SENATE CONCURRENT RESOLUTION 23

(By Senators Maroney, Takubo, Azinger, Deeds, Grady, Hamilton, Hunt, Plymale, Roberts, Rucker, Tarr, and Weld)

[Originating in the Committee on Health and Human Resources; reported on March 8, 2023]

Requesting the Bureau for Medical Services to propose and initiate a study to determine the impact of public benefit income eligibility guidelines on direct care workforce participation and mitigation strategies to encourage the greatest direct care workforce participation possible (Direct Care Workforce Benefit Cliff Study).

Whereas, The Legislature recognizes that some low-income West Virginians can become ineligible for public benefits with a small increase in income from working additional hours and that the small increase in income is often insufficient to offset the value of the lost benefits (i.e., the benefit cliff); and

Whereas, The Legislature recognizes that benefit cliff can discourage increased workforce participation from current and potential part-time and full-time direct care workers; and

Whereas, The Legislature recognizes that there is a significant direct care workforce shortage in West Virginia that causes harm to older and disabled West Virginians who are unable to obtain sufficient long-term services and supports (LTSS) to avoid poor outcomes;

Whereas, The Legislature recognizes that avoidable poor outcomes are an emotional burden to older and disabled West Virginians and their families and a financial burden for the state budget;

Whereas, It is in the public interest for West Virginia to identify the strategies to lessen the burden and costs associated with poor outcomes associated with insufficient direct care workforce in the state; therefore, be it

Resolved by the Legislature of West Virginia:

That the Legislature hereby requests the Bureau for Medical Services propose and initiate a benefit cliff study to understand the impact of benefit cliffs on direct care worker hours, recruitment, and retention and identify successful state strategies to alleviate the negative impacts of benefit cliffs, including any federal and state options to allow greater income limits and/or cost sharing (e.g., allowable income disregards, provider paid benefits, etc.); and, be it

Further Resolved, That the study be conducted by an academic institution with experience in relevant research and policy areas; and, be it

Further Resolved, That the study include a literature review of state and national studies focused on the impact of government health, nutrition, income, housing, and other public benefits on workforce participation, including studies focused specifically on: (1) The impacts of benefit cliffs and plateaus on the direct care workforce as well as studies on similar issues in other workforce sectors; and (2) the impact of benefit cliffs and plateaus on care availability and state Medicaid budgets as well as state policy solutions that have successfully addressed the negative impacts of benefit cliffs and plateaus; and, be it

Further Resolved, That, based on insights gathered through the literature review, stakeholder interviews, and available data sources, the study will provide an estimate of the statewide workforce, access to care, and budget impacts of the current state benefit cliffs and the costs and benefits of potential state policy solutions including a Medicaid buy-in program as proposed in Senate Bill 610 and House Bill 3274, utilizing Medicaid 1115 or 1335 waivers or an advanced premium tax credit approach; and, be it

Further Resolved, That the Bureau for Medical Services provide the study results and recommendations to the Legislature, the Legislative Oversight Commission on Health and Human Resources Accountability and the Joint Committee on Government and Finance by July 1, 2023.