Below you will find information on the 2019 Health and Human Service Omnibus Bill.

HCO is excited that the 2019 Legislative Session listened to concerns and are working to find solutions that help address provider financial stability.

Below is information from ARRM on both the HHS Omnibus Bill and additional details regarding the Competitive Workforce Factor.  As you can read, the competitive workforce factor has many stipulations including CMS approval, banding, and each individual rate calculations. During the next two months we will be learning more from ARRM, DHS and CMS how each of these changes will impact HCO and our services.

HCO is committed to quality services and competitive wages.  We will continue to work with our legislators, stakeholders and staff to fulfill these commitments and our HCO Mission.

Stay tuned!

If you have any questions, please contact Suzanne R. Horstman (SuzanneH@hco.org).

From ARRM:

Last week, ARRM sent a letter to each member of the Health and Human Services (HHS) Conference Committee, the group which will combine the House and Senate versions of HHS budget bills into one for final passage. This committee has several provisions in front of it related to critical issues for the home and community-based services (HCBS) more than 35,000 Minnesotans with disabilities utilize to support their independence and community inclusion.

ARRM, on behalf of its more than 160 provider members and the HCBS industry as a whole, sent a letter to conference committee members outlining its guidance on several issues. Two provisions stand out for our organization and many aligned stakeholders in this field:

• Workforce investments (ARRM supports): Both bill versions introduce targeted re-investments in the reimbursement rates for services, directed to increase the wages of the support professionals who work directly with clients, up to a projected $133 million over the next four years (current statewide average just over $13/hr). This would begin to address the structural 17 percent wage gap between these jobs and other positions competing for similar workforce talent; ARRM strongly supports these measures, with a preference for the House language.
• Caps on support (ARRM opposes): Language in the Senate bill would place a cap on the number of qualifying people who could receive Medicaid waivers. ARRM and other aligned stakeholders strongly oppose this measure: reducing access to the primary source of financial support for people with intellectual and developmental disabilities to receive services which help them stay out of institutional settings and maximize their abilities is not the answer to solve concerns over costs or capacity.

There are several other issues ARRM is fighting for and asked the committee to consider in its letter:

• Supporting the ability for all Intermediate Care Facilities (ICF) to seek service rate exceptions for the people they support to ensure they are able to meet their changing needs
• Supporting additional investigation capacity for reviewing complaints to ensure a quality and timely process, but ensuring fee increases to pay for this are recouped in cost-of-service reimbursements and do not become additional unfunded expenses on provider organizations
• Preventing policy from passing which would reduce the capacity of adult foster care through the forced closure of resident slots

The scope of legislation related to this field currently under consideration will have significant impacts to this sector serving tens of thousands of vulnerable adults, and employing more than 100,000 statewide.

HCO self-advocates, staff, and family members recently visited the Minnesota State Capitol to attend disability services rallies for ARC and ARRM Days at the Capitol. Two buses of 45 people (90 total) signed up to attend one (or both) of the trips.  Advocates attended and spoke in support of the Best Life Alliance Bill SF6/HF179. On both trips, advocates: attended the rally in the rotunda, held appointments with local legislators, and dropped off information packets to those who were unavailable to meet.

ARC Day: Tuesday, February 19th

During meetings with legislators at their morning appointments, various HCO representatives shared their experiences and concerns:

• Two individuals and one support staff spoke on their specific care needs and how staff assist them in their daily lives
• One individual living independently talked about the importance of the few hours of service she receives each week and how it helps her to remain independent
• One staff spoke on supporting an individual with end of life care and the toll it takes on staff   (watch the video here)

ARRM Day: Tuesday, March 12th

At ARRM Day, an individual served by HCO introduced Senator Miller at the rally on stage in front of over 1,000 people! When meeting with legislators at their afternoon appointments, HCO representatives spoke on numerous topics:

• One individual shared how they are able to live independently because of staff support
• One staff spoke on her experiences currently supporting 13 individuals who live independently and how the people she has supported for the past 18 years have impacted her life. She now has two daughters that also work for the agency.
• One staff spoke on providing care to a young man with challenging behaviors and how they support him in order to keep him out of crisis so that he can continue to live in his community

Video Link for ARRM Day at the Capitol/Best Life Alliance can be found here.

After the Minnesota Department of Human Services (DHS) reviewed and denied requests for a contested case proceeding to appeal the 7% rate adjustment under the Disability Waiver Rate System (DWRS), ARRM, MOHR, and 4 individual waiver recipients returned to the federal appeals court to file suit again. The case was back before Judge Wilhelmina Wright to review, and she had 60 days to respond with a verdict. On February 15th, Judge Wright dismissed the lawsuit, citing that there were multiple points where plaintiffs lacked the standing to push the case forward in federal court – particularly centered on whether irreparable harm from the cuts was truly significant and unavoidable. She did not, however, issue a ruling as to whether the overall action by DHS overstepped its authority or the law, leaving the possibility open for future litigation in either state or federal court.

From ARRM:

Business is speeding up dramatically at the State Capitol on a host of legislative priorities for ARRM, as well as new related legislation.

