This week’s Concord Monitor, and the Laconia Citizen, ran an Op Ed written by Home Care Association of New Hampshire CEO Gina Balkus discussing the underfunding of CFI long term care services for the elderly in New Hampshire.
SB 8 – Funding for Nursing Homes and CFI
In mid-March, the NH Senate passed SB 8 — which prevents NH DHHS from taking any funds from nursing homes and home and community-based services to fill a current budget deficit. This was in response to a DHHS proposal to use “unexpended funds” from long-term care services appropriations to fulfill a Legislative mandate to cut $7 million in general (state) funds. Of the $7 million, $1.9 million would come from nursing home funds and $5.1 million from home and community based care (CFI). Keep in mind that general funds are matched with federal funds, so a $5.1 million cut in general funds results in a $10.2 million total cut.
When SB 8 crossed over to the House, GSHHA supported the bill. Gina Balkus and GSHHA lobbyist Valerie Acres testified before the full Finance Committee and its HHS subcommittee. Last week, the House passed an amended version of SB 8. This version returns all the nursing home surplus to nursing homes (which an existing law already requires) and provides a one-time, retroactive 2% increase to CFI providers, based on their SFY 2015 CFI billings. The balance of the CFI “surplus” would be used to fill the budget deficit.
Governor Hassan issued a news release signaling her support for the House version of SB 8. The bill must now go back to the Senate, which can choose to concur with the House version, non-concur and request a conference committee, or kill the bill. It is uncertain what the Senate will do, but Senate Finance Committee Chairwoman Jeanie Forrester has been very vocal that CFI funds should only be used for CFI services.
Granite State Home Health Association is working diligently on this issue. We will do our best to keep you posted on this complex, very fluid situation. To make things even more complicated, the Senate version of SB 8 has been embedded in the House version of HB 2 (the budget trailer bill.) Therefore, the House has now adopted two completely different positions on the same issue.
HB 1 and HB 2 – The State Budget
On May 1st, GSHHA was asked to brief the Senate Finance Committee about CFI funding. Gina Balkus and Valerie Acres walked Senators through DHHS’s long history of ignoring the home health rate-setting law and rules, and explained the challenges for providers and public policy ramifications for long term care. GSSHA recommended specific rate increases for CFI RN visits, home health aide services, PCSPs and homemaker services. Our recommendations were based on an analysis by BerryDunn of what the CFI rates would be if the Medicare home health market basket index was applied to CFI rates since 2010 (the last time there was a slight rate adjustment for some services) as required by current law. We also asked for equity between CFI PCSP rates and Medicaid PCA rates.