SENATE BILL REPORT
EHB 1564
This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent. |
As of March 18, 2019
Title: An act relating to the nursing facility medicaid payment system.
Brief Description: Concerning the nursing facility medicaid payment system.
Sponsors: Representatives Macri, Schmick, Cody, Tharinger, Jinkins, Kilduff, Appleton and Lekanoff; by request of Department of Social and Health Services.
Brief History: Passed House: 3/08/19, 98-0.
Committee Activity: Health & Long Term Care: 3/18/19.
Brief Summary of Bill |
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SENATE COMMITTEE ON HEALTH & LONG TERM CARE |
Staff: LeighBeth Merrick (786-7445)
Background: Long-term services and supports are for individuals who need assistance with daily living tasks such as bathing, dressing, ambulation, transfers, toileting, medication assistance or administration, personal hygiene, transportation, and other health-related tasks. The Department of Social and Health Services (DSHS) administers Medicaid funded long-term services and supports to eligible individuals in Washington State. Individuals may receive these services in their home, in an adult day center, in an adult family, in an assisted living facility, or in a nursing home.
There are currently 196 nursing homes licensed in Washington to serve about 9700 Medicaid clients. Nursing homes are licensed by DSHS and provide 24-hour supervised nursing care, personal care, therapies, nutrition management, organized activities, social services, laundry services, and room and board to three or more residents.
Medicaid Rate Methodology for Nursing Homes. The Medicaid nursing home payment system is administered by DSHS. The Medicaid rates in Washington are unique to each facility and reflect the client acuity—sometimes called the case mix—of each facility's residents. In 2015 and 2016, the Legislature modified the nursing home rate methodology. Any Medicaid payments to nursing homes made after June 30, 2016, must be based on the new methodology.
Medicaid payments for nursing home residents are shared by the state and federal governments at the state's Federal Matching Assistance Percentage (FMAP) rate. The current FMAP rate in Washington is 50 percent.
Tribal Nursing Homes. Washington's 29 federally recognized Indian tribes, as well as tribal organizations and the federal Indian Health Service, may operate nursing homes. Currently, only the Confederated Tribes of the Colville Nation operates a nursing home. Tribal nursing homes in Washington are subject to the same Medicaid rate methodology as all other nursing homes. The federal Centers for Medicare and Medicaid Services (CMS) permit alternate or enhanced rates for American Indian/Alaska Native clients in tribal nursing homes. It may also reimburse for such services with 100 percent federal funding rather than at the standard 50 percent.
Summary of Bill: Numerous technical corrections are made to the nursing home rate methodology statute to clarify terms and modify dates.
Nursing homes operated by the federal Indian Health Service, a tribe, or a tribal organization are exempt from the state's Medicaid nursing home rate methodology, and may be paid at alternate rates subject to CMS approval. DSHS may adopt emergency rules to implement this provision.
Appropriation: None.
Fiscal Note: Available.
Creates Committee/Commission/Task Force that includes Legislative members: No.
Effective Date: Ninety days after adjournment of session in which bill is passed.
Staff Summary of Public Testimony: PRO: It is important that the long-term care system is adequately resourced so that it can provide the necessary care. This bill is agency request legislation, and ensures that there is access to nursing home care in rural areas and helps address health disparities. There is one tribal nursing home in the state, and it is struggling to maintain operations under the current Medicaid payment methodology. Tribes are working to keep their elders in their community. By 2030, the number of Native American elders is expected to be two and half times more than it was in 2012. Tribal nursing facilities are rare, but an enhanced rate would allow more tribes to provide nursing home care so that tribal elders can receive care in their community. These nursing homes also create jobs within in the tribe so that tribe members can care for their elders.
Persons Testifying: PRO: Representative Nicole Macri, Prime Sponsor; Michael Moran, Confederated Tribes of the Colville Reservation; Janet Nicholson, Confederated Tribes of the Colville Reservation; Andy Joseph, Confederated Tribes of the Colville Reservation; Bea Rector, Department of Social and Health Services.
Persons Signed In To Testify But Not Testifying: No one.