Nursing Home Strike Threat Drives Momentum for Medicaid Rate Boosts

The looming specter of a strike at nursing homes in Connecticut has prompted leaders in the state to support increases to daily Medicaid rates for institutional care.

Connecticut Gov. Ned Lamont this week expressed support for three Medicaid rate boosts through 2021, a move that the CT Mirror — which first reported the news — characterized as a key step toward potentially averting the long-threatened strike.

“I will work with legislative leaders in the Connecticut General Assembly over the coming days to address the funding for these rate increases in the state budget for the upcoming biennium,” Office of Policy and Management secretary Melissa McCaw wrote in a Monday letter sent to nursing home leaders. “You can expect to receive additional information from the Department of Social Services in the coming weeks regarding the implementation of these increases.”

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The Constitution State implemented a 2% hike to the state’s Medicaid rates in November 2018, but Lamont — a Democrat elected to the post last fall — had previously balked at any additional funding boosts over the coming two years amid budget shortfalls. That freeze in part prompted about 2,500 members of SEIU 1199, the New England Health Care Employees Union, to authorize a strike starting May 1.

The union noted that many of its members had been working without contracts for two years, and that persistent understaffing at nursing facilities represented a strain for both employees and residents.

“Many of our members have complained that they are really working short, so sometimes they have one assistant for 30 people,” SEIU 1199 spokesman Pedro Zayas told SNN back in April.

Low Medicaid rates have been a persistent theme in the nursing home industry over the past year, with insufficient funding causing closures and staffing crunches in states across the country. Workers and advocates in Massachusetts and Wisconsin, for instance, have been lobbying for increases in the daily Medicaid reimbursement rate for nursing homes, which frequently lags behind the actual cost of caring for Medicaid beneficiaries. In Pennsylvania, the typical nursing home takes a $48-per-day hit, while that number balloons into the mid-$70 range for Wisconsin operators.

Union leaders in Connecticut temporarily suspended the strike threat at the end of April amid signs of progress, but on Tuesday an additional 600 workers joined the strike call, with a new date set for June 3, according to a local news report.

The Lamont administration’s plan would include a 2% rate increase on July 1, with two more 1% rate boosts scheduled for October 1, 2020 and January 1, 2021, respectively — all on top of the 2% gain already on the books from this past November. However, for operators, there’s a catch: The money must be used to raise workers’ wages and expand benefits, McCaw wrote in her letter, though facilities can apply for exemptions to that rule.

Legislators in the state must approve the increases as part of the final state budget, as McCaw noted, and the gains may not necessarily be enough to avoid the strike. The June 3 deadline remains firm unless operators agree to new contracts with members, the union asserted in a statement provided to SNN — though the statement also emphasized that the workers “cheered” Lamont’s move.

“We are grateful for his endorsement of Medicaid rate increases,” union president Rob Baril said. “To avert a strike, now we must make sure that this proposal is reflected in the state budget, and that contract settlements are signed with nursing home bosses.”

For its part, the Connecticut Association of Health Care Facilities also applauded the funding increase.

“Nursing home residents, employees, and operators can rest a little easier tonight knowing that Gov. Lamont and Secretary McCaw have made increased Medicaid funding for Connecticut nursing homes a priority at this critical time,” CEO and president Matthew Barrett said in a statement provided to SNN. “It’s especially important leadership from the Lamont administration to recognize these needs given the state’s ongoing fiscal challenges.”

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