Last week saw both the House and Senate take formal floor action on their Health and Human Service Omnibus bill. The House passed their version on party line vote, while the Senate proceeded with a bit more “across-the-aisle” backing, gaining votes from all three caucuses (GOP, DFL, and independents). With the House and Senate having drastically different provisions in their Omnibus proposals, a conference committee will be formed to work through the differences and come to a compromise piece of legislation.
Below, please find an update of ARRM’s legislative priorities and where they stand in the House and Senate Omnibus bills, as well as an idea of what to expect in the final two weeks of session, before the constitutionally-mandated adjournment date of Monday, May 17th.
- Retainer Payments for Home and Community-Based Service Providers: The Senate uses the one-time 10% FMAP enhancement that was passed in the American Recovery Act to create retainer payments for a certain group of Home and Community-Based Service providers, including waiver service providers. These retainer payments would be distributed to providers on a quarterly basis beginning July 1st, 2021 through July 1st, 2022 and would be based on the previous month’s Medicaid billing. While we are still trying to establish the exact impact the retainer payments will have, early estimates have indicated that they will equate to an approximate 3.25% increase in spending. The House does not take a position on the spending of federal dollars from the American Recovery Act, citing the need for guidance from CMS before they will move forward with any proposal.
- Remote Supports Rate Framework: Both the House and Senate create a separate set of component values for services that are provided remotely. The House version is the same as what was contained in the Governor’s original and supplemental budget and would result in an approximate 12% reduction in rates for services that are provided remotely. The Senate proposal keeps component values the same for remote supports as they would be if the services were provided in-person.
- ICF/DD Rate Increase and Variable Rate Changes: The Senate includes ARRM’s proposal of a 5% increase for ICF rates effective July 1st, 2021 as well as adjusting the Services During the Day rate to 100% of the DT&H rate and removing the barrier to requesting a variable rate for an individual. The House does not include any adjustment to ICF rates or policy.
- Choice in Technology Policy Statement: The Senate bill contains a provision that ARRM worked closely with the Disability Law Center and The Arc MN in crafting that would ensure that individuals are being presented choice in technology as part of their service plan. This policy statement will join the three other disability policy statements that were put in place during the 2020 legislative session, requiring individuals to be given choice in where they want to live, where they want to work and how they want their services directed. The House does not have this policy language in their bill.
- Transition to a Fee Schedule for Background Studies: The House HHS Omnibus bill removes background study fees from statute and gives the Department of Human Services the authority to create an annual fee schedule for background studies, ARRM opposes this provision as it will result in an increase to the background study fees that providers pay. The Senate does not carry this proposal.
- Direction to the Commissioner to establish a service allowing Personal Care Assistants (PCA) and Direct Support Professionals (DSP) to be reimbursed when supporting individuals during short term, acute hospital visits: The Senate HHS Omnibus bill contains ARRM’s language from our policy bill that would direct the Commissioner of Human Services to work with stakeholders in creating a service that would allow Direct Support Professionals and Personal Care Assistants to be reimbursed when supporting an individual during a short-term, acute hospital visit. The House does not have this provision in their bill.
- Daily Rate Change for Individualized Home Supports with Training: The Senate is carrying language that would change the Daily Rate option of IHS with Training to anything over 6 hours a day. Current language says the Daily Rate can be used when services are provided on average 6 hours a day, but anything more must use the Unit Based Rate. The language also allows IHS with Training to be a shared service with up to three people. The House does not carry this language in their bill.
- Extension of Transition Lease Opportunities for a person’s Own home: The Senate carries language that allows for multiple transitional leases if after the initial lease and transitional lease time period is up and the provider is still required to co-sign an individual’s lease when they are living in their own home. The House does not have this policy language.
- Extension to 180 Days for Compliance in Peace Time Emergency Background Studies: Both the House and Senate have language in their Omnibus bills that would take the current window of 60 days after the Peacetime Emergency ends for individuals to be in compliance with a full background study, and extends that to 180 days.
- Family Foster Care Rate Framework: The Senate does not carry the new Family Foster Care Tiered Rate Framework in their bill, as a result, rates will not be changed for Family Foster Care providers. The House does carry this provision which would allow the Department of Human Services to transition Family Foster Care providers to a new tired rate framework.
- Waiver Re-Imagine Phase 2 and Phase 3: The House provides authority for the Department of Human Services to proceed with Phase 2 and 3 of Waiver Re-Imagine, the Senate does not.
Legislative leaders and the Governor agreed to work over the weekend to set joint budget targets for the finance and tax bills. Without these targets it is impossible for conferees from the House and Senate to do much ‘real’ work. Complicating this year’s negotiations is the addition of federal appropriations from the America’s Rescue Plan and widely varying view of the House and Senate majorities in Minnesota on how these dollars should be allocated and who should make those allocations. With just two weeks left in the session it is difficult to see how this can all be accomplished by May 17th, the constitutional deadline for adjournment. If an agreement is not reached by the 17th Minnesota will face another ‘Special Session’. To set realistic expectations, the last time the legislature adjourned a regular budget session on time was 2013.
Conference Committees will begin meeting early next week. Due to the remote nature of session, Conference Committees will look different than they have in the past, with each committee only allotted three hours a day to meet, Monday through Saturday. ARRM will be sending a formal letter to Conference Committee members, outlining our position on priority items and will continue to work with our members to reach out to conference committee members in support of our policy priorities.
Please continue to watch for Action Alerts and updates from me in the final two weeks of session, and as always, please reach out with any questions you may have.
--Sara Grafstrom, Director of State and Federal Policy