Hello LeadingAge Missouri Members!

It’s your perspective, recently shared with Missouri Legislators, that shapes my perspective this first week of March!  

On Advocacy Day, February 18, 31 LeadingAge Missouri Provider and Business Members, nine Leadership Academy members, three LA MO staff, and eight member residents, collectively met with 26 members of the General Assembly to advance policies supporting Missouri seniors and those who serve them. Your efforts raised our brand as “the trusted voice for aging in Missouri” and fostered important relationships with policymakers. Our “lobbyists-for-a-day” also educated legislators on three policy initiatives: Medicaid preservation, APRN practice expansion, and property tax exemption.

Medicaid Preservation

Diverging from past Advocacy Day messaging, we chose not to ask legislators to rebase or raise Medicaid reimbursement rates for SNFs and HCBS in FY 2027. Instead, having avoided cuts to SNF and HCBS appropriations in budget bills seeking to trim a $2 billion budget gap, we embraced current versions of HB 10 & 11, which allow for higher utilization at existing reimbursement rates and increased payments to SNFs that deliver high quality care. We thanked legislators for past reimbursement increases and asked them to protect us from cuts later in the budget process. So far so good, but we are watching the process and will alert members to contact their representatives if Medicaid reimbursement cuts are added to HB 10 (HCBS) or 11 (SNF).

APRN Practice Expansion

LA MO has long supported Missouri joining a majority of states, which sanction full practice authority for advanced practice registered nurses (APRNs). Such a policy will allow increased primary and geriatric healthcare access for older Missourians and deliver healthcare cost savings. In the majority of states (also Missouri when APRN restrictions were lifted during COVID), the benefits of expanded APRN practice occur without safety issues. LA MO has supported incremental APRN practice right expansion in enacted legislation, but we believe current bills offering pathways to full practice authority – recognizing an APRNs graduate level education and training – is sound policy. On Advocacy Day, our members shared this perspective with legislators.

Property Tax Exemption for Non-profit, 501 (c)(3) Providers

Historically, non-profit 501(c)(3) senior living and healthcare providers were exempt from local property tax. More recently, some local governments assess and collect taxes on provider property or require providers to pay PILOTS (payments in lieu of property tax). Taxation inconsistency and, more important, diversion of resources away from a non-profit provider’s care mission are problematic for our field. Accordingly, LA MO members used Advocacy Day to test the waters with legislators about a preemptive state law property tax exemption for non-profit 501(c)(3) providers. The results were mixed with many legislators non-comital. What do you think about this policy idea? Let me know at billbates@leadingagemissouri.org.

On Advocacy Day, participants were also introduced to Sarah Willson, Director of Missouri’s Department of Health & Senior Services. Director Willson overviewed Missouri’s new Master Plan on Aging. She also shared the Department’s commitment to fair regulatory oversight of all long-term care facilities and to reasonable financial reimbursement for HCBS and Personal Care programs. Welcome news to LA MO members!

Advocacy Day is a single day annually for our members to advance our field’s public policy agenda. More is needed to persuade policymakers. We can’t expect legislators to understand the breadth, depth, and needs of aging services in short, annual meetings. We need developed legislative relationships. For this reason, our “lobbyists-for-a-day” concluded each legislator meeting this year with an invitation to visit LA MO member communities in his or her district to learn more and build sensitivity to our field’s needs. We encourage all LA MO members to invite your representatives to visit your communities. We are here to help you make these constituent visits easy and productive. Call on us!

Yours in service,