Overview
Over the course of the 60-day 2024 legislative session, lawmakers considered a plethora of policy issues and crafted a Supplemental Operating Budget that builds upon the 7/1/23-6/30/25 State Operating Budget passed in the 105-day 2023 session.
Our goals this session included improvements in Medicaid funding for assisted living clients and passage of SSB 5802, legislation to permit orderly implementation of the Patient Driven Payment Model (PDPM) for skilled nursing facilities.
Because many of you made it a priority to weigh in with legislators on these important measures, we can report positive outcomes in both areas. Your advocacy efforts have been critical, and we are truly grateful for the strong and united front. While we understand our work is far from finished, we celebrate this progress and look forward to continuing to elevate your needs in subsequent sessions.
Please take a moment to thank your legislators for their support in the 2024 legislative session.
Assisted Living – Supplemental Budget Hits Three Important Notes
For assisted living providers serving Medicaid clients, there is additional relief in the supplemental budget:
- Base Medicaid payment rates are increased by 2.5 percent, bringing reimbursement for labor costs from 78 to 82 percent.
- Specialized Dementia Care daily rate add-on is increased from $43.48 to $50 per resident day.
- One-time bridge funding for high-Medicaid census facilities is expanded to provide a $20.99 add on for those providers serving a Medicaid resident census of more than 75 percent.
While we haven’t lost perspective that assisted living Medicaid rates need to be fully funded, we are grateful for the continued effort to fully implement the rates methodology adopted in 2018. We are thankful that funding for the July 1, 2024 rates rebase is also continued in the supplemental plan.
Skilled Nursing – SSB 5802 Passes, Paves Way for PDPM Implementation
For skilled nursing facilities, the passage of SSB 5802 is good news. The legislation authorizes a transition to the current federal data source which will be used to determine patient acuity scores to calculate Medicaid payments. The use of PDPM data will be phased in according to funding made available for that purpose. The supplemental budget allocates $7.7 million to support the initial implementation beginning July 1, 2024.
From here, WHCA will work with DSHS on casting July 1, 2024 rates using PDPM data. This is a first step, and we will be focused on a conservative transition that will not bring harm to providers. SSB 5802 includes amendments which require detailed stakeholder engagement to develop a phase-in plan. We appreciate the staged approach to implementation as necessary for mitigating significant rate swings.
The funding provided in the 2023-2025 Operating Budget for an annual rate rebase remains untouched in the supplemental budget.
Unfinished Business – HCBS Discharge Legislation Expected to Return in 2025
The issue of discharge appeal rights for residents in community-based settings – including assisted living, adult family homes, and enhanced services facilities – continues to face scrutiny in Olympia. The 2024 session contained an effort to pass HB 1859, which would have extended all skilled nursing facility resident rights to residential care settings. The legislation failed to advance beyond the committee stage amid opposition from WHCA and other stakeholders.
There are pronounced differences in the types of care offered between skilled nursing facilities and residential care settings in Washington, and the current legislation fails to recognize statutory limitations on the care that can be provided. The Washington LTC Ombuds Program had petitioned DSHS and the Governor’s office to engage in rulemaking around this issue. Both declined because of the lack of statutory direction about those rights.
WHCA is continuing to educate key lawmakers around this issue and shape further legislation that may arise in the 2025 session. We will keep you apprised of our work in this area.
Stay Engaged in the Interim
Rep. Ed Abbarno visits Chehalis West AL for a facility tour in December of 2023.
Session may be over, but our work as advocates continues to be essential in the interim. Your engagement is critical; whether through responding to WHCA’s action alerts or partnering with our Government Relations team to host a facility tour, lawmakers must hear from you. The foundation we build from now until January is integral to our success in the 2025 session and beyond.
Watch for WHCA’s action alerts and Advocacy Exchange newsletter on the third Tuesday of every month. If you have questions, ideas, or any other advocacy-related needs, reach out to Eric Negomir.