FALL 2015 MEMBER,
LEGISLATIVE AND BUDGET
UPDATE
2015-2016
BOARD
ELECTIONS
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Four county positions up : Kim Cobaugh, Molly Hess, Frank Geramita,
Louann Simpson
Eight total positions remain on for another year
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Nominations:
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Jim Shadduck (past president, Bradford County Manor
Terry Brennan (president-elect), Berks Heim
Rich Adams, Southwestern Veterans Center
Al Alison, Baptist Homes
Jen Eslinger, Conestoga View
Nancy Pastorius, TCU
Barbara Raymond, PA Soldiers and Sailors
Kim Cobaugh, Administrator, Communities at Indian Haven
Jasen Diley, CEO, Rouse-Warren County Home
Frank Geramita, Administrator, Lafayette Manor
Molly Hess, Administrator, Philadelphia Nursing Home
Louann Simpson, Administrator, Valley View Nursing Home
Additional nominations?
Discussion?
FY 2014-2015 Year-end Budget Highlights:
• Facility Dues increased by $24,000
• Spring Conference +12,000 over
budgeted, +16,000 from last year;
Expense
• Received $72,000 from PELICAN
• Net Profit expected to be $29,000
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Will bring reserve back up
FY 2015-2016 Budget Highlights
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Start of increase in affiliate fee of 4-5 percent each
year through 2020
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FY15-16 -$206,000
FY 20-21 - $262,350
Increase in conference expenses
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Facility quality
Number of attendees
Keynote speakers
Vendor shows
Should translate into increased conference income
FY 2015-2016 Budget Highlights
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Projected increase in member numbers
marketing in 2015-2016
Back to $52,000 from PELICAN
Increased Conference Revenue
Net projected profit at year’s end of $8,000
BENEFITS
Member Benefits Update:
 Website – sign up for members only section
 Health Exchange – HDH Insurance
 Group Purchasing Option (GPO) – Amerinet
 Regional Meetings
 Some Conference Changes:
 Keynote
 New and improved materials
ADVOCACY
Member Benefits Update (continued) :
 IGT
 HB 1062
 Budget Adjustment Factor
 MLTSS
 Improved partnerships
ACCOMPLISHMENTS
FOR 2014-2015:
 New and improved PACAH website
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 Improved conference program with advertising availability
 Improved member directory (separate pocket addition) with emails and 
now also online
 Added Newsclips and Blasts for important updates
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 Instituted a Spring Vendor Show with improved prizes and vendor directory
 Offer advance Vendor registration at prior Vendor show
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 Instituted a wine outing with sponsorship and wine glasses
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 Increased sponsorship opportunities
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 Launched a PACAH Health Exchange with HDH Insurance
 Launched a PACAH sponsored GPO with Amerinet
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 Added PACAH committees (MLTSS, Business Member Advisory, Marketing)
to provide better feedback from membership
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 Instituted Regional Meetings with participation from Department of Health
(DOH)
 Launched a Facebook page; LinkedIn page, and Twitter account
Changed bylaws to allow non-county members full-voting membership
status
Changed logo and name upon direction of board and marketing committee
to better reflect changing needs of association
Have increased conference attendance by 25-30 percent with the last two
conferences selling out
Have increased vendor show participation by 35 percent
Created member incentive (free conferences) for referring new members
Created marketing items – banners/displays for registration; professional
folders; tablecover, marketing flyers, etc.
Added a Meeting and Marketing Manager position with increased
responsibilities
Added a PACAH marketing intern to assist and improve conferences and
marketing
ADVOCACY AND
LOBBYING “WINS”
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Used county home study to advocate for county
homes’ priorities including increased rates;
elimination of county share; increased funding
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Maximized partnerships and advocacy with
commissioners and legislators
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Regular meetings with DHS staff and Sellers
Dorsey to discuss ways to increase funding for
county nursing homes including the potential for
limited IGT
Increase in MDOI from Assessment for county
homes
Introduction of HB 1062 by Representative Killion
Held Commissioner break-out at CCAP
Conference entitled “How to run your County
Nursing Home like a business.”
Creation of Managed Long Term Services and
Supports (MLTSS) Committee to help PACAH
address implementation of MLTSS in
Pennsylvania
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Informational session with the House Aging and
Older Adults Committee on County Nursing Homes
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Meeting with new Department of Human Services
Secretary (DHS) – Ted Dallas to discuss nursing
home funding and the impact of county nursing
home privatization
Significantly improved partnership and
communication with CCAP
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Appointment of President Terry Barley on MLTSS
Sub-MAAC committee
Successfully opposed the proposed 2015-2016 BAF
changes
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Sample advocacy letters available for county
and private homes
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ACTION PLAN
2015-2016
HIGHLIGHTS
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Continued focus on
advocacy – rates, IGT,
BAF, Assessment,
MLTSS
Further partnering with
legislators and
commissioners
Focus on bringing in
new members –
including better referral
incentives
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Newsletter
Website
Awards
Webinars
LEGISLATIVE AND BUDGET UPDATE
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FY 2015-2016 Budget Impasse
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Governor Wolf proposed budget March 2015
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The increased funding is largely directed toward basic
and higher education, coupled with offsets in the school
property tax. Funds are generated by enactment of a
severance tax on natural gas, an increase in the income
tax from 3.07 percent to 3.7 percent, a higher sales tax
from six percent to 6.6 percent, coupled with a broader
base (including SNF services) and applying new taxes to
tobacco products.
