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Advocacy in Action April 26, 2019

Posted By Jennifer Gill, Friday, April 26, 2019
Updated: Thursday, April 25, 2019

April 26, 2019

And the Crystal Ball Says…

With the caveat that “those who live by the crystal ball soon learn to eat ground glass,” our quick and unscientific survey of leading voices at the North Carolina General Assembly forecasts adjournment of the “long session” perhaps as early as late July. As with most sessions involving the first year of the two-year biennium, key to legislators heading back home is resolution of the budget. LeadingAge North Carolina continues to work hard on the issues most important to you and we’ll continue pushing for our priorities as Senators and Representatives consider our issues.

New Changes to CMS Nursing Home Compare Released Yesterday
Changes in methodology with the CMS Nursing Home Compare numbers kicked in yesterday. In conjunction with LeadingAge New York, we’ve done a preliminary run of the impact by state and sponsorship type for the overall 5 star rating and each of the 3 components (staffing, health inspections, and quality). Overall, 15% of nursing homes nationally gained 1 or more stars and 36% lost one or more stars. The variation by state and provider type can be substantial. We’ve dovetailed pretty closely to national averages here in North Carolina, with 21% of nursing homes gaining one or more stars and 35% losing one or more stars. A complete look at state numbers can be found by clicking here.

As expected, the inspection rating was almost equal for the ups and the downs on a national level. On staffing, there were 3 times as many facilities losing a star as gained a star. On the quality measures, 47% of facilities lost 1 or more stars and only 7% gained 1 or more stars.

Make Sure to Attend the Town Hall Conversation at the Annual Conference
The LeadingAge North Carolina Town Hall Conversation is your opportunity to provide input to LeadingAge – both at a national and state level – about ways public policy is affecting you, the older adults you serve, and how policy could be changed for the better. This year’s Conversation will be held on May 6 from 2:30-4pm at our annual conference in Myrtle Beach. Results of the Conversation will be shared with LeadingAge’s Policy
Committee, Board of Directors and staff, and will be used to set public policy priorities to better represent your interests and the interests of older adults in Washington, DC.

Federal Updates
Congress is pushing forward with work on budget and appropriations measures for fiscal year 2020, which begins on October 1. One of the first considerations will be raising caps on discretionary spending that were imposed by the Budget Control Act of 2011. The budget caps would require draconian cuts in
funding for a wide range of federal domestic programs, including affordable housing and home- and community-based services for older people. The House Budget Committee has approved an increase in the spending caps for fiscal years 2020 and 2021.

Affordable Senior Housing
Preliminary work has begun on determining spending levels for housing programs for fiscal 2020. In conjunction with LeadingAge national, we are advocating for the following:

  • Expanded funding for new Section 202 homes to $600 million.
  • Full funding for rental assistance contracts renewal. • Full Service Coordinator funding, as well as $30 million to expand Service Coordinators to more communities.
  • Enactment of legislation to improve and expand the Low Income Housing Tax Credit program.
  • Protection of the National Housing Trust Fund, Capital Magnet Fund, and Private Activity Bonds.

Medicare Observation Days
Legislation has been introduced in both the House and the Senate, H.R. 1682 and S. 753 respectively, to resolve the observation days issue by requiring all time Medicare beneficiaries spend in a hospital to count toward the three-day stay requirement for coverage of any subsequent post-acute care. Both bills are bipartisan. In conjunction with LeadingAge
national, we strongly support the legislation and are urging legislators to cosponsor these bills.

Home and Community-Based Services
Money Follows the Person: Both the House and Senate have passed H.R. 1839, the “Medicaid Services Investment and Accountability Act,” to extend the Medicaid home- and community-based services spousal impoverishment protections through September 2019 and provide an additional $20 million for Money Follows the Person. We are hearing that the President plans to sign the bill into law.

Older Americans Act
The law that funds a wide range of home and community-based services, including congregate and home-delivered meals, family caregiver support, and transportation, is due for reauthorization this year. In conjunction with LeadingAge national, we are working with other stakeholders on reauthorization legislation, including an increase in funding to meet the needs of an aging population.

In conjunction with LeadingAge national, we are working for passage of S. 299, the “Geriatrics Workforce Improvement Act” introduced by Senators Susan Collins (R-ME) and Bob Casey
(D-PA). This bill would help to ensure a more adequate supply of health care and other professionals trained and educated to meet the special needs of people as they age.

Nurse Aide Training Lock-Out

Since the automatic loss of training authority is statutory, LeadingAge national has worked with Rep. Sean Duffy (R-WI) on the introduction of the “Nursing Home Workforce Quality Act,” H.R. 1265. The bill has bipartisan cosponsorship and in conjunction with LeadingAge national, we are working to get more House members to sign onto it.

Proposed Fiscal 2020 Medicare Rule
CMS posted the proposed rule late on Friday, April 19, along with a fact sheet. Among many other provisions, the proposed rule, “projects aggregate payments to SNFs will increase by $887 million, or 2.5 percent, for FY 2020 compared to FY 2019. This estimated increase is attributable to a 3.0 percent market basket increase factor with a 0.5 percentage point reduction for multifactor productivity adjustment.” CMS again reminded nursing homes that the Patient Driven Payment Model reimbursement system will take effect for fiscal 2020. LeadingAge national is analyzing the rule and will file comments on it; the comment deadline is June 18.

Bill Trackers
Both LeadingAge North Carolina and LeadingAge national maintain legislative “bill trackers.” Click here for LeadingAge North Carolina’s version; click here for LeadingAge national’s version.

Information About Memorials for Mike Walsh
The First Presbyterian Church in Burlington was packed to the rafters earlier this week for Mike Walsh’s memorial service. Mike, executive director at The Village at Brookwood, was one of the most beloved colleagues for many of us in North Carolina. His service was a celebration of his life, his passions, and his legendary humor. In lieu of flowers, memorials may be made to the “Michael D. Walsh Family Trust” in care of the Village at Brookwood, 1860 Brookwood Avenue, Burlington, NC 27215 for his children’s education. We hope that you will consider a contribution to Mike’s kid’s future educational needs.

LeadingAge North Carolina | 222 N. Person Street, Raleigh, NC 27601
919-571-8333 | |

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