LeadingAge New Jersey - News from Trenton
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May 9, 2013
Pressure to Balance Budget and Legislative Proposals of Interest
The pressure to balance the budget is becoming apparent in Trenton. Last month The Legislature’s non-partisan budget analyst, David Rosen, said that the state could still end the fiscal year in July with a $300 million shortfall. In a controversial effort to reduce the shortfall, Community Affairs Commissioner Richard Constable, who heads The Council on Affordable Housing made a decision to let the Christie administration take $140 million set aside for local affordable housing projects.
A large part of the money comes from towns hit the hardest by Superstorm Sandy. Affordable Housing advocates and local officials claim the money is vital for post-Sandy reconstruction. Additionally, this move would force towns to raise other taxes to meet their requirement under state law to construct more affordable housing.
Details of the process to take the money remain unclear. Commissioner Constable said towns would have until May 22 to respond to a letter instructing them to turn over the affordable housing project money.
In other news, there are legislative proposals of interest to hospitals, continuing care retirement communities, health plans and pharmacies that are moving in Trenton. In early May, Assembly Bill 4092, Assembly Bill 3964/2188 were released by the Assembly Health Committee. Assembly Bill 4092 (Spencer/Wimberly/Pending Intro) would create a “Local Hospital Fee Pilot Program” enabling specified municipalities and counties to assess a fee upon their local hospitals to generate revenue. Assembly Bill 3964/2188 (Conway/Eustace) would permit reuse of returned prescription drugs and would establish a prescription drug donation repository program in the Department of Health (DOH).
As proposed in A4092, the host municipality or county would secure its share of revenue through a defined agreement with their local hospitals. The remaining funds would then be subject to inter-governmental transfer, a process where the funds are matched by the federal government using the state Medicaid program. A similar bill S2466 (Sarlo) is pending in the Senate Health and Human Services Committee.
These bills are similar to the “Nursing Home Quality of Care Improvement Fund Act” which established a quarterly assessment on nursing homes.
The New Jersey Hospital Association (NJHA) expressed support for the concept of the pilot acknowledging the need to secure additional revenue for the state’s Medicaid program. However the NJHA is concerned about how best to implement the program. The Association noted that while other states have used the inter-governmental process, it is subject to careful scrutiny by the Federal government.
Other action included release of Assembly Bill 3964 (Eustace) and Assembly Bill 2188 (Conway/Eustace) which were combined. The bills establish a program that would allow for the donation of unused prescription drugs and supplies by persons, health care facilities, and pharmacies to a central repository for redistribution to medical facilities and pharmacies in order to re-dispense these medications that would otherwise be destroyed. The participation of any person, facility, or other entity in the program is voluntary.
April 9, 2013
Budget Hearings and Medicaid Waiver
The New Jersey Senate and Assembly Budget Committees are holding hearings on the FY 2014 State Budget: Budget Overview and Revenue Forecast from the Office of Legislative Services (OLS) and the Treasury Department. In addition, the departmental budget meetings are scheduled through May.
OLS and Treasury are both expecting growth in revenue for the remainder of this fiscal year but their numbers are far apart. OLS is predicting 8.4 percent growth in gross income tax while the administration is projecting 10.4 percent growth. On corporation business tax, OLS projects 17.4 percent growth, whereas the administration is projecting 26 percent growth.
OLS and the Treasury Department will appear again before the Senate and Assembly Budget Committees on Monday, May 20 and Tuesday, May 21 respectively to update committee on FY 2014 budget.
As mentioned in his State Budget Address, Governor Christie is taking action to expand health care coverage for New Jersey’s most vulnerable citizens through Medicaid. Doing so will mean that more New Jerseyans at or near the poverty line will have access to critical health services, while saving New Jersey taxpayers money.
New Jersey received approval of its Comprehensive Medicaid Waiver, which allows the state to move forward with Medicaid reforms. The goal is to care for our state’s most vulnerable residents and help to preserve the program over the long term while at the same time reducing costs to New Jersey taxpayers. New Jersey is one of few states across the country that advanced Medicaid reform without affecting eligibility, imposing co-pays or cutting optional services.
