Washington State continues to gouge adult family home providers by seeking to increase licensing fees to $325 per bed, per year, driving up the cost of long-term care for elderly consumers in Washington State.
Since 2008, Medicaid occupancy in AFHs has increased from 46% to 57% of the available bed pool. Since these Medicaid recipients live in adult family homes at an average daily cost of $87, we estimate that the State saves an average of $100 per day per resident who would otherwise reside in a nursing home. This equates in savings to the State worth millions of dollars each year.
As adult family home licensing fees and staffing costs continue to increase, the number of beds available continues to decline. The Department of Social and Health Services (DSHS) anticipates loosing nearly 1,000 more AFH beds over the next two years.
Generally, many providers say they feel overworked, over regulated, over taxed, underpaid. They care for the frailest among us 24/7 and many of the more seasoned and experienced providers are quitting!
Meanwhile, demographic research suggests a continued increase in consumer demand for AFH services, so as the bed count continues to decline, this trend is clearly again the public’s best interest.
According to the WSRCC (Washington State Residential Care Council) the increase in adult family home licensing fees would raise less than $1.5 million each year, so if as few as 50 residents were displaced from their AFH into skilled nursing homes by the continued decline in AFH bed availability, the increased cost to the state would be more than 1.8 million annually, minimum – those doing the math seem to be missing something.
It has been suggested that AFH owners “must pay their fair share” by funding the cost of the State’s AFH licensing program, just as other health care industries do. The biggest issues with this rationale are:
- If industries are charged to pay for the cost of being licensed and regulated, how can we monitor and keep the regulators from government over-spending tax payer’s money? And yes, we are paying those taxes!
- The second issue is that the legislature compares and places adult family homes in the same category as institutions like nursing homes and assisted living facilities. But we are nothing like them. We’re closely related cousins of foster homes for children, and that licensing program is nearly fully subsidized by state. Like foster homes for kids, we have very small licensing capacity of only 6 residents which severely limits the income potential, and the ability to fund the licensing program, especially when adult family home care providers are getting paid Medicaid rates that are nearly 10 years out of date! On the other hand, institutions like assisted living and nursing homes are typically licensed for 40 to 120 OR MORE beds! How can we be put in that same category of business?
Regardless, providers have not received a fair share, and are paying more than their fair share:
- We accept and serve the highest acuity of any home and community-based setting, at an average reimbursement rate of $87 per day, which is amongst the lowest
- Loss of AFH beds for high acuity clients increases the likelihood of residents being placed or displaced in more restrictive and expensive settings like nursing facilities at an average of $190 per day.
- We receive rates 10 years out of date, open our homes to frail, disabled people in need, and save the state millions of dollars by diverting Medicaid residents out of nursing homes.
If you feel compelled to help, please reach out to The House Appropriations Chair Representative Ross Hunter, and ask him NOT to pursue his budget proposal of raising AFH licensing fees to $325 per year, per bed!
Here is how to voice your concerns:
- eMail Representative Ross Hunter
- Call Rep. Hunter’s office at 360-786-7936
- If you don’t know who your legislator is, go here.
- Or call the legislative hotline at 1.800.562.6000
Source: WSRCC, WA State Legislature
