www.ohca.com SPRING/SUMMER 2024 The Oregon Caregiver 15 PUBLIC POLICY Resident Experience Drives Policy Priorities By Libby Batlan, Oregon Health Care Association Resident care is at the heart of everything we do at OHCA, including how we develop our legislative agendas. On March 7, Oregon concluded its most recent legislative session. Even-numbered years mean the Legislature meets for a shorter period of time—less than 35 days—with a focus on addressing urgent budget and policy needs. OHCA brought forward three bills with the goal of relieving regulatory burdens on providers and improving the resident experience in Oregon’s long term care system. House Bill (HB) 4122 is the next step forward in the years-long process to modernize and strengthen Oregon’s background check system. We heard stories from providers on a weekly basis about challenges with struggling to get background checks returned for individuals applying to be caregivers at their facilities or agencies. It is not uncommon for the State to take 30 to 45 days to process a background check. This inefficiency exacerbates the workforce shortage and has been contributing to the issue we’ve seen with a “staffed-bed” capacity being lower than a facility’s true capacity, due to a lack of qualified staff. What happens when background checks get backlogged is that applicants may abandon careers in long term care for other employment opportunities where a background check is not needed, and, thus, they can start working sooner. HB 4122 will bring Rap Back to Oregon, which, once fully funded and implemented in 2025, is the long-term solution to Oregon’s background check woes. Rap Back stands for “Record of Arrest and Prosecution Back.” It is a fingerprint-based system that allows for the state to connect to the FBI’s background check database; it continuously checks enrolled employees’ records against incoming arrest or conviction information. This eliminates the need for background re-checks over time and enhances consumer safety. Ultimately, making Oregon a “Rap Back” state is the most efficient and thorough way to fix what is broken with our state’s system. However, it will require frontend work from providers and workers to come into compliance with its protocols. Notably, every caregiver subject to background checks by law—both current and prospective—will need to be fingerprinted. OHCA will keep our members updated as Rap Back is implemented. The second staffing-related bill OHCA championed this session is Senate Bill (SB) 1521, which makes critical changes to acuity-based staffing requirements (ABST) for assisted living, residential care, and memory care communities. The recent implementation of acuity- based staffing tool (ABST) mandates in community-based care settings by the Oregon Department of Human Services (ODHS) resulted in many challenges and an inordinate number of conditions being placed on provider’s licenses despite their best efforts to comply. SB 1521 aims to accomplish three key things: • Clarify that ODHS is only required to place a condition on a facility’s license for substantive issues related to a facility’s use of an ABST or for the insufficiency of staffing levels to meet the residents’ scheduled and unscheduled needs, 24/7. This is aimed at reducing the instances of facilities receiving conditions on their licenses for ABST violations if the conditions are related to technical issues with the tool. • Require ODHS to consider the impact and administrative burden on facilities before changing rules around minimum requirements and design of an ABST to help ensure compliance targets do not change on a whim. • Remove the requirement that a facility with an ABST-related condition on its license be continuously monitored for six months and replaces it with a requirement that the continuous monitoring may be lifted once the department removes the condition. Lastly, OHCA was successful in extending the nursing facility provider assessment through HB 4033. Under the bill, the assessment will be extended for six more years to 2032. Since the assessment is a key component of Oregon’s Medicaid rate-setting methodology for nursing facilities, the passage of HB 4033 provides certainty and stability for these facilities and ensures that Oregon’s innovative and success rate-setting process will continue for the near future. All nursing facilities in Oregon except for the two Oregon Veteran’s Homes pay the assessment and most see a net benefit from their investment. Taken together, we believe these bills will improve and support the experiences of residents receiving care in long term care communities across the state. We know that in order for Oregon’s long term care system to thrive we need appropriate regulatory actions and adequate funding, and this will continue to drive our policy efforts in upcoming sessions. Libby Batlan is the SVP of Government Relations at OHCA.
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