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 things that ARRM is 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 contacted members who would see their fees go up by more than 29%, with specific messaging to use when reaching out to their House member.
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 that 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 changes to the Positive Support Professional Training
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 six months, the Commissioner would reduce adult foster care bed capacity by one. The bill also implements DD and CADI waiver caps as of June 30, 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 they support and putting on record the provisions that they have concerns or are opposed to. In the House, ARRM attempted to remove the licensing fee increase through amendment, but the amendment was not adopted. ARRM also worked in the House to draft an amendment which stated that 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.
ARRM is anticipating that amendments will be taken in the Senate this week and will work with key Senate leaders to craft amendments that would work to address the concerns they have with the bill as drafted.