2017 Session Outlook
The 2016 session will be remembered for all that was not accomplished—no comprehensive transportation funding package, no tax bill and no bonding bill, despite the fact that legislative leaders on both sides of the aisle and the Governor had identified these as top priorities for this year. In the end, only $182 million of the state’s $900 million surplus was spent in the supplemental budget bill—which was hastily crafted in the last 36 hours of the legislative session. The bill included funding for increased broadband access, funding to address racial and economic disparities, funding for Minnesota’s state operated services at Anoka and St. Peter and the Governor’s pre-kindergarten proposal.
Perhaps the biggest disappointment of the session, was the lack of any new funding included for Medicaid-funded home and community based services for the elderly for the second year in a row.
Yet, for all of the criticism that can be made about this particular legislative session, in the context of the biennium, there were significant advancements in the area of senior care:
The Establishment of a Legislative Committee Focused on Seniors
For the first time ever, the House took the step in 2015 to establish a committee on Aging and Long Term Care Policy as a direct result of advocacy work by LeadingAge MN and its members. This was significant, because it allowed lawmakers to step back and ask questions about whether Minnesota is headed in the right direction for its aging population. It helped to shed light on the caregiving workforce crisis, the need for senior care reimbursement reform and the need for additional work in the area of Long Term Care Financing Reform. Our work in the next session will focus on encouraging the House to maintain this committee, no matter which party is in control and to continue to advocate that the Senate create a similar body in the next biennium.
Advancements in Senior Care Reform
LeadingAge MN successfully advocated for the passage of a comprehensive senior care reform package, which included $138 million of new investments in care centers and in Elderly Waiver customized living services. The implementation of a new payment system for care centers started in January of this year and the implementation of elevated caps for Elderly Waiver customized living will begin in July of this year. Lawmakers will return to the capitol next year fully aware of the budget implications of these reforms, so it is essential for LeadingAge MN and our members to fully engage with lawmakers so that they can understand at a local level how crucial these reforms were and how important it is to maintain these reforms going forward.
Workforce
LeadingAge MN successfully advocated for some significant improvements to help in workforce training and retention in the past two years, including the establishment of a new HCBS scholarship program and enhancements to the nurse loan forgiveness program and the care center scholarship program. Looking ahead to next year, there will be work to reauthorize the HCBS scholarship program and make it a permanent feature of the state budget process. It will be important for members that have benefitted from this program to help us showcase the importance of this program. Also, in the bucket of unfinished business is advocacy to support a proposal to support a promotional campaign for careers in the field of senior care.
Elections
All 201 members of the House and Senate are up for election in the November this year. Aside from the Presidential election, these legislative races will be the focal point of the elections in Minnesota, as there are no statewide races. While it seems that rhetoric will be largely focused on the “do nothing” session that just concluded, lawmakers will be looking for some positive accomplishments that they can highlight. Senior care issues are likely a prime candidate, and given that there were 148 lawmakers that supported the final passage of some of the reforms and investments of 2015, it is likely that provider members will be receiving many requests from candidates to publicly discuss these reforms. This is an important opportunity that should not be passed up. Not only is it to support all of those lawmakers that supported senior care over the past two years, it is also an opportunity to discuss what is next in terms of our agenda to enhance the experience of aging in Minnesota.
It is not clear which party will control either body of the Legislature, but there is sure to be significant turnover, due to a large number of retirements this year. In addition, there are a number of very close races, especially in greater Minnesota. It is important for providers, caregivers, families and residents to stay engaged this session and talk to candidates from all parities about the work that lies ahead.
Interim Policy Work
Campaigns and door knocking won’t be the only thing that keeping policymakers busy this summer and fall. There are many interim work groups underway that LeadingAge MN is actively involved in:
EW Reform for Assisted Living and Adult Day Providers
A traditional approach of requesting a rate-on-rate increase for all HCBS Waiver programs has not gained traction for several years. Lawmakers are looking for a different approach that is more targeted to addressing issues within the Waiver programs and that are tied to outcomes. To that end, LeadingAge MN, along with our partners in the LTC Imperative, have appointed a joint workgroup of members and business partners to help design a proposal to reform the EW program as it related to assisted living settings. As this proposal is developed, it will be shared with members and external stakeholders, and the goal is to share the proposal with legislative candidates this fall so that it is ready for introduction in the 2017 session.
For adult day providers, LeadingAge MN has convened a group of our adult day members to develop a reform proposal as it relates to adult day services.
Electronic Surveillance in Senior Care Settings
The circumstances in which a resident or family member can install hidden electronic surveillance equipment in a resident’s room or unit was questioned in this legislative session. As a result, a workgroup has been appointed by the Minnesota Department of Health to look at making recommendations to the legislature for next session. LeadingAge MN has an appointee to the workgroup, and we expect legislation to come out of this group next year.
Swing Beds/Hospital Discharge
Another unresolved issue in 2016 was the proposal to increase the state limit on swing bed days in critical access hospitals. While a workgroup was not legislatively mandated, LeadingAge MN made commitments to continue to working on this issue over the interim, and currently we are working with the Office of LTC Ombudsman, who plans to convene a working group on swing beds as well as hospital discharge procedures.
Property Reimbursement Reform for Care Centers
Another unfinished aspect of senior care reimbursement reform was the reform of the care center property reimbursement system. Currently, appraisals are underway of all care centers to help inform this work, and LeadingAge MN and our members are actively involved in a DHS stakeholder group on this issue.
All of these efforts could result in legislation in the 2016 session. In addition, LeadingAge MN is actively involved in other state agency initiatives, including the continued discussion about Food Code revisions, implementation of the CMS Settings Rule, and the Disability Rate Setting Methodology revisions.
2017 will be a budget year, where the primary task of lawmakers will be to craft the state budget for the next two years. As you can see, 2017 is shaping up to be significant in terms of the advocacy agenda that LeadingAge MN will present. We will count on members to help us with these efforts again next year, building upon the strong grassroots advocacy over the past two years.
The 90th Legislative session will begin January 3, 2017.