In March, Senate Health Committee Chairman Joseph F. Vitale, Senate Commerce Committee Chairwoman Nia H. Gill, and Senate Majority Leader Loretta Weinberg introduced legislation that would provide Medicaid health insurance to hundreds of thousands of New Jersey residents. This bill would establish the statutory framework to make the Medicaid expansion possible.
The bill would expand Medicaid income eligibility for non-elderly adult residents of New Jersey to 138 percent of the federal poverty line, authorized under the federal Patient Protection and Affordable Care Act (ACA).
The bill has been referenced to the Senate Health, Human Services and Senior Citizens Committee.
March 12, 2013
Governor Christie Unveils FY 2014 Budget
Governor Christie unveiled a Fiscal Year 2014 budget that provides $32.9 billion in state spending with no tax increases. The budget includes a record $1.676 billion pension payment and a $40 million Sandy contingency fund for expenses not reimbursed by the Federal government. The budget reflects the Governor’s decision to participate in Medicaid expansion under the Affordable Care Act. Key funding priorities in Education, Higher Education, and Health and Human Services were included in the Governor’s budget address.
Governor Christie announced that New Jersey would take money from the Affordable Care Act to extend Medicaid coverage to tens of thousands of low-income individuals. The Medicaid expansion originally was mandated by the Affordable Care Act, but last year the Supreme Court ruled that states could opt out.
Christie’s decision to expand the state’s Medicaid program is expected to help cover 300,000 uninsured New Jersey residents. Approximately 1.4 million New Jerseyans are covered by Medicaid. According to Governor Christie, as a result of New Jersey’s reforms, instead of having the standard Medicaid program that forces seniors into nursing homes as the only option when they need long-term care, New Jersey seniors will now have a choice. They will be able to stay in their homes and communities while receiving the services and support they need.
Fourteen Republican governors have rejected expanding Medicaid in their states. Overall, 24 states and the District of Columbia have signed on to the expansion.
The Medicaid expansion will be 100 percent federally funded for the first three years. By 2020, states in the program will have to cover ten percent of the cost. Starting in January 2014, the program will provide Medicaid coverage to single New Jersey residents nineteen to sixty five who make less than $16,000 a year.
February 19, 2013
Governor Christie Outlines Path Forward to Best Maintain New Jersey's Delivery of Excellent Healthcare to Residents
Federally Administered Health Exchange Most Responsible Choice for New Jersey
Trenton, NJ – Continuing with his commitment to comply with the mandates of the Affordable Care Act in a manner that protects the best interests of New Jersey and New Jerseyans, Governor Christie today gave formal notice to the federal Department of Health and Human Services (HHS) that New Jersey is opting to put in place a federally administered Exchange for Plan Year 2014, because it is the most responsible choice for the state. In a letter to HHS Secretary Kathleen Sebelius, the Governor affirmed his Administration’s commitment to protecting high quality healthcare for New Jerseyans, cooperating with the federal government as an exchange comes online in New Jersey, and detailed the many steps taken to improve the excellence in care for all of our state’s residents.
“My Administration is committed to meeting our obligation to comply with the Affordable Care Act, but only in a manner that is the most effective and efficient for the residents of New Jersey, and the businesses that will carry the costs of this new program. New Jersey enjoys a respected and earned reputation as a national leader in treatment and coverage, and our residents rightfully expect excellence in healthcare,” said Governor Christie. “In order to move forward in a manner that best meets that standard for our families and businesses, and that ensures that all New Jerseyans have access to the best healthcare options supported by the most effective insurance coverage, I have determined that federal operation of the Exchange is the responsible choice for our state.”
Under the Christie Administration, New Jersey has already taken numerous significant steps to comply with the federal mandates under the Affordable Care Act, while also instituting numerous reforms and initiatives to improve the quality of and access to care for all New Jerseyans.
In December of 2012, New Jersey selected an Essential Health Benefits Benchmark plan, as required under the Affordable Care Act.
New Jersey has successfully implemented NJ Protect, a federally subsidized health insurance program for individuals with pre-existing health conditions. NJ Protect enrolled its first policyholders in August of 2010 and now serves 1,400 New Jerseyans with serious illnesses such as cancer and heart disease by providing them access to affordable insurance and care.
