Wednesday, October 14, 2009
American Health Care Association President and CEO Bruce Yarwood was also interviewed, noting that Medicaid has chronically underfunded the care of nursing home care and the disparity between the cost to provide care and reimbursement levels continues to increase over time. In 2008, the national average hourly Medicaid reimbursement for nursing home care was only $6.70 and hour. Yarwood went on to say that most every state is facing a budgetary crisis as they grapple with the reality that demand and need for Medicaid financed care is up, while funding levels for the program are limited or are in jeopardy.
On October 1, an administrative cut in Medicare funding for skilled nursing care went into effect – eliminating an estimated $1.05 billion in FY 2010 alone, or as much as $16 billion over the next ten years. The Medicare cuts, coupled with Medicaid underfunding and state budget crisis, will result in job losses and will jeopardize the recent quality improvements seen in our nation’s skilled nursing facilities.
Long term care facilities are facing even more funding uncertainty, as temporary increases in Medicaid funding that came from the American Recovery & Reinvestment Act (ARRA) stimulus package will expire on December 31, 2010. All of these funding cuts and underfunding come at a time when the long term care sector must be preparing to face an upswell of individuals requiring both short-stay rehabilitative care and long stay 24-hour nursing care and support.
Please help Save Our Seniors. Contact your Members of Congress by phone or e-mail and urge them to oppose the nursing home funding cuts contained in health care reform.
Sunday, August 16, 2009
Since labor represents 70% of nursing home operating costs, we worry that such deep cuts would affect jobs - forcing layoffs, lowering salaries, or reducing benefits - and ultimately, hurting residents' quality of care. Congress must stop proposals that further cut nursing home care and reconsider how the existing $12 bllion in cuts, combinded with the state Medicaid funding shortfall that will occur when federal stimulus dollars run out, will negatively impact seniors' care.
FHCA, together with the American Health Care Association, are calling on Congress to ensure that total funding for nursing home care remains adequate to preserve quality care for America's seniors and protects caregiver jobs. Please join us in this advocacy campaign by clicking on this link for resource materials you can use to better educate Congress about these cuts as we campaign to Save our Seniors today.
How You Can Help:
- Call or e-mail your U.S. Senator and Representative today!
- Attend a Town Hall Meeting or set up a meeting in your local district with your U.S. Senator, Representative or a member of their staff.
- Invite your U.S. Senator or Representative into your facility.
Tuesday, August 4, 2009
“We intend to make certain the interests of nursing home residents remain a priority for lawmakers as they pursue health care reform in Washington, and will make sure they understand that the Medicare funding cuts on top of the looming Medicaid funding crisis plaguing Florida’s seniors and providers after stimulus dollars are expended is unsustainable,” Emmett Reed, Executive Director of FHCA said.
In the year 2010 alone, Florida’s Medicare cuts amount to $78.4 million – the 2nd highest level of cuts in the nation. The estimated economic impact on Florida in the year ahead, according to an analysis from the American Health Care Association (AHCA) and the Alliance for Quality Nursing Home Care, will be a reduction of $132.2 million in business activity, a reduction of $65.9 million in labor income, and a loss of 1,960 jobs.
Continued Reed: “Having now just suffered a massive Medicare funding cut of up to $16 billion – distinct and separate from the reductions our sector has willingly and cooperatively agreed to shoulder as part of achieving broader reform – we are alarmed the sheer size of the cumulative cuts we ultimately suffer will be especially damaging to seniors in states like Florida, where our Medicaid program is already underfunded*. Medicare and Medicaid funding are inextricably linked, and the combination of cuts to both programs squeezes our local facilities in a manner harmful to Medicare beneficiaries’ care needs, detrimental to our state’s local economy, and injurious to our caregiver jobs base.”
Reed noted that Florida nursing homes are seeing an increasingly diverse patient base, and providing a greater variety of acute care, rehabilitative and convalescent services that cannot be delivered elsewhere – care services which are now in jeopardy due to the sheer size and scope of the Medicare funding cuts. These massive funding cuts, Reed said, will undermine facilities’ ability to effectively treat this more medically complex patient population, and also put the jobs of the direct care workforce they depend upon in substantial danger.
“Achieving a sweeping health care reform bill we can all be proud of, and which will improve the health of every Florida resident is a necessity, not an option,” Reed continued. Yet, protecting vulnerable seniors in the process must always remain a key priority from which we must not deviate.”
