2024 Oregon Long Term Care State Report www.ohca.com 22 Policy Priorities The Oregon Legislature must reassert its commitment to services for low-income older adults and people with disabilities by making investments in Medicaid long term services and supports in the 2025–27 biennium. In the wake of the COVID-19 pandemic, a workforce crisis, and mounting new regulatory requirements, providers are struggling to keep up with the rising cost of care, continue to raise caregiver wages and benefits, and address the needs of all Oregonians. Here’s what the Legislature can do to support the long term care agenda in 2025–27: Invest in Medicaid Long Term Services and Supports: Low-income older adults and people with disabilities rely on Oregon’s Medicaid program to get the care they need, when they need it, in the setting of their choice. Currently, reimbursement to long term care providers through Medicaid is underfunded and needs to be increased. � Approve cost-of-living-adjustments for in-home care agencies and community-based care facilities. This may also include reimagining underlying rate models for home and community-based services to ensure rates truly meet the rising cost to provide care statewide to increasingly complex and highneed residents. � Approve full re-basing of rates for nursing facilities in accordance with the Medicaid rate methodology in Oregon law. � Oregon has some of the highest direct caregiver wages in the nation, and the average caregiver wage is now 20% higher than Oregon’s standard minimum wage. We want to continue to grow wages for this valuable workforce and encourage the Legislature to help fund wage growth through wage add-on programs, which have been successful in the past in helping providers with fixed revenues afford ongoing wage growth. Improve State Systems to Advance Accountability and Efficiency: Removing systemic barriers to accessing affordable care, aligning the regulatory burden put on providers with what is needed for the best quality care outcomes, and ensuring state agencies have appropriate resources to achieve their core missions are the only way to ensure our system is able to meet impending demand. � Streamline and expedite the Medicaid application and eligibility assessment process. Oregonians currently wait too long and navigate far too complicated processes to receive Medicaid benefits. This exacerbates hospital discharge backlogs to post-acute settings and harms individual and families who need care. � Ensure providers are reimbursed on-time for care provided to Medicaid beneficiaries. Currently, some providers are not paid on time or at all for services, creating backlogs of unpaid bills, and putting providers in challenging financial positions. Address the Nursing Crisis: Oregon must address critical nurse workforce shortages and provide funding for increased nurse requirements to enable facilities to maintain capacity and access to care. � Increase nurse faculty salaries to reduce the discrepancy in compensation between educational and clinical settings and enhance incentives for nurses to work as instructors. � Better promote, fund, and support programs for clinical placements or nurse mentorship in long term care settings for nursing students. � Explore establishing loan forgiveness programs for nurses who pursue careers in long term care after graduation.
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