UPDATE: Published December 18, 2019
CMS Approves the Competitive Workforce Factor
In an announcement today, the Minnesota Department of Human Services informed all counties and providers it has received approval from the federal Centers for Medicare and Medicaid Services to apply the 4.7 percent Competitive Workforce Factor to Disability Waiver Rate System framework rates. Yay!
Providers and support teams can now move forward projecting the rates for service agreements renewing on or after Jan. 1, 2020 with full confidence in how the the frameworks will be calculated.
As a reminder, the overall impact of this implementation is projected to be an average increase to DWRS rates of 4 percent, equivalent to more than $150 million dollars over the next four years. It is paramount to forecast the impact for your own organization by reviewing each agreement, as the Competitive Workforce Factor only applies to direct staffing costs. Find information and resources in the ARRM Training Archive.
The department is moving quickly to update the Rate Management System, which should take place this evening.
Published December 16, 2019
Late on Friday, Dec. 13, the Minnesota Department of Human Services (DHS) released an update on the Competitive Workforce Factor (CWF) announcing it had not yet received a response from the federal Centers for Medicare & Medicaid Services (CMS) on whether the application of the CWF had been approved. Where does that leave providers, lead agencies, advocates and individuals served as they try to complete authorizations and compute rates for services that start in 2020?
To recap, here’s what we know so far:
-
The final omnibus health and human services (HHS) bill that Gov. Walz signed into law following the 2019 special legislative session included a competitive workforce factor of 4.7% that applied to direct care awake staff. It did not apply to asleep staff, supervisory hours, or RN and LPN nursing hours.
-
On October 1, 2019, DHS sent a waiver amendment application to CMS that included the CWF as well as many other changes to the existing waiver amendment. CMS has 90 days to make a formal response, which means their response could come as late as December 31, 2019. In their response, they can approve or deny it wholesale, or respond with questions and/or concerns for DHS to respond to, which would start the 90-day clock all over again upon DHS’ response.
-
In October 2019, DHS released the Disability Waiver Rate System (DWRS) component values for 2020. They were identical to the 2019 values with the exception of the asleep overnight wage component increasing from $9.86 to $10.00 per hour to reflect the state’s new minimum wage, effective January 1, 2020.
-
In November, 2019, DHS notified lead agencies and home and community-based service waiver providers that use the Rate Management System (RMS) within the MnCHOICES Support Plan that they would update the RMS on December 13, 2019. This RMS update would include changes to some framework component values which would affect 2020 rate calculations, and would include the CWF if CMS’ approval was received by that time.
What now?
Even though CMS did not meet the DHS preferred date of December 13, DHS staff are optimistic and fully expect to receive formal approval before December 31, 2019.
According to Alex Bartolic, Director of the Disability Services Division for DHS, “In talking with CMS, they have no remaining questions and we are essentially done. As soon as we receive their approval, new instructions will be issued about how to move forward and what to do with any work that happens in the meantime. Our staff have been working with counties, and meeting with them, because we know this influences how they manage their workload, and the same is true for the providers.”
It is ARRM’s understanding that because DHS has preemptively prepared its RMS guidance for CWF approval, there should be little delay between CMS sending approval of the new rate factor and implementation by DHS.
We at ARRM are staying abreast of any developments related to this issue, and will arrange communications with our members as soon as there is news to report.
Remember, if your organization has questions about the impact of the Competitive Workforce Factor and the end of rate banding in 2020, ARRM has resources for members. Find recordings of trainings and sample worksheets available free to all members on our Training Archive, and for customized support visit www.arrm.org/CWF.