New Jersey is in the final stages of modernizing our Medicaid and social service eligibility information systems, which will work with the federal exchange, through the Consolidated Assistance Support System (CASS). CASS will allow one-stop shopping – easier access, holistic benefit delivery, and unified casework – for New Jerseyans who qualify for the state’s most-used social service programs.
In 2011, New Jersey was certified as operating an “Effective Rate Review Program” in all insurance markets. The certification meets a requirement of the Affordable Care Act and confirms that consumers are paying reasonable rates.
The State of New Jersey worked with the Obama Administration to protect access to the state’s most affordable insurance coverage, “Basic and Essential” coverage utilized by approximately two-thirds of the 145,000 New Jerseyans covered by individual insurance in New Jersey, a coverage option under threat due to the provisions of the Affordable Care Act.
In October of 2012, New Jersey secured approval of our Comprehensive Medicaid Waiver in order to preserve New Jersey’s Medicaid program for the most vulnerable. The waiver allows the Christie Administration to move forward with bold, innovative reforms to decrease the cost of care, improve quality and delivery through integrated, managed care, and offer premium payment assistance for needy families. This is being accomplished without affecting eligibility, imposing co-pays, or cutting optional services.
Previously, Governor Christie declined to establish a state run exchange citing the many critical, open policy questions before states – even as federally imposed deadlines loomed to make far-reaching and significant decisions with respect to implementation of provision of the Affordable Care Act. The absence of clarity denied states the requisite information needed to make informed decisions for their residents. Those concerns were detailed in Governor Christie’s veto message of S-2135.
Click here for a copy of Governor Christie’s letter to Secretary Sebelius.
January 10, 2013
New Year Welcomes New Political Challenges
The New Year welcomes new political challenges. As 2012 closed its doors, New Jersey’s political infrastructure focused on the “Fiscal Cliff” debate and the relief package for hurricane victims in the Tri-state area. Needless to say, the hangover left by the lack of results coming out of the Nation’s capital will help fuel another exciting year in New Jersey politics.
In his annual State of the State address Governor Chris Christie began the New Year by reinforcing his commitment to stay the course on the recovery and rebuilding of New Jersey. The Governor said a lot of work lay ahead — both in New Jersey and in Washington, D.C. While acknowledging Sandy took a toll on New Jersey’s economy Governor Christie made his point clearly and unequivocally saying, “despite the challenges that Sandy presents for our economy, I will not let New Jersey go back to our old ways of wasteful spending and rising taxes. We will deal with our problems but we will continue to do so by protecting the hard earned money of all New Jerseyans first and foremost.”
The health care industry is focused on the potential impact of the fiscal cliff and an expected 2 percent reduction in their Medicare reimbursements. This could cost New Jersey health care facilities $133 million in 2013 and affect hospitals, nursing homes and physicians who accept Medicare. It could also cost the state the loss of roughly 14,000 health related jobs next year and have a substantial impact on the State’s elderly relying on Medicare.
Also on the national front, New Jersey's two US Senators Robert Menendez and Frank Lautenberg and three New Jersey House members, all Democrats, have issued statements joining President Obama in calling for national gun safety measures in the wake of the Newtown, Connecticut school shooting.
In the state Assembly, Joseph Cryan introduced a measure that would limit the capacity of ammunition magazines from the current maximum of fifteen to five. Senator Richard Codey said that he plans to introduce a bill requiring the state to divest pension funds invested in any company that sells or manufactures assault rifles. The measure would also ban any future investments.
The battle over increasing the minimum wage continued last month as the state Assembly passed a bill to constitutionally guarantee a minimum wage increase from $7.25 to $8.25 and tie future increases to the Consumer Price Index. As with all proposed changes to the state constitution, this measure must be put to the voters as a public question on the 2013 general election ballot.
Governor Christie opposes the automatic annual increases and has indicated he would veto the bill. Anticipating this, Democrats can still get the measure on the ballot without the Governor's signature by passing the bill with simple majorities this year.
