Legislation that would have provided $45 million over two years to assisted living communities in Maryland to cover the cost of COVID-19 testing for residents and staff members has been shut down by Gov. Larry Hogan (R).

In vetoing Senate Bill 741 and House Bill 836 — the COVID-19 Testing, Contact Tracing, and Vaccination Act of 2021 — last week, Hogan called the bills “misguided” and said the act would “revert the state back to the early planning phases of Maryland’s COVID-19 pandemic response efforts by requiring the Maryland Department of Health to redevelop its testing, contact tracing and vaccination plans” already in place for more than a year. 

LeadingAge Maryland President and CEO Allison Roenigk Ciborowski told McKnight’s Senior Living she was “disappointed” about the veto on legislation the association supported. She said while she appreciates the efforts of the governor to develop and implement a “robust” testing, contact tracing and vaccination strategy, as well as the state’s recent work to increase Medicaid reimbursement rates, there is more work to be done.

“I agree with the governor that many of the items set forth in the bill have already been developed and implemented by the Department of Health and other state agencies,” however, she said the bill also included the potential for funding the cost of COvID-19 testing for long-term care, Ciborowski said. “Surveillance testing is expensive. Testing mandates from the state and CMS [Centers for Medicare & Medicaid] have been in place for much of the last year, without enough additional funds to fully reimburse these costs.”

Providers, she said, have received some Provider Relief Funds. But increased operational costs from personal protective equipment and staffing, combined with lost revenue, mean that relief funds have not always been enough to make up the difference.

Joseph DeMattos Jr., president and CEO of the Health Facilities Association of Maryland, supported the act in testimony to the state House Health and Government Operations Committee earlier this year. COVID-19 testing in assisted living, group homes and skilled nursing facilities is central to identifying outbreaks and hotspots, and “ultimately saving lives,” he testified.

Since September 2020, the state has distributed 1.3 million point-of-care tests to Maryland’s assisted living communities, skilled nursing facilities, group homes and other congregate settings. Those tests, DeMattos said, augment commercial lab PCR testing and can be used for one of the two weekly staff tests required by the Maryland Department of Health.

The act included provisions to pay for ongoing testing and reimbursement in senior living and care. 

“Increased, targeted testing in the community-at-large and continued surveillance testing in our sector and other congregate settings will continue to be critical going forward,” DeMattos said, adding that as visitation increases, there likely will be a role for point-of-care testing.

The Maryland Department of Health testified that the act would mandate $54.5 million in grants in fiscal year 2021 and $98 million in fiscal year 2022 to long-term care facilities, home health agencies and local jurisdictions to cover the cost of testing residents, patients and staff. Those mandates, the health department stated, might conflict with federal COVID-19 relief requirements. Of those dollars, $9 million would have gone to assisted living in 2021, with $36 million slated for 2022.

The legislation also would have required the Maryland Department of Health to adopt a two-year plan to respond to the COVID-19 pandemic. The plan would have been required to address the disproportionate effect of the pandemic on underserved and minority communities and would have been required to establish a Maryland Public Health Modernization Workgroup to assess the public health infrastructure and resources in the state.

Maryland lawmakers will consider whether to overturn Hogan’s vetoes in the next legislative session, which begins in January.