Did You See That? – October 2023

Federal Recap

Making History Isn’t Always a Good Thing

So……. Who had the U.S. Congress ousting Speaker McCarthy on their 2023 bingo board? In a crazy turn of events, in a historic vote, the U.S. House of Representatives voted 216-to-210 to oust Republican Speaker Kevin McCarthy, marking the first time a speaker has been removed from their position. The vote was forced by a contingent of hard-right conservatives, led by Rep. Matt Gaetz of Florida, who called for a motion to vacate McCarthy earlier this week. In the end 8 Republicans joined all Democrats in voting to removed McCarthy as speaker, throwing the House and its Republican leadership into chaos.

To make matters worse, apparently, the Problem Solvers Caucus is close to collapsing because of the Speaker drama. The Problem Solvers Caucus is made up of moderate Republicans and Democrats, whose main goal is to find common ground on many of the key issues facing the nation. According to Politico, Democrats in the Caucus proposed a possible arrangement whereby a bloc from their party would vote to save McCarthy in return for a more expansive role in operating the House. Some ideas included giving the two parties an equal number of seats on the powerful Rules Committee and changing the rules of the House to make it harder for a splinter faction to eject a speaker. Democrats asked McCarthy to delay the vote, in order to continue negotiations, as well as a clearer promise that he would be willing to actually work across the aisle. Republicans in the Caucus believe that the Democrats were negotiating in bad faith since the rest of their party had decided to vote to oust McCarthy because it would thrust the GOP into chaos. In the end, the roughly 30 Democrats in the Problem Solvers stuck with House Minority Leader Hakeem Jeffries and voted to oust McCarthy. Republican Caucus Chair Rep. Brian Fitzpatrick (R-Pa.) told Fox News that he asked a group of Dems to vote present on a procedural vote, allowing Republicans to temporarily kill Rep. Matt Gaetz’s move against McCarthy. Gaetz (R-Fla.) would surely have tried again, he noted. Rep. Fitzpatrick and over 10 Republicans in the Caucus have said that they are now considering breaking up the group in frustration, due to the lack of cooperation during the speaker fight.

I mean come on. At some point we have to put the good of the country above politics and optics. While we all may not agree with McCarthy’s politics, we can all agree that it only weakens our country overall when we continue to have such disarray in Congress. Congress only has a month and a half to pass a spend bill, which will need to include not only aid for Ukraine, but aid for Israel. At the rare everything is going, there is little chance that Congress will succeed in coming to any sort of agreement. This is like expecting a football team to play well without a head coach. Please tell a time when any sports team/country/company, literally any operation succeeded with a power vacuum at the top.

In the meantime, Rep. Patrick McHenry, Majority Deputy Whip, takes over as interim Speaker until a new one is named. In a closed-door meeting, Republicans elected House Majority Leader, Steve Scalise to be their candidate for Speaker. Scalise won the election 113-99 over House Judiciary Committee Chair, Jim Jordan. The vote came after Republicans killed a proposal to change the nominating process that was intended to avoid a messy floor fight. Though Scalise won the GOP speaker election, at the moment he does not have the votes to win the entire House vote, if all Democrats vote against Scalise, like they did during the McCarthy Speaker election. Scalise needs to win a majority from the full House.

Senate Finance Committee Hold Hearing on Importance of Home Care

On Monday, the Senate Finance Subcommittee on Health Care held a hearing on home health and the vital role of home health in access to care. This hearing was unlike most hearings I have watched over my career. Usually, you see committee members battle each other over their opposite beliefs on the subject of the hearing. that was not the case this time. Senators on both sides of the isle seemed to agree on one major topic, the importance of home-based care, and the need for more investments.

Witnesses for the hearing included: William A. Dombi, the president of the National Association for Home Care & Hospice; Carrie Edwards, the director of home care services at Mary Lanning Healthcare; Judith Stein, the executive director of the Center for Medicare Advocacy; and David Grabowski, a professor and researcher at Harvard Medical School.

The main topic of the hearing was CMS’s proposed rate cut to home health repayment rates. Witnesses were given the opportunity to share how these proposed cuts will be detrimental to the industry. They were also able to discuss the dangers of skyrocketing referral rejection rates, the impact of further Medicare Advantage (MA) penetration and the issues the provider community takes with Medicare Payment Advisory Commission’s (MedPAC) reports on home health care.

