It's hundreds and hundreds of pages long, spends billions of dollars, and regulates thousands of state programs and private organizations. If you're thinking of the Health and Human Services Omnibus Budget Bill, you're right on!
ARRM has completed its review of this massive piece of legislation. This article walks through what's in, and what's out, and how it matches up with the association's priorities. Our team will be breaking down key provisions in an ongoing series of fact sheets and articles, but this provides your general overview. Items that are italicized will be featured in future blog posts in the coming two weeks with a more thorough background and analysis, items with an asterisk were included on ARRM’s 2019 Legislative Agenda.
If you have any questions about any of the items listed below, please feel free to reach out to Sara Grafstrom at sgrafstrom@arrm.org.
Included in the Health and Human Service Bill that we SUPPORT
- * Competitive Workforce Factor for DWRS at 4.7%: A Competitive Workforce Factor has been added to the DWRS framework at 4.7%. This adjustment will cost the state $34 million in 2020 and 2021 and $30 million in 2022 and 2023 and represents about a 4% increase in DWRS rates.
- * Change to the inflationary adjustment from every 5 years to every 2 years: Beginning in 2022, component factors will automatically be adjusted ever 2 years, using 30 month and 1 day old data.
- * Requirement of an annual conversation on technology: At annual planning meetings, providers must have a conversation about how technology may be used as a part of someone’s services.
- * Changes to the training requirements and qualifications for the Positive Support Professional, Positive Support Analyst and Positive Support Specialist position: Many changes were made to this service; one highlight is that the Positive Support Specialist and Positive Support Analyst now have 90 days to get their required training.
- * Removal of the hourly requirements for Annual Training: The hourly requirements that were in statute for the annual training requirement have been removed. Annual training and Orientation training is now competency based.
- Creation of a Technology First Advisory Council: A Technology First Advisory Council has been created with ARRM being granted a seat on the council. The goal of the council is to advise the commissioner on strategies to increase the use of supportive technology in services and programs.
- Direction to the commissioner for a Value-Based Models study: The commissioner, in consultation with stakeholders shall study value-based models and outcome-based payment strategies with a report due by October 1st, 2020.
Not Included in the Health and Human Service Bill that we SUPPORT
- No caps to the DD and CADI waivers: A proposal that would have capped the DD and CADI waiver at June 30th, 2019 levels was not adopted.
- No increase to HCBS Licensing Fees: A proposal that would have increased 245D provider licensing fees from 25-300% was not adopted.
- No new language relating to the closure of Adult Foster Care beds: A proposal that would have permanently closed one adult foster care bed for every two that are vacant for six months or more was not adopted.
Included in the Health and Human Service Bill that we OPPOSE
- New definition of shared respite: New language states that for shared respite, the rate shall be the total payment for one individual divided by the number receiving the service, not to exceed three.
- Removal of the ILS Specialist Service from the framework: The ILS Specialist Service has been removed from the framework and no longer available for providers to provide.
Not Included in the Health and Human Service Bill that we OPPOSE
- * No language allowing for the expansion of variable rates for ICFs and an increase in the reimbursement for Services During the Day: ARRM’s legislative proposal that would have allowed all ICFs to request a variable rate and would have changed the Services During the Day reimbursement rate from 75% of the DT&H rate to 100% of the DT&H rate was not included.
- * No extension of the licensing moratorium exception for adding a 5th bed: During committee, the Senate amended our language around the 5 bed moratorium extension to 6 beds and removed the sunset language. There was opposition from the advocacy community around the 6 bed proposal and because of that, the entire proposal, including our language to extend the 5 bed sunset date was not adopted.
Included in the Health and Human Service Bill that we are NEUTRAL on and Impacts Members
- New definition provided for Residential program: A new definition of residential program has been added to 245A.02
- New HCBS Documentation and Billing standards: New documentation and billing requirements have been added to 256B.4912. ARRM worked closely with the department on this language over the last several years to ensure that this language is the least burdensome to providers.
- New language around change in ownership: The language provides direction and clarity for licensing and providers when a change in ownership occurs
- Electronic Visit Verification Language: Language allowing the department to move forward with EVV was adopted. The language states that any penalty that the department receives due to not coming into Federal compliance cannot be passed along to providers.
- New Labor Market Reporting Requirements: On an annual basis providers will be required to submit labor market data. Language is included in the bill directing the commissioner to streamline reporting as much as possible.
- Report and Proposal requirements for Waiver Re-imagine: A report and proposal to move forward to streamline the four waivers to two is required to the legislature by 2021.
Broader Disability Community Initiatives
- TEFRA Parental Fees Reduced by 15%
- MA Spend down for individuals with a disability eliminated
- Allowance of CDCS shared services
- PCA SEIU Labor Contracts ratified
- Bulk purchasing incontinence product program repealed
- MSOCS Operating adjustment