VHCA-VCAL successfully advocated for Virginia’s nursing facilities and assisted living facilities during the 2020 General Assembly session. As a result, the association-backed bill on assisted living individualized service plans is headed to the governor’s desk for signature and an auxiliary grant increase was included in the budget. VHCA-VCAL also weighed in on bills related to staffing, minimum wage, employment issues, and more.

The General Assembly will return to Richmond on April 22 for its reconvened session to consider any amendments Gov. Ralph Northam may have to legislation or the budget.

Highlights of assisted living bills tracked by VHCA-VCAL include: 

Budget Items  

Auxiliary Grant Increase – 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. 

Adult Dental Medicaid Benefit – The Senate budget included $34 million in general funds over the biennium for an adult dental benefit under Medicaid. Securing funding for this benefit is a key priority of the Virginia Health Catalyst (VHC), formerly known as the Virginia Oral Health Coalition; VHCA-VCAL has been an active participant in VHC’s advocacy efforts in recent years as dental care is often cited as the most frequent unmet need of older adults.

AL-Related Legislation

Assisted Living Individualized Service Plans (ISPs) – VHCA-VCAL requested that Gov. Ralph Northam sign SB 686, the bill to require only documentation in individual service plans (ISPs) of “significant change” of condition, not any change. SB 686 will improve staff efficiency and encourage more time spent on direct care by only requiring documentation of a significant change to a resident’s condition in a resident’s individualized service plans (ISP). Under current regulations, if any aspect of the resident’s condition changes, the resident or his/her responsible party and facility staff need to sign to affirm those changes to the ISP. VHCA-VCAL and other assisted living stakeholders supported the bill. It passed the House and Senate unanimously.

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 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, the bill that helps to clarify the role nursing facility and assisted living facility staff can play in administering CBD or THC-A to residents or patients who have a valid, written certification for these medications, is awaiting action by the governor.

Employment Bills

Minimum Wage – The General Assembly passed a minimum wage increase (HB 395 and SB 7). We anticipate that Gov. Ralph Northam will support this legislation as he has publicly signaled support for a minimum wage increase. The compromise legislation will increase the hourly wage as follows:

• • January 1, 2021: $9.50 / hour
  • January 1, 2022: $11.00 / hour
  • January 1, 2023: $12.00 / hour

The bill also includes language directing the Virginia’s Department of Housing and Community Development, Economic Development Partnership Authority and Employment Commission to conduct a study in 2022 about the effects of the minimum wage and also consider whether a regional approach would be useful and how it would be done.

If wages are to rise further, legislators would have to pass a measure to reenact the legislation for increases to $13.50 in 2024 and $15.00 in 2025. If the General Assembly opts to keep the minimum wage at $12.00 per hour, it would be linked to the CPI-U for 2024 forward. If wages are increased to $15.00, the indexing will begin after 2025.

We will be discussing with DMAS how the added wage costs will be captured in the rate setting process; the fiscal year 2021 rates have not been adjusted for the six months of the increased wage at $9.50 per hour.

Right-to-Work – These bills, which VHCA-VCAL and the business community opposed, are dead for the year. The bill to repeal the Right-to-Work statute, 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 before crossover.

Paid Sick Leave – Although a paid sick leave measure passed the House and Senate, the Senate ultimately chose not to vote on the conference report ironing out the differences between the House and Senate amendments. SB 481 would have required public and private employers with 15 or more employees to provide employees with an hour of paid sick time for every 30 hours they work. Other bills related to paid family and medical leave (HB 825 and SB 770) and earned sick leave (HB 898) died before crossover.

Workers’ compensation for repetitive motion injuries – VHCA-VCAL opposed 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.

Workers’ compensation for psychological injuries – HB 1596 Workers’ compensation for psychological injuries was incorporated into a bill that only applies to law enforcement and firefighters; VHCA-VCAL wrote a letter to the patron in opposition to the bill as introduced.