On Monday, February 11^th, the Best Life Alliance Legislation (HF 179) was heard in the House Health and Human Service Policy Committee. ARRM author, Rep. Laurie Halverson, presented the bill and Judy Marder, chair of the Best Life Alliance group, provided testimony in support of the bill. The bill was referred to the Ways and Means Committee through a unanimous roll call vote and has now been re-referred to the Health and Human Services Finance Committee.

In addition to the Best Life Alliance proposal, an alternative proposal was also heard during committee on Monday. HF 168, which is carried by Rep. Jennifer Schultz, was heard and amended. The amendment does the following:

• Moves the inflationary adjustment from every 5 years to every 2 years and accesses the most recently available data when making the adjustment
• Officially removes the 7% from statute, effective retroactively to July 1, 2018
• Requires providers to pay Direct Support Professionals, at a minimum, the amount that is listed in the Base Wage within DWRS for that particular service
• Puts new reporting requirements on providers focused on workforce

As written, ARRM and the Best Life Alliance have concerns with the amendment because it puts new requirements on providers for compensation but does not provide any new funding. The bill’s author has indicated that additional amendments will be presented during future committee meetings that work to address these concerns.

During committee, ARRM and MOHR members were able to testify and bring forth their concerns about the bill as drafted. ARRM member Butch Karcher of Karcher Foster Services offered testimony on the workforce crisis and the struggles he, along with other providers, are facing around staffing. MOHR member Lynne Noren of Rise provided testimony outlining concerns with the mechanics and implementation of the bill language as written.

Workforce Hearing in the Senate
Also on Monday, Senator Jim Abeler held a hearing in his committee, Human Services Reform, Finance and Policy, focused on the workforce crisis in long term care services. ARRM staff and members provided testimony. Additional testimony was taken from the advocacy community and the older adults community. While there was no direct outcome from this hearing, it was a good opportunity to be able to get important messaging in front of the committee and continue to push for legislation to help address the workforce crisis.

You can watch clips of the hearing on ARRM’s Facebook page.

Progress on other ARRM Bills
ARRM’s ICF bill (SF 909) was heard in the Senate Human Services Reform, Finance and Policy Committee. ARRM’s Director of State and Federal Policy, Sara Grafstrom, testified on behalf of the bill along with lead author, Sen. Bruce Anderson. The bill was laid on the table until a formal fiscal note is available.

ARRM’s Policy bill (HF1256) was introduced in the House on Thursday; carried by Rep. Hunter Cantrell. ARRM is working with leadership to obtain a hearing for this bill in both the House and Senate.

Looking Ahead to Next Week
On Tuesday, February 19^th, the Governor’s budget will be released. Please watch for information from ARRM and the Best Life Alliance on any potential actions that may be needed from our grassroots advocates in response.

Stay tuned for more updates as they become available through HCO’s Grassroots Blog or at ARRM’s website.

Best Life Alliance Legislation: (SF 6/HF 179)

The Best Life Alliance bill has been introduced in both the Senate and the House. The bill received its first hearing this past Wednesday in the Senate Human Services Reform and Finance Committee. ARRM Board member Cindy Ostrowski from Hiawatha Homes offered testimony to the importance of ending the 7% cut.

In addition to the Best Life Alliance legislation, alternative legislation has been introduced in both the House and Senate. SF 92/HF 168 would set the Competitive Workforce Factor at 4.55% which would buy back about 3.8% of the 7% cut. SF 92 was also heard in the Senate Human Services Reform and Finance Committee this past Wednesday.

It is important to remember that while there are alternative proposals being introduced, the Best Life Alliance, as well as ARRM is committed to advocating for the full buy back of the 7% cut. Please watch for future action alerts for guidance on how you can lend your voice to the efforts!

ARRM Policy Bill: (SF 174/HF XXX)

ARRM is once again bringing forward a policy bill that contains similar provision to the bill that was contained within the Supplemental Spending bill last year and was vetoed by Governor Dayton. The bill was introduced in the Senate this last week and will hopefully be introduced in the House next week.

In addition to the stand-alone bill, Senator Abeler has introduced SF 74, which is a “mini omnibus” bill of policy provisions from last session that had agreement on. All of the policy provisions that ARRM brought forward last session are also contained within SF 74 – ARRM will continue to monitor the progress of that bill.

ICF Legislation and Unfunded Mandate Legislation:

ARRM is in the process of gathering authors for these two pieces of legislation and they hope to have them introduced within the next couple weeks.

Service Termination Legislation:

ARRM has a small group of members that are working on service termination legislation. The legislation would tighten the timelines for judicial review when a service termination is appealed and clean-up language within the current service termination statute. They are still in the process of meeting with stakeholders about this legislation and addressing concerns with the language that are being brought to them. ARRM hopes to move this language forward to the drafting process within the next few weeks.

Stay tuned for more updates as they become available through HCO’s Grassroots Blog or at ARRM’s website.

The Minnesota Department of Human Services (DHS) reviewed HCO’s request for a contested case proceeding to appeal the July 1, 2018, 7% rate adjustment under the Disability Waiver Rate System (DWRS). DHS determined that Minnesota Statutes do not authorize a contested case proceeding in this circumstance, and have denied the request.

We are currently working to determine future courses of action, which may include potentially returning to the federal appeals court to file suit. HCO continues to work closely with ARRM and MOHR to explore all avenues available to address the 7% adjustment, and more information will be released as it’s made available.