A package of bills recently passed by the Oregon Legislature aims to address long-term care staffing, transparency and healthcare for residential care facility employees.
Several bills went through substantial amendments over the course of the legislative session through stakeholder conversations, which included the Oregon Health Care Association, among other senior living association representatives.
On the heels of the pandemic and a devastating wildfire season, the state approved investing $30 million to support long-term care providers in making facility infrastructure upgrades related to air quality, emergency power, reduction of the spread of infectious diseases and emergency preparedness.
“This session, the Oregon legislature approved significant investments to enhance quality of care and address critical challenges in Oregon’s long-term care sector,” OHCA Senior Vice President of Strategy Rosie Ward told McKnight’s Senior Living.
Like other states, and the senior living and care sector in general, Oregon is facing a critical workforce challenge, Ward said.
To help alleviate some wage pressures on providers, the Legislature approved an optional “wage add-on” program for Medicaid providers that meet certain criteria, including minimum wage thresholds.
Through this program, Ward said, caregiver pay for assisted living, residential care providers and in-home care must be $15 or higher in year one of the next biennium and $15.50 in year two.
Skilled nursing providers can receive an enhanced rate if they pay certified nurse aides a starting wage of $17 or higher in year one, and $17.50 in year two.
Two bills — SB 714A and SB 266B — codify existing standards and practices that assisted living and other community-based care providers must comply with to ensure they are using acuity-based staffing plans. The bills also are meant to ensure that the Oregon Department of Human Services is adequately enforcing standards around staffing requirements.
Libby Batlan, OHCA senior vice president of government relations, testified in favor of an amendment making the staffing requirements applicable only to community-based care in assisted living and resident care communities, including memory care communities, and not nursing facilities.
Batlan said in her testimony that SB 266 “elevates the issue of staffing in community-based care in a way that will promote high-quality care for residents in these settings.”
LeadingAge Oregon CEO Ruth Gulyas also testified in favor of SB 266, calling it a “workable approach to assure that there are sufficient staff within residential care facilities to meet the scheduled and unscheduled needs of residents.”
The bill is a companion to SB 714, which would require the DHS to develop an acuity-based staffing tool to evaluate whether an assisted living community, residential care facility or other long-term care facility with a memory care unit has sufficient staffing, and to assess the number of direct care staff hours required to meet resident needs.
Batlan previously told McKnight’s Senior Living that SB 714, as originally written, “would not move the needle forward on quality.” OHCA was working with the bill’s proponents and lawmakers to evaluate unintended and harmful consequences of the measure.
LeadingAge Oregon also testified previously against SB 714, noting that regulatory oversight, enforcement mechanisms and quality improvement tools already exist to ensure sufficient staffing levels.
Another bill in the package, SB 800, invests $30 million to create the Oregon Essential Workforce Health Care Program. The healthcare trust is meant to give long-term care workers in assisted living and other residential care settings access to affordable healthcare.
Ward said the trust, a voluntary program for providers, reduces costs for employers through leveraging state funds, employer contributions and a federal Medicaid match.
A fourth bill, SB 703A, adds a direct care worker to the Quality Measurement Council, where the staffing acuity tool will be developed. The bill also directs the Oregon Department of Human Services to conduct a study on the cost of long-term care in Oregon to better understand how Medicaid reimbursement rates meet — or do not meet — the cost of care, as well as evaluate certain employment metrics, Ward said.
The measure also requires residential care facilities to notify the state when there is a management or ownership change. That information will be posted on the DHS website.
The Service Employees International Union hailed the package of bills as “a bold step forward” in reforming the way older adults and people with disabilities are supported in Oregon.