Medicaid memory care waiver considered

Members of the Health and Human Services Committee heard testimony Jan. 22 on a bill that seeks to establish a Medicaid reimbursement rate for assisted living facilities that provide memory care services.

LB61, introduced by Whitman Sen. Tanya Storer, would require the state Department of Health and Human Services to apply to the federal Centers for Medicare and Medicaid Services no later than Sept. 30, 2025, for a waiver amendment to include reimbursement rates for assisted living memory care.

The bill also states intent to appropriate an undetermined amount from the General Fund for fiscal year 2025-26 and FY2026-27 for the payment of memory care rates.

Storer said the current reimbursement structure — which provides an umbrella reimbursement rate for assisted living facilities regardless of the level of care provided — does not adequately account for the additional support, training and staffing that memory care facilities require.

She also noted the growing number of individuals diagnosed with Alzheimer’s disease in Nebraska.

According to the Alzheimer’s Association, she said, over 35,000 Nebraskans age 65 and older currently are living with Alzheimer’s, a number that is projected to increase by 21% this year.

“It is undeniable that we are going to have a significant increase in need in our state,” Storer said. “Ignoring that reality is not going to make it go away.”

Kiersten Reed, speaking in support of the bill on behalf of LeadingAge Nebraska, said the costs associated with specialized care for dementia disorders — which is the most expensive to provide — has caused many providers to close.

The number of Nebraskans experiencing dementia has steadily increased while the number of assisted living facilities that accept Medicaid and provide memory care services has dropped significantly, she said.

“The current reimbursement rate and the current system that we have is not set up to manage that kind of influx,” Reed said. “We just simply don’t have the capacity with 44 providers.”

Heath Boddy, testifying on behalf of Vetter Senior Living, said lawmakers need to take swift action to ensure access to care for vulnerable Nebraskans.

“I can say with certainty that access to care, specifically assisted living memory care, in rural Nebraska for those that rely on state assistance is already an issue,” Boddy said. “My assessment is that this is only going to get worse.”

No one testified in opposition to LB61 and the committee took no immediate action.