The Virginia General Assembly kicked off its 2019 legislative session on January 9. Legislators are scheduled to meet for 45 days this year. VHCA-VCAL’s priorities includes securing Medicaid inflation increases for nursing care services. As we shared in December, Gov. Ralph Northam included a 3 percent inflation update for FY 2020 in his budget amendments.

This year we have worked with legislators to introduce legislation countering the nursing home attack ads as well as a bill related to adding temporary beds at facilities accepting evacuated residents during emergencies under the terms of the LTC Mutual Aid Plan. We are also working aggressively against a bill that would mandate on-site generators at assisted living facilities (ALFs).

Details on those bills and other VHCA-VCAL priorities for the session include: 

Medicaid Funding for Nursing Care Services

VHCA-VCAL supports full funding of the Medicaid forecast, which includes the inflationary update of 3 percent for Medicaid nursing facility services for 2020 (rates beginning July 1, 2019). This funding was included in Gov. Ralph Northam’s budget amendments.  

The General Assembly is poised to have some tough discussions as legislators weigh how to handle a variety of tax and budget issues. However, at this early stage of the budget process, we are in the best possible position. 

Truth in Advertising Legislation to Counter Attack Ads Against Nursing Homes

HB 2219 and SB 1217 propose that if an advertiser uses information from a survey or inspection report in an ad, the advertisement must also include details of the corrective action plan and the date the deficiency was corrected. The legislation does not prohibit the use of information from surveys or inspections in ads.

Del. Bobby Orrock (R-Caroline) and Sen. Steve Newman (R-Lynchburg) have introduced these bills on VHCA-VCAL’s behalf following the activity of a Florida-based plaintiff’s firm that placed 55 full-page paid advertisements in 38 papers across the Commonwealth attacking over 75 of Virginia’s nursing homes to solicit potential legal clients for medical malpractice cases in 2018. 

VHCA-VCAL encourages nursing homes that were subject to these ads to write to their legislators using a sample letter asking them to support the bills. Look for a message from Amy Hewett to assist in this grassroots effort.

Emergency Evacuation of Nursing Homes

VHCA-VCAL supports legislation to grant the State Health Commissioner authority to exempt nursing homes or hospitals from the requirement to obtain a certificate to add temporary beds to address a bed shortage elsewhere during a public health emergency when a natural or manmade disaster has caused the evacuation of nursing homes or hospitals.

HB 1870, HB 2451, and SB 1277 introduced by Del. Mark Sickles (D-Fairfax), Del. Dickie Bell (R-Staunton), and Sen. George Barker (D-Fairfax), respectively, on behalf of VHCA-VCAL, is essential to help nursing homes comply with the federal emergency preparedness regulations. Under those federal requirements, nursing homes must develop arrangements with other health care facilities to accept their residents in the event they have to limit or cease operation in an emergency. Many Virginia nursing homes and hospitals have signed the Virginia Long-Term Care Mutual Aid Plan Memorandum of Understanding (LTC MAP MOU) to satisfy this requirement. The MOU is a voluntary agreement among participants to share supplies, resources, and even house residents from other facilities when a serious need arises. A key component of the MOU requires a participating facility to have the ability to expand its bed capacity to 110 percent of its licensed bed capacity to accept residents from evacuating facilities.

Mandate for Generators in ALFs

VHCA-VCAL opposes SB 1077, which would mandate that all of Virginia’s licensed ALFs that have six or more residents have an on-site generator and be able to connect to and utilize such temporary emergency electrical power source for the provision of electricity during an interruption of the normal electric supply.

This one-size-fits-all approach does not account for arrangements facilities have made to comply with the existing emergency preparedness provisions of the ALF regulations issued by the Department of Social Services (DSS), like the requirement to be able to  connect to a temporary emergency electrical power source. It also ignores the comprehensive approach ALFs already use to prepare their residents, staff, and volunteers for an emergency event.

SB 1077, introduced by Sen. Janet Howell (D-Reston), specifies that the required temporary emergency electrical power sources would need to be sufficient to provide power for the following:

• Operation of any necessary medical equipment necessary to protect the health of residents;
• Refrigeration adequate to preserve food and medications requiring refrigeration;
• Heating, cooling, lighting in an area that provides no less than 60 square feet of floor area per resident; and
• Operation of at least one elevator in a building with elevators.

VHCA-VCAL has requested that all assisted living member provide immediate feedback on whether their current systems meet these requirements, and if not, what enhancements would need to be made to do so. We will share this information with legislators as they consider the bill.

ALF Disclosure of Emergency Electrical Power Source

VHCA-VCAL supports HB 1815, introduced by Del. Patrick Hope (D-Arlington), which would require ALFs to disclose in writing whether the facility has an on-site emergency electrical power source for the provision of electricity during an interruption of the normal electric power supply.

This bill reflects the recommendation of Virginia’s Joint Commission on Health Care, which studied this issue in 2018.

Certificate of Public Need (COPN)

As in other recent legislative sessions, VHCA-VCAL will speak with legislative leaders about the unique position of nursing centers in the state’s COPN process and stress the importance of COPN for the continued delivery of reliable, cost-effective nursing care services.  VHCA-VCAL will closely review all COPN-related bills to ensure nursing beds are not inadvertently affected. 

CCC Plus

Although not the topic of specific legislation, in numerous meetings with legislators and their committee staff, as well as staff in the Northam Administration, we have stressed that we believe  all the managed care organizations (MCOs) should be in contractual compliance with CCC Plus. The MCOs have had nearly 18-months to resolve the ongoing primary and secondary claims issues. VHCA-VCAL members cannot sustain additional administrative burdens and delays related to this program.

Legislators have until January 18 to file legislation. VHCA-VCAL is monitoring the bills as they are introduced to assess their impact on members.