The legislature is moving toward the end of the constitutionally required adjournment date of May 23rd. The house and the senate are currently finishing up their health and human services conference committee bill. This bill will contain several issues we have been tracking for both elderly waiver (EW) and nursing facilities (NFs).

Currently, we are anticipating that the legislature will wrap up the budget items after the publication of this newsletter, and therefore, we will be sending out a member email on Friday, May 13th outlining the status of the conference committee budget proposals.

As a reminder, here is a side-by-side list of the current house and senate proposals:

Proposed Cuts to Older Adult Services in HHS Conference Committee Bills

The conference committee has adopted many policy-related items in their report. Current Policy Issues adopted include:

Phaseout of rate equalization: The phaseout is currently in the conference committee report. The proposal takes steps to phase out the outdated policy of limiting the market forces in nursing home pricing. The current proposal is to allow nursing homes to charge private pay 2% more than MA rates in the first year. Then in the second year, the proposal would allow an additional 2%. The governor has put in his letter to the conferees that he will not sign a bill that includes any change in the policy of rate equalization.

Elderly waiver simplification issues: Long-Term Care Imperative staff has been working with stakeholder groups as well as with the Department of Human Services to find agreement and common ground. At this time we have agreement on the following: with the permission of the client, the provider may provide a copy of their own assessment outlining their own recommendations; and, in setting the EW customized living and 24 EW customized living rates, the lead agency should consult with the provider of services to ensure there is a documented need for the services. This policy language has been adopted into the conference committee language.

Surcharge: One remaining outstanding issue is the use of the surcharge. The governor raised the surcharge the full amount and included it in his budget; it was not clearly demonstrated that this revenue was returning to older adult services. Neither the house nor the senate has taken action to increase the surcharge. It continues to be a hot button in each of the caucuses. Our message to legislators has continued to be that if we raise the surcharge, we need to dedicate the money back to older adult services.

There are many rumors about the next steps with the conference committee report. Because the governor has insisted that they come to agreement and then begin negotiations with his office, we anticipate that the final negotiations with the governor will begin following the conference committee conclusion. We are hearing mixed and contradictory reports on the process that will be used for the bill. One report is that decision-makers will not take the bill straight to the floor for a vote, but will keep the bill open and negotiate with the governor. If the negotiations arrive at a compromise, then they will quickly craft the changes and pass the conference committee report to conclude the session on May 23rd.

The final 11 days of the session are sure to be full of twists and turns! Look for a member email tomorrow to keep you updated on the status of our budget issues. Next week look for member emails and Action articles to keep you up-to-the minute on final negotiations.

Toby Pearson
952.851.2480
tpearson@careproviders.org

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