The Oregon Caregiver FALL/WINTER 2024 www.ohca.com 18 $20 billion in 2017–19 to just over $31 billion in 2023–25. Underlying this budget growth is the fact that the legislature recently approved new programs that have not yet been fully paid for. Other factors effecting the budget include: • Medicaid caseloads are high, • Devastating wildfires have ravaged the region summer after summer causing large spikes in prevention and recovery costs, • Housing and homelessness remains a major concern, • Oregon’s public schools are underperforming, and • The legislature must fund another transportation package in 2025 to keep up with the maintenance of roads, bridges, and other infrastructure. To make matters even more complex, it is assured that Oregon’s unique “kicker” tax law will again be triggered, siphoning off about $1 billion of General Fund monies back to taxpayers that would otherwise be used to fund program and service requirements. Long Term Care Impact With all this in mind, the biggest budget risk for long term care next session is the potential risk of cuts to Medicaid reimbursement rates from policymakers looking to reduce spending or reallocate funding to other priorities. We know that reducing or maintaining Medicaid rates, and not increasing them to keep up with inflationary care costs, reduces access to care for low-income Oregon seniors, and so OHCA will be focused on ensuring that is not the outcome. Through our advocacy program, OHCA has been able to translate strong budget years into historic, double-digit Medicaid rate increases for the sector. These increases came at a time when labor and medical supply costs were soaring and enabled many of our members to continue to operate and provide care during this challenging economic time. In the 2025 session, we will make the case that funding for Medicaid long term services and supports is a core service delivery area for the state, and that any cuts will result in tragic impacts for low and middle-income seniors that need care in their homes or in a licensed setting. Workforce Standards Board Beyond the budget, OHCA will be focused on defending against legislation that would create a home and community-based services workforce standards board in Oregon, which would likely be harmful to the sector’s ability to provide affordable care depending on how it was structured and the authorities it is provided under the law. Workforce standards boards have emerged in other states in recent years, but only three states have adopted them specifically for care-related workers and in different capacities than what the Oregon bill is pushing for. These boards are empowered by the legislature to set and enforce workplace standards— including wages, benefits, training, and safety—that cover all workers in a particular sector regardless of individual operator’s specific circumstances, locations, Medicaid mix, and other important factors that affect operators and organization budgets. OHCA has and will always support raising caregiver wages, improving workforce challenges in the long term care sector, and enhancing care outcomes for older adults. While we understand a workforce standards board is an idea some advocacy groups believe is best to address workforce shortages, OHCA is concerned about potential catastrophic, unintended consequences for consumers, providers, and the state, primarily care affordability and access to care in certain parts of the state. As always, we will call on our members to help us advocate effectively next session. The support and engagement of providers is central to our success, and we look forward to working with you once again as we can on both the opportunities and challenges of the next legislative session. Libby Batlan is the SVP of Government Relations at OHCA. »PUBLIC POLICY, CONT. PUBLIC POLICY OHCA has and will always support raising caregiver wages, improving workforce challenges in the long term care sector, and enhancing care outcomes for older adults.
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