Great News….United States Senate Calls Off Their Healthcare Vote

Submitted by Dave Totaro, Chief Gov’t Affairs Officer, Lotus Division (LOT)

Earlier this week, Senate Majority Leader Mitch McConnell announced the Senate would not proceed with a vote on their Better Care Reconciliation Act (BCRA) and that is great news!  The proposed bill, as written, would have severely cut Medicaid and would have cut services to medically fragile children with cancer, parents with Alzheimer’s, and persons who rely on mental health services, just to name a few. 

The Government Affairs Office (GAO) and our Hearts for Home Care Ambassadors and advocates stood at the ready.  We were prepared to replicate our outreach effort from a couple of weeks ago, under our #NoHearingNoVote campaign, which resulted in 125,000 emails and over 600 phone calls to Senators in a mere 72 hours.  Regardless, whether you are a Democrat, a Republican or an Independent, the issue was simple – save the programs and the services that we know are crucial to the health and well-being of so many of our clients and caregivers. 
 
GAO will continue to follow developments in Washington closely and keep you posted.  Thank you, as always, for your support of our advocacy programs.

NJ HCA Advocacy Day in Trenton – May 25

Submitted by Louise Lindenmeier, Director, NJ Government Affairs (GAO)

BAYADA participated with the NJ Home Care Association in Trenton for a Home Care Advocacy Day. Over 30 BAYADA employees joined other providers for an informative morning of speakers including regulators, lobbyists, and legislators. After lunch, there was an opportunity to attend a health committee hearing, where legislators heard bills pertaining to health issues and then voted on moving the legislation forward. The day was successful and very informative.

Reporting Success with Help from our Hearts for Home Care Advocates

Submitted by Lee Dobson, Area Director, NC Government Affairs (GAO)

With active engagement from our Ambassadors and other Hearts for Home Care advocates, together we accomplished the following legislative wins:

·         Obtained an Aide Rate Increase                                  
Lawmakers passed a rate increase for aides services in two (2) Medicaid program – Personal Care Services (PCS) and the Community Alternatives Program for Children (CAP-C) – taking the rate from $13.88 to $15.52, effective July 1, 2017, and to $15.60, effective January 1, 2018.  Due to a technical issue around budget neutrality, an increase was not passed for CAP for disabled adults (CAP-DA). However, we have the commitment of both the General Assembly as well as the Department to institute a fix in the 2018 session.     
Provision successfully passed the General Assembly
·         Protected Certificate of Need (CON) Once Again
There were as many as four bills introduced, but not passed, related to CON to either eliminate or modify CON law. As any change to remove or minimize CON law will negatively impact our existing Medicare offices, GAO will continue to work collaboratively with other health care settings behind-the-scenes to prevent the erosion of CON. Educating lawmakers on its implications is key.  
Provision successfully excluded
·         ID/DD Individuals to Access Services
A budget provision added some 400 slots to the Innovations Waiver program. Originally the provision included 250 slots. After lobbying, discussion, and debate that number was increased. While it won’t completely address the 900 individuals on the waiting list, these additional slots will help our HAB practice provide services to individuals in need.    
Provision successfully passed the General Assembly
·         Medicaid Reform Remains In Play
GAO was invited to a meeting with Secretary Mandy Cohen and Medicaid Director Dave Richard to discuss their plans to align mental health and physical health more quickly than 3 years after transition to managed care. In the development of this new waiver, they intend to include stakeholders as well as other protections. 
Bill is eligible to be taken up during a Special Session

Maryland’s 2017 Legislative Session Now Closed

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

Wrapping up on April 10, the General Assembly considered 2,876 bills and resolutions over the 90-day session.  Of those, 940 bills and resolutions passed.   I am preparing a full session report but, of note, the bill containing our offices’ ability to accept orders from physicians in neighboring states passed and will become law as soon as Governor Larry Hogan signs it.  The budget passed nearly two weeks before it was due, including a 2% increase in Medicaid home health care reimbursement rate.  A bill mandating paid sick leave statewide passed but is expected to be vetoed.  Finally, three separate efforts to increase the minimum wage to $15 – statewide, in Baltimore City, and in Montgomery County – all failed.  Now the work to prepare for next session begins.

A Day in the Life of a Massachusetts Mom/Advocate

Submitted by Rick Hynick, Director, Client and Family Advocacy

On February 27, several BAYADA employees, home health care family members and others working toward getting a patient bill of rights passed, gathered at the state house in Boston to meet with legislators.  Lisa B. was en-route with her son, an adult home care client in his early 30s, and his son’s nurse.  Their goal for the day was to speak with different elected officials about the need for a rate increase for continuous skilled nursing services and to advocate for a patient bill of rights that is making its way through the legislative system toward becoming a law.  Just four miles from the state house, Lisa and the nurse saw that her son’s medical condition had changed and they quickly pulled their van over near the outskirts of a public park to help him.  He was struggling to breath due to a mucous plug.  In addition to this, he had lost control of his bowels.  As they pulled off the road, it happened to be near where an undercover police officer was working.  Startled by their presence, the officer approached them.  It took a bit, but Lisa and the nurse were able to clear the plug and get him back to a normal status.  They also changed his clothing and got everything back to normal.  The police officer was so motivated to help the family that he provided them with a police escort to the state house.  As a result of their dedication to the greater cause of helping people with special medical needs, they were still able to meet with senators and representatives and discuss the importance of home care nursing and the patient bill of rights from the perspective of the family.

Statewide Mandate For Paid Sick Leave Continues To Be Negotiated in Maryland

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

Several years in the making, a bill that would require employers offer paid sick leave continues to be negotiated within the state legislature.  The House and Senate have passed different versions of the bill, carving out certain types of employees and offering different amounts of sick time per year.  Representatives and Senators now must negotiate a version that can be passed identically through both chambers before any regulation will be put in place.  Many business and industry groups, including the Maryland-National Capital Homecare Association, have advocated against this legislation.

Setting A Rate Floor Gains Traction in Delaware

Representative Debra Heffernan, Vice Chair of the House Health and Human Development Committee, has offered to sponsor and draft a bill that would set a reimbursement rate floor for skilled nursing care for all payers under the state’s Medicaid equal to what Medicaid pays directly.  This bill would go a long way in helping home health care providers have consistency in their plans.  Rep. Heffernan represents an area north of Wilmington along the Delaware River, east of Fairfax.   Two other representatives have offered to sponsor the bill as well, and an additional representative has offered to co-sponsor the bill.

Debates Heating Up In Baltimore City, MD

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

Debate over mandating employer-paid sick leave statewide and an increased minimum wage for Baltimore City is heating up this week.  Both are expected to pass.  By the end of last week, the Maryland Senate and the House both reached their thousandth bill introduced since the 2017 session opened in mid-January.  Bills must be fully approved by both chambers before the last day of session, which is April 10 this year, or start anew in the following year in the state’s condensed legislative calendar.