In late December, following a state inspection report detailing alleged neglect at several for-profit memory care homes that cater to patients with Alzheimer's disease and dementia, Assembly Democrats Valerie Vainieri-Huttle and Connie Wagner introduced legislation to improve state oversight in order to combat abuse in these facilities. These facilities specialize in an alternative kind of senior care and are not as highly regulated as nursing homes.
In campaign news, Cory Booker announced last month that instead of making a run for Governor against incumbent Governor Christie he will instead make a run for 88-year-old Frank Lautenberg’s U.S. Senate seat in two years. According to reports former Governor Richard Codey has hinted at possibly running as well as Senate President Stephen Sweeney of West Deptford. Senator Barbara Buono has already entered the race.
A nod usually reserved for a Democratic candidate, Governor Christie was endorsed by Laborers' International Union of North America. The Laborers are one of the largest construction worker unions in NJ.
December 10, 2012
Election Update & 2012 Priorities
ELECTIONS
In New Jersey’s Federal Elections, Democrat Senator Robert Menendez was reelected to his second full term. The New Jersey’s House delegation changed from 7-6 Democrat to an even 6-6 split with the loss of a district seat following redistricting.
In the New Jersey Legislature, special elections were held for State Districts 4, 16 and 26. Gabriela Mosquera (D), Donna Simon (R), and Betty Lou DeCroce (R) all won over their competition with comfortable margins.
New Jersey voters approved both statewide ballot questions. The first measure approved $750 million in bonds for New Jersey’s higher education facilities by a significant margin. Voters a
lso approved the second ballot question on Tuesday night. The question amended the state constitution to allow contributions set by law to be taken from the salaries of Supreme Court Justices and Superior Court Judges for their employee benefits, as agreed to by the Legislature. These benefits include pension and health care coverage.
Going into 2013, the Democrats will control the Senate, 24-16 and the Assembly 48-32. The Governor and all State Legislators are up for reelection in November 2013.
2013 PRIORITIES
Hurricane Sandy
The Christie Administration has announced a total assessment of the damage sustained from Hurricane Sandy to the State of New Jersey, which places the total cost at $36.9 billion. This total accounts for the unprecedented and widespread damage caused by Hurricane Sandy to personal property, businesses, transportation and utilities infrastructure, the impact on the state’s tourism industry, mitigation and prevention costs, and is inclusive of aid received to date and anticipated from federal sources including FEMA and the Small Business Administration. The total assessment includes $29.4 billion in repair, response and restoration costs previously released, plus $7.4 billion in mitigation and prevention costs that have since been determined.
Both the Governor and the Legislature have committed the recovery and rebuilding of New Jersey as their highest priority.
The Office of Legislative Services projects that FY 2012 and FY 2013 revenues will be $536.9 million less than the estimates in the FY 2013 Governor's Budget Recommendation. Specifically:
• For FY 2012, the OLS revenue estimates are $144.9 million, or 0.5%, below the Executive budget estimates.
• For FY 2013, the OLS revenue estimates are $392 million, or 1.2%, below the Executive budget estimates
As we enter the election year of 2013 a few issues will be front and center. The minimum wage increase has passed both houses and goes to the Governor’s desk with the potential Constitutional Amendment to include CPI clearing its first hurdle. The Affordable Care Act implementation and Supreme Court Nominations will continue to cause great debate with both political parties, as well as the continued wrangling over education funding and women’s health care.
In addition to the usual challenges that face current office holders during campaign season, these candidates are still reeling from the state-wide destructive aftermath of Super Storm Sandy and the mitigation moving forward. There are additional committee hearings being held around the state and resulting legislation being introduced on a daily basis.
As a result of the storm, there will also be new debate surrounding prior proposed legislation. As an example, before the minimum wage bill made it to the governor’s desk the post storm debate included the negative impact on small businesses severely damaged in the storm.
Recently, Marc Ferzan was appointed to manage Hurricane Sandy Recovery efforts within the Office of the Governor. Mr. Ferzan will be responsible for directing the vital task of overseeing and coordinating Governor Christie's long-term recovery efforts for New Jersey in cooperation with all federal, state, local, private, and non-governmental partners. In addition, Governor Christie announced the retention of Witt Associates, a team with vast experience in disaster recovery and large scale mitigation management, to assist in the long-term rebuilding process.
