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On November 8, voters in Washington State overwhelmingly passed a ballot initiative that strengthens training requirements for most newly hired long-term care workers there.

Workers will now undergo 75 hours of state-mandated training, a significant increase from the previously required total of 34 hours.

PHI first wrote about the ballot initiative last month.

– by Matthew Ozga

The October issue of the PHI Training and Organizational Development (TOD) newsletter is available online.

The latest issue includes “Navigating Hard Times in Long-Term Care,” by members of the PHI TOD team, and “Easing the Distress of Room Changes,” by guest blogger Ann Wyatt, residential care policy and strategy consultant at the Alzheimer’s Association, NYC Chapter.

To read past blog posts and subscribe to the TOD newsletter visit the TOD blog.

– by Deane Beebe

Nearly 200 national organizations, including PHI, ran a newspaper ad in key Congressional districts urging readers to urge their Congress members not to cut Medicaid-funded long-term services.

Cutting Medicaid-funded long-term care services would deny millions of older Americans and people with disabilities “the choice to receive the services they need to live independently in their homes and communities,” the ad explains.

The Medicaid cuts could also lead to the loss of “thousands of direct-care jobs, putting a greater burden on individuals and families.”

The ad, paid for by AARP, ran primarily on October 31 and November 1 in newspapers including the Arizona Republic, Lansing State Journal, Annapolis Capital Gazette, Olympian, Columbus Dispatch, Nevada Appeal, Boston Globe, and Helena Independent Record.

The congressional “Super Committee,” tasked with proposing $1.5 trillion in federal budget cuts by November 23, is considering deep cuts to the Medicaid program (pdf).

– by Deane Beebe

PHI Massachusetts, a new section of the PHI PolicyWorks website, will provide news, facts, and other resources about the state’s direct-care workforce.

The site also contains information on several state-focused priorities, including educating policymakers about the direct-care workforce, transforming care environments, and building skills for workers.

Visitors can sign up for e-mails alerting them to new Massachusetts content at the PHI Massachusetts homepage.

The PHI Massachusetts page is the third state-focused page that PHI has introduced this year, following PHI New York and PHI Michigan.

“We are thrilled to have this platform to speak out about the unique challenges and opportunities facing Massachusetts’s largest occupational group,” said PHI Massachusetts State Director Amy Robins.

Task Force Bill Would Help Workers

One of those unique opportunities is “An Act to Establish a Task Force Relative to the Direct-Care Workforce,” a bill recently introduced to the Massachusetts legislature by State Senator Pat Jehlen (D).

If passed into law, the task force bill would require the state to take steps to ensure that it has an adequate workforce and infrastructure to meet the rising demand for long-term care services and supports.

The bill (S45) is covered in depth at the new PHI Massachusetts site.

A public hearing for the bill will take place on November 15 at 10:30 am at the Massachusetts State House.

HHS Secretary Kathleen Sebelius

U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius notified Congress on October 14 that her office would not be able to go forward with implementing the CLASS program because it would not be affordable or fiscally solvent over time.

However, just three days later the White House announced that it opposed repealing the federal voluntary long-term care insurance program.

While these mixed messages have reportedly left supporters of the CLASS program confused as to whether the program will ever be realized, they are accepting what administration officials have called a “misinterpretation” of the HHS announcement in private conversations with leading CLASS supporters.

Both LeadingAge President Larry Minnix, Jr. and Connie Garner, who heads up Advance CLASS, Inc., said that administration officials have told them that they do not intend to “kill the program” (subscription required).

Advocates are continuing to press the administration to carry on with the CLASS program. They are heartened by what was said in these private conversations, as well as by the former Centers for Medicare and Medicaid Services Chief Actuary Bob Yee‘s remarks, reported in Inside Health Policy, that “the administration has the tools to effectively implement CLASS within the parameters of the statute.”

“It may be possible to design a modest government-run voluntary long-term care insurance program that is financially viable,” said Howard Gleckman, a fellow at the Urban Institute, in a blog post. “That at least is the message buried in the reams of documents released by the Department of Health & Human Services last Friday when it abandoned CLASS.”

A provision in the Affordable Care Act (ACA) requires that the CLASS Act must be fiscally solvent for 75 years.

Not Fully Gone Yet

On October 19, Judy Feder, professor at the Georgetown University Public Policy Institute, said in a radio interview [begins at 36:21] that the administration’s “reluctance to stand up for [the CLASS program] is a disappointment.”

She added that CLASS “is not fully gone yet. It’s still hanging by a thread.”

A few days before the HHS announcement, 100 organizations — including PHI, AARP, National Multiple Sclerosis Society, and the Paralyzed Veterans of America — sent a letter to President Obama (pdf) about the value of the CLASS program to American families.

The letter concludes by saying, “Mr. President, Congress gave you authority to make changes to the design of CLASS to make it work. We fully expect the Administration to go forward and use that authority in implementing the law.”

Future of the Personal Care Assistant Workforce Advisory Panel Unknown

Also still unknown is the future of the Personal Care Assistant Workforce Advisory Panel, which was mandated by a provision in the ACA under the CLASS Office. The panel is responsible for advising Congress on the adequacy of the number of personal care aides, their wages and benefits, and access to their services, for both the CLASS and Medicaid programs.

Sebelius released an HHS report on the CLASS Act on October 14, which explains that 13 of the panel nominees have been accepted but have yet to meet.

PHI Director of Policy Research Dorie Seavey, who was appointed to the panel (pdf), said, “We hope that CLASS proceeds, but regardless, the issues that Congress intended the PCA Panel to address remain paramount. Our country must develop a personal care workforce panel that is able to meet the rapidly growing demand for in-home services and supports, and it would be a mistake to shelve the important work of this panel.”

– by Deane Beebe

Kathy Greenlee, Assistant Secretary for Aging, HHS

Assistant Secretary of Aging Kathy Greenlee, who heads up the CLASS Office, announced in a September 28 blog post that the U.S. Department of Health and Human Services (HHS) would be releasing a report and recommendations in mid-October about how to proceed with the CLASS program.

This announcement came after a week of media coverage on the CLASS program left many people in doubt as to whether the voluntary long-term care insurance program created under the Affordable Care Act (ACA) would be implemented in 2012 as planned.

HHS tried to counter reports that the CLASS office was closing, after an actuary from the program disclosed this information in an email that was picked up by the press.

HHS said the staff at the CLASS office was being “reduced,” and reiterated that they were still determining whether the program was “fiscally solvent and self-sustaining into the future,” as the law requires.

Greenlee says in her blog that “we are looking at the CLASS program from every angle.”

She said that a report from the program’s actuaries that provide an “actuarial analysis of a number of potential CLASS benefit plans” would be part of a “comprehensive review of our work on CLASS over the last 18 months.”

Personal Care Attendants Workforce Advisory Panel

The future of the Personal Care Attendant (PCA) Workforce Advisory Panel, which was mandated by a provision in the ACA under the CLASS Office, is still unknown.

The members of the panel were to be announced one year ago. The panel is responsible for advising Congress on the adequacy of the number of personal care aides, their wages and benefits, and access to their services.

– by Deane Beebe