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2022 Legislative Update and Tips for Following the General Assembly Session

Colleen Grady

Legislative Aide

Delegate Rodney Willett

colleen@rodwillett.com

571-438-1142

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HB425: Continuing care providers; requirements for providers, complaint process, report.

Delegate Willett worked with VaCCRA members to introduce HB425, which would have made the following changes to the regulatory process for CCRCs and CBCCs:

Establish an online and telephone complaint line for which a resident may make a complaint for an alleged violation of Chapter 38.2
Require every provider to include resident representation on its Board of Directors that is equal to or greater than 20% of the total number of board members, or 1 resident representative, whichever is greater.
Provide residents the right to post information regarding residents rights and the complaint process without retaliatory conduct.
Require CCRCs/CBCCs to include information related to emergency call systems, criteria and requirements for transfer between levels of care, and its policies and procedures for services, including check-in procedures, in its annual disclosure statement.

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HB425 (cont).

Legislative Process

The bill was heard in the House Subcommittee on Commerce and Energy #1.
Delegate Willett presented the bill, and the committee heard testimony in support from VaCCRA President Penny Jez and VaCCRA Policy Committee Chair Sara Coleman.
Representatives from Leading Age as well as Executive Directors from Cedarfield, Westminster-Canterbury, and Pinnacle Living, spoke against the bill.

Main argument against the bill is that CCRCs are already a highly regulated industry, and that there is no other industry in which the General Assembly mandates certain board representation.

The subcommittee voted to “lay the bill on the table” by a vote of 6Y-2N. This means that 6 members voted against the bill, and only 2 voted in support, meaning the bill would not advance to the full Commerce and Energy Committee
You can read a transcript of the bill hearing online here.

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HB425 : Non-Legislative Progress on SCC Website for CCRCs

In her testimony, LeadingAge lobbyist Dana Parsons noted that she had spoken with the SCC, and that they had agreed to work with stakeholders to enhance the Guide to Regulations of CCRCs and develop a CCRC focused webpage to help consumers better understand the regulatory process and access facility disclosure statements.
Following the Legislative Session, I organized a meeting with representatives from the SCC, VaCCRA, and LeadingAge to discuss potential improvements to make the website more consumer friendly, easier to navigate, and develop two versions of a regulatory guide — one for consumers and one for providers.
All parties reported that the conversation was productive. The SCC is now reviewing suggestions and is working on implementing these updates.

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Nursing Home Staffing Standards

Delegates Watts (HB330)and Carr (HB646) both introduced legislation that would have established mandatory staffing ratios at nursing homes and certified nursing facilities in Virginia.
Virginia is one of only 18 states that does not currently have staffing ratios in nursing homes. Similar legislation has been introduced in 17 consecutive legislative sessions.
Both bills failed to report from HWI Subcommittee #3. However the Committee Chair, Delegate Orrock, made a commitment to hold future meetings on the subject. The first meeting was held on April 27th.

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Nursing Home Staffing Standards

Arguments made in favor

Majority of other states have mandatory staffing ratios.
The pandemic highlighted and exacerbated the dangerous impacts of low staffing levels on the health of nursing home residents.
Centers for Medicare and Medicaid Services considers 2.8 hours of certified nursing care to be the safe standard..

Arguments made in opposition

The workforce to meet the staffing requirements is not available in the current labor market.
The vast majority of nursing facilities are actively recruiting more staff and have increased compensation to improve retention. Facilities need more money in reimbursement rates to keep up with the market.
Virginia has just started a Value Based Purchasing program to provide financial incentives to increase staffing levels. Let’s try that before we establish mandates.

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Improving Virginia's Adult Guardian and Conservator System

In 2021, JLARC conducted a study of Virginia’s Adult Guardianship and Conservator system.

Guardians or conservators are appointed following a circuit court hearing in which an adult is deemed incapacitated due to dementia, a traumatic injury, a disability or a severe mental health condition. Under the private system, a family member, friend, attorney, professional guardian or organization would then gain the power to make a broad range of life decisions on that person’s behalf, as well as financial ones if they’re named a conservator.

