Hosting facility tours for legislators is the single most effective way to advocate on behalf of your residents and staff — this toolkit will guide you step-by-step to make this essential action easy.
State lawmakers must have knowledge that runs a mile wide and an inch deep, so they rely on relevant experts to inform their decisions. This is especially true for long term care. As a local leader in long term care, you are an expert. Educating legislators about your work through a facility tour leads to meaningful improvements in the lives of your residents and staff.
This resource provides everything you need, from sample invites to thank you letters, to host a facility tour that both establishes you as a trusted expert and compels legislators to support your work.
Here are the steps:
- Find who represents you in Olympia by entering your facility’s address in the State’s District Finder. Research their bio and what committees they serve on and consider signing up for their newsletter.
- Email them the invite. Your legislators’ emails will follow this form: [firstname.lastname@leg.wa.gov]. Send invites to each legislator individually. Be sure to cc WHCA Grassroots Coordinator Eric Negomir (ericnegomir@whca.org). If you don’t hear back from your legislator within one week, follow up.
- Begin planning the tour. Ensure your staff and residents are prepared with talking points. If multiple legislators are scheduled to attend the same tour, make sure each person knows who else will be in attendance.
- Conduct your tour! This is easy with the preparation you have done in Step 3. Just tell your story and know your legislator is there because they want to help. Avoid partisan/politically charged language. Be brief and polite and ask them questions as well. Remember to take a few photos before, during, and after the tour.
- Post social media thanking the legislator for visiting. ‘Tag’ the legislator and WHCA if possible. Make sure to send a follow up thank you note, including any pictures featuring them, to the legislator. Consider also submitting a letter-to-the-editor for your local newspaper.
- Fill out this survey to let the WHCA team know how your tour went. This information is important to ensure your work has optimal impact.
As you move through the process, know that WHCA Government Relations Manager Eric Negomir (EricNegomir@whca.org) is standing by to assist you.
Lawmaker Invite
Subject: Invitation to Tour [Facility/Community Name]
Dear State Representative/Senator [Name]:
Thank you for supporting policies in the 2023 legislative session that benefit your constituent seniors and staff at my facility. However, more must be done to ensure we can provide the highest quality of care for all who need it. That’s why I am pleased to invite you to visit [Facility/Community Name], where we employ [Number] of your constituents and care for [Number] of residents. [If Medicaid-contracted: [Number] of these residents rely on Medicaid funding.] This visit will provide you with an opportunity to speak to residents, family members, and caregivers, and learn more about the importance of consistent, reliable long term care for all Washingtonians.
One of the most important efforts for Washington’s legislature is to ensure the long term care workforce is available to provide care to the growing population of individuals who require support. This tour will help you understand why your support for the long term care workforce is so important. At the same time, your support for equitable and adequate Medicaid funding to support the cost of long term care is important to this conversation.
Insufficient Medicaid funding threatens low-income seniors’ access to critically needed long term care services and drives a staffing crisis that must be addressed as our aging population places more demand on the long term care system. Bad policies can also imperil our ability to provide quality care.
I realize the enormity of the responsibility on our shoulders and the numerous issues you deal with as a lawmaker, which is why I want to be a resource for you. You should feel like you can turn to long term care professionals in your district, such as myself, when you have relevant policy questions.
We will work closely with you and your staff to plan a convenient tour when you are available. Please feel free to contact me directly at [Phone number] or [Email address] for more information on arranging a date and time.
Thank you for all you do for our community. I look forward to speaking with you soon and sharing ideas on safeguarding the care of our seniors.
Sincerely,
Name
Title
Facility
Email
Phone
CC: Eric Negomir (EricNegomir@whca.org)
Tour Outline (30-60 minutes)
Introductions (10-15 minutes):
- Welcome
- Intros of a few key staff
- Summary of your building (ie: number of employees, percentage of residents or patients on Medicaid, why you got into this field and have stayed)
- Importance of fully funding Medicaid and utilizing long term care professionals as an educational resource
Tour (15-30 minutes):
- Have your facility profile filled out to make it easier to answer questions along the way
- Prepare three to five employees and residents to speak to along the way (talking points provided)
- Challenges of finding and retaining staff at current wages
- Demand for care is rising and supply isn’t keeping pace
- Policies must reflect the practicalities of long term care
- Explain the importance of Medicaid to low-income seniors
- Costs have greatly increased in recent years
- Ask the lawmaker their thoughts and how you can help
Conclusion (5-10 minutes):
- Thank them for their time
- Offer to be a local resource for if/when policy issues arise next session
Facility Profile
Facility Name
Address
City, State Zip Phone Number
Administrator
Administrator Cell Number
About Facility
- Total Licensed Units
- Total FTE Employees
- Annual Payroll, Property and Personal Taxes
- Total Number of Residents Served Annually
- Total Number of Medicaid Clients Served Annually
About Our Residents
- Provide details about the people you serve – i.e., types of care needs, diagnoses, number of medications administered, where they admit from, anecdotes about how SNF care has been the answer for a family in need. Give a face to those you are serving.
