Increasing Reimbursement Rates for RNs and LPNs in Delaware

At the end of June, 2017, through the efforts of our Ambassadors, our industry partners, our clients, and our legislative champions, the Rate Floor Bill passed the Delaware General Assembly.

This year, in the second year of Delaware’s two-year legislative session, our major legislative goal is to achieve an increase in the Medicaid fee schedule for RN and LPN hourly care. These two rates have stagnated since 2006. We are asking the legislature to update both according to the Consumer Price Index. Doing so would move LPN care from $46.14 to $56.01 and RN care from $51.50 to $62.51 per hour.

Our initial meetings with key members of the Joint Finance Committee have been very positive.  We are working with them to include increased funding for this request in this year’s budget. If successful, our MCO contracts would have to be renegotiated so that reimbursement would be equal to or greater than the new fee schedule amounts.

If you’d like to learn about how you can get more involved in our advocacy efforts, sign up to be a Heart for Home Care!

Plans for Healthcare Overhaul in Delaware

In his State of the State Address last week, Delaware Governor Carney said, “Here’s the bottom line.  We’re spending too much money on healthcare, and we’re not getting the best results.  We need to come to the table – state government and hospitals most of all – and be part of the solution… Now it’s time to make the hard decisions and change the way we deliver healthcare.”

We’ve heard Department of Health and Social Services’ (DHSS) Secretary Odom-Walker discuss similar issues over the last several months. In public hearings across the state, she has discussed health care reform in other states across the country and the need for fundamental changes to the way health care is delivered, how chronic health issues are prevented and treated and how funding can be used to encourage better coordination and more focused care to obtain good health outcomes.

Secretary Odom-Walker and Governor Carney have great faith that Delaware’s small size will enable quick transition to a new, more efficient delivery model. We are closely monitoring these developments and have reminded both the Secretary and the Governor of the importance of home health care in reducing costs and obtaining better outcomes for Delawareans.

If you have any questions about what’s going on in Delaware’s state capitol, let’s chat! Email me at sgahs@bayada.com.

Increasing Maryland’s LPN Rate

This session, our major legislative goal in Maryland is to increase the Medicaid LPN rate across all programs and client groups from $34.16 to $42.81. It is an ambitious goal—initial budget estimates place the cost to the state at $26 million per year. With neighboring states reimbursing LPN care at $45, $46.14 and $50 per hour, it is easy to see why there is such a problem of access to care across Maryland. The low reimbursement simply does not support a sufficient wage to be able to consistently recruit and retain the skilled nurses that we need to be able to commit to serving a larger number of clients.

Problems within the Maryland Department of Health and a general lack of transparency have hindered this effort in past months. There have been a few targeted data points essential to such a large budget ask that BAYADA and Maryland-National Capital Homecare Association (MNCHA) through our best efforts, have been unable to obtain.

We started this session asking key legislative champions to help us get this information, using their political pressure to get information from the Department of Health or to introduce legislation that would establish an oversight working group to investigate the issue. Several legislators have been deeply troubled by the idea of children and adults with disabilities being unable to access the skilled nursing care they need to remain at home safely and have stepped up to help. This information, and the support we are gaining from those in key positions to move this effort through to becoming law, is a key step in increasing this LPN rate.

Thank you to Ambassadors Dan Guidebeck, Nikita Mutter, and Matt Paske for joining in legislative meetings and sharing the stories of how this issue impacts our clients and employees. Your commitment to advocacy reminds me of why we do what we do every day.

If you’d like to learn about how you can get more involved in our advocacy efforts, sign up to be a Heart for Home Care!

Sick Leave Becomes Law in Override of Maryland Governor Hogan Veto

At the end of the 2017 session, the Maryland General Assembly voted in favor of a statewide sick leave law. It was the sixth consecutive year that the bill was introduced.

The measure was fiercely debated and amended several times. The final version mandates that employees who work more than 12 hours in an average week earn paid sick leave at a rate of one hour per 30 hours worked, up to 64 hours per year. The sick leave may be used for the employee’s own sickness or that of a family member, to obtain preventative health care or to prevent domestic violence or stalking.

