2020 Legislative Priorities: An Exciting & Anticipatory Year for GAO States & the National Home Care Industry

2020 is gearing up to be a monumental year for BAYADA’s Government Affairs Office (GAO). GAO directors and Chief Government Affairs Officer Dave Totaro have worked diligently with BAYADA leadership to agree upon this year’s legislative priorities. Check out GAO’s state-by-state priorities below! To find out more about your state’s issues and how you can get involved, see the list of state GAO directors and associates within the article.

FEDERAL
Chief Government Affairs Officer Dave Totaro
Federal Affairs Associate Victoria DeLone

#1: Support PQHH and NAHC to pass the Home Health Payment Innovation Act

  • Eliminates behavioral assumptions to set reimbursement rates and limits changes in reimbursement to +/- 2% in any year
    • BAYADA impact: $12-15 million
    • Practice: Home Health

#2: Support the passage of the Home Health Care Planning Improvement Act

  • Allow non-physician providers to certify a patient’s eligibility for coverage – including face to face requirements
    • BAYADA impact: TBD (awaiting score from CBO)
    • Practice: Home Health

#3: Introduce and pass the Home Care Access and Savings Act (H-CASA)

  • Modernizes the Medicaid program through quality, efficiency, and integrity improvements
    • BAYADA impact: Policy only
    • Practices: ACSP and SNU

NORTHEAST REGION
Area Director Louise Lindenmeier (NJ, RI, NY, MA)
Director Ashley Sadlier (RI, NY, MA)
Associate Marissa Fogal

NJ

#1: Secure increase for PCA to offset minimum wage increases in 2021 by $3 per hour

  • BAYADA impact: $7.2 million
    • Practice: ACSP

#2: Increase the state fee for service rate for RNs and LPNs by $10 per hour in Private Duty Nursing and set a minimum rate floor for managed Medicaid.

  • LPN increase of 26.3% from $38 per hour to $48. RN increase of 20% from $50 to $60.
    • BAYADA impact: $19.1 million
    • Practice: SNU

#3: Pass legislation to mandate commercial insurance to cover PDN

  • Impact: Potential savings of $50-70 million for state Medicaid dollars
    • Practice: SNU

NY

#1: Gain NYC Department of Education’s Request for Proposal to achieve status of “approved vendor” to provide school nursing services in the New York City boroughs

  • BAYADA impact: $429,000
    • Practice: SNU

RI

#1: Pass legislation to ensure clients turning 21 have continuity of care 

  • BAYADA impact: $1.1 Million
    • Practices: SNU and ACSP

#2: Defend Cost of Living Adjustment (COLA) for Medicaid Home Care/Hospice rates

  • Governor has proposed an additional 5.9% increase for skilled nursing and CNA services in the 2020-2021 budget, effective 7/1/2020
    • This proposal must still go through the legislative decision-making process, with the final budget set to be signed by the end of June 2020. GAO will continue to monitor its progress and advocate for this increase
    • CNA Current Average: $25.51 à $27.02 (+$1.51)
    • LPN Current Average: $47.79 à $50.61 (+$2.82)
    • RN Current Average: $54.20 à $57.40 (+$3.20)
    • BAYADA impact: $219,791
    • Practices: SNU and ACSP

#3: Secure an increase for Medicaid FFS reimbursement rates

  • 16.3% increase from $25.52 to $29.67
    • BAYADA impact: $431,912
    • Practices: SNU and ACSP

#4: Secure a rate floor for Managed Medicaid rates so they cannot be below the set Medicaid FFS rates

  • BAYADA impact: $163,000
    • Practices: SNU and ACSP

MID-ATLANTIC REGION
Area Director Laura Ness (PA, DE, MD, IN)
Associate Director Rob Lattin (DE, MD, IN)
Senior Associate Maggie Tracy

DE

#1: Secure an increase for PDN LPN and RN reimbursement rates

  • 21% increase from $46.14 to $56.01 for LPNs, and 21% increase from $51.50 to $62.51 for RNs
    • BAYADA impact: $5.3 million
    • Practice: SNU

