ARRM's Daily Dispatch

Daily Dispatch, April 30, 2009: Thank you for contacting your legislators. You made a real difference!

ARRM's "Keep Your Promise" campaign to make 100,000 calls to Representatives has been a huge success. Thousands of calls and emails to legislators were logged this week. As a result, the House of Representatives reduced provider rate cuts to 2.58%.

If you’ve already contacted your legislators, thank you.

Our difficult work isn't done yet -- let's keep the momentum going! Each call makes a difference, and quantity is still really important right now. So please recruit 2 to 3 friends, colleagues, family members, or neighbors to do the same. Let them know why this issue is important to you and how they can make a difference by calling or emailing their legislator today.

Please ask them to report back to you once they contact their decision-maker so you can share the numbers back with Barb Brynstad at ARRM (bbrynstad@arrm.org).

Here's how to find your legislator: http://www.gis.leg.mn/mapserver/districts/index.html

Next Steps:

We recently sent out two Alerts, asking you to maintain momentum by taking the following steps:

1. Join ARRM's Advocates on Facebook.
2. Send a letter to the editor.
3. Attend a vigil at the capitol.
4. Contact the conference committee members for the Omnibus Health and Human Services bill (H.F. 1362).

You'll find all of the information about each campaign when you visit ARRM's website, at http://www.arrm.org.

If you  have questions or feedback, please contact Barb Brynstad at bbrynstad@arrm.org.

Daily Dispatch, April 28, 2009: House reduces rate cut

Last night the Minnesota House of Representatives adopted an amendment – with only two “no” votes – to reduce provider rate cuts to 2.58%. The Senate Bill still carries a 3% cut.

Earlier in the afternoon Rep. David Bly (DFL-Northfield) offered a virtually identical amendment that would have lowered the cut to 2.25%. Rep. Bly withdrew the amendment when it became clear that the debate would become fodder for political partisanship.

We had made our point – that the rate cut is a significant political issue that will have to be addressed in conference committee and after the Health and Human Services Omnibus Finance Bill is vetoed and the legislature and governor head into phase two. During his moving presentation of the amendment Rep. Bly read a handout from ARRM.

Then ...a pleasant surprise. Rep. Rod Hamilton (R-Mountain Lake) offered the same language with updated math to cut the cut to 2.58%. When it became clear that the amendment would pass, Speaker of the House Margaret Kelliher (DFL-Mpls.) switched her vote to “yes” and the board lit up with green “yes” votes.

To pay for the reduction both amendments adopted the Governor and Senate’s language to limit waiver slots. It’s our understanding that limiting slots would violate the maintaining eligibility provisions that came with the state’s federal stimulus money. So that issue will have to be ironed out.

We now have raised the political importance of a rate cut as we focus on the end game – conference committee and negotiations after Gov. Pawlenty vetoes the first round of tax and spending bills.

Three things made this happen:

First – You! Your calls and emails to House members made this an issue that the House couldn’t ignore. Read the legislators' feedback and responses to your calls and emails here. Please pass this link along to your staff and congratulate them for work well done. And keep sending your reports of grassroots advocacy to bbrynstad@arrm.org so ARRM can highlight the outstanding work done by our Superhero Advocates.

Second – and critically important – is the wonderful leadership provided by Steve Larson of The Arc of Minnesota. Steve worked tirelessly for days on this effort.

Third – the coalition of residential and DT&H providers that followed through with the base laid by you and Steve.

A number of ARRM, Arc and CCD (Consortium for Citizens with Disabilities) members also were on hand at the capitol – on very short notice – to underscore the issue with their representatives and senators. Thank you!

We’ll provide more information and ammunition for you today or tomorrow. This amendment is significant, but only Round One. We must keep the pressure on until there is final resolution.

Daily Dispatch, April 27, 2009: HHS Bills on House and Senate Floors today; House amendment would reduce cut

The Minnesota House and Senate will take up the Health and Human Services Omnibus Finance Bill today. In the House Rep. David Bly (DFL Northfield) will offer an amendment to reduce the rate cut to about 2-1/4%.The Senate convenes at 11 a.m. and the House goes in at noon.

Advocates and providers will be gathering in front of the Senate chamber at 10:45 a.m. The bill will go though the afternoon.

Keep Your Promise Campaign Gathers Momentum

Members are calling and emailing their house members in droves as a part of ARRM's Keep Your Promise Campaign -- please keep up the great work! Our goal is to make 100,000 phone calls by Friday, May 1st.