Following the 2017 session, Governor Larry Hogan vetoed the legislation, calling it bad for Maryland businesses. The legislature overrode the veto on the second day of session this year, January 11. It will go into effect 30 days after the override vote, pending a new bill introduced this week that would delay implementation. POL has been notified of the change and will issue guidance on how this will impact BAYADA offices.

If you have any questions about what’s going on in Maryland’s state capitol, let’s chat! Email me at sgahs@bayada.com.

Legislature is in Session!

Both Delaware and Maryland have opened their 2018 legislative sessions and our advocacy work is in full swing. Delaware’s legislature will be open until June 30 in the second year of its two-year legislative session. The Maryland General Assembly is already nearly 20% over—as of today, there are 74 days left in the 90-day session.

Both sessions have been very busy already. Delaware and Maryland Hearts for Home Care Ambassadors and I have been working hard to reach legislators to educate and inform them about what home care means to our clients and families, and about what can be done to address the issues our industry faces every day.

If you’d like to learn about what you can do to take part in our advocacy efforts, sign up to be a Heart for Home Care!

Federal Legislators from Maryland Hear from Community Leaders and Constituents on Medicaid

Submitted by Shannon Gahs, Director, MD Government Affairs (GAO)

On November 16, I met with Congressman “Dutch” Ruppersberger (D-MD2) and Senator Chris Van Hollen (D-MD) at a community event about access to Medicaid, which was the same day that the U.S. House of Representatives passed the Tax Cuts and Jobs Act, which includes major provisions affecting Medicaid eligibility and tax issues that will impact our employees.  It is important that our federal legislators see home health care for the good work we do in their districts, as they make decisions that impact how we are able to practice.  The Senate will debate this bill in coming weeks.

 

Building Relationships with Federal Legislators and Community Partners in Delaware

Submitted by Shannon Gahs, Director, DE Government Affairs (GAO)

Wilmington (WIL) Director and Hearts for Home Care Ambassador Kim Roman and I joined the Alzheimer’s Association Delaware Valley Chapter for coffee with Senator Tom Carper (D-DE).  Healthcare issues, including funding for Medicare and eligibility for Medicaid, are increasingly in the federal spotlight and up for debate in Congress.  It is important to build relationships with our federal legislators and to make sure they know how important home health care is in their states!

 

Sharing Education with Legislators Prepares them for Session in Maryland

Submitted by Shannon Gahs, Director, MD Government Affairs (GAO)

 This week, Harford County Visits (HFV) Marketing Manager Nicole Matricciani and I met with Delegate Andrew Cassilly (R-35B), who represents many of our clients and employees in the county.  I also met with Delegate Antonio Hayes (D-40) who is a member of the House Health & Government Operations Committee and represents parts of Western Baltimore City.  The Government Affairs Office (GAO) is building these important relationships to help our legislators understand the complex and important work we do in their communities, and the benefit home health care brings to the state.

Photo: Delegate Antonio Hayes and Shannon Gahs
Photo: Delegate Antonio Hayes and Shannon Gahs

Delaware Department of Health and Social Services Continues Toward Development of Total Cost of Care Model

Submitted by Shannon Gahs, Director, DE Government Affairs (GAO)

Secretary Kara Odom Walker held a public hearing on how the state can focus on the Total Cost of Care this week.  Thought leaders from across the country, and representatives from states that have undertaken these sorts of efforts, already gave presentations and shared lessons.  Secretary Odom Walker is intent on building a data-driven system based on nationwide best practices.  As this effort moves forward, the Government Affairs Office (GAO) will work with our division directors and state government leaders to ensure that the value and importance of home health care in this effort is recognized.

 

Building Foundations for Advocacy is a Team Exercise in Maryland

Submitted by Shannon Gahs, Director, MD Government Affairs (GAO)

The “Interim” or time between the end of one legislative session and the beginning of the next, is a key time to develop relationships with partners and legislators.  Much of this work is behind the scenes, but you can get involved!  We need ambassadors and other office or field employee volunteers to step up to organize district office visits, where you and I will visit key legislators in the communities they represent.  These visits are key to helping educate our legislators about the people we care for and the people we employ in their districts and build a foundation for future advocacy.  Call or email me if you’d like to get involved.