The General Assembly has begun another legislative session as of January 8. Legislators are scheduled to meet for 60 days this year. Much of their focus will be developing the next biennial budget. Even with the shift in party power to Democrats in both the House and Senate, VHCA-VCAL is confident in the relationships we have built with key leaders in both parties and our efforts to inform their understanding of the issues facing you.

We are monitoring bills as they are introduced to assess their impact on members. Issues our lobbying team will be focusing significant attention on include the Medicaid budget and rebasing, the LTSS Screening process, staffing ratios, minimum wage and employment issues, and certificate of public need.

The following is a summary of our efforts on these priority issues. In the coming weeks we will provided detailed updates on specific bills.

Medicaid and Rebasing

As we told you in December, Gov. Ralph Northam’s introduced budget, which is the starting point for legislators, is based on a negative rebasing outcome of -2.25 percent (estimated to be -$27.4 million) and an inflation adjustment assumed at 2.8 percent. While there is a net aggregate increase of 0.5 percent across the sector, there are significant rate reductions for individual facilities within that aggregate effect due to the rebasing. 

Del. Mark Sickles (D-Fairfax) and Sen. George Barker (D-Fairfax), who are key leaders on the House Appropriations and Senate Finance and Appropriations Committees have agreed to introduce budget amendments on rebasing to address the situation of the incorrect data in the model on the Medicaid managed care days and the bias observed in the peer groups toward lower cost facilities in terms of rate setting. If passed, these amendments would restore about $18 million in funding.

LTSSS Screening

Del. Sickles and Sen. Barker will also serve as patrons of our bill to improve the Long Term Services and Supports (LTSS) Screening process. I know many members have encountered challenges in obtaining these screenings from hospital screening teams. The solution we have proposed has garnered support from the Virginia Hospital and Healthcare Association, and we’ve received technical assistance from DMAS as well. We will be working diligently to educate legislators on the committees that will consider this bill to secure its passage.

Staffing Ratios

We are also working aggressively against a bill that would mandate staffing ratios for nursing facilities. Our key arguments will focus on the necessity of avoiding a one-size-fits all approach to staffing, the ongoing workforce shortage, and the financial impact to the Medicaid program to fund such a mandate.

Minimum Wage and Employment Issues

We are also keeping a careful eye on the various bills that would repeal the right to work statute, raise the minimum wage, and other employment-related issues. We have engaged a firm to provide us data on how a wage increase would impact individual centers. We have already been communicating with legislators on the impact of a minimum wage increase and have been working with other Medicaid providers on a unified message.

Certificate of Public Need

Lastly, as we have done in recent sessions, we are keeping a close eye on the bills introduced related to certificate of public need (COPN). Over the summer a group of stakeholders convened in efforts to reform the COPN process but did not come to consensus. VHCA-VCAL monitored the workgroup to ensure the outcome would not impact nursing center beds. Further, the workgroup reassured the association its proposed reforms are not intended to impact COPN for nursing facilities.