About Our Workforce
- Job types (nursing staff, direct care staff, housekeeping, facilities maintenance, food services, regional staff support, etc.)
- Immigrants/English as a second language
- Age ranges and averages, percentage of female workers, challenges of the workforce
LTC Services and Supports Provided
Detail the services and activities provided to your clients, i.e., long term convalescent care, transitional nursing care, hospice services, physical and occupational therapy, specialized dementia care, assessments, care coordination, etc.
- Community Service/Awards/Activities
- Quality Award Recipient
- Best Employer/Best Places to Work
Talking Points
Core Messaging: 1.) Problem, 2.) Causes, 3.) Solutions
- Identify the Problem: There is, and will be, growing demand for long term care services without the ability to fully staff care.
[AL, SNF, ESF]:
-
- Although lawmakers’ work to address these issues is recognized and appreciated, we must continue momentum that restores the long term care workforce and ensures quality care for our most vulnerable.
- Washington’s population is aging, and a large and growing number of seniors lack adequate retirement savings. Vulnerable people are and will be reliant on Medicaid support. Private pay residents currently subsidize care for Medicaid clients – as the share of Medicaid clients increases, this will become even more unsustainable.
- When seniors don’t have supports at home, they rely on Washington’s long term care services.
- The Medicaid funding shortfall severely harms residents and patients, families and caregivers. (See funding specifics below.)
- The shortfall of nurses in Washington is severe and is expected to intensify.
- Statewide staffing shortages at long term care facilities mean caregivers are stretched to the limit – restricting access to long term care and reducing quality of care.
- When staff shortages force long term care facilities to turn people away, hospitals become backed-up and everyone is impacted.
- Washington’s low-income seniors and people with disabilities deserve quality long term care, regardless of payment source. By failing to address workforce challenges in long term care, the state is failing to meet its obligation to these constituents.
- Identify the Cause of the Problem: Insufficient Medicaid funding and workforce barriers limit access to, and quality of, long term care.
[AL, SNF, ESF]:
-
- Process barriers, such as limited training/certification opportunities and severe credentialing backlogs, make it difficult to hire and retain professional staff who provide care.
- State Medicaid funding covers only a portion of what it really costs to care for residents. Private pay residents make up the difference, which isn’t fair to them and limits Medicaid beneficiaries’ access to long term care.
- Long term care facilities pay nurses less than hospitals and other care settings – meaning long term care is hard-hit by the nursing shortage.
- The nurses and caregivers in long term care deserve fair wages and benefits. Being overworked and underpaid isn’t good for them or their residents.
[AL Medicaid]:
-
- For assisted living, Medicaid paid 68% of the hourly wages needed to care for a beneficiary. The 2023-2025 State Operating Budget increases that to 82% but that still does not reflect current labor and operating costs, which have grown tremendously in recent years years. Under these conditions, it is difficult for those who provide care to Medicaid beneficiaries to compete in the labor market.
- Without a budget that covers 100% of Medicaid labor costs, those who provide care to Medicaid beneficiaries will continue to struggle to compete in the labor market or provide the best possible care.
[SNF]:
-
- Nursing facilities provided over $620 million in uncompensated Medicaid care to Washington’s low-income patients from 2017-2022, and that funding shortfall continues to affect our ability to compete for qualified staff.
[ESF]:
-
- Enhanced services facilities care for individuals with complex behavioral, medical, chemical dependency and/or mental health needs. Policies and Medicaid rates must fully recognize the elevated number of staff required in this setting, as well as the challenge, skill, and variability involved in their work.
