Issue Paper



User Fees

Background:

 In his FY 2001 budget proposal, President Clinton once again has included a variety of user fees to be imposed on health care providers to offset some of the operating expenses of HCFA. Two of those proposed fees apply specifically to nursing facilities and would raise approximately $63 million.

The first proposed user fee would permit either HCFA or the State to charge facilities a fee to cover the full cost of their initial Medicaid/Medicare surveys. Those fees are projected to generate $13 million. The second fee would cover 33% of the costs for recertification surveys and generate an additional $50 million.

WAHSA’s POSITION: WAHSA members seek your support in opposing the imposition of any additional user fees on nursing facilities and other health care providers.

Supporting Arguments:

  • Simply stated, the imposition of user fees on nursing facilities would take limited resources that should be used for resident care and shift them to pay for services that are the responsibility of government. Congress has defeated these proposals before; we hope you will do so again.

  • At a time when 91% of WAHSA nursing facilities are incurring Medicaid costs to serve their residents that outpace Medicaid reimbursement, by an aggregate total of $66.7 million, now is not the time to impose nursing facility user fees.

  • At a time when the Wisconsin Legislature has passed a wage pass-through for certified nursing assistants and is considering a wage pass-through for support service staff, both aimed at addressing a severe staffing shortage, now is not the time to siphon off funds needed for staff recruitment and retention to pay for the nursing home quality monitoring services government has a responsibility to provide.

  • At a time when several national, for-profit nursing home chains have filed for bankruptcy, now is not the time to impose nursing facility user fees, for financial uncertainty is not the sole domain of the for-profit provider.
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    The Wisconsin Association of Homes and Services for the Aging (WAHSA) is a statewide membership organization of not-for-profit corporations principally serving elderly and disabled persons. Membership is comprised of 190 religious, fraternal, private and governmental organizations which own, operate and/or sponsor 194 not-for-profit nursing homes, 71 community-based residential facilities, 39 residential care apartment complexes, 100 independent living facilities, and 446 community service programs which provide services ranging from Alzheimer's support, child day care, hospice and home care to Meals on Wheels. For more information, please contact the WAHSA staff at (608) 255-7060: John Sauer, Executive Director; Tom Ramsey, Director of Government Relations; or Brian Schoeneck, Financial Services Director.



    WAHSA 204 South Hamilton Street Madison, WI 53703
    Telephone: (608)255-7060 FAX:(608)255-7064