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.

Equalizing Access Legislation Approved in PA House Health Committee

Submitted by Laura Ness, Director, PA Government Affairs (GAO)

On November 21, the House Health Committee met and unanimously voted to approve HB 1829. HB 1829 allows individuals to be presumed eligible for home health care. This practice is currently allowed for nursing homes but is not extended to home care. Because of this, Pennsylvanians often go without the help they need or are unnecessarily placed in a nursing home. The legislation approved included two amendments, which changes the name “presumptive eligibility” to “deemed eligibility”. It also extends this process to allow adult day centers to do presumptive eligibility as well. We are very pleased with this outcome. Next the bill will go to the House Appropriations Committee. The Government Affairs Office (GAO) is working to set up meetings with Appropriations Committee members to ask them to support this legislation.

Government Affairs Office Hits the Road in North Carolina

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

Often we talk about sharing our message, making our point, and communicating our value proposition.  Those are things we, in the Government Affairs Office (GAO), must do as we seek support for our issues with lawmakers.  One such conversation was had with Representative Nelson Dollar earlier last week, where Chief Government Affairs Officer Dave Totaro and I thanked him for his past support on the rate increases and continued our conversation around our priorities for the year to come.

If we are to continue to be successful in building a strong advocacy base, it is not enough to build relationships with lawmakers.  We must also get to know our internal BAYADA customers–our staff and clients.  As such, we visited six home health offices on the I-85 corridor.  It was great to be able to provide a legislative update, share advocacy information, and solicit feedback.  It helps ground our efforts and put things into perspective.

Special thanks to Division Director Richard Hopson, Area Director Shad Morgheim, and the office directors for allowing us to visit. We really enjoyed visiting with staff at CV, CHF, GAV, CAV, SC, DAV, RV, and DRF.

Photo: Area Director Lee Dobson, Rep. Nelson Dollar, and Chief Government Affairs Officer Dave Totaro
Photo: Area Director Lee Dobson, Rep. Nelson Dollar, and Chief Government Affairs Officer Dave Totaro

Government Affairs Office Presents at NJ Statewide Meeting of Councils

Submitted by Tara Montague, Manager, Client and Family Advocacy, NJ (GAO)

On November 18, I had the opportunity to present at the statewide meeting of the Regional Family Support Planning Councils on The State of Home Supports and Services for the Medically Fragile Population in NJ.  The members of the 10 regional councils monitor and evaluate family support programs, provide information to policymakers, and advocate to local officials and state legislators about the needs of those who support a family member with a developmental/intellectual disability at home.  As part of the day’s program, we also had the chance to meet a representative of Governor-elect Phil Murphy’s campaign who emphasized the new administration’s desire to learn more about the disability community and its needs.

 

PA Client Visit to Discuss BAYADA’s Advocacy Program

Submitted by Rick Hynick, Director, Client and Family Advocacy (GAO)

 On Friday, October 20, Chief Government Affairs Officer Dave Totaro and I met with adult Home Health Aide client, William Bezdziecki at his home near Wilkes Barre to discuss the BAYADA Hearts for Home Care program and different client advocacy opportunities.  Also, present at the meeting were William’s parents, Jack and Mary Lou Bezdziecki, Wilkes-Barre/Scranton (WBS) Clinical Manager Susan Youells, WBS CSM Kristie Spinello and Certified Nursing Assistant Gerald Stevenson.

PA Long-Term Care Council Workforce Committee Meets to Discuss Data Needs

Submitted by Laura Ness, Director, PA Government Affairs (GAO)

Last week, the Long-Term Care Council met in Harrisburg along with the various sub-committees.  The Workforce Committee continued the discussion regarding how we continue to care the aging Pennsylvanians.  It was clear that direct care workers are the foundation of caring for older Pennsylvanians.  There was also the recognition that more direct care workers will be needed and recruited for the role.  The majority of our time was spent discussing the data needed to make the case for higher pay, better support, and professionalizing the profession.  The Government Affairs Office (GAO) is looking forward to continuing our work with the group.

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 the Client & Family Advocacy Program

Submitted by Rick Hynick, Director, Client and Family Advocacy (GAO)

 

On August 23, the Government Affairs Office (GAO) gathered in Philadelphia, along with a few office and field employees with advanced advocacy interests.  The goal of the day was to develop tactics to engage both clients and employees who enjoy advocacy to influence decision makers to support home health care.  Building awareness, Inspiring engagement and Empowering advocates were three main phases that were at the heart of our discussions related to grassroots advocacy efforts for our clients and families here at BAYADA and also for the many others who will be moved to join us from the community.