Legislative Bulletin: CMI and FI Workgroups Underway

Following an extended Memorial Day weekend, lawmakers will return to Albany on Wednesday to kick off the final four weeks of session. It’s crunch time – and we need your advocacy to bring our issues to lawmakers’ attention.

Legislative Work Set to Resume Following the Memorial Day Weekend

The legislature is currently out of session for an extended weekend for the celebration of Memorial Day. Lawmakers will be using these few days to gear up for a lengthy last four weeks of session. Upon the return to Albany on Wednesday, the Senate Higher Education Committee will be taking a look at S.6011, a bill sponsored by Senate Health Chair Gustavo Rivera that would authorize pharmacies to store medication in automated dispensing machines if a contractual agreement is in place with a nursing home or healthcare facility at such facility for the residents. This is in response to recent developments that questioned the use of the machines. LeadingAge New York has received feedback from members on this legislation and is working with our colleagues to ensure a positive outcome.

LeadingAge New York continues to urge members to engage with their lawmakers on our top legislative priorities and concerns. With just 13 session days left, we have a very narrow window of time to advance the initiatives we support and defeat those that we oppose. Please connect with your legislators today and over the weekend to let them know how the below bills will impact your organization and the individuals you serve!

• CCRC Revitalization Act: S.1803 (Rivera) would reform CCRC laws and regulatory oversight, eliminating many of the current barriers to developing, expanding, and efficiently operating CCRCs in New York State. Click here to contact your lawmakers through email and social media!
• SSI Increase for ACFs:  S.2601 (Serino) would increase the Supplemental Security Income (SSI) reimbursement rate for adult care facilities (ACFs) by $20 per day per resident over five years, beginning April 1, 2019. Click here to send your lawmakers a pre-written letter or tweet urging their support.
• Role of the Nurse in ACFs: S.1788 (Rivera) would allow all ACFs and assisted living providers that employ nurses the option to provide nursing services directly. Click here to engage with your legislators on this bill through email and social media!
• Affordable Independent Senior Housing Assistance Program: A.4358 (Cymbrowitz)/S.4538 (Kavanagh) would establish an Affordable Independent Senior Housing Assistance Program to complement the State’s historic commitment of $125 million for senior housing capital and create a cost-effective model for seniors to age in place. Click here to encourage your lawmakers to co-sponsor this important legislation!
• Psychotropic Medications in SNF & ACF: A.1033 (Gottfried)/S.5441 (Sepulveda) would require an enhanced level of informed consent before psychotropic medications can be prescribed for residents of nursing facilities (NFs) or adult care facilities (ACFs). Click here to contact your lawmakers today!
• Prevailing Wage: A.1261 (Bronson)/S.1947 (Ramos) would impose public works “prevailing wage” requirements on most types of private sector projects receiving any level of financial support from state or local entities, increasing overall construction project costs by 15-20%. Click here to urge your legislators to exempt senior services providers from the legislation.

This weekend’s Memorial Day festivities also provide another valuable opportunity to speak with your lawmakers and invite them to visit your campus for any of your celebratory events. Your continued advocacy and communications to lawmakers will help to ensure that these bills be addressed this legislative session. While LeadingAge New York connects with legislators in Albany we need the support of our members, the constituents, to keep the pressure on and finish the 2019 session strong!

 

Action Alert: Oppose an Increase in Penalties for ACF

This week, LeadingAge New York learned that there appears to be growing support for A.4416 (Gottfried)/S.3460 (Rivera), a bill that would increase potential penalties for ACF violations from $1,000 to $5,000 per violation per day and makes changes to the process by which an ACF can rectify a violation. While the highest fine is targeted to serious incidents, the overall increase and the potential per day fine is exorbitant.The bill has been added to the Senate Floor Calendar but has not yet seen movement in the Assembly. LeadingAge NY has issued a memo of opposition to the Senate Health Committee and others, but your advocacy is vital in stopping this bill from passing the Senate! Click here to contact your lawmakers today!

 

LeadingAge NY Staff Opinion Piece Featured in Newsday

Vice President of Advocacy and Public Policy at LeadingAge New York, Ami Schnauber, was featured in Newsday this week with an opinion piece highlighting the importance of vaccinations for older adults. Ami’s article stresses that the CDC’s Advisory Committee on Immunization Practices must continue to recommend all vaccinations for older adults and leave in place the pneumococcal vaccination standard. The online article was posted on Thursday morning and will also be printed in the Saturday, May 25^th edition of Newsday.

 

CMI and FI Workgroup Meetings Underway

As has been reported, LeadingAge NY and its members are well represented on two key workgroups emanating from the enacted 2019-20 State Budget – one on nursing home case mix and the other on Fiscal Intermediaries (FIs) for the Consumer Directed Personal Assistance Services (CDPAP) program. The first meetings of both workgroups have come and gone, and we are here to keep you informed.  