If you would like to watch a recording of the hearing, use this LINK.

Look Ahead

Always About the Dolla’s

I’ll keep this short. The only thing that Congress will be working on for the next couple months, outside of picking a House Speaker, is trying to pass a full-year budget. On October 1st, President Biden signed a continuing resolution (CR) that funds the government until November 17. The next Speaker, whoever it is, first task will be to pass a CR to allow for more time for a final spending package to be passed, because the odds that both chambers can come to an agreement on a final spending package are as low as my chances of getting a date with Margot Robbie.

This budget will be even more contentious given the recent war that broke out in Israel and the ongoing Ukraine war. Democrats will be looking to provide federal aid to both countries which will likely cause a massive battle with their Republican counter parts. While support for Israel is coming from both sides of the isle, support for Ukraine is lacking in House, which will likely hold up much of the negotiations on a budget. The House GOP under former Speaker Kevin McCarthy did not include any aid to Ukraine in their spending package, which differed from the Democrat led Senate budget proposal. This stalled the last budget negotiations until a CR was agreed upon which included no aid to Ukraine.

In the end, it’s going to be a lot of late nights in DC for staffers, as they try to hammer out an agreement on a CR. Lets hope they can finally get something done, though I’m not gonna hold my breathe.

State Recap

Massachusetts Takes First Steps towards Passing Salary Transparency Legislation

Massachusetts is on its way to becoming the 9th state to pass salary transparency laws. Today, the House of Representatives passed H.4109, An Act Relative to Salary Rance Transparency, which mandates any public or private employer with at least 25 employees include a projected salary or wage alongside any job listing and requires employers with 100 or more full-time Massachusetts employees to submit wage data reports. The Executive Office of Labor and Workforce Development will publish aggregate wage data on an annual basis. The passing of this bill comes after House Speaker Ron Mariano’s office said the chamber’s top Democrats were making it a priority to bring forward salary transparency legislation.

Rep. Josh Cutler of Duxbury and Sen. Patricia Jehlen of Somerville, co-chairs of the Joint Committee on Labor and Workforce Development, proposed the bill as a way to build on the state’s equal pay law by better empowering workers. They dubbed the bill the Frances Perkins Workplace Equity Act, commemorating a Massachusetts native who was the first woman to serve as U.S. labor secretary. HCA will provide updates as the Senate takes up the legislation.

Governor Healey Signs Tax Relief Package

Today, Governor Maura Healey signed a $1 billion tax relief plan that aims to put more money in taxpayers’ wallets and make Massachusetts more competitive. The signing of the bill marks the first Massachusetts tax cut in over 20 years. Twenty months elapsed between Republican Gov. Charlie Baker using his final State of the Commonwealth address in January 2022 to ignite debate about slashing taxes and the final enactment of the package. Legislative leaders said the total impact of the measure for fiscal year 2024 will be $561.3 million. By 2027, when the changes are fully phased in, they say the total impact will be $1.02 billion.

The package will beef up tax credits for caregivers, renters, and seniors, and appease the business community as well. The package’s largest item, worth about $165 million this year and up to $307 million once fully implemented, is an overhauled child and dependent tax credit. To relieve pressure on individual taxpayers, the package would more than double a tax credit available to parents, those who care for dependent seniors, and those who care for a disabled dependent. That credit would rise from $180 per dependent to $310 per dependent in fiscal year 2023, then again to $440 per dependent in fiscal years 2024 and beyond. More than 565,000 Massachusetts families would qualify for the credit, according to a bill summary. Changes to the senior circuit breaker tax credit could save some taxpayers up to $1,200 per year, while renters are in line for an extra $50 annually thanks to an increase to the maximum rent deduction. Additional reforms include changes to the estate tax threshold, and short-term capital gains tax rate.

