SAN DIEGO — The outcome of the midterm elections Nov. 6 will determine whether assisted living operators will have another fight for Medicaid on their hands, National Center for Assisted Living Executive Director Scott Tittle said in his remarks Sunday during the opening session of NCAL Day.

“There is a lot on the line in November,” he told the approximately 230 members attending the special event held on the eve of the full American Health Care Association / NCAL Annual Convention & Expo.

If Republicans maintain control of both the House of Representatives and the Senate, Tittle said, “we would anticipate the possibility of them taking another run at Medicaid reform.” House Speaker Paul Ryan (R-WI), he noted, made Medicaid reform part of congressional efforts to repeal the Affordable Care Act in 2017.

“The bills coming out of the House and Senate, if they had passed as-is, would have resulted in about a 20% cut to the entire Medicaid program across the board over 10 years, which would’ve been dramatic for all Medicaid providers, none the least of which are home- and community-based services and assisted living,” he said.

The bills were defeated in part because of AHCA and NCAL members, Tittle said. “Our combined associations … sent over 100,000 contacts to Capitol Hill in just a few weeks on those bills to share your stories from the front lines on what it would be like to have reduced Medicaid expenditures in your states and what it would mean for our nation’s seniors,” he said.

Assisted living funding primarily is private-pay, but Medicaid funding for services is increasing, Tittle said. “At NCAL, we stand for the proposition to make sure that Medicaid continues to be a viable reimbursement option for those seniors that you’re seeing come through your doors today and in the future, who come through with a little bit higher acuity and a little fewer resources,” he told attendees.

‘Focus on what we can control’

In addition to every member of the House and one-third of the Senate being up for vote in November, 36 gubernatorial and other state races also will be on the ballot, the executive director noted. Tittle called on members “to focus on what we can control” — invite officials and their staffs for facility tours and participate in NCAL’s ‘fly-in’ in June in Washington, D.C., “to talk about what you’re doing to improve quality, collecting data and the important role that assisted living regulation plays at the state level” with members of Congress and their staffs.

“Another proposition we stand for at NCAL is that we believe that the states should continue to be incubators for assisted living in the future. A one-size-fits-all out of Baltimore is not where assisted living should be going,” he said. “Your state regulators and your state policy leaders know what’s best to meet the local expectations of current residents and future residents. We want to make sure that assisted living stays regulated at the state level as long as possible.”

Regarding the upcoming election, Tittle said, historical trends when conditions were similar — when both chambers of Congress with a majority belong to the same political party as a president who has an approval rating of less than 50% — would suggest that the Democrats will win control of the House from Republicans in the midterm election. The political climate has been unpredictable, however, he added, noting that the recent confirmation process of Supreme Court Justice Brett Kavanaugh could result in “a true rush to the polls by their bases for different reasons.”

Republicans currently hold a “razor-thin” majority in the Senate, he noted. Several polls suggest that the party will maintain control of the body.

Also during NCAL Day:

  • Keynote speaker Robyn Benincasa shared eight essential elements of human synergy for leadership and team-building that she learned as an adventure racer: total commitment, empathy and awareness, adversity management, mutual respect, ‘we’ thinking, ownership of the project, relinquishment of ego and kinetic leadership. See her website for more information.
  • NCAL membership has increased by more than 7% so far this year, NCAL Board Chair Ashley Blankenship said. NCAL welcomed its 44th and 45th state affiliates this year — Connecticut and Kentucky, she added.
  • This year’s 47 assisted living winners of AHCA/NCAL Silver Quality Awards represented a 75% increase over the previous year, Blankenship said, adding that 2018 saw the first two assisted living communities win Gold Quality Awards.
  • Previously announced NCAL awards were presented at a luncheon ceremony.
  • To see a demonstration of NCAL’s AL Cost Calculator, visit the Prime Care Technologies booth in the Expo Hall (No. 1520) on Monday at 2 p.m., Blankenship announced.

Stop by the McKnight’s booth (No. 517) during Expo Hall hours to pick up copies of the latest McKnight’s Senior Living and McKnight’s Long-Term Care News print publications and meet staff members.

The full AHCA / NCAL annual meeting begins Monday and continues through Wednesday.

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