The regulator insists that brutal honesty from providers can change the course of Medicaid

DENVER – Despite perceptions that state officials are unreachable or reluctant to help caregivers in the long term, the right caregiver stories can influence policy and help shift funding in the right direction.

That was what took on Monday two experts who were often on opposite sides of government funding decisions but who had built a strong and open relationship. By doing so, they have fostered a higher level of staff support and funding for nursing homes and other aging service providers.

Working with and through regulators can often be a more beneficial strategy than starting with lawmakers, said Colin Laughlin, deputy director of the office in the Colorado Department of Health Care Policy and Finance. Busy lawmakers may not have a broad understanding of current health care policies or funding mechanisms. When service providers share their stories, whether with bureaucrats or lawmakers, it encourages “brutal honesty.”

“Without providers in the field, sometimes, the focus is so hard on what that place looks like, especially when it comes to the financing we get from Medicaid,” said Laughlin, a 10-year veterinarian at the state’s LTC funding branch. . “Without educating people and talking to them about what’s bothering the industry, creating some administrative facilities, if you will, trying to lighten the workload there, figuring out what they’ve been through during COVID, all of that, if it doesn’t come from the provider, doesn’t have the same effect.”

He was joined by Deborah Lively, Director of Public Policy and Public Affairs for LeadingAge Colorado, in a session at the 2022 LeadingAge Convention and Expo.

“It’s really important for providers to advocate for Medicaid and Medicaid changes because the state is always looking for broader political ramifications, they look at the budget in general, and I think sometimes, the provider perspective can get lost in that,” Lively said. to their Medicaid agencies and remind them of what it is every day.”

Over the past several years, the Colorado Department of Health has advocated and received a $225 million funding increase, a basic pay increase for direct continuum care workers, and a 16-point plan to improve employment. Much of this work was reported through regular conversations between service providers and the office that organizes them.

The state needs about 52,000 additional direct care workers over the next eight years, and the state health department is working closely with providers on how to find, fund and retain workers. Lively chairs a state government commission that explores workforce solutions.

But session attendees from other states said they were often told they were alone in voicing their concerns. This is a sure sign that individual providers must play as large a role as their local associations, said Joe Franco, director of grassroots politics at LeadingAge.

Among the advice given by the committee for building partnerships with state officials are the following:

• Clarify how things work, or don’t work, through real-life examples and data.

• Regular meetings or phone calls with state regulatory officials, on a weekly basis.

• Refusing to leave the table when decisions are bad.

“Take the ball and go home, that’s a huge missed opportunity,” Laughlin said. “Even if there is disagreement, even if there are different views represented … I really believe that almost everyone in this industry, no matter what position they are in, is really in it for the right reasons.”

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