During the upcoming August recess, Reed said, the long-term care community will ask federal lawmakers to keep the interests of nursing home residents and those who care for them foremost in their minds. “We intend to explain in a tangible, informative manner why it is essential for Congress, upon its return to Washington in September, to recalibrate its thinking on health care reform and scale back these enormous Medicare cuts.”
*An Eljay, LLC analysis of the nation’s Medicaid program released in October by the American Health Care Association (AHCA) projects that Medicaid underfunded the actual cost of providing quality long term care in 2008 by $188.5 million annually in Florida, and that Florida seniors rank 10th in terms of cumulative underfunding of nursing facility care.
Thursday, July 16, 2009
The moment to take action is NOW. FHCA is joining the American Health Care Association in asking you to you weigh in with your U.S. Representative and let him/her know that cuts of this magnitude are simply unsustainable. Tell your Representative that cuts to Medicare will have a negative impact on nursing homes and will create a ripple effect - putting at risk the quality of care to our state's frail elders and people with disabilities and the loss of tens of thousands of jobs for long term care providers across the country.
We must put a stop to these egregious cuts before it's too late. Congress has made health care reform a priority this year and intends to pass a bill as early as August. Your voice needs to be heard on this vital issue. Click here to take action today by sending a letter to your U.S. House Representative and telling them to OPPOSE Medicare payment cuts to SNFs contained within HR 3200, America's Affordable Health Choices Act of 2009.
Thursday, June 25, 2009
On Wednesday, June 24, Senator Jack Latvala, who is running for Senate District 16 (he previously represented a nearby area) visited Palm Garden of Clearwater and Administrator Roy Meredith and his staff provided a tour followed by sandwiches and sweets. Great job!
That evening we headed to Bradenton to the home of Senator Mike Bennett (R-21), where we joined FHCA Executive Director Emmett Reed and FHCA Vice President Nina Willingham at a fundraiser for Greg Steube (R), candidate for House District 67. Warm breezes off the Gulf and good food and drink enabled everyone to relax and meet the candidate, who is an Iraq war veteran and the son of the local sheriff. We look forward to having Greg visit some local nursing homes in the near future.
We encourage our FHCA members to invite their local legislators and 2010 candidates into your building to help educate them about the valuable work you do in caring for Florida's nursing home residents. First-hand visits are a great way to help them learn more about our long term care issues and help your residents and staff meet the lawmakers who impact their lives. You can visit the Members Only Legislative Section on the FHCA Web site for tips on how to conduct a successful legislative visit, and be sure to e-mail me an update and photos so we can share it with the rest of the membership.
FHCA Testifies Before US Aging Committee, Urges Importance of Coordination Between Policymakers & Long Term Care Providers In Planning for Disasters
“The Florida Health Care Association has been taking the lead in Florida in ensuring that our state’s frail elders and citizens with disabilities residing in nursing homes and assisted living facilities are able to retain access to the long term care and services essential to their health and well being during a disaster,” stated J. Emmett Reed, FHCA Executive Director. “We encourage Congress to take swift action to ensure that all care providers – regardless of tax status – can access federal assistance for disaster relief efforts.”
In her testimony before the Senate Special Committee on Aging, Polivka- West discussed complications that occurred during the 2005 hurricane season, stating, “As decisions were being made regarding evacuations, many nursing home administrators did not have the same knowledge or guidance about when and if they should evacuate as hospitals did. Following several hurricanes during that season, utility services did not understand the special needs of the frail elderly and those with disabilities in nursing homes and assisted living communities, leaving them without electricity and telephone services.”
As the Senior Vice President with the Florida Health Care Association (FHCA) and Principal Investigator of the John A. Hartford Foundation Emergency Preparedness grant, Polivka-West discussed the steps that need to be taken by our nation’s long term care facilities and policymakers to develop appropriate disaster planning. These steps include creating a disaster planning guide and software that facilities can refer to, including disaster preparation training exercises in nursing home staff program, and assembling annual hurricane summits.
Polivka-West addressed the importance of keeping facilities informed and supplying them with the tools to be prepared in any given emergency situation. She stressed that forming a constructive dialogue with legislation is crucial to creating a well-executed disaster plan. “Due to the very vulnerable and complex population that we serve it is essential that we work together with policy makers to better prepare ourselves for any disaster,” stated Ms. Polivka-West.
