The Health and Human Services Conference Committee report was voted out of both the House and the Senate. In both, the votes were along party lines, with only a couple of republicans voting no in the House and one republican voting no in the Senate. The Governor has signaled certain veto of this report. After the veto, the two sides will continue to negotiate and attempt to find a compromise. During this process we will continue to update you on the changes made that are affecting older adult services.

During the Conference Committee we have been watching several issues impacting older adult services. Here is a brief update on a few of the items we have been watching most closely.

First, the budget items:
The nursing facility (NF) reductions came in at the House target number of 4.4 million dollars. These non-rate reductions include the planned closure rate adjustment, nursing facility property rate inflation, and bed hold changes. Yesterday, they did insert an amendment which gave an increase to some of the lowest reimbursed nursing homes. Under the amendment, nursing facilities with an operating rate DDF 1.0 that is under the 18th percentile of all nursing home operating rates (DDF 1.0) in the state will receive up to a 2.45% operating rate increase.

Second, the committee continued the cuts approach to elderly waiver. Elderly waiver cuts came in at 32.4 million dollars. We continue to meet with the Department of Human Services and the Administration in an effort to find some relief to these cuts.

Proposed Cuts to Older Adult Services in HHS Conference Committee Report

Other items of note include:

Phaseout of rate equalization. The phaseout of rate equalization remains 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 The proposal takes steps to phase out the outdated policy of limiting the market forces in nursing home pricing.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 language included in the conference committee report allows nursing homes to charge private pay 2% more than MA rates each year, and it will accumulate each year. So the second year would allow 2% more than the year before. The governor has written 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 the following language is included in the conference committee report: with the permission of the client, the provider may provide a copy of their own assessment outlining their own recommendations. This policy language has been adopted into the conference committee language.

Other issues of note: electronic transmission of applications for nursing assistant registry, changes to the compliance with elevator code changes, changes to the Nurse Licensure Compact, a change to the spousal contribution requirements, and a nursing facility pilot project.

Read the entire conference committee report.

Toby Pearson
952.851.2480
tpearson@careproviders.org

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