LEGISLATIVE AND BUDGET UPDATE
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FY 2015-2016 Budget Impasse
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In May, HB 1192 introduced in the legislature. Contained
same funding as 2014-2015
On June 26, House and Senate Republican leaders
announced legislative budget agreement, amended into HB
1192
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The budget included funding for nursing homes at relatively the
same amount as the Governor's proposed budget (no rate increase).
While there is a slight increase over last year's funding (5 percent) in
the long term care line item, there are also decreases in one-time
transfers from the lottery and tobacco funds.
The Home and Community Based Services (HCBS) line item was
increased approximately 30 percent, but there was also a decrease
in one-time lottery fund transfers to HCBS reducing the amount of
this increase.
LEGISLATIVE AND BUDGET UPDATE
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FY 2015-2016 Budget Impasse
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July 1, Governor Wolf vetoes HB 1192 in its entirety
Creates budget impasse – PA is prohibited from
making any payments
What will be paid?
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Health care services paid for through Medical Assistance,
for hospitals, other healthcare providers and nursing
homes
HCBS – attendant care
Medicare Part A and B premiums
LEGISLATIVE AND BUDGET UPDATE
FY 2015-2016 Budget Impasse
What won’t be paid?
 “Most payments to vendors or to grantees for
programs or expenditures incurred during FY
2015-16 that are authorized through the budget
will be delayed until a budget is approved”
 Example: P4P, non-public supplemental MDOI,
etc., county MDOI, Assessment MDOI
LEGISLATIVE AND
BUDGET UPDATE
FY 2015-2016 Budget Impasse
 On August 25, House Republican leadership attempted to
override 20 of the line all of which failed by a vote of 115-83
(a 2/3 majority is needed to override a veto), with
Republicans voting in favor and Democrats voting against.
 This week, SB 1001 was introduced, a stopgap budget bill
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Two nursing home line items included, non-public MDOI and
county supplemental (DE)
“not viable”
We have seen our first lawsuit – PA Coalition of Children,
Youth and Family Services (PCCYFS)
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provide services to at risk children and families in child welfare,
juvenile justice and behavioral health system deemed non
essential
WHAT CAN YOU
DO?????
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Write to legislators – will have sample letter on
website
Urge them to resolve the impasse to assure
core human services programs are not
jeopardized (long term care)
Also continue to urge them to support long
term care funding
Keep track of impact and share with PACAH
RATES
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Being paid at April 2015 Rates (posted on OLTL
website)
http://www.dhs.state.pa.us/provider/doingbusi
nesswithdhs/longtermcarecasemixinformation/
rates/index.htmFacebook Page
July proposed rates on website inaccurate
BUDGET ADJUSTMENT FACTOR
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DHS proposed changes
Based on high MA Occupancy and MA Day One
admission
Public comment period –PACAH successfully
opposed, DHS decided not to move forward
Will be discussing changes this upcoming year
IGT/CPE
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Discussions continue with state on this, attempts to
accurately calculate net
Negotiating the return of left-over CPE funds
Cannot move forward without the budget in place
Good feedback from commissioners/members
NURSING HOME ASSESSMENT REDESIGN
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B1/B2 test not met
Workgroup
New factors – high MA Occupancy; increase in
county payment
April – draft public notice
HB 1062
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Introduced April 22 by Representative Killion (Del.
Co.)
Would eliminate the county share
10% non-federal portion of Medicaid costs
counties are required to pay
$20 million
In House Health and Human Services Committee
ALL MEMBERS ASKED FOR ADVOCACY/SUPPORT
MLTSS
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Webinars – monthly
Website http://www.dhs.state.pa.us/foradults/managedlongtermsup
ports/
Sub-MAAC, PACAH President Terry Brennan has been
appointed
Comments due July 2015 (view PACAH’s at
www.pacahpa.org)
RFP to be released October 2015
First enrollment January 1, 2017 in the Southwest
PACAH MLTSS Subcommittee will hold in person meeting in
November
THE “LAWSUITS”
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Attorney General named 14 Golden Living facilities in complaint
"Defendants' staffing practices cost residents their dignity and comfort, and
jeopardized their health and safety," the attorney general's complaint said
Defendants claim this lawsuit is the result of their suit against the AG regarding
her relationship and payment of contingency fees to law firm
Philadelphia-based legal aid organization, Community Legal Services, also
accused the Pennsylvania Department of Health of failing to properly investigate
complaints about nursing homes or enforce regulations that are designed to
protect residents' safety.
 DOH inspectors dismissed 92 percent of complaints from 2012 through
2014 for about 46 nursing homes that operated in Philadelphia.
 It also said the department minimized the severity of violations, and never
found violations in follow-up inspections
We are hearing increased scrutiny, if not at the state level than follow-up from
feds
kandrisano@pacounties.org (717) 526-1010
QUESTIONS?