“The road ahead is no doubt challenging,” concluded Polivka-West. “But the important task before us is to objectively examine how local, state, and federal governments – working with transportation, the health care spectrum and business groups – can better prepare for and coordinate disaster recovery efforts for our most vulnerable citizens nationwide.”
FHCA partners with its national affiliate, the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), to make available emergency preparedness resources and information to other long term care facilities across the country. Polivka-West serves as a member of the AHCA/NCAL Disaster Preparedness Committee. FHCA has worked in concert with AHCA/NCAL in coordinating a number of national summits, including the most recent one in December 2008 which brought together state and federal partners in long term care, transportation and emergency management to examine the availability of and access to transportation resources for long term care providers during emergency situations.
Monday, May 11, 2009
Additionally, there will be no permanent elimination of the annual price level increase in the nursing home budget. Facilities’ financial stability will be preserved, as well as their ability to effectively recruit and retain qualified staff and cover their increasing costs of fuel, utilities and property/casualty insurance. Legislators also agreed to allow a one-year waiver of the lease bond requirements, which takes effect July 1, 2009.
Also taking effect July 1st is the restoration of the 2.9 CNA staffing level contained in the statute. The provision allowing nursing homes to “buy back” their rate cuts will ensure the funding is available to pay for the staffing that is resulting in dramatic improvements to nursing home quality care.
The collective efforts of FHCA members, staff and lobby team resulted in this year's successful outcomes, at a time when many other areas saw significant funding cuts. The impact of the hundreds of nursing home owners, administrators, caregivers and family members descending on the Capitol during Lobby Wednesdays, as well as the thousands of e-mails sent to legislators urging them to protect funding for nursing home residents did not go unnoticed. FHCA is thankful to all who helped make a difference during the 2009 session to preserve quality care for our state’s frail elders.
Tuesday, April 28, 2009
Sunday, April 26, 2009
Meanwhile, a limited number bills are moving in either chamber. As we've been reporting, a health care train that contains the Agency for Health Care Administration's regulatory bill along with a Medicaid fraud bill now includes language on a new way to provide home care through the state's medical schools. Could this be another attempt at Medicaid reform? Last week, the nursing home therapeutic formulary bill we've been monitoring was amended to include so many requirements that it has been removed from the pharmacy bill. In other news, the controversial election bills may be dead for the time being, but we've seen oil drilling pop up as a last minute issue, so it will be interesting to watch that debate.
It seems as if the drive to reduce regulation and streamline governmental operations this session has lost its momentum. One wonders if the overriding pressure from the state budget is causing this low number of bills to pass this session. In any event, FHCA will continue tracking those health care bills on which we've been reporting in these last nine weeks, as well as keeping an eye on whatever outcome results as the clock ticks away on lawmakers' timetable to pass a budget in the final days.
Wednesday, April 22, 2009
The nursing home therapeutic formulary bill, SB 1868, will be debated on the Senate floor on Thursday. FHCA is continuing its communication with all Senators to help them understand how important this issue is to long term care providers.
FHCA also continues to work on an amendment to ensure that nursing home residents have access to voting at the polls. As we mentioned previously, an elections bill has, in fact, been passed by the Senate, SB 956, and by the House, HB 7149, but will need much work if it is going to pass the full bodies on the floor.
Tuesday, April 21, 2009
Among the public interest groups calling for defeat of the bill during Monday’s press conference were the League of Women Voters, AARP, AFL-CIO, NAACP, Advocacy Center for Persons with Disabilities and Miami-Dade Election Reform Coalition. Joining them were more than a dozen Democratic legislators who cited a critical New York Times editorial titled "Suppressing the Vote in Florida."
FHCA is particularly concerned about the proposed changes to Florida’s voting and elections laws outlined in SB 956, which further limits acceptable IDs for voter registration and identification at the polls. Retirement center identification would no longer be valid with this bill, which is likely to disenfranchise many elderly voters, including those in nursing homes, who no longer have a driver’s license. Additionally, the bill eliminates the only free forms of ID that are currently valid and proposes no acceptable alternatives. Several FHCA member nursing homes currently serve as election polling places, and the limitations that SB 956 imposes on acceptable IDs would prohibit facility residents from the ability to exercise their right to vote in person.
Friday, April 17, 2009
The House version contains language that continues to prohibit the Agency for Health Care Administration (AHCA) from citing facilities for failure to comply with the 2.9 CNA staffing level as long as the facility remains above the 2.6 CNA staffing level through June 2010.
