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VHCA-VCAL Priorities for the General Assembly Session

VHCA-VCAL Priorities for the General Assembly Session

A view of the Virginia State Capitol Buiding.As the General Assembly kicks off another legislative session this week, VHCA-VCAL has been working in earnest to ensure legislators know the importance of Medicaid funding for nursing centers.  Legislators are scheduled to meet for 45 days this year and will amend the state budget for the remainder of this fiscal year (FY 2017 and next (FY 2018).  They will also debate thousands of bills, many of which will address health care regulatory issues.

Medicaid Reimbursement and Rebasing

We are starting from a strong position because Gov. Terry McAuliffe included $10.9 million in additional funding for Medicaid inflationary increases for FY 2018 in the budget amendments he presented to the General Assembly last month.  As you may recall, only one-half of the FY 2018 inflation funding was funded in the 2-year budget passed this spring.  Nursing facilities are alone among provider groups to receive full FY 2018 inflation funding. While the state budget has included Medicaid increases in recent years, it is critical that we hold on to this funding through our advocacy efforts.

VHCA-VCAL staff, with guidance from the Board of Directors and Executive Committee, is also pursuing strategies to mitigate the impact of the rebasing calculations which, in the aggregate, are not positive for nursing centers. (Rebasing is a process completed every three years when DMAS compares actual base year costs to estimated costs and rates are rebased as determined by that result and the rate setting methodology.  Base year “rates” are then inflated forward to the relevant rate year, which in this case will be FY 2018.)  

In addition to those budget issues, other VHCA-VCAL priorities for the session will center on the following:

  • Certificate of Public Need (COPN) Reform
    VHCA-VCAL has continued to speak with legislative leaders about the unique position of nursing centers in the state’s COPN process. All of the key legislators with whom we have spoken have assured us that even if a bill moves this session, COPN for nursing centers and rehabilitation beds will be maintained.
  • Mandatory Electronic Monitoring
    Pursuant to legislation passed in 2016 and supported by VHCA-VCAL, staff participated in a VDH-sponsored work group to draft regulations for the Board of Health to consider outlining procedures for nursing centers that choose to offer electronic monitoring services in resident rooms. The initial legislation mandated that centers offer electronic monitoring, but the mandate was removed at the insistence of VHCA-VCAL and other nursing center representatives. The Board of Health is expected to consider regulations on this topic at its March meeting.  It is possible another mandate bill will be proposed this session.
  • LPN PPD Testing Administration
    In response to a question from an assisted living community, the Department of Health Professions clarified that, according to the Drug Control Act, a licensed practical nurse (LPN) cannot perform a tuberculin purified protein derivative (PPD) test without the presence of a registered nurse (RN) unless a prescriber is present. Multiple VHCA-VCAL members have expressed concern about the law, which has been in effect for many years, and have asked that there be a legislative fix pursued to make it easier for an LPN to provide these services without the physical presence of an RN. Del. John O’Bannon (R-Henerico) has introduced HB 2301 to address this issue.  HB 2301 will also allow LPNs to administer vaccinations to adults without immediate physical presence of an RN.

Next Steps

Legislators have until January 20 to introduce legislation. VHCA-VCAL is reviewing all bills to assess whether they have an impact on nursing or assisted living centers. We will work to ensure legislation does not adversely affect the membership. We will provide weekly updates in CareConnection throughout session.

Register for the Legislative Conference on January 25-26, 2017 at the Omni Richmond Hotel, where we will provide additional updates on our legislative activity. You can also meet with your legislators in person on January 25 and at the Legislative Reception that evening.