Joint Committee Holds Hearing on Raising State Minimum Wage Bill

On Tuesday, the Joint Committee on Labor and Workforce Development held a hearing on a number of bills that pertain to minimum wages. These bills covered wages for everything from state minimum wage, the minimum wage for workers who also earn tips, to wages for overtime work, and more. The headline bill that was raised in front of the committee was An Act Relative To The Minimum Wage (S.1200 / H.1925), which would increase the state minimum wage by $1.25 per year until it reaches $20 in 2027 and index it to inflation. It would also increase the sub-minimum wage for tipped workers to $12 by 2027 and set it at 60 percent of the full minimum wage in future years, and stipulate that the minimum wage applies to municipal workers.

This hearing marks the reopening of discussion as to what is considered a livable wage in Massachusetts. It is important to note that the state minimum wage was increased to $15 an hour in 2023. Proponents for raising the minimum wage argue that with rising inflation and housing prices, that not only is a $15 minimum wage not a “liveable wage”, a rise to $20 an hour would still not be making a “living wage.” MIT’s Living Wage Calculator estimates that an adult with no children would need to make $21.35 per hour to support themselves in Massachusetts. For an adult with one child, the living wage would rise to $45.57 an hour, and two working adults would each need to make $24.72 an hour to support themselves and one child in Massachusetts. National Federation of Independent Business Massachusetts state director argues that “raising the base wage to $20 is not only unsustainable for Massachusetts employers who are already raising compensation to counteract the state’s labor shortage and attract workers into the workforce, but additionally, these types of one-size-fits-all mandates hurt smaller, Main Street businesses that cannot absorb the cost the most.” HCA will be sure to provide updates on the minimum wage legislation as it progresses.

Look Ahead

All For The Headlines

After successfully passing a tax relief package, the legislature has a new target in their sights, gun reform. For the last couple of years, legislatures and party leadership have been discussing sweeping gun reform legislation. Last week, House Democrats re-introduced/re-drafted an old gun reform bill that previously caused intense infighting. An Act Modernizing Firearm Laws, HD.4607, seeks to rein in the spread of untraceable “ghost guns,” update the state’s assault weapons ban, limit the presence of firearms in certain public spaces and streamline the licensing process.

House Speaker Ron Mariano said the latest bill penned by Judiciary Committee Co-chair Rep. Michael Day is “significantly different” than one he unsuccessfully tried to advance over the summer, when gun owners groups mounted vociferous opposition and some representatives appeared to balk.

This is not going to be an easy package to pass. At a House hearing on gun reform, gun control and gun safety groups threw their support behind the bill. While gun owners contended the legislation represents an unconstitutional infringement on their Second Amendment rights without offering much, if any, upside to public safety. History has shown that the two sides could not be farther apart on beliefs than when it comes to gun control. The gun lobby is going to fight this bill hard, as they do in every state that tries to pass gun reform legislation.

The gun reform legislation is just the beginning as the state government looks to pass big ticket legislation after basically doing nothing for the first 10 months of the year. The legislature has signaled that they are also looking to pass a climate package and salary transparency legislation. I believe the sudden urgency is a result of the continuous crap that the press has been giving leadership for the lack of legislation that has been passed this session. Hell, it took a record amount of time for them to agree on a budget. I personally find it to be very frustrating and a little patronizing for the legislature to think its okay to just bulldoze through big ticket items and forget about “smaller” less significant legislation like the home care licensure bill. They are supposed to be passing legislation regularly, not just when they are called out for not doing anything. This is exactly what annoys people about politics, when politicians only do their job when it’s most beneficial for them.

2022 New England Home Care & Hospice Conference Call for Speakers Now Open!

The New England Home Care & Hospice Conference and Trade Show is the region’s premier event for home care and hospice agencies. The conference is hosted by the six New England state home care associations, which collectively represent nearly 400 organizations. This coming year, the conference heads to Newport, RI from May 11-13!

The conference is designed for senior and mid-level administrative and clinical staff. The conference features multiple keynote sessions, workshops, and intensive programs. Topics are designed to meet the needs of all agencies, including Medicare-certified, private duty, and hospices. The trade show is the largest home health and hospice expo in the Northeast.

We are pleased to open the call for speakers up to any and all who are interested. We highly encourage agency staff members to submit innovative programs they have developed within their companies to present to colleagues.

Vendors who submit proposals are highly encouraged to include an agency in their presentation for preferential review.

The deadline to submit proposals is Sunday, November 14th by end of day.

For more information on our conference you can go to www.NEHCC.com!