The staffing issue generated some debate on the House floor, as Reps. Ocscar Braynon (D-109) and Yolly Roberson (D-104) discussed how the 2.9 staffing has greatly improved care in Florida nursing homes. Chairman Kevin Ambler (R-47) responded that nursing homes funding is being cut because providers were able to buy back previous rate cuts from January 1, 2008 and January 1, 2009 with the Quality Assessment Program that passed during the special session earlier this year. To help ameliorate the current funding cut proposed, he stated, the House extended the 2.6 staffing for another year. He argued that between a recent AHCA staffing report showing quality of care was very good under the 2.6 staffing and the flexibility this gives nursing homes, the extended staffing moratorium should not have any impact on quality of care. Reps. Braynon and Roberson pressed Chairman Ambler that, if the money could be found for nursing homes, the 2.9 staffing should be restored. Ambler responded that if any additional money is put into the health care line item during the budget conference, the restoration of nursing home funding and the staffing level will be his first priority.
Rep. Braynon offered an amendment that, if the tobacco tax passed through the legislature, then the 2.9 CNA staffing level for nursing homes is restored. Unfortunately, the amendment did not directly link any revenues from tobacco money to a nursing home rate restoration, so after a positive discussion with Chairman Ambler on the House floor, he withdrew his amendment.
FHCA's position continues to be one of supporting the higher staffing ratio of 2.9 CNA hours if the legislature provides the appropriate funding. We believe that funding and staffing must be aligned. In the meantime, we will continue monitoring the budget process once the conference begins on Monday and keep urging legislators to reconsider these funding cuts to nursing home care for our most frail elders.
Thursday, April 16, 2009
It was a good day to be at the Capitol, as there were several health care committees meeting. Most relevant was the discussion on SB 1868, which creates a formulary for nursing homes similar to that in place for hospitals. This is an important issue for FHCA, and during the meeting Dr. Kaplan, a medical director who currently works for Opis, testified in support of the bill. He asked all the long term care providers in the room to stand, and it was an impressive sight. Be sure to check out this week's Provider Program online video update to see more.
HB 1209 and SB 2284, which will give nurses in Florida the opportunity to voluntarily contribute toward the Florida Center for Nursing, are moving in both the House and Senate.
The Agency for Health Care Administration has been working to keep its deregulation bills, HB 651 and its companion, SB 2286, moving in both chambers. In fact, these bills appear to be this year's health care train as there are many other provisions being added on in the form of amendments. These bills contain several deregulation provisions for nursing homes, and we will be pleased to see the final version signed by the Governor.
The Senate Judiciary Committee passed a version of the workers' compensation bill (SB 2072); however, it does not match the version passed by the full House (HB 903), so these differences will have to be resolved before it can go to the Governor for signature.
SB 2004 also passed through the Senate Criminal Justice Committee this week. This is the red-light bill, sponsored by Sen. Thad Altman (R-24), which uses a portion of the motorist fines to go toward creating an add-on for qualified nursing homes serving residents with brain and spinal-cord injuries.
FHCA is continuing to monitor the budget which, after today, will head to conference for resolution. Hopefully agreement between both chambers will be reached so the session can end on time.
Monday, April 13, 2009
Things were a bit stormy inside the Capitol, as well, as the amendments started flying for a health care bill we've been tracking. HB 651, sponsored by Rep. Matt Hudson (R-101), is the Agency for Health Care Administration's bill which contains several "deregulation" provisions. It appears to be the perfect "health care vehicle" to move its way through session, and while some of the amendments stayed and some did not, in the end it is still a bill supported by FHCA. The next stop the bill will make is the House floor, so there appears to be a silver lining on the horizon. The Senate companion, SB 2286 sponsored by Sen. Andy Gardiner (R-9), is currently in the Senate Judiciary Committee.
Most of the House Health Care Services Appropriations Committee was taken up by HB 433, sponsored by Rep. Ken Roberson (R-71). FHCA supports this bill, which implements a "formulary" for nursing homes similar to the one that has been in use by hospitals for nearly 25 years. The debate primarily centered around whether the physician was notified prior to the dispensing of the substituted drug (what we have now) or simply notified (the way a formulary system works). A hand-written amendment, filed during the committee meeting by Rep. "Doc" Renuart (R-18), added the "prior to dispensing" language, which is not in the companion Senate bill (SB 1868) also set to be heard later this week. This issue is far from over.
