Becerra Addresses Top Aging Issues Before House Committee

by Libbie Chapuran, LAMN

On March 28, US Health and Human Services Secretary Xavier Becerra appeared before the House Ways and Means Committee to discuss the President’s FY24 budget proposal. Top aging services issues were discussed, such as the Three-Day Hospital Stay Requirement, Nursing Home Mandatory Staffing Ratios, and Home and Community Based Services (HCBS).

Here are a few highlights from the hearing:

  • Representative Linda Sánchez (D-CA) praised the budget proposal to add $150 billion to fund Medicaid home and community-based services but emphasized that given the aging demographics and need for personal care services amongst our aging population, expanding Medicaid HCBS was not enough to solve the problem. She pressed Secretary Becerra to think about how to fund necessary long-term care outside of the Medicaid program (the only government funding mechanism currently).
  • Representative Adrian Smith (R-NE) asked about some COVID waivers, including the three-day stay, and the impact of these waivers ending with the Public Health Emergency on access to care. Secretary Becerra indicated he would need Congress’s help, and we will follow up with Rep. Smith to pursue his interest.
  • Several members asked about the President’s nursing home reform proposal. The Secretary spoke a lot about the transparency rule and the budget request for more money for program integrity. He also mentioned this budget request in relation to hospice program integrity oversight.

House Human Services Committee Releases Omnibus Bill with Mixed Results for Senior Care

by Erin Huppert, LAMN

The Minnesota House Human Services Committee released its omnibus finance bill this week. The budget bill includes some priority legislation like Elderly Waiver funding and a PACE rate study but stops short of investing in skilled nursing care for older adults.

What’s in the bill for aging services

In a significant improvement from the Governor’s budget, the House Human Service Omnibus Bill proposes to invest $265 million over two years in Elderly Waiver services. This is a Long-Term Care Imperative legislative priority since investment in Elderly Waiver would more accurately reflect the cost of caring for seniors, benefiting adult day services, assisted living, and customized living under CADI and BI waivers.

Additional aging services provisions include:

  • A DHS rate study for PACE, Program for All-Inclusive Care for the Elderly, and Imperative legislative priority.
  • Changes to the Board of Aging to develop a statewide tribal-based system for caring for Native Elders
  • Grants for Live Well at Home and Age Friendly Minnesota programs.

Nursing homes left out of House spending bill

Consistent with the Governor’s budget, the House Human Services Finance Omnibus Bill makes no additional investment for Minnesota’s nursing homes beyond a $4 million grant program for critical access nursing homes. With a $17.6 billion surplus, the House and Governor propose to spend less than 0.02% to help nursing homes pay their caregivers a livable wage and preserve access to care across the state.

On Tuesday, LeadingAge Minnesota CEO Kari Thurlow testified to the dangers of this piecemeal approach and leaving seniors out of One Minnesota.  “For years, we have advocated an infusion into Elderly Waiver.  We thank you for recognizing that insufficient funding results in inadequate wages for staff, less access for low-income seniors, and a growing affordability problem for the middle class,” she testified to the House Human Services Committee. “$330,000 a piece for 15 rural nursing homes using one-time money and a mechanism that just creates another funding cliff. That’s it. That will not stop the collapse of our nursing home sector. The final message to staff in nursing homes is that they should wait to earn a family-sustaining wage … It is simply not inaccurate to state that nursing home workers are ‘better off’ compared to other caring professions.”

What happens next?

This is one more step in the process, so we have time to advocate for changes in the bill. The committee will amend its bill today and move to its next stop.

All members of the House will ultimately vote on it after they return from spring break in mid-April. Ahead of each stop, we will continue increasing pressure and accountability to ensure that seniors are genuinely part of “One Minnesota.”

What can you do?

There is still time to take action by contacting your House Representative. Next week, legislators are returning home to their districts. This means many of them will be hosting community town halls or forums to engage with constituents.

If you don’t follow your local senator and representative on social media or subscribe to their newsletter, please consider it. Those channels will provide information on when, where, and how to participate. 

Please make time to attend, and ensure they know seniors must be part of One Minnesota. Their caregivers need $1 billion over four years to raise wages by $5 per hour. To learn more about town halls, check out this resource link.

Take Action Today

“I believe that the values of a community stand strong by where they put their resources. I ask the governor and the legislatures to put resources where our values really are, and that is with the elders.” – Cami Peterson-DeVries

Yesterday, Cami Peterson-DeVries, VP of Senior Services and Christine Bakke, Regional Director, advocated for our organization and all of the MN Senior Living industry.

What can you do?

There is still time to take action by contacting your Representative. Next week, legislators are returning home to their districts. This means many of them will be hosting community town halls or forums to engage with constituents.

If you don’t follow your local senator and representative on social media or subscribe to their newsletter, please consider it. Those channels will provide information on when, where, and how to participate.

Please make time to attend, and ensure they know seniors must be part of One Minnesota. Their caregivers need $1 billion over four years to raise wages by $5 per hour.

If you are unable to meet with your representatives, please send them a letter, by following this link:

New Housing Support Rate Effective July 1

On March 23, 2023 by Libbie Chapuran, LAMN

On July 1, the Housing Support maximum monthly room and board rate will increase to $1,135.