Initial feedback suggests that legislators are being barraged with ARRM's messages to keep the budget cuts fair. We'll be posting some of the positive legislative responses on our website this week, so be sure to send your legislator's feedback to bbynstad@arrm.org and we'll include it on our website.

Daily Dispatch, April 23, 2009: ARRM Launches "Keep your Promise" Campaign

Goal: 100,00 calls to House of Representative leaders by Friday, May 1st.

Ask your staff and families to join our Facebook Group, so they can be a part our online community and learn more about this grassroots event.

House leaders promised to protect our most vulnerable citizens with FAIR budget cuts. They broke their promise - and EVERY House member needs to hear that again and again.

In the health and human services funding bill nursing homes got off scott free and hospitals got nicked. But disability services took a huge hit – way out of whack and incredibly UNfair.

So...every ARRM member must activate your people – caregivers, board members, families and managers to make at least two telephone calls:

One to your/their House member. Here's a link to the district finder tool: http://www.gis.leg.mn/mapserver/districts/

One to House leaders – Speaker Margaret Kelliher (651-296-0171) and/or Majority Leader Tony Sertich (651-296-0172).

Here’s what to say – the more in your own words the better:

1. House leaders promised fair cuts that would protect our most vulnerable citizens with disabilities.

2. The House broke its promise.

3. Disability programs took $72 million of the total $400 million in cuts. – That’s unfair.

4. Programs will close and people will get hurt.

5. Be fair with cuts – DON’T BALANCE THE BUDGET ON THE BACKS OF PEOPLE WITH DISABILITIES!

Our goal is to flood every House member – Republican and Democrat – with 100,000 total calls by Friday May 1st.

You will get a call from an ARRM Public Affairs Committee member to inspire you. This is a serious emergency – as things can only get worse without immediate and powerful action now. These decisions are political and the House needs to know they made a serious mistake. We are a force to be reckoned with if we all do our part.

And, by next week expect a letter-to-the-editor template that you will send to your local newspaper.  Stay tuned, be engaged and we shall prevail!

Ask your staff and families to join our Facebook Group, so they can be a part our online community and learn more about this grassroots event.

Daily Dispatch, April 22, 2009: House HHS bill hits us hard on two key issues, but includes many ARRM measures. Rep. Thissen to offer ARRM amendments.

When we saw the funding cuts in the House health and human services finance bill, our initial reaction was to blast away. Leaders in the House had said on many occasions that services for the elderly and people with disabilities would be treated fairly. While we did get many provisions we worked hard for, we got nailed – along with all of continuing care – on the two big issues:

• A 3% rate cut and

• An increased license fee.

The hit was way out of whack within the overall $400 million cuts. Hospitals and nursing homes, for example, did better – with most of the money buying back the cuts to Minnesota Care proposed by Gov. Pawlenty.

We are tempering our messages – at least for now. We know we’ll have to work with House leaders in the next few weeks, but we should and will continue to voice our displeasure. And ... we want to see what the Senate bill does.

Amendments in the works:

We are now working on several amendments, most of which Rep. Paul Thissen has agreed to author, either in the full Finance Committee or on the floor: among them:

• A way to at least mitigate the impact of the license fee – if not get rid of it entirely. And we remain hopeful that the Senate will reject the fee increase proposed by the Governor as many senators reacted negatively to it.

• Language to insert our principles into the development of new payment methodologies.

• An amendment to delay the Governor’s proposed moratorium on shift staff development for two years. This will buy us time to further push innovations within foster care and in alternative settings – both of which our Transformation Bill promotes.

• A dropped provision from our Transformation Bill that allows providers to serve three or fewer people in a county without getting a license.

Rep. Thissen said he won’t offer an amendment now to tell counties they can’t require the same level of services with a rate cut because of resistance from others when we earlier proposed it, but said he would continue to work on the concept as a technical amendment later.

Buying back the cut is not possible as the committee chair, Rep. Tom Huntley, would require taking the money from someone else – something he would not support.

Here some of the things we like in the House Bill:

• Slot limits delayed for two years.

• Elimination of dental, occupational therapy, physical therapy, chiropractic and rehabilitation services cuts that were proposed by the Governor.

• A buy back of MnDHO limits proposed by the Governor.

• Continuation of the Region 10 Commission.

