Last week saw both the House and Senate releasing their Health and Human Service Omnibus bills. While each of the bills contain quite a few changes important to Home and Community-Based Service providers, below are a couple highlights of things we support, oppose or are watching in each of the pieces of legislation.
House Health and Human Service Omnibus Bill
Changes to the Disability Waiver Rate System
- 4.7% Competitive Workforce Factor with automatic 2% changes in 2022 and 2024
- Moves the inflationary adjustment from every 5 years to every 2 years and uses the most recently available data
- Includes new workforce reporting requirements
- Includes rate encumbrance language
- For residential providers: 66% of your rate must be used for direct care wages and employee related expenses
- For day service providers: 45% of your rate must be used for direct care wages and employee related expenses
- For unit based service providers; 55% of your rate must be used for direct care wages and employee related expenses
245D Licensing Fees
The bill includes the Licensing Division of the Department of Human Services’ proposal to increase licensing fees for 245D providers. The new fee schedule would raise fees based on revenue with changes ranging from 20%-300%.
Last week ARRM sent out messages to the lead contacts of members who would see their fess go up by more than 29%, with specific messaging to use when reaching out to your House member. It's important to make these contacts now, as it will increase the possibility of removing this language later in conference committee.
Senate Human Services Reform Finance and Policy Omnibus Bill
Changes to the Disability Waiver Rate System
- Includes a Competitive Workforce Factor set at 4.7%
- Moves the inflationary adjustment from every 5 years to every 2 years, using data that is 30 months old
- Includes new workforce reporting requirements for providers
- Includes encumbrance language that states any new revenue received from the Competitive Workforce Factor must be used to increase Direct Support Staff wages
ICF Legislation
- Removes the restrictions on applying for a variable rate, allowing any provider to request a variable rate for their ICF
- Changes the Services During the Day rate from 75% to 100% of the DT&H Rate
ARRM’s Policy Provision
- Moves the sunset date for adding a fifth bed to a home to 2021 (Note: The language was also changed from 5 beds to 6 beds)
- Requires an annual conversation on the use of technology
- Clarifies the Annual Training Competency based requirements
- Includes the Positive Support Professional Training changes
245D Licensing Fees
The bill does not include language that would increase licensing fees for 245D providers.
Adult Foster Care Bed Closure and DD/CADI Waiver Caps
The bill includes language that would mandate that for every two beds that are permanently vacated for over 6 moths the Commissioner would reduce adult foster care bed capacity by one. The bill also implements DD and CADI waiver caps as of June 30th, 2019, not allowing any new waiver recipients unless someone leaves the waiver and prioritizing those waiting for waiver services by need.
ARRM’s Response
ARRM provided testimony in both the House and Senate to these bills, highlighting the provisions we support and putting on record the provisions we have concerns or are opposed to. In the House, we attempted to remove the licensing fee increase through amendment but the amendment was not adopted. We also worked in the House to draft an amendment which stated DHS would need to study the feasibility of creating a rate system for ICF/DD similar to that of DWRS. DHS testified that the amendment would have a cost and therefore it was not adopted.
We are anticipating amendments being taken in the Senate this week and will work with key Senate leaders to craft amendments that would work to address the concerns we have with the bill as drafted.
Looking Ahead
The legislature will be on break next week, coming back April 22nd where things will begin to move very quickly on the way to adjournment on May 21st.
Please contact me with any questions.
-- Sara Grafstrom, Director of State and Federal Policy