One week into the 2023 General Assembly session, VHCA-VCAL is closely monitoring numerous bills affecting nursing facilities and assisted living facilities (ALFs).

• To-date, over 1,950 bills and resolutions have been filed. Legislators have until January 20 at 3:00 pm to file legislation.

Focusing in: VHCA-VCAL has been concentrating its efforts on meeting with legislators to secure support for our approach to a nursing facility staffing minimum aligned with the Medicaid Value-Based Purchasing (VBP) Program, and support for our LTSS Screening legislation and budget requests.

For context: VHCA-VCAL is still assessing the impact of bills and meeting with bill patrons and key committee members that will consider the proposals. We will provide additional details on these measures as the session continues.

Highlights of bills tracked by VHCA-VCAL.

Nursing Facility Bills

Nursing facility minimum staffing standards: HB 1446 was reported and referred to the to the House Appropriations Committee on a 20-2 vote.

• • This is the first step in the legislative process of advancing our legislation to align a staffing mandate with the Medicaid Value-Based Purchasing (VBP) Program.
  • The 3.08 hprd staffing standard in the legislation is consistent with the attainment level for total nurse staffing hours as defined in the VBP Program.
  • SB 1339, the companion Senate bill introduced by Sen. George Barker (D-Fairfax) has been referred to the Senate Education and Health Committee.

LTSS Screening – HB 1681 and SB 1457 are the VHCA-VCAL backed fix to address a discrete issue in the LTSS Screening process that results in denial of access to Medicaid coverage for certain individuals.

• • This legislation addresses those instances when screenings by the hospital screening teams did not occur or information is withheld by a patient or their responsible party, which subsequently lead to a nursing home admitting a patient without a needed LTSS Screening prior to admission.
  • Both bills are awaiting action before their chambers’ respective health committees.

Patient visitation from clergy members during declared public health emergency – SB 925 was “passed by indefinitely” in the Senate Education and Health Committee, a motion that effectively ends consideration of the legislation for the session.

• • The bill was rejected because of the conflicts it created with legislation on visitation at nursing homes and hospitals in prior legislative sessions as well as CMS and CDC guidance on visitation.
  • The House version, HB 1689, has not been heard in committee.
  • VHCA-VCAL opposes these bill.

In-person visitation – SB 1297 and HB 2160 would require nursing facilities, ALFs, and other health care providers to establish certain in-person visitation policies and procedures.

• • VHCA-VCAL has serious concerns about these bills for their potential to set up conflicting requirements per federal guidance on visitation.
  • The association is meeting with the patron of SB 1297, Sen. Bill DeSteph, and other stakeholders to discuss the patron’s intent with the bill and providers’ concerns with its provisions.

Assisted Living Facility Bills

Minimum liability insurance – SB 1221 would require the Board of Social Services to adopt regulations requiring each ALF to maintain a minimum amount of liability insurance, as determined by the Board, and provide notice of such insurance, upon request, to any resident or prospective resident.

• • Under current law, ALFs must provide a statement disclosing whether the facility maintains liability insurance but can only state that it does if it meets a minimum amount of coverage of $500,000 established by the Board.
  • The bill is pending a hearing before the Senate Rehabilitation and Social Services Committee.

Use of supplemental nursing services agencies in assisted living – SB 1458 would direct the Department of Health Professions (DHP) to review and adopt regulations regulating the use of supplemental nursing services, defined in the bill, in ALFs.

• • The bill would require DHP to certify supplemental nursing services agencies and set conditions for the training, screening, and related recordkeeping for its employees.
  • The bill is pending a hearing before the Senate Rules Committee.

Regulations for ALFs with fewer than 25 residents – SB 1407 would require DSS to amend the Standards for Licensed Assisted Living Facilities  for facilities with fewer than 25 residents to meet adjusted requirements for staff training, administrator licensure, and the minimum age for staff employment.

• • The bill is pending a hearing before the Senate Rules Committee.