For FHCA, it will be a busy week as we welcome our members to town for our last Lobby Wednesday. The House and Senate, for their part, will spend lots of time in Session, and anything can happen when legislators are on the floor. FHCA will continue tracking these bills, as well as our important reimbursement issue, and will continue keeping members up-to-date as things progress.
Wednesday, April 8, 2009
In the end, budget bills were positioned for a floor debate next week. Next week is back to "business as usual," as policy committees will meet to move several important regulatory bills. Included is HB 651 by Rep. Matt Hudson (R-101), and the companion, SB 2286 by Senator Andy Gardiner (R-9), which are the deregulation bills put forth by the Agency for Health Care Administration. In addition, FHCA staff and lobbyists continue to work on other priorities of the Legislative Committee, including reimbursement, resident voting, ombudsman issues, duplicative inspections and reports and guardianship fees.
FHCA's last Lobby Wednesday will be on April 15th, and a large crowd is expected. Participation at these events has far exceeded last year's numbers, and FHCA appreciates everyone who takes the time to come to Tallahassee and help advocate for our critical long term care issues.
Tuesday, April 7, 2009
In discussing the Budget Implementing bill, Rep. Oscar Braynon (D-103) offered an amendment to strike language which extends the moratorium for another year on nursing home staffing above 2.6 CNA hours. He, as well as Rep. Yolly Roberson (D-104), called for higher staffing and the funds to pay for it. Rep. Ambler provided an extensive defense of the 2.6 hour staffing, including findings from a recently released Agency for Health Care Administration report, as well as the current budget situation. Rep. Braynon withdrew the amendment and asked that everyone continue to look at this issue.
In the end, the Council approved both the budget and the budget implementing bill along party lines. FHCA will continue to monitor the proposed cuts to nursing homes, urging legislators of the negative effect these cuts would have on nursing home quality care for residents.
Monday, April 6, 2009
“Nursing homes cannot be treated as just another line item in the state budget,” said Deborah Franklin, FHCA Chair. “Washington has provided the much-needed relief…we cannot allow these millions of dollars in cuts to nursing home care.”
Franklin noted during today's event that the solution for funding nursing home care passed in the January 2009 special session with the Quality Assessment Program. Providers began self-imposing a 5.5 percent assessment on April 1, 2009 to allow the state to draw down more than $390 million in federal money. This is in addition to the $4.2 billion that Florida Medicaid will receive in federal stimulus dollars over the next 27 months.
Florida legislators have no reason to impose these cuts when the funding is available through the federal stimulus package. They are simply unnecessary and unacceptable and threaten to undo relief from the Quality Assessment Program, as well, which has barely begun to take affect,” Franklin said.
“We have witnessed a dramatic improvement in nursing home care, and that's a credit to the hard work of the nurses and CNAs who do health care's toughest job,” said Senator Nan Rich. “Our state is in a fiscal crisis that is soon to turn into a moral crisis if we continue cutting critical services for our most vulnerable citizens.”
Rich and Franklin both noted that the elder care reform (SB 1202) that passed in 2001 that required increased minimum staffing standards has resulted in dramatic improvements to nursing home quality. Florida hired over 12,000 nurses and CNA positions over the past eight years, and today has among the highest ratio of staff-to-resident care in the nation. Maintaining steady quality improvements for resident care is a goal strongly supported by elder care advocates including AARP, Florida Association of Homes and Services for the Aging, Florida Catholic Conference, Florida CHAIN and the Service Employees International Union, among others.
Let it be said that this short week may be more exciting than week's past. We're jumpstarting this Monday with a press conference today at 12:15 p.m. on the 4th Floor of the Senate Rotunda to address our concerns with these provider cuts when money is available through the stimulus package. FHCA will be joined by Senator Nan Rich (D-Weston), Leslie Spencer of AARP and Cloreta Morgan of SEIU. Watch for our next update with more on this event, and the resulting discussions that surround the state budget.
Wednesday, April 1, 2009
This is very important, as we are in the midst of serious budget problems and need everyone's support to help educate legislators to the extent of the problem. The proposed nursing home funding cuts - $81 million in the Senate and $69 million in the House - could threaten quality care and quality of life for our state's frail elders. These cuts are unacceptable, particularly when money is available from the federal stimulus package, yet lawmakers are moving over $780 million of stimulus dollars out of health and human services and into other areas. FHCA members, family members of residents and long term care staff are encouraged to contact their legislators and urge them to oppose these funding cuts and use the stimulus dollars as they were intended - to fund the Medicaid program. You can click here, or use the Take Action link to the right under the FHCA Online Resources section to send this important message to your legislators.
