to the Ventilator Dependent Resident Grant Program.
  • $8.1 million to provide services to reduce the waiting list for the OPTIONS program of home based services provided through the Department of Aging. General information on the budget includes:
  • Overall spending is proposed at just over $36 billion in state general funds, which is a 4.22% increase over the available funds for 2019-20.
  • The governor did recognize vulnerable populations other than seniors with funding for other priorities such as $19 million for persons with intellectual disabilities.
  • The proposed budget discusses a blueprint for overcoming several obstacles to joining the workforce such as transportation, childcare, updating licensure requirements, and gaps in training.
  • The governor’s address included generous funding for public schools, including $1 billion dollars to fix toxic school buildings.
  • The address mentioned keeping Pennsylvania safe and adds $10 million for gun violence prevention.
  • In the coming weeks, the governor promises to put forth a health care reform plan that will address the high cost of prescription drugs, protect consumers, and empower more families to make decisions about their futures without being held captive by their health insurance.

As additional information becomes available, we will be sharing it with members.

Please know that LeadingAge PA has already begun advocacy for a 2% rate increase for nursing homes and the LIFE program. We are also urging the General Assembly to include $17 million of new funding to begin a nursing home quality incentive program. Your advocacy will be necessary if we are to be successful. Please watch for calls to action in the near future.

LeadingAge PA Calls 2020-21 PA Budget Proposal 'Disappointment'

MECHANICSBURG, Pa. (Feb. 4, 2020) - LeadingAge PA, an association representing more than 350 nonprofit providers of services for seniors, today issued the following statement from President and CEO Adam Marles on the 2020-21 budget proposal from Gov. Tom Wolf:

"Pennsylvania has essentially flat-funded Medical Assistance for more than five years and must stop ignoring nursing home residents who rely on Medicaid. That's why today's announcement that the latest budget proposal will continue to flat fund nursing home care felt like Groundhog Day all over again. Last year alone, there was a $632-million loss that hurt nursing homes' ability to maintain high quality care, and retain and attract staff. We urge the Pennsylvania General Assembly to insert a 2% rate increase into the budget and provide an additional $17-million investment in Community HealthChoices to fund a quality incentive initiative. This would reward nursing facilities that staff well, utilize public funds to provide better salaries and benefits to direct care workers, and demonstrate quality. Pennsylvania should reward its best nursing homes, and provide the funding necessary to properly care for its oldest citizens."

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May 2019

6/9/2019 - PARCR Admin

LeadingAge Pa has asked for help from PARCR members with the following plea:

Tell the General Assembly About Medical Assistance Funding Shortfalls!

LeadingAge PA needs our help! We must engage with elected officials in the general assembly NOW about the shortfalls in medical assistance for our nursing facilities. We must tell them how the cost of providing care under the medical assistance program is significantly more than our communities get reimbursed.

Use the resources provided by LeadingAge PA, which are attached. Every time we call, write, or invite our elected official to our nursing facility, we all get a step closer in making an important impact!

LeadingAge PA has provided the following information regarding efforts to include assisted living in medicaid funding which will be managed by the Community HealthChoices program.

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Bill to Include Assisted Living in Community HealthChoices Introduced

Early in the week of May 13, 2019, HB 1442 was introduced by Steve Mentzer (R-Lancaster). This bill is a result of the advocacy efforts of LeadingAge PA on one of their major initiatives. The bill would require the Department of Human Services (DHS) to include assisted living services in the Community HealthChoices program. The bill would also require DHS to review waivers of assisted regulations such as room size and bathroom capacity. These are some of the issues most often given by personal care homes that might otherwise want to convert to assisted living.

LeadingAge PA will keep us informed as our advocacy becomes necessary.

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Tidbits for January and February

2/26/2019 - PARCR Admin

Anne Henry has requested that any PARCR Member or attendee who has been able to make personal contact with any state legislator to please contact her so that LeadingAge PA can build on the relationship. Anne can be contacted at 717-790-3949 or ahenry@leadingagepa.org.

LeadingAge Government Affairs Team reported the following advocacy that had been accomplished by the end of January. The LeadingAge PA Government Affairs team completed 10 visits with legislators and/or staff including discussions on the upcoming 2019/2020 budget with staff from all four caucuses of the Appropriations Committees. Additionally, they met with the Secretary of the Governor’s Budget Office, the Secretary of Health, the Auditor General, the Deputy Secretary from the Department of Human Services (DHS) Office of Long Term Living, and DHS legal, DHS policy and Office of Income Maintenance staff. More regular updates on the progress made on issues critical to PARCR are planned.

LeadingAge PA reported that Governor Wolf announced his 2019-2020 Budget on Tuesday Feb. 5, 2019 before a joint session of the General Assembly. LeadingAge PA is gravely disappointed that the Governor has once again declined to provide a Medical Assistance (MA) rate increase for long term care providers. Despite the Governor’s repeated claims of supporting the needs of all Pennsylvanians, he continues again this year to ignore the needs of seniors. LeadingAge PA shared a press release, as well as urging the General Assembly to address this oversight in the Governor’s budget and will be calling on LeadingAge PA members for grassroots advocacy to support efforts to fairly fund senior care services in the commonwealth. LeadingAge PA plans to continue reviewing the Governor’s budget proposal and provide further information on the specifics as they become available.

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