Tuesday, March 13, 2012

Session results in minimal funding reduction, reduced paperwork for nursing homes

The 2012 session ended March 9 with nursing homes spared from significant funding cuts when the Legislature passed the 2012-13 Florida state budget. The final budget (HB 5001) reduced the originally-proposed 2.5 percent ($76 million) Medicaid funding cut to nursing home care to a lower cut of 1.25 percent ($35.2 million) and reflects full funding of price level increases (inflation). Additionally, the budget expands the Nursing Home Quality Assessment, which allows for some “buyback” of previous Medicaid reductions. “The stories that were shared by the hundreds of long term care professionals this session of how facilities have had to cope with cuts to Medicaid and Medicare over the past six months made a difference. We’re pleased that legislators recognized those challenges and were able to minimize the impact on nursing homes when the final budget passed,” said Emmett Reed, Executive Director of the Florida Health Care Association.

FHCA has always been proactive in offering suggestions to legislators that would help the state with its growing Medicaid budget. A member-driven priority for FHCA this session was the concept of allowing life insurance policies to be used for payment of long term care services. FHCA commissioned Florida State University's Center for Economic Forecasting and Analysis to examine the use of life insurance policy assets as a means of private funding in order to pay for long-term health care needs. The study found that annually there are approximately 4,272 to 4,486 residents with the potential to convert their life insurance policies into long-term health care benefit plans. According to the study, that would represent a net savings to the state's total Medicaid budget of approximately $138.3 - $157.4 million.

This concept was the premise behind SB 1756 by Sen. Joe Negron (R-28) and HB 1055 by Rep. Rachel Burgin (R-56), which received positive feedback in both chambers this session. However, given that it involves two very complicated issues – Medicaid eligibility and insurance – Rep. Burgin recommended that further study on this issue be conducted.

FHCA is pleased to report that the budget also included proviso language to establish a technical advisory workgroup to examine methods to allow an insured under a life insurance policy or the contract holder of an annuity, to convert the policy or annuity to a long term care benefit. The workgroup will include, but is not limited to, representatives from nursing home providers, life insurance companies, and life insurance agents. FHCA will keep members apprised of the outcomes of the workgroup, which will be important to helping address any technical issues before legislation is reintroduced next session.

Nursing homes will also see relief from duplicative requirements with a number of FHCA-supported regulatory changes that were passed as part HB 787 by Rep. Carlos Trujillo (R-116). These changes will have a positive impact on residents, as caregivers will have more time to focus on care rather than duplicative paperwork requirements. Provisions in HB 787 include: elimination of the 24-hour Adverse Incident report and the quarterly staffing report; clarification of eviction and nursing home discharge laws; implementation of requirements to allow nursing homes to provide respite care; placement of pediatric staffing standards into statute; allowance of home-office audited financial records in the CON process; and care plan and medical records revisions, as well as other regulatory fixes.

Although the Legislature was unable to reach an agreement on assisted living facility reforms this year, FHCA was able to educate lawmakers about the differences between nursing homes and assisted living facilities, with a particular emphasis on the negative impacts that electronic monitoring devices ("granny cams") have on resident privacy.

FHCA is extremely grateful to all of those who joined us in advocating for our long term care priorities both before and during the 2012 legislative session. No doubt the outcomes of this session resulted from a combined effort by FHCA members and staff in fostering legislator relationships, building a strong and comprehensive strategy and taking a proactive and unified approach to convey our key messages. FHCA members can read a more thorough wrap-up report of the 2012 legislative session by clicking here.

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