The report found that in our current system:

Some judges lack adequate information when deciding to appoint a guardian or conservator in the first place. The report recommends providing more training.
Private guardians are not required to regularly visit the adults they serve either, which may hinder their ability to assess their needs or notice changes in their condition.
Guardians have too much authority to restrict family or friends from visiting. It notes that this socialization is critical to prevent and recognize potential issues.
There is a need for a centralized complaint system. The current process is fragmented in various state agencies and confusing.

In contrast to the private system, JLARC found that the state’s public guardianship program, which serves low-income adults who don’t have access to other resources, has effective oversight, visitation and training requirements.

However, the public system is not meeting the current need. JLARC found there are nearly 700 adults on the waitlist with delays ranging from 3 months to 4 years, depending on the organization. Those sitting in the backlog either have a temporary private guardian or are not being served at all, according to JLARC.

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Improving Virginia's Adult Guardian and Conservator System

To improve our Guardianship and Conservator System, a number of bills were passed to improve court processes, strengthen the rights of Virginians in this system, and prevent abuse and neglect of vulnerable adults.

HB94 — Establishes Public Guardianship and Conservator Ombudsman office.
HB95 — Requires financial institutions to cooperate in any investigation of alleged adult abuse, neglect, or exploitation conducted by a local department of social services.
HB634 — Directs the Department for Aging and Rehabilitative Services to convene a work group on a potential requirement that private guardians visit with the individual under their guardianship at least once every 90 days.
HB623 — Requires guardian ad litem appointed to represent the interests of and individual in a guardianship/conservator case to notify the court is if the individual in their custody requests counsel.

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Study of Regulation of Nursing Homes, Assisted Living, and Independent Living Facilities

The General Assembly passed HB234, directing the Secretary of Health and Human Resources to study the current oversight and regulation of nursing homes, assisted living facilities, and other congregate living settings to improve efficiency and effectiveness of regulation and oversight, provide better transparency for members of the public navigating the process of receiving services from such facilities, and better protect the health and safety of the public.
Currently the following agencies regulate each portion of this industry:

Department of Health — Nursing Homes
Department of Social Services — Assisted Living Facilities
State Corporation Commission — CCRCs, CBCCs, and ILCs

The Secretary is required to report his findings and recommendations to the Governor and the Chairmen of the Senate Committees on Education and Health and Finance and Appropriations and the House Committees on Appropriations and Health, Welfare and Institutions by October 1, 2022.

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Questions about the 2022 Legislative Session?

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Useful Terminology (cont)

Sine e die: Latin term that means “without day.” A legislature adjourning sine die means it is the final adjournment of the assembly without a day set for reconvening.
Move the Pending Question: If the debate on an issue or a bill goes on too long, a delegate can “move the pending question” to ask for a vote on the bill.
Lay on the Table: A nice way of “killing a bill.” A committee chair can bring the bill back up for debate with a majority vote, but this never happens.
Pass by Indefinitely (PBI): A meaner way of “killing a bill.” A committee chair cannot bring the bill back up for debate.
Carry Over: The bill is dead for the current session and can be re-introduced in the following session. Carry Over can only happen during even-year sessions and the bills can be re-introduced only in odd-year sessions. This is because each member serves a two-year term before being re-elected.

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Useful Terminology

(Joint) Conference Committee: A committee appointed to resolve differences the houses on a specific bill or resolution, usually consisting of an equal number of members of the House and Senate.
Budget Conferee: The Senate and the House appoint members of their Appropriations committee to discuss the budget with the fiscal analysts and members of the other legislative body. In the House of Delegates, seven members, from the Appropriations Committee (five majority party and two minority party) are appointed by the Speaker of the House.
First Reading: A bill’s title is printed in the Calendar or is read by the Clerk of the House of Delegates.
Second Reading: Bills are considered in their order in the Calendar. Its patron explains the bill and answers any questions that arise. The House votes to engross the bill and pass it to its third reading by voice vote.
Third Reading: Engrossed bill titles appear in the House calendar. The House passes the bill by a recorded vote.

