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Virginia Health Care Association | Virginia Center for Assisted Living

Proposed Budgets Offer Strong Support for LTC

Proposed Budgets Offer Strong Support for LTC

This week the House of Delegates and Senate approved their respective budget proposals and sent the measures to a conference committee to negotiate the differences. While that process will not be settled until the scheduled end of the session in mid-March, at this time the budgets include significant funding for nursing facilities, which will result in greater funding for direct patient care at your centers.

First, both chambers have left intact the Medicaid inflation increase for fiscal year (FY) 2017 proposed by Gov. Terry McAuliffe. The increase will boost reimbursement rates by 0.9 percent, which equates to $16.4 million in additional funding for patient care over the two years of the biennium. The Senate has included an inflation increase for FY 2018 of $25.4 million; this funding is not included in the House proposal and will therefore become an issue to be negotiated in the budget conference.

Second, both chambers have included language to fix the issue we discovered late last fall whereby the Department of Medical Assistance Services (DMAS) made a policy change to use a “0” instead of the actual inflation rate for 2016 as part of its rebasing forecast. Without this correction, the DMAS policy change would have compounded the impact of this previous, one-time inflation deferral (and potentially, future deferrals). We are very pleased that the General Assembly has addressed this problem, eliminating a situation whereby centers could have been prevented from realizing over $37 million in reimbursement in FYs 2018-2020.

Here is another way to look at the proposed budgets:

Click image for larger view

Click image for larger view

In summary, we believe the proposed biennial budgets for FYs 2017 and 2018 currently contain the following additional Medicaid funding for nursing centers:

Click image for larger view (NOTE: This includes 2017 inflation for the Administration; 2017 inflation and restoration of 2016 in the rebasing for both the House & Senate Budgets; and restoration of 2018 inflation for the Senate Budget only.)

Click image for larger view

(NOTE: This includes 2017 inflation for the Administration; 2017 inflation and restoration of 2016 in the rebasing for both the House & Senate Budgets; and restoration of 2018 inflation for the Senate Budget only.)

Also of note, Sen. Emmett Hanger (R-Augusta) and Del. John O’Bannon (R-Henrico) have been particularly strong champions for funding for long term care services and conveyed our budget request to the money committees.  Their influence is evident in the committee proposals, which included so many of our budget priorities.  We are grateful that the Senate Finance Committee and the House Appropriations Committee demonstrated their support for funding for nursing centers in their budgets.

Other long term care-related budget items include:

  • Elimination of the funding for the planned closure of Catawba Hospital. (The Senate has also included $500,000 for a consultant to determine the best way to care for geriatric psychiatric patients; the House has proposed setting up a work group to review the geropsychiatric system)
  • A directive in the Senate budget to the Department of Behavioral Health and Developmental Services  to have Hancock Geriatric Hospital recertified by CMS to see Medicaid patients.
  • An increase in the Senate budget of $883,000 in Auxiliary Grant funding for qualified assisted living facilities.
  • Language in the House budget to set up a DMAS-led work group on the Alzheimer’s Assisted Living Waiver.
  • Provision in the Senate budget directing the Department of Aging and Rehabilitative Services to work on the Interdisciplinary Memory Assessment Clinics with Dementia Care Management as described in the Dementia State Plan.
  • Language in the Senate budget giving the General Assembly the authority to review the Delivery System Reform Incentive Payment (DSRIP) program before DMAS moves forward with it.

VHCA-VCAL will be closely monitoring budget developments and reiterate our thanks to decision makers for their support of long term care services.