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 [email protected].

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.