MD

  • Protect the yearly rate increase for LPNs providing private duty nursing.
  • BAYADA impact: Unknown
  • Practice: SNU

PA

#1: Secure an increase for Personal Assistance Services under Community Health Choices

  • 8% increase (dollar amount depends on MCO)
    • 2019 goal was a 10% increase, and a 2% increase was secured. Thus, the 2020 goal is to obtain the remaining 8%
    • BAYADA impact: $3.2 million
    • Practice: ACSP

#2:  Pass legislation to allow Deemed Eligibility for home care

  • BAYADA impact: Unknown
    • Practices: ACSP and AN

#3:  Eliminate the requirement for nurses to call home health aides every two weeks

  • BAYADA impact: Unknown
    • Practice: PED

SOUTHEAST REGION
Area Director Lee Dobson (NC, SC, GA, MO)
Director Melissa Allman (GA, SC, MO)
Senior Associate Lindsey Wright

GA

#1: Secure a 6% increase for all Medicaid nursing services

  • BAYADA impact: $426,862
    • Practice: SNU

NC

#1: Secure an increase for nursing under Medicaid’s PDN Program–

  • 13.6% increase from $39.60 to $45
    • BAYADA impact $8.4 million
    • Practice: SNU

#2: Secure an increase for aide wages under Personal Care Services, Community Alternatives Program, and CAP for Children

  • 18.6% increase from $15.60 to $18.50
    • BAYADA impact: $1.89 million
    • Practice: ACSP

SC

#1: Secure a 10% PDN rate increase, effective July 1, 2020

  • The state recommended a 15% increase effective July 1, 2020. After further advocacy efforts focused on the urgent need for an immediate increase, DHHS issued the initial 5% increase, effective January 1, 2020. DHHS is committed to including the remaining 10% to be effective July 1, 2020. If the provision is passed into law as planned, then PDN services will see a total 15% increase from 2019 levels (5% increase effective January 1, 2020, and an additional 10% targeted for July 1, 2020).
    • BAYADA impact: $690,000
    • Practice: Skilled Nursing

#2: Secure 24% for RN and 35% for LPN increase for Medicaid nursing waivers

  • BAYADA impact $1.16 million
    • Practice: Skilled Nursing

#3: Secure a 10% increase for Personal Care Waivers

  • BAYADA impact: $158,000
    • Practice: ACSP

GRASSROOTS ADVOCACY & PUBLIC AFFAIRS
Grassroots Advocacy Senior Manager Mike Sokoloski
Public Affairs Senior Manager Alisa Fox

Grassroots Advocacy: In 2020, the GAO Grassroots Advocacy team is seeking to further enhance the Ambassador program by creating a new “Senior Ambassador” role in order to have seasoned advocates guide and mentor newer advocates. Senior Ambassadors will also be able to attend special and strategic events in order to hone their skills and to advise GAO on issues their office(s) see. If you would like to learn more about the Ambassador and/or the Senior Ambassador program, or how you can get involved in advocacy, contact the Grassroots Advocacy team at msokoloski@bayada.com.

Public Affairs: Following the success seen in 2019, BAYADA has expanded its public affairs program to open up resources for smaller states that may benefit from a public affairs campaign. In first quarter, BAYADA has employed three campaigns thus far: A campaign to increase PDN and PCA rates in New Jersey, a campaign to further increase PDN rates in South Carolina, and a campaign to create regulations in Rhode Island to ensure that medically-complex children aging out of the pediatrics program can continue to seamlessly access care. Other states that may soon be seeing public affairs campaigns are: Florida, Indiana, Massachusetts, Missouri, and Pennsylvania.

Public Affairs: BAYADA’s First Full Year of Full Time Public Affairs Efforts Secures Media Attention and Contributes to Legislative Wins!

BAYADA’s public affairs program has generated public and legislative awareness about home care, its importance in communities across the country, and the issues clients and families face accessing care due to low state reimbursement rates.