- Individuals are referred to enhanced services facilities if they are transitioning out of psychiatric hospitals or have no other placement options due to their complex care needs. Investing in support for enhanced services facilities generates cost savings and addresses a problematic gap in Washington’s health care system.
- Identify Solutions: Remove barriers to growing the long term care workforce.
[AL, SNF, ESF]:
-
- Long term care operators are your friends and neighbors. We hope you’ll look to us as trusted experts when making decisions.
- Training and certification opportunities for long term care professionals must be made more available. Worker-friendly regulations and increased state funding can accomplish this.
- The State Operating Budget must provide Medicaid funding that completely covers the cost of care. Doing so will help not just patients, residents and caregivers, but all Washingtonians.
- Innovative workforce solutions, such as WHCA’s new NAC-to-LPN Apprenticeship Program, should be funded and encouraged.
Social Media
Hashtag:
#WhyICare
Sample posts:
#1: Thank you [Legislator name] for visiting [Facility/Community name] and supporting policies that benefit WA’s seniors, patients and residents at our facilities. More must be done to ensure we can provide the highest quality care for all. Fully fund #Medicaid and show constituents #WhyICare about long term care. [WHCA Tag] [Photo] [WHCA Tag]
#2: Washington’s low-income seniors deserve quality long term care. There is a great human cost to patients, residents, their families and caregivers when #Medicaid is inadequately funded, which is #WhyICare. Thank you [Legislator name] for meeting with us and hearing concerns. [WHCA Tag] [Photo]
#3: Washington’s population is aging and the state’s #Medicaid budget is not keeping pace with demand. Thank you [Legislator name] for recognizing the urgency of this issue and working with us to address funding shortfalls. Show seniors #WhyICare about long term care. [WHCA Tag] [Photo]
WHCA Tags:
Instagram: @whcacares
Facebook: @WashingtonHealthCareAssociation
LinkedIn: @WashingtonHealthCareAssociation
Twitter (X): @WHCAcares
Thank You Note to Lawmaker
Dear State Representative/Senator [Name]:
On behalf of our staff, residents, patients, and their families, thank you for taking the time in your busy schedule to visit [Facility/Community name]. Everyone here greatly enjoyed meeting you and are grateful for your support and commitment to issues affecting the quality and future of long term care in our community.
[Personal comment from tour: ie: your comments on the need to fully fund Medicaid had a lasting impression on me. We’re lucky to have you representing us in the state Capitol.]
Fully funding Medicaid is critical to serving all Washingtonians who need long term care because it allows facilities to care for more people and pay competitive wages to address the nurse and caregiver staffing crisis. I recognize your responsibility and challenge to be informed about the many issues you must make decisions on, so when you have relevant policy questions, I hope you feel like you can turn to long term care professionals in your district such as myself. If I can be of any assistance when technically complex issues involving long term care are before you, please call on me any time.
I look forward to speaking with you again soon and sharing ideas on safeguarding the care of our residents and patients. Let me know if you’d like me to facilitate an employee or resident roundtable for you or if you’d like to attend our upcoming [BBQ, luau, trivia night, holiday party, etc.] Also attached are some photos we took during your tour in case you’d like to share them and any information you learned in a constituent newsletter.
Sincerely,
Name
Title
Facility
Email
Phone
CC: Eric Negomir (EricNegomir@whca.org)
Letter to the Editor
Washington’s population is aging and the state’s Medicaid budget is not keeping pace with demand. According to the U.S. Census in 2020, Washington was home to more than 1.2 million residents over 65 years old, accounting for 16% of the state population. This number is expected to grow to more than 20% in the next few years.
Inadequate state funding is fueling a nursing and caregiver staffing crisis, threatening access to critically needed health and long term care for low-income seniors. While state lawmakers provided an additional $170 million in the 2023-2025 operating budget, more still needs to be done to fully fund Medicaid, which would allow facilities to care for more people and pay competitive wages to nurses and caregivers. When legislators consider policies, they should turn to professionals for education, which is why I’m grateful [Legislator name] recently visited [Facility/Community name] to hear from our staff, residents and patients.
We appreciate [Legislator name] supporting policies in the 2023 legislative session that benefit Washington’s seniors. However, more must be done to ensure we can provide the highest quality of care for all. These are your parents, grandparents and neighbors, and will soon be us. Now is the time to invest in the future of long term care.