The state budget is often one of the last bills to get worked out during the session, so we know there is a process ahead, With the magnitude of the funding cuts, however, we cannot afford to wait or let up on our elected officials.
Next Monday, April 6th, FHCA will host a press conference with Senator Nan Rich and other elder care advocates to oppose these cuts and raise awareness about using the stimulus as it was intended. If you're in town, please stop by the 4th floor Senate Rotunda at 12:15 p.m. to show your support. In the meantime, stay tuned for more on this important issue next week.
Monday, March 30, 2009
FHCA doesn't stop working on its legislative priorities until the session comes to a close, so be sure to check back for updates soon.
Thursday, March 26, 2009
Wednesday, March 25, 2009
Legislators did not let them down as the Senate Health Care Regulation Committee kicked off the morning hearing SB 1562 by Senator Mike Bennett. As expected, the Long Term Care Ombudsman spoke against the bill, stating the health care of residents is up to the Ombudsman and that the Ombudsman program has changed the persona of nursing homes due to the care that these volunteers provide to residents. FHCA Chair Deborah Franklin followed with passionate testimony about her 25+ years in long term care and the focus she and her fellow providers in the audience have on quality of care and quality of life for residents. She took time to thank the Ombudsman volunteers who do spend time in facilities advocating on behalf of residents, but noted that the administrative assessment has evolved to duplicate the inspection AHCA is already conducting on facilities through its certified team of nurses, dieticians, life safety experts, etc.
The passage of 1562 will help the Ombudsman refocus their role back on resident advocacy and provide them more time to spend in the facilities, speaking with residents, family and staff about the important role they play in resolving resident complaints. FHCA is thankful to Senator Bennett for the great job he did in responding to this issue and correcting the record, and the bill passed favorably out of the committee, 7-1.
Later in the day HB 433 passed the House Health Care Services Policy Committee, with only seconds to spare at the end of the meeting. This bill creates a "therapeutic formulary" for nursing homes, similar to that used in hospitals. The House Health Care Regulation Committee also approved HB 1097, which begins the implementation of electronic records in Florida.
Tuesday, March 24, 2009
Thursday, March 19, 2009
What this means is that after the funding of the minimal “must funds,” such as Medicaid workload and maintenance of effort, education, and prisons, the projected deficit for Fiscal Year 2009-10 is approximately $6.1 billion without consideration of Federal Stimulus funds. After application of the Federal Stimulus funds available to the state of Florida, the deficit is reduced to $3.1 billion. Given Florida’s constitutional mandate to have a balanced budget, the legislature will be charged with finding an additional $3.1 billion in additional cuts or revenue enhancements.
As a result, today the Senate Health and Human Services Appropriations Committee required each of the agencies for which they have jurisdiction to present options to achieve a 10% budget savings. Foremost among the options presented by the Agency for Health Care Administration was a proposal to reduce nursing home Medicaid rates by 12.1 percent, which equates to $357 million ($115.5 General Revenue) in reduced funding. This would equal approximately $22.75 per Medicaid patient day.
AHCA also included options to expand the Capitated Nursing Home Diversion Program by another 1,000 slots, saving $14 million ($4.5 million General Revenue), and the elimination of adult Dental, Visual and Hearing Services, saving $30 million ($9.6 million General Revenue).
Clearly draconian cuts of the nature being discussed would be totally devastating to our profession. Now is the time for FHCA members to let legislators know how difficult it is to survive the March Medicaid rate reductions of an average of $14.77 and what a cut of $22.75 per Medicaid patient day would do to your ability to care for Florida’s frail and elderly residents.
Of note, the proposed cuts would threaten the employment of over 10,000 nursing home workers and exceeds the entire amount of funding provided under the provisions of SB 1202, which increased Certified Nursing Assistant staffing from a regulatory requirement of 1.7 hours per patient per day to 2.9 hours per patient per day. How can providers be expected to maintain the quality of care improvements that have been made with such a loss in funding???
Wednesday, March 18, 2009
On the calendar for today was SB 1562, sponsored by Senator Bennett, which reduces many duplicative regulatory activities. Time ran out before that bill or SB 2286, which is the Agency for Health Care Administration's deregulation bill sponsored by Senator Gardiner, could be heard. We can only hope they are on the agenda for March 25th.
