Hello LeadingAge Missouri Members – Whenever I’m overwhelmed by work or life, I recall sage advice from a respected colleague, “Focus on Top Three Things.” That advice always helps. At times, we all “juggle” at work and in life, but expert jugglers (real and metaphorical ones!) will tell you, “you can’t have too many balls in the air.” My “real” juggling skills limit me to three balls. So, here’s my tripartite Mid-May perspective.

Last Call for Annual Conference!

Your LA MO staff, Board, conference presenters, inspirational keynoter, and supportive exhibitors are primed and ready.  Education, recognition, fellowship, and fun await at the beautiful Lake of the Ozarks, May 28-30.  All we need is you!  It’s not too late to join colleagues and friends to relax, recharge, and invest in yourself.  Bring your whole team!  We’ve got post-conference Friday afternoon team-building opportunities!  We’ve got a Presidential Medal of Freedom keynoter!  We’ve got tons of timely, topical education – all with CEUs!  We’ve got helpful, innovative product and service presentations!  And we’ve got Missouri’s best providers of aging services – all at a great venue on the Lake!  Won’t you join us? Register now right here.

Missouri General Assembly Session Concludes

Senate Republicans ended this year’s Regular Session two days early when they employed a rare procedural move to stop filibusters and force passage of a referendum to adjust Missouri’s abortion law and a bill to remove sick leave requirements from a previously passed citizen initiative raising the minimum wage.

Prior to the abrupt end, this Session was one of the most productive (in terms of number of bills passed) in years.  But not for aging services.  Here’s a brief rundown on relevant activity or lack thereof:  

• Budget – The State Budget goes to the Governor for consideration with no Medicaid rate increases for SNFs or HCBS in FY 2026 (commences July 1, 2025).  However, the Budget includes money to pay for higher SNF and HCBS utilization in 2026 at 2025 rates.  This is not an insignificant win, but it sets the stage for a reimbursement battle royale next year.  Depending on Federal Medicaid reforms (see below), that battle may be a war.
• Taxes – a mixed bag for our field.  We are concerned by a bill passed that exempts capital gains from Missouri income tax (because reduced state revenue makes for tighter budgets and tougher Medicaid rate increase fights) but we welcome expansion and improvement, in the same bill, of the Missouri senior citizens’ income tax credit available to qualified seniors for property taxes paid by property owners and renters (known as “circuit breaker”).  The bill raises both the income cap and the amount of the credit – making the credit more widely available to seniors – and the bill also adds an inflation adjustment for each.    
• Healthcare – LA MO worked behind the scenes to keep several bills, detrimental to LTC, from gaining traction.  LA MO also monitored, but remained neutral on, several proposals that gained traction but died when Session adjourned, including bills that waived ALF inspections for nationally accredited ALFs; that imposed oversight on LTC referral agencies; that prohibited mandatory physician assessment for employees prior to ALF/RCF employment and relaxed survey citation public notification requirements.  LA MO is pleased a bill expanding audio telehealth passed.

House of Representatives Advancing Reconciliation Bill That Threatens Medicaid

All eyes are on Washington DC as President Trump’s “big beautiful bill” carrying key components of his domestic policy agenda nears a critical House vote.  At this writing, final bill language to be voted on is still in the works.  However, LeadingAge believes all concerns it raised before Committee consideration last week remain.  The central Medicaid concerns include changes to retroactive coverage; a moratorium on new or increased state provider taxes; revisions to home equity limit for determining LTC services; confusing language on the senior exemption from work requirements; and limitations on Section 1115 waivers.  Greater detail on these and other concerns is found here. 

The Reconciliation Bill may go before the House of Representatives for a vote as this newsletter is distributed.  If passed, the Reconciliation process moves to the Senate, where Missouri U.S. Senator Josh Hawley and others have publicly shared concern about Medicaid cuts.  Stay tuned for updates and Action Alerts and please communicate with your Congresspersons here to share our field’s concerns about Medicaid reforms. 

Yours in service,