The annual recalculation of the Housing Support, formerly Group Residential Housing (GRH), which covers rent and raw food for eligible participants, will increase by $94 per month. The new rate of $1135 will be effective July 1, 2023 through June 30, 2024.

Housing Support is a state-funded program that provides an income supplement to approximately 20,000 recipients each month to pay for rent and food. The amount of a Housing Support payment is based on a federal and state standard of what an individual would need, at a minimum, to live in the community. All of those supported by the program are at risk of institutional placement or homelessness.

Legislative Leaders Announce Joint Budget Targets

On March 23, 2023 by Erin Huppert, LAMN

This week, legislative leaders and Governor Walz announced they had reached global budget targets for creating Minnesota’s biennial budget (FY2023-2025). This agreement sets the stage for the Legislature to spend the state’s $17.6 billion surplus. According to the agreement, human services has been given a $1.3 billion target for the two-year period, and health care an additional $755 million.

These targets come at a time when the legislative activity remains at an all-time high; the House and Senate both reached 3,000bill introductions this week, which has never happened in the first year of the biennium (based on records starting in 1983).

What do these targets mean for aging services?

The joint budget targets released this week leave many questions for seniors and their caregivers, like:

  • How much of this $1.3 billion is ongoing versus one-time funding?
  • Where will other proposals with financial considerations fall within these targets?

We need $1 billion over the next four years to get our caregivers a starting wage of $22 an hour. Other providers in human services also have deep needs, so we worry that $1.3 billion for all of human services is not close to enough to cover the severe needs of seniors, people with disabilities, and professional caregivers.

Committees will begin building their omnibus bills starting next week, so LeadingAge Minnesota is working closely with its Long-Term Care Imperative partner to gather more information on the specifics of these targets.

In the meantime, we must keep pressure on our state representatives and senators. The governor did not prioritize seniors and their caregivers in his proposed budget, so the Legislature needs to show leadership on this Minnesotan value. They need to make the most of that $1.3 budget target and, given a $17 billion surplus, determine if more can be done.  

Contact your local legislator today and ensure seniors are included in “One Minnesota.”

Bill Introduced to Add Assisted Living Services to Veteran Benefits

A bill introduced by US Senate Veterans Affairs Committee Chair Jon Tester (D-MT), along with Sens. Patty Murray (D-WA), Jerry Moran (R-KS), and Mike Rounds (R-SD) to add assisted living services to veterans benefits.

The Expanding Veterans’ Options for Long-Term Care Act would create a small pilot program to offer eligible veterans who participate the option to have their care needs met in an assisted living community rather than at a Department of Veterans Affairs state home.

Currently, VA is not allowed to pay for room and board fees for veterans living at assisted living facilities—preventing many veterans from utilizing this long-term care option. This pilot program will save taxpayer dollars by allowing eligible veterans to access the appropriate level of care for their needs at assisted living facilities, instead of having to seek more costly care at nursing homes.

press release about the bill includes a quote from our national partners LeadingAge and Argentum, along with other aging services associations: “The leading organizations that represent the assisted living profession applaud the leadership of Sen Tester, Moran, Murray, and Rounds for introducing this legislation. This pilot program makes sense for a number of reasons: it offers a new option in long-term care for veterans, creates significant savings for the Department of Veterans Affairs, and will demonstrate the numerous benefits of assisted living. The VA’s daunting cost estimates for long-term care, both current and in the future, illustrate the need for policies that mitigate the significant financial burden. We are encouraged by this legislation to jump-start these efforts.”

The Senators’ bill received strong backing from various Veterans Service Organizations (VSOs) and stakeholders nationwide.

Tell Congress to Eliminate the 3-Day Hospital Stay Requirement for Skilled Nursing Care

Federal law requires an inpatient hospital stay for three consecutive days before Medicare will cover a patient’s care in a Skilled Nursing Facility (SNF). However, this three-day qualifying hospital stay requirement has become antiquated and onerous for patients and providers as the care landscape has changed in the nearly 60 years since Medicare was enacted.

The three-day qualifying hospital stay requirement was waived in 2020 during the pandemic, and beneficiaries who otherwise qualified for skilled nursing care received it—regardless of spending any amount of time in the hospital.

With the public health emergency set to end on May 11, now is the time to take legislative action to fix this unnecessary requirement permanently.

Tell Congress to eliminate the three-day stay requirement once and for all. Take action now!

Primary Election Day in MN

Tomorrow is Primary Election Day in Minnesota. A primary election determines which candidates will be on the ballot in November for the General Election. This August, voters will see partisan offices, like House, Senate or Governor, up for election and non-partisan offices, like county commissioner and municipal office races.

St. Francis Health Services encourages all Minnesotans, including those living and serving in long-term care settings, to exercise their right to vote. Democracy is stronger when we all engage. With one million seniors in Minnesota, now is the time to ensure that their needs are represented by policymakers in St. Paul and Washington, DC.

In Minnesota, you may register at least 21 days before Election Day, or you may register on Primary Day/Election Day at your polling place. Check out or download this factsheet on what you will need to register at a polling place on Tuesday. Note that for residents of long-term care settings, a staff person is permitted to go with residents to a precinct polling location to confirm a resident’s address. Learn more about helping residents exercise their right to vote here.