The Oregon Caregiver SPRING/SUMMER 2023 www.ohca.com 14 PUBLIC POLICY What a New Legislature Means for Long Term Care By Libby Batlan, Oregon Health Care Association Oregon’s legislative session has been underway since January and must adjourn by the end of June. Since the Legislature will still be in session at the time this article is published, the final outcomes are not yet known. However, this article offers a look at what the OHCA government relations team has been focused on this session and what likely outcomes may be. Every Oregon Legislative session is unique. The 2023 session so far brought another “walkout” from Senate Republicans starting in mid-May, which has intensified the unpredictability and cadence of session. It has also brought new legislators to the process. Many legislators are serving in their first term, with even more serving in their first in-person session since the beginning of the pandemic in 2020. During the 2022 election cycle, many longstanding policymakers retired or moved on to different opportunities. This was particularly true for individuals who served in leadership roles, many of whom were in those roles for a significant period. For example, Peter Courtney, the longest-ever serving president of the Senate, retired and Tina Kotek, the former Speaker of the House, is Oregon’s new Governor. The wave of change impacted rank-andfile members in addition to those in leadership positions. Nearly one-third of the seats in the Oregon House of Representatives turned over, giving way to a new generation of legislators chairing key policy committees and budget subcommittees that impact long term care. Higher than normal turnover in the Legislature is a double-edged sword. It provides the opportunity to cultivate new champions for long term care and secure support for the sector. It also means there is significantly more work to do to fill in the deficit of knowledge to Oregon’s long term care system and the needs of OHCA members to be able to serve seniors, grow the workforce, and thrive. Medicaid Rates With a possible recession looming and a nearly $4 billion kicker tax credit to pay next year, lawmakers are operating in a more conservative budget environment and are faced with difficult choices this session. Last biennium, lawmakers had unprecedented amounts of federal funding—nearly $1 billion—to appropriate to programs and services. With that one-time money, the Legislature started new programs, including some for long term care, that now must end or take funding from other sources to stay operational. Over the last three years, OHCA was successful in securing multiple temporary Medicaid rate increases to ensure providers had the necessary resources to respond to COVID-19 and the worsening workforce shortage. Notably, those increases included a 5 percent COVID-19 Add-On for all providers and an Enhanced Wage Add-On (10 percent for community-based care facilities and in-home care agencies and 4 percent for nursing facilities). Both add-ons are scheduled to sunset on June 30, 2023. OHCA is advocating for the add-ons to be made permanent since the cost of care has been fundamentally reset at higher levels. Incorporating both add-ons into the base rate for home and community- based care providers, effective July 1, 2023, will provide true rate stability in the first year of the biennium. We are also asking for a 5 percent cost-of-living- adjustment (COLA) in the second year of the biennium, which would become effective July 1, 2024. For nursing facilities, OHCA is asking the Legislature to fully re-base rates at the 62nd percentile in accordance with the Oregon law. Support for long term care services is not a partisan issue. The sector has strong advocates amongst legislators and budget writers on both sides of the aisle. The challenge for legislators is primarily on funding and sustainability. Medicaid rate decisions will be finalized likely in late June when the Department of Human Services budget bill is adopted. Until then, OHCA will continue to advocate effectively on behalf of providers. Temporary Staffing Agency Costs and Quality Oregon continues to lead the way in reforming the temporary staffing agency industry. Long term care providers have experienced poor business practices and skyrocketing rates from some staffing agencies, which have negative outcomes for providers, workers, and consumers. House Bill 2665A is a central component of OHCA’s legislative agenda this session. The bill establishes annual maximum rates that temporary staffing agencies may charge providers as well as ensure staffing agencies are held accountable for deploying high quality, appropriately trained staff to long term care facilities and hospitals. Capping business-to-business contact rates through government action is a challenging proposition and tends to divide along party lines. Ultimately, OHCA’s advocacy for this bill is based on containing the cost of care for providers, ensuring care staff are treated equitably,
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