1 Public Policy Update Annual Conference June 17, 2015

2 Agenda Harrisburg Happenings Harrisburg Happenings Advocacy and You Advocacy and You LeadingAge PA Government Affairs Team LeadingAge PA Government Affairs Team

3 Harrisburg Happenings 2015/2016 State Budget 2015/2016 State Budget Other Bills to Watch Other Bills to Watch Other Issues of Interest Other Issues of Interest

4 2015/2016 State Budget

5 Budget - In General Structural Budget Deficit Between $1B & $2B

6 In General Major Themes of Governor Wolf’s Executive Budget Jobs that Pay Schools that Teach Government that Works Funding Request of the Wolf Proposed Budget $29.9B in State Funds - $78.6B in Total Funds Increase of $777M or 2.65% in State Funds over what is available this year HB 1125 and SB 810

7 Governor’s Request Long Term Living Funding Request $1.7B in State Funds - $5.8B in Total Funds Request does not include rate increases Request includes additional funding for 3,372 more individuals to be served in the community

8 House Budget HB Adolph (R-Delaware)

9 Governor’s Policy Initiatives of Interest Increase the Minimum Wage from $7.25 to $10.10 SB 195 – Tartaglione (D – Philadelphia) HB 250 – Kim (D - Dauphin) Other Minimum Wage Bills SB 836 – Leach (D – Montgomery) $7.25 to $15 SEIU proposal SB 610 – Wagner (R – York) $ $8.75 over three years - $.50 increments

10 Governor’s Policy Initiatives of Interest Taxes Increase to the Personal Income Tax from 3.07% to 3.7% Increase and Expand Sales Tax Increase from 6.0% to 6.6% Expand to include Non-Prescription Drugs, Home Health Care Services, Nursing and Residential Care Facility Services, Other Ambulatory Health Care Services, Social Assistance, Personal Care Services, Other Personal Services Decrease in Property Tax and some other Business

11 House Response to Governor’s Tax Plan HB 860 – Saylor (R – York) HB 283 – Keller (R – Snyder/Union)

12 Governor’s Initiatives to Improve HCBS for Seniors Expand Services to Older Pennsylvanians and Reduce Long Term Care Costs Rebalance the System – 50% of individuals in Home and Community Based Service and 50% of individuals in facility based care Serve 5,500 more individuals in the Community (3,372 in OLTL Budget) Save $162.2 M in NF costs

13 Governor’s Initiatives to Improve HCBS for Seniors Phase in Medicaid Long Term Care Managed Care - MLTSS Discussion Document – June 1, 2015 Public Comment through July 1, 2015 Phase 1 – Southwest – January 1, 2017 Phase 2 – Southeast – January 1, 2018 Phase 3 – Rest of State – January 1, 2019

14 MLTSS – Program Components Person-Centered Program Design and Service Plan Development Services and Supports Coordination Access to Qualified Providers Emphasis on HCBS Performance-based Payment Incentives Participant Education & Enrollment Supports Preventative Services Participant Protections Quality & Outcomes-Based Focus

15 Governor’s Initiatives to Improve HCBS for Seniors Improve LTL Waiver Enrollment and Service Plan Development Process Home Modifications through Selective Contracting

16 Governor’s Initiatives to Improve HCBS for Seniors Implement Online Homecare Registry SB 119 – Haywood (D – Montgomery) Home Care Workers MAY register with PDA Application will need to be approved before worker is listed

17 Governor’s Initiatives to Improve HCBS for Seniors Implement Online Homecare Registry House Response HB 142 – Hickernell (R-Lancaster) Under OAPSA - R egistry of persons found to be substantiated perpetrators of abuse, neglect, abandonment or exploitation of older persons

18 Governor’s Initiatives to Improve HCBS for Seniors Ensure Seniors have Choices about Where to Age Executive Order to form The Governor's Advisory Group on Participant- Directed Home Care DHS Secretary to meet and discuss issues with a Representative of workers

19 Harrisburg Happenings Other Bills to Watch

20 SB 4 – Aument (R – Lancaster) Constitutional Amendment to allow the General Assembly to set guidelines for Purely Public Charities Passed the Senate Sits in the House Finance Committee Opposition – Some Unions, Local Municipalities

21 SB 747 – Vogle (R - Beaver, Butler, Lawrence) Amends the MCARE Act to limit punitive damages against physicians, nursing facilities, personal care homes, assisted living facilities to 200% of compensatory damages but not less than $100,000 Passed the Senate Banking & Insurance Committee

22 HB 264 – Carbon Monoxide Detectors Passed the House In the Senate Public Health & Welfare Committee

23 Harrisburg Happenings Other Issues of Interest

24 NF Provider Assessment Notice in the Pennsylvania Bulletin – June 6, 2015 Notice in the Pennsylvania Bulletin – June 6, 2015 Assessment Amounts Non-MC Day Assessment Amounts Non-MC Day CCRC’s, NF’s with 44 Beds of Less and NF’s with 94% or more MA occupancy $ 8.01 All Other Assessed NF’s$30.06

25 NF Provider Assessment Supplemental Payments to Providers Supplemental Payments to Providers Non-Public NF’s $ per MA Day County NF’s - MDOI $11.31 per MA Day

26 Nursing Facility Budget Adjustment Factor Rewarding Cost Efficient Providers? DHS to Modify the BAF formula - July 1, 2015 DHS to Modify the BAF formula - July 1, 2015 Each facility will have a facility specific BAF Each facility will have a facility specific BAF Factors to include: Factors to include: MA Day One Admits MA Day One Admits Total Costs Compared to Peer Group Median Total Costs Compared to Peer Group Median Budget Neutral for State Budget Neutral for State

27 Excessive Overtime Passed into Law – Act 102 of 2008 Passed into Law – Act 102 of 2008 Legislative Mandated Deadline – April 1, 2010 Legislative Mandated Deadline – April 1, 2010 Regulations enforced by L&I; effective date July 1, 2009 Regulations enforced by L&I; effective date July 1, 2009 Attorney General Report – April 22, 2015 Attorney General Report – April 22, 2015

28 Advocacy and You!

29 Advocacy and You! Regional Policy Structure Regional Policy Structure Navigating the Rules of Advocacy: A Non-Profits Guidebook Navigating the Rules of Advocacy: A Non-Profits Guidebook Advocacy: You Can Make A Difference Advocacy: You Can Make A Difference Share Relationships You Have Share Relationships You Have

30 LeadingAge PA Regional Public Policy Structure

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32 Regional Structure Chair – Susan Drabic West Chair – David Fenoglietto Deputy Chairs – Tammy Lininger, Nicole Fedeli-Turiano Central Chair – Eva Bering Deputy Chairs – Debra Larkin, Katherine Hershey East Chair – John Meacham Deputy Chairs – Jefferson Kaighn, Anthony Manzo

33 Updated Version Navigating the Rules of Advocacy: A Non-Profit’s Guidebook What you can and cannot do in the advocacy arena as a 501 (c)(3) What you can and cannot do in the advocacy arena as a 501 (c)(3)

34 VideoAdvocacy: You Can Make A Difference!

35 Leading Age Staff are always there to help! Join The LeadingAge PA Advocacy Team! Experts can be hired… Real people, with real stories, cannot!

36 LeadingAge PA Government Affairs Staff

37 The LeadingAge PA Government Affairs Team Anne Henry, VP of Government Affairs (717) Ana Puig, Director of Legislative Affairs (717) Beth Greenberg, Director of Regulatory Affairs (717) Brandie Karpew, Data & Reimbursement Manager (717)