The General Assembly is past the half-way point of the 2020 session. Bills affecting assisted living facilities related to ISPs, audio-visual recording of residents, and the role of ALF staff in administering cannabidiol or THC-A to residents who have a valid, written certification for these medications are advancing through the legislative process. In addition, funding for an increase in the auxiliary grant (AG) of $92 ($12 for the required SSI increase and an additional $80) is on track with the release of the House and Senate budgets.

The AG funding increase was originally proposed by Gov. Ralph Northam in his introduced budget in December. VHCA-VCAL wrote to the governor in November 2019 to express support for the increase. The cost of this increase is being funded by unexpended balances in the program.  The House and the Senate are expected to send the budget to a conference committee later this week, setting up the process for budget negotiators to reconcile the differences between the two versions before sending the final budget on to the governor.

Highlights of ALF bills:   

Assisted Living Individualized Service Plans (ISPs) – VHCA-VCAL and other assisted living stakeholders have been calling for a tweak in the AL Standards on signature requirements when documenting a change in condition on an ISP since the updated standards were issued in 2018. SB 686 would direct DSS to make the necessary change. It passed the Senate unanimously and is on the docket to be heard by the Social Services subcommittee of the House Health, Welfare, and Institutions (HWI) Committee.  

Regulations to allow audio-visual recording of ALF residents – SB 355 would direct the Board of Social Services to promulgate regulations by July 1, 2021, governing audio-visual recording of residents in ALFs, and requires DSS to convene a workgroup of stakeholders to make recommendations on such regulations by December 1, 2020. SB 355 has passed the Senate and is now on the HWI Committee’s Social Services subcommittee docket. This approach to audio-visual recording is intended to model the state regulations on the same topic for nursing facilities.

Possession of cannabidiol or THC-A in nursing homes or assisted living facilities – SB 185 has passed the Senate and has a positive recommendation from the HWI Committee’s Health subcommittee. The bill provides a clearer sense of the role staff can play in administering these items to residents or patients who have a valid, written certification for these medications. VHCA-VCAL worked closely with the bill patron, the Board of Nursing and the Board of Pharmacy to obtain clarification on the impact of this bill.

Other bills of interest to ALFs include:

Staffing Ratios – SB 397, which included language about staffing ratios, training and background checks, was rewritten directing the Virginia Department of Health to establish a work group that includes VHCA-VCAL and other stakeholders to look at increasing nursing facility workforce availability. This bill is now what is called a Section 1 bill, meaning it does not end up in the Code of Virginia. It has passed the Senate and will next be heard by the HWI Committee. HB 737 which would have set a minimum number of hours of direct care services in nursing facilities was left in the House Appropriations Committee. This means it is dead for the session.

Right-to-Work – These bills, which VHCA-VCAL and the business community opposed, are dead for the year. The repeal bill, HB 153, was left in committee without advancing for a vote on the House floor. SB 426, which would have allowed for fair share fees was killed by a bipartisan vote in the Senate Commerce and Labor Committee last week.

Minimum Wage Increase – The House and Senate have each passed different approaches to the wage increases. The current House bill, HB 395, calls for annual incremental increases beginning July 1 until the minimum wage reaches $15.00/hour in 2025. The Senate’s current approach in SB 7 is to raise wages on different schedules that vary by region across the state. While wages will eventually reach $15.00/hour and above across the state, the various regions will move up at different increments over time.

Increasing the minimum wage will have a significant fiscal impact on the Commonwealth and will therefore become part of the budget negotiations. Based on funding, it is likely that any passage of a minimum wage increase could look different than either of these bills in their current forms. VHCA-VCAL will continue to monitor this issue closely and share information with the budget negotiators on the impact to providers and the Medicaid program. 

Workers’ compensation for repetitive motion injuries – We wrote a letter of opposition to the bill patron of HB 617, which would have added repetitive motion injuries to the list of compensable injuries covered by workers’ compensation. The bill has been rewritten as a Section 1 bill directing the Workers’ Compensation Commission to engage a national research firm to examine the implications of covering repetitive motion injuries. It is awaiting consideration in the Senate.

Earned sick leave – The Senate has passed SB 481 requiring employers with six or more employees to provide those employees with earned paid sick time. The measure provides for an employee to earn at least one hour of paid sick leave benefit for every 30 hours worked. An employee shall not use more than 40 hours of earned paid sick time in a year, unless the employer selects a higher limit. It is awaiting consideration by the House Labor and Commerce Committee. A similar measure in the House, HB 898 received a favorable vote in the Labor and Commerce Committee and was referred to the House Appropriations Committee where it died. 

Dead Bills

• HB 737 – Mandated staffing ratios for nursing facilities: DEAD (left in committee)
• HB 825 – Paid family and medical leave: DEAD (left in committee)
• HB 898 – Earned sick leave: DEAD (left in committee)
• HB 1172 – Mandate for EHR in digital format: DEAD (stricken in committee; VHCA-VCAL wrote a letter to the patron in opposition)
• HB 1596 – Workers’ compensation for psychological injuries: DEAD (incorporated into a bill that only applies to law enforcement and firefighters; VHCA-VCAL wrote a letter to the patron in opposition)
• SB 770 – Paid family and medical leave: DEAD (passed by indefinitely in committee with a letter)

The House of Delegates and Virginia Senate have until March 7, the scheduled session adjournment, to pass bills in identical format to forward them to Gov. Ralph Northam for his consideration.