BAYADA has used public affairs efforts throughout the past several years. That is—in states where GAO and state leadership knew that increased public awareness and engagement would reinforce a strong lobbying message, GAO deployed these efforts, which resulted in increased legislative & regulatory pressure on BAYADA’s key issues. This was particularly true where BAYADA, home care recipients, and the industry needed rate increases to stay sustainable and to be able to recruit and retain enough caregivers to meet clients’ demand.

2019 was the first year that BAYADA invested in a full-time public affairs program. Here, public affairs staff executed several state-specific campaigns to further BAYADA’s legislative agenda, as well as an “umbrella” campaign to highlight the challenges seen regularly on the national home care and home health care front.

GAO enlisted public affairs firm Regan Communications Group (RCG) full-time to put clients’ and caregivers’ stories in the spotlight. No easy task, especially as media and newsworthy issues tend to change minute-by-minute, RCG regularly delivers by getting GAO’s legislative message out via broadcast, print, and non-traditional media outlets. As a result of full-time public affairs efforts in 2019, state governments heard us loud and clear, and often made policy changes in order to help alleviate the issues BAYADA staff, clients, and families faced.

Below, see a list of media that BAYADA’s GAO was able to gain through its partnership with RCG in 2019:

Federal/Industry-Wide

Home Health Care News: Immigration Reform, Minimum Wage Increases Top of Mind for BAYADA

Home Health Care News: Medicaid legislation introduced in Congress

STAT News: Health aides’ low wages threaten home health care, a necessity for millions

Modern Healthcare: More middle-income seniors face financial insecurity

Home Health Care News: Industry Insiders: Don’t Overlook CMS’s Dual-Eligibles Directive

Home Health Care News: Immigration “Pathways” Vital to industry’s future

Home Health Care News: BAYADA Hits 1M Clients Served. Here’s Why Hitting 2M Will be More Difficult

Modern Healthcare: Nursing home staffing levels often fall below CMS expectations

Everyday Health: Demand on the Rise for Home Healthcare

Authority Magazine: The Future of Healthcare: “First and foremost, reprioritize long-term care into the home setting” with David Totaro of BAYADA Home Health Care

Delaware

Delaware Public Media: Advocates call on state lawmakers to raise Medicaid reimbursement rates

Delaware State News: BAYADA Pediatrics director awarded national honor for advocacy work

Indiana

RTV 6: Hoosier families want more resources for home health care

WTHR 13: Gasping for Care: Indiana families desperately seek care amid home nursing shortage

New Jersey

NJTV & NJ Spotlight: Shortage of Home Care Nurses on Horizon

My Central Jersey: NJ’s shortage of private duty nurses taking toll on families

NJ 101.5: A home health care nursing shortage is looming in NJ

NJ Star Ledger: Prefer to age at home in N.J.? It will soon be even harder | Editorial

Pennsylvania

Bucks County Courier Times: BAYADA Home Health Care’s Langhorne office recently nominated Melissa Husted, of Morrisville, and Winnie Gittens, of Philadelphia, for the Pennsylvania Home Care Association’s 2019 Direct Care Worker of the Year Award

PennLive/Patriot News: Advocates call on lawmakers to make home-based care services more accessible for seniors and disabled

Generocity: BAYADA transitions from for-profit to nonprofit to save its mission-driven culture

Pittsburgh Post-Gazette: An old refrain: Better wages, conditions a must for direct care workforce

PennLive/Patriot News: An opportunity to do the right thing for vulnerable Pennsylvanians: Raise home health aides’ wages

WXPI & WPGH: Lack of home health care aides impacting local patients

Pittsburgh Post-Gazette: Increase funding for home care providers

Pittsburgh Tribune Review: Donna Pierantoni: Home care crisis’ impact on disabled adults, seniors

Rhode Island

Valley Breeze: Aging Out: Local family says vulnerable son fell through state’s cracks

Valley Breeze: Family frustrated after near-miss on losing care hours

Providence Business News: Anxious R.I. families await decision on special medical coverage

South Carolina

Post & Courier Gazette: Lowcountry home health care experts speak on the need for more workers in the field

Summerville Journal: Helping Mason: Family of Police Officers with Sick Child Loses Home Nurse Right Before the Holidays, need to raise Medicaid Reimbursement Rates in SC for 2020