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How to Track Legislation Online

All bills can be found at https://lis.virginia.gov/

If you know the bill number you are looking for, click “Bills and Resolutions” and search by the bill number.

You can also track all upcoming committee meetings online at https://lis.virginia.gov/cgi-bin/legp604.exe?221+oth+MTG, or by clicking “Meetings” on the homepage
See all Committees online at https://lis.virginia.gov/221/com/COM.HTM. You can click on each committee to see a list of its members, upcoming agendas, and past committee reports.

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How to Read a Bill and Virginia Code

Any language that is in regular type font is already a part of Virginia code. The part of a bill that is strikeout or in italics are the changes the bill would make by either deleting or adding to the code. The Virginia Code website can be accessed here.
The code is organized by titles, sections, and chapters, that break up the code into sections by topic.
Example of Code Abbreviation: § 54.1-2704.

Title 54.1 (Professions & Occupations)
Chapter 27 (Dentistry) Section 04 (Nominations for the Board of Dentistry)

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Example: Reading a Bill

Introduced bill

Text as passed the House

Text as passed House and Senate

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1950 is the current version of the Code in use. The bottom of each section show dates that the code section was changed. For recent years, you can click on the linked numbers in blue to see the bills that revised the code section.

When I clicked on “505” and “587” I was brought to the LIS page for the above bills which made changes to the nomination process for the Board of Dentistry

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Impact statements are prepared by our budget and committee staff. They are an analysis of the potential costs of a bill on state or local government.

These costs are estimates, but legislators pay careful attention to a bill’s FIS, as we typically do not want to pass laws that are unfunded.

Impact Statements

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Bill history is listed on each bill’s webpage and provides the date and action taken at each phase in the legislative process.

The example shown is short because the bill failed to advance pass its first subcommittee. For legislation that becomes law, this section can be 20-30 lines long.

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How a Bill Becomes a Law

Bill is introduced by Delegate or Senator. The Speaker of the House assigns the bill to a Standing Committee

Committee Chair will send the bill to subcommittee for consideration. If the bill “reports” it is then sent to the full committee.

The bill then must report from the full committee to advance to the House/Senate Floor

First Reading: The bill is printed in the calendar and read by the Clerk of the House

Second Reading: Delegates will stand up to introduce the bill and ask the body to engross it. The bill is amenable on 2nd read, and the patron will answer questions from other members. Voice vote is required to pass.

Third Reading:The next day, the engrossed bill is printed in the calendar and read by the clerk. A recorded vote is required to pass.

If passed, the bill is then sent to the opposite chamber and repeats the same committee and floor process.

If there are differences between the House and Senate versions of the bill, one chamber must accept the other’s version. If they will not accept, a conference committee is formed to resolve differences.

If a bill passes the House and Senate, it is printed as an enrolled bill, and signed by the Speaker and Senate President

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How a Bill Becomes a Law (cont.)

Enrolled bill is sent to Governor where he may take one of four actions

Sign the bill into law.

Amend the bill and return it to the General Assembly for approval by a simple majority in both chambers

Veto the bill and return it to the GA, where they can override the veto with a ⅔ majority in both Houses

Do nothing, and the bill will pass without his signature

Compared with other states, Virginia’s Governor has significant power in the legislative process. The Governor is able to veto bills in their entirety, as well as portions of a bill, also known as a “line item veto”. The Governor also has the authority to send down recommendations that rewrite provisions of the bill and change legislation substantially.

Virginia holds a reconvene session to vote on vetoed bills (typically 1 day, but can be as long as 3) on the sixth Wednesday after the adjournment of the Regular Session.

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When do new laws take effect?

Helpful Links and Resources

Laws enacted during a Regular Session (or following Reconvene Session) take effect on July 1st following the session, unless another date is specified in the bill.
Laws enacted during a Special Session are effective on the 1st day of the fourth month following the adjournment of the Special Session.