On the House side today, the House Health Care Regulation Committee passed HB 651, sponsored by Representative Matt Hudson, which is the companion AHCA deregulation bill. FHCA supports this bill which eliminates unnecessary paperwork and gives nursing home staff more time to focus on resident care. I testified on behalf of FHCA members noting that, while we supported the bill, we were concerned about the elimination of the Quality Monitors and would hope they could be retained to focus on problem facilities. The Committee also passed HB 433, sponsored by Representative Roberson, which creates a formulary system for nursing homes similar to the one presently used by hospitals.
So, it was a good day for FHCA, and along with so many great members in town and the sun shining upon us, we continue to work on behalf of long term care providers tomorrow and every day thereafter.
Monday, March 16, 2009
There has been lots of press surrounding SB 1562, sponsored by Senator Mike Bennett, which eliminates several duplicative surveys and procedures. The bill will be amended on Wednesday to fix several problems created during the bill drafting process. One of the most important issues in the bill for long term care providers is the removal of the administrative assessment by the Long Term Care Ombudsman. The elimination of the assessment does not, however, prevent the Ombudsman from continuing to do his or her most important job, which is to advocate for residents at any time needed.
Keep watching FHCA's legislative blog for updates during the week, and be sure to tell your friends to sign up to follow.
Thursday, March 12, 2009
The Senate Health and Human Services Appropriations Committee held a ½ day meeting today on numerous health care programs under its jurisdiction. The audience, numb by endless presentations from Agency staff, perked up when Senator Peaden concluded the meeting by directing all health agencies to submit a plan to the committee for its next Thursday meeting that will reduce their next year budget by 10%.
Wednesday was also Catholic Days and the traditional Red Mass was held last night. This mass is for legislators to ask for guidance during the legislative session ahead.
Finally, I was excited to see a group from Emerald Shores in special t-shirts and enjoying the singing and dancing taking place in the Capitol Courtyard. This facility is one of our FHCA members and had come to town with residents and staff to enjoy Ambassadors for Aging Day. Thanks to them for making the trip and being part of all the excitement at the Capitol.
Wednesday, March 11, 2009
Tuesday, March 10, 2009
Health care issues on the agenda today included HB 753, which urges Congress to continue funding of the Silver Alert program, HB 767, which allows for the combination of mental health services and substance abuse services at one time, and HB 109, which allows certain medical professionals to violate confidentiality if necessary for someone's safety.
FHCA will be tracking the progress of these bills throughout the legislative session, and as always, long term care providers can stay up-to-date on the Members Only Legislative Section of the FHCA Web site.
Monday, March 9, 2009
Wednesday is Ambassadors for Aging Day, and FHCA will be one of the many organizations promoting services for Florida's seniors. That same day, FHCA will have a dedicated group of members in town for our Lobby Wednesday activities, where they'll have an opportunity to meet with legislators and talk about our important long term care issues. Stay tuned for more information as we continue to track the issues that impact long term care providers, including the beginning of budget negotiations, ongoing negotiation of our legal reform bills and fine tuning of the regulatory reduction bill. You can stay up-to-date on these and other critical issues that impact long term care on the Members Only Legislative section of FHCA's Web site.
Thursday, March 5, 2009
In addition, the House continues its discussion on the elimination of some sales tax exemptions, which has been an ongoing issue that is still not settled. For example, if you buy a U.S. flag, pole and hardware, the entire purchase is tax exempt. If you buy the flag in the morning and go back later for the pole and hardware; however, the flag is tax exempt but the hardware purchase is taxed.
Dyke stated this $661 million can be freed up for any other purpose by the Legislature except placement in reserve or rainy day funds. This initiated a number of questions from legislators, such as whether funds can be used to increase reimbursement rates or if it could empty the wait lists for Home and Community Base waiver programs, and "yes" was the answer to all. In 2009-10 FY, the increase will be $1.169 billion or $646 million of additional funds after fully funding Medicaid programs.
This was the first good news for legislators who fear they will have to make massive cuts to health care services.
Wednesday, March 4, 2009
It will be interesting to watch these bills progress, and FHCA members can stay up-to-date through our weekly legislative updates on the FHCA Members Only Legislative Page.