On Wednesday, May 15^th, DOH convened the first of four meetings of the CDPAP/FI workgroup, providing a roadmap for the group’s work. Participants, which included LeadingAge NY member Andy Cruikshank (Fort Hudson Health System, Fort Edward) and staff person Darius Kirstein, stressed the need for well-defined and understood roles for clients, FIs and managed care plans. The group suggested some standards and best practices for the program, agreeing that the program is critically important and acknowledging the need to balance its consumer directed nature with an appropriate level of oversight.  The workgroup is comprised of clients, consumer advocates, organizations that provide CDPAS services, social services district staff, managed care plans, and associations and is charged with helping the state to develop selection and contracting criteria for FIs while also considering other issues including quality and reporting requirements.  

More recently, the Nursing Home Case-Mix workgroup met on Wednesday May 23^rd in Albany. The 27-member workgroup is chaired by Medicaid Chief Financial Officer Michael Ogborn and includes four LeadingAge member representatives and two LeadingAge NY staff. The meeting made clear that DOH is constrained to obtain the $246 million in budgeted total savings and indicated that the $246 million is not a cap on the actual savings that could be realized. The Department does not believe that any changes in either law or regulation are needed to implement their proposed change effective July 2019, using MDS assessments from prior periods. The focus of the workgroup and its recommendations is on how to improve the accuracy of the case-mix determination process, and to reduce or eliminate abusive practices, for future rate periods (i.e., beginning Jan. 2020).

The Nursing Home Case-Mix workgroup members raised several questions and concerns about the workgroup’s charge, the operational realities of conducting MDS assessments and taking credit for services that could affect RUG-III scoring. The group pointed out how unrepresentative the MDSs for the Aug. 8 - March 31 period are for rate setting, and the need for facility validation that all of the MDSs used in rate setting are included and accurate as to payer code, etc. Above all, the group stressed the devastating impact that this cut will create for many facilities. The workgroup will be meeting two more times in June, and will arrive at final recommendations by June 30^th.

 

LeadingAge National Policy Update

 Fiscal 2020 senior housing appropriations: Just before Congress begins a Memorial Day recess (District/State work period), the House Appropriations Subcommittee has approved a HUD spending bill that would provide some welcome increases in funding in fiscal 2020.

 According to what Linda Couch has learned, the bill includes the following provisions:

• The Section 202 account at $803 million is $125 million above funding levels enacted for fiscal 2019 and includes $129 million for new 202 housing.

• While the subcommittee’s funding level is not all we are advocating for, this is the largest amount of single-year funding for new 202 homes since 2010.

• The bill also includes full renewal funding, a $5 million increase for service coordinators, and $10 million for the home modification program.

Linda is writing up more information on this legislation. The next step for the fiscal 2020 appropriations bill will be consideration by the full Appropriations Committee.

 The wild card in the fiscal 2020 appropriations process is the lack of any over-all budget plan for allocating total federal spending among federal agencies and programs. The, shall we say, lack of consensus between the White House and the congressional leadership so far has prevented passage of budget legislation to set spending totals, raise the Budget Control Act’s draconian budget caps, and increase the federal debt ceiling. So appropriators are using current program funding levels as a sort of guide for developing 2020 spending bills.

 Retirement income legislation: Before recessing, the House passed H.R. 1994, the Setting Every Community Up for Retirement Enhancement (SECURE) Act. The legislation would enable working people to save and invest more for retirement through incentives for workplace retirement programs, especially for those employed by small businesses or part-time. Companies could also join together to provide a common retirement program for employees even if the companies do not belong to the same industry. The bill includes provisions to raise the age at which withdrawals from 401(k) retirement accounts become mandatory from age 70 ½ to age 72.

 Similar legislation, S. 972, has been introduced in the Senate and is before the Finance Committee.

 Opportunities for enhanced retirement saving and investment could be an important factor in future generations’ ability to finance housing and long-term services and supports as they age. This legislation may be particularly important for the “middle market” of older people who do not qualify for assistance under public programs but yet have difficulty paying for aging services they need.

Keep in mind: Next week is not only the celebration of Memorial Day, it is also is a week long period where members of Congress return home to do work in their districts. This is a prime opportunity to continue the conversations from Lobby Day and the Spring District Work period and help us apply more pressure and get more momentum for our legislative agenda.

 

LeadingAge NY Members Address the Workforce Crisis at Annual Conference

Finally, LeadingAge NY would like to thank all those who attended our Annual Conference & Exposition in Saratoga Springs this week! The full-day pre-conference focused on addressing workforce challenges was particularly well-attended and well-received. Attendees discussed what the secret is to getting and keeping good people and what differentiates companies that invest in solving their staffing challenges from those who continue to spin their wheels. The pre-con was an attempt to shift corporate mindset to thinking differently about investing in today’s employees and reducing the expensive churn of recruitment. The concepts addressed in the full-day session were supplemented by an on-going conversation through-out the conference about the challenges surrounding workforce. There is no one “silver-bullet” solution to the issue, but rather, a culmination of different strategies can alleviate the impact of staffing challenges.

 

Ami Schnauber, aschnauber@leadingageny.org, 518-867-8854

Sarah Daly, sdaly@leadingageny.org, 518-867-8845