The 2021 regular legislative session ended this last Monday, May 17th without the passage of a final state budget. Legislative leaders including Governor Walz, House Speaker Hortman and Senate Majority Leader Gazelka reached a broad budget deal on Sunday evening and announced budget targets on Monday morning, however, that did not leave enough time for legislators to complete their work by the constitutional deadline.
Looking ahead, committee chairs were given instructions to complete their budget spreadsheets by May 28th and have supporting language drafted by June 4th, with a Special Session happening in mid-June. Health and Human Services were given a budget target of $100 million over current spending in the coming biennium. As a reminder, the legislature is required to pass a balanced budget before June 30th or certain state government services will begin shutting down.
As far as ARRM’s legislative priorities, none of the provisions that we have been advocating for were included in the slimmed down Conference Committee report that was passed on Monday. This report contained provisions from the House and Senate Omnibus bill that were either the same or non-controversial.
Below, please find a list of items that we included in a letter to conference committee members in early May, and their position in the House and Senate going into Conference Committee. All items remain a priority to ARRM and we will continue advocating for them to be included, or not included, in the Special Session Health and Human Service budget:
- Retainer Payments for Home and Community-Based Service Providers: The American Rescue Plan contains a one-time yearlong 10% enhanced FMAP for Home and Community-Based Services. By using the enhanced FMAP for retainer payment, we will be ensuring a fair and equitable disbursement of dollars while allowing each unique service sector to use the dollars in a way that most directly meets their needs
- Remote Supports Rate Framework: The utilization of remote supports throughout the COVID pandemic has ensured that individuals with disabilities remain connected to their services and supports even when it is not safe to be face-to-face. It is critical that this service option remain an option for individuals who choose to receive services remotely. The proposed rate framework for remote supports in the Senate Omnibus bill acknowledges the costs that come with providing services remotely and will help to make sure access to these important services is not interrupted. The proposed rate framework for remote supports in the House Omnibus bill will result in a 7-12% cut to rates for certain services and will make it difficult for providers to continue to provide this service
- ICF/DD Rate Increase and Variable Rate Changes: The last rate increase that ICF/DD providers received was at 1% in ICF/DD providers are often supporting individual with complex medical support needs and individuals that are older and choosing to age in their home. It is the state’s responsibility to ensure that individuals who choose to live in an ICF/DD are given the resources they need to live safely. ARRM supports the Senate position that not only provides a 5% rate increase to ICF/DDs across the state, but also adjusts the current “Services During the Day” rate and removes the barrier for ICF/DD providers to request a variable rate to meet the changing needs of individuals.
- Family Foster Care Rate Framework: Family Foster Care providers are an integral part to the spectrum of services available to people with disabilities. ARRM shares the concerns brought forward by other Family Foster Care providers that the tiered rate framework being proposed by the Department of Human Services for Family Foster Care providers could have a destabilizing effect of those providers and result in the disruption or loss of those service providers. ARRM supports the Senate approach which does not move forward with the current proposed rate
- 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: PCAs and DSPs can serve a critical role during short-term hospital stays for people with disabilities. They help to reduce stress for the individual served, provide much needed support and lessen the overall time that a person stays in the hospital. This need was recognized by the Federal government when they past language in the CARES Act 3.0 that gives states the authority to authorize this service, having this as a service option in Minnesota is an important part of the continuum of services for people with disabilities. ARRM supports the Senate position that Directs the Commissioner to work with stakeholders in the development of this critical service.
- Choice in Technology Policy Statement: ARRM has long promoted the use of technology when providing services to people with disabilities. ARRM supports the Senate position that adds a Choice in Technology Policy Statement to accompany the three other disability policy statements. We are hopeful that the addition of this policy statement will help bring awareness to individuals that receive services as well as their support teams, providers and case managers on the different options that are available through technology in supporting individuals with disabilities.
- Informed Decision-Making Definition: The development of a definition for Informed Decision-Making is a key step in ensuring that all individuals accessing services are given choice in where they want to live, where they want to work, how they want their services to be directed and whether they would like to utilize technology in their services. ARRM supports the Senate position that adds the Informed Decision-Making Definition to statute.
- Daily Rate Change for Individualized Home Supports with Training: As waiver service providers support individuals during their service transition through Phase 1 of Waiver Re-Imagine, one challenge has been the delivery of services to individuals with higher support needs who are living in their Own Home. Allowing for a Daily Rate for IHS with Training for anything over 6 hours a day and allowing that service to be shared by up to three people will help to ensure that individuals can continue to live where they choose with the services that work best for them. ARRM supports the Senate language that makes the needed policy changes to this service.
- Extension of Transition Lease Opportunities for a person’s Own home: Current policy allows for a provider to co-sign a lease with an individual who is living in their own home for a time-limited two years, after which, if the individual’s landlord is still requiring a co-signer the provider can sign a time limited “transition lease.” Following the two-year transition lease time, there is no option in current statute for an individual to continue living in their own home and having someone co-sign a lease, if that is what the landlord still requires. ARRM supports the Senate language that will allow for additional transition leases to be signed to ensure that individuals will not lose access to their home or their services.
- Transition to a Fee Schedule for Background Studies: Providers do not have the ability to adjust their prices when additional costs for providing services occur, transitioning to a fee schedule that could change on an annual basis would be a costly change for providers. ARRM supports the Senate position that does not remove the current cap to background study fees from statute.
- Extension to 180 Days for Compliance in Peace Time Emergency Background Studies: Thank you to both the House and Senate for including the language that would extend the current 60-day window for full compliance with background studies to 180 At a time when providers are experiencing a crisis level workforce shortage, it is critical that we are not losing staff due to system backlogs or available fingerprinting locations. Given the complexities associated with this issue and the large amount of background studies that were completed under the Peacetime Emergency, ARRM supports further conversations around extending the window for compliance even further, moving from 180 to 365 days.
- Waiver Re-Imagine: We appreciate the thoughtful dialogue that has taken place around Waiver Re-Imagine this legislative session and are in support and agreement of the broad goals associated with Waiver Re-Imagine as a catalyst in moving our service system forward. As providers continue to adapt and work through the rolling implementation of phase one of services throughout 2021, we support a deliberate pause in implementing future phases until all unknown and unintended results of the new menu of services are addressed.