More great news in Tallahassee today. Rumor has it that President Obama is going to announce that Florida's Division of Emergency Management Director, Craig Fugate, is being tapped to head the Federal Emergency Management Administration. Fugate has run the Division since 2001. If confirmed by the U.S. Senate, Fugate would replace acting FEMA director Nancy Ward as head of the agency, which employs 2,600 full-time staff and has more than 4,000 stand-by disaster employees.
This decision reinforces the recognition Florida has received as a result of our success during the 2004 and 2005 Hurricane seasons. FHCA is very excited about this opportunity for Craig.
FHCA was supportive of this provision, and we’re not sure why it was removed. We will continue to watch the Senate companion bill, SB 702 sponsored by Sen. Don Gaetz (R-4), to see what happens.
Tuesday, March 3, 2009
Monday, March 2, 2009
The group also provided the Senator with a historical timeline of how nursing home quality has steadily improved in Florida since the passage of landmark elder care reform in 2001, which mandated increasing minimum staffing requirements up to 2.9 CNA hours of care per resident, along with tougher regulation, quality improvement and risk management programs. The recent creation of the Quality Assessment Program during the 2009 Florida legislative special session helped nursing homes avert significant, increased funding cuts by allowing the state to draw down more federal dollars to fund nursing home care.
Discussions with Senator Nelson also surrounded the anticipated influx of federal stimulus dollars through the passage of the American Reinvestment and Recovery Act of 2009 and what that means to long term care providers and the residents they serve in Florida. Mr. Reed, Ms. McGinley and the others shared with Sen. Nelson that the Florida Health Care Association and the members it represents will be urging legislators during the 2009 regular session to preserve Medicaid funding to support the 2.9 hour staffing mandate and ensure facilities have the resources needed to not only continue providing quality care, but also to make much-needed renovations to aging facilities, modernize health care settings through health information technology and meet the growing demands of Florida’s aging baby boomers through a strengthened health care workforce.
Friday, February 27, 2009
FHCA members can stay up-to-date on the progress of this bill and other Association legislative priorities by visiting the FHCA Members-Only Legislative Section.
FHCA members are encouraged to let your legislators know how important these bills are for the residents in your building. Need help finding who represents your district?Visit Online Sunshine to find a list of your Representatives and Senators, as well as their contact information.
Tuesday, February 24, 2009
As we prepare for the start of the 2009 regular session, FHCA will continue communicating with legislators about the importance of preserving Medicaid funding to support the 2.9 CNA hours of per patient care. We believe that the increased staffing standards that were mandated in 2001, and the accompanying funding, have greatly improved care for Florida's frail elders and citizens with disabilities in our nursing homes. By preserving the funding, facilities will have the resources they need to do their critically important work, quality care for residents will continue to improve, facilities can make much-needed renovations and our state can meet the growing demands that aging baby boomers will have on long term care through a strengthened health care workforce.
Friday, February 20, 2009
The Agency for Health Care Administration (AHCA) gave a presentation to the Senate's Health and Human Services Appropriations Committee on the impact of the federal stimulus package to Florida, which includes the FMAP increase. The Federal Medical Assistance Percentage is used in determining the amount of federal matching funds for the state's expenditures for assistance payments for certain social services, such as Medicaid. Florida is expected to see close to $3.5 billion for health care from the package, with its federal share of the match rising from the current 55% to 68%. The Committee also heard a presentation on Medicaid fraud and abuse, which costs the state significant dollars each year.
The House Health Care Appropriations Committee heard a presentation from AHCA on the Nursing Home Quality Assessment Program, which was created during the special session in January. The Assessment will help draw down additional federal dollars and allowed nursing homes to avert nearly $231 million in cuts to resident care funding. Instead the Assessment will restore the Medicaid funding cuts imposed on nursing homes in January 1, 2008 and January 1, 2009, as well as March 2009. The Assessment will become effective April 1, 2009 and will be calculated annually on a per-resident basis, exclusive of Medicare resident days. AHCA must seek a federal waiver from the Centers for Medicare and Medicaid Services for this to occur and precautions are in place in case that waiver has not been approved.
A number of bills were filed this week that impact long term care providers in Florida. Deregulation, insurance, "therapeutic interchange," personal needs allowance and the use of video surveillance in nursing homes are among the top issues we are tracking. You can read more about these bills and FHCA's position on the issues, as well as other legislative activities happening on behalf of FHCA members by visiting our Members-Only Legislative Section.