• Key elements from our Transformation Bill, including:
  • The establishment of a process to replace existing rules and law with a single set of standards for home and community based services.
  • Utilization of technology for overnight supervision.
  • An allowance for consumers to take their GRH money in the form of MSA shelter needy money to alternative settings and – significantly – to allow services providers to be the housing provider in alternative settings.
  • The elimination of having to do duplicative background studies on the same individual.
  • The elimination of quality assurance reports for ICFs/MR.
  • The elimination of quarterly variable rate reports.
  • Continued monitoring of funding changes needed for ICFs/MR.
  • A charge to DHS to engage a stakeholder process for the common service menu.
  • Elimination of the requirement for physician’s statements.
  • Elimination of ICF/MR occupancy reports.

As of early this morning we don’t know when the Senate will release its proposed bill and tracking sheet. Keep your fingers crossed.

And, more importantly, be ready to act on new Alerts as the process unfolds. After initial bills get vetoed, we’ll really have to keep the pressure on. At the same time, it is important to get as much of our language into the first bills as opportunities will be more limited down the road to make these kinds of changes.

Finally ONLY if you live in Rep Paul Thissen’s district send a very short email simply saying “Thank You!” for working with ARRM. His email address is: rep.paul.thissen@house.mn

Daily Dispatch, April 21, 2009: Urgent Calls Needed to Your House Representatives Now

If you haven't already done so, please pass this alert on to staff and families.

First House HHS Bill makes 3% cut and imposes licensing fee 

The House Health and Human Service Finance Division laid out its proposal for health and human services funding yesterday. While House leadership promised their budget would protect the state’s most vulnerable citizens, their proposal for disability providers and their clients is no better than the Governor’s proposal. In fact, it is the Governor’s proposal!

It proposes the following:

• 3% rate cut for disability providers—same as the governor.

• Increase in license fees at the same level as the governor.

The House target for cuts to human services is far lower ($400 million) than the governor’s $1.4 billion cut. Yet, the House proposed cuts to disability providers are the same as the Governor’s.

This bill will be vetoed by Gov. Pawlenty because it depends on a tax increase. That means there will be another HHS bill with larger overall cuts.

The Omnibus Health and Human Services Finance Bill may be on the House floor as early as Friday or Saturday. It is critical your representatives hear from you and your staff today. Numbers of calls/contacts do make a difference! 

Please contact your representative and tell them:

1. Disabilities have taken more than our share of cuts.

2. Cuts to continuing care providers represent almost 20%of the $400 million cut. While other providers were also cut, most received better treatment in the House proposal than what was proposed in the Governor’s budget.

3. Tell them whatever happens with future bills that anything more than 3% will be devastating to programs supporting our most vulnerable citizens with disabilities.

4. Ask them to keep their promise to protect the state’s most vulnerable citizens.

Please let ARRM know what you heard from your Representative by contacting Barb Brynstad at bbrynstad@arrm.org.

In other provisions of the 305-page bill, the House did take all of our Transformation/Reform measures, had no slot limits in the first two years, erased cuts to dental and MnDHO.

The Senate HHS Omnibus Bill should be released within a day or two.

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Daily Dispatch April 20, 2009 - April Board Meeting Held in Rochester

As part of ARRM's efforts to increase its presence in the non-metro portions of the state, the April 16, 2009 Board of Directors Meeting was held at the Mayo Civic Center in Rochester. The Rochester Convention and Visitors Bureau (CVB) hosted the meeting, and a reception for ARRM members and providers of disability services followed at the Kahler Grand Hotel . 

Board members and ARRM staff toured the Civic Center prior to the meeting to determine the feasibility of holding the Annual Conference and/or a large workshop in Rochester in the future. After the 2009 Annual Conference has concluded in mid-May, the ARRM Board will examine the possibility of holding a large conference in greater Minnesota.

Daily Dispatch, April 15, 2009: HHS Omnibus Finance Bills Delayed – ARRM working on many provisions

The House and Senate Omnibus Health and Human Services Finance bills were supposed to be public by now and marked up in committee tomorrow. But delays in getting scores of fiscal notes, which price out the cost of provisions, from DHS have set the bills back – possibly until Monday.

Typically the bills’ authors and committee chairs, Rep. Tom Huntley and Sen. Linda Berglin, present the bills after working with other committee members and staff. To make any funding changes to the authors’ bills money would have to be found by reducing another provision to keep the bill in balance. Those changes will be few and far between.

Here’s what we’re watching and working on in the omnibus bills:

Rate cut: We know there will be rate cuts, but don’t know how much. We’ve pushed hard for a cut lower that the Governor’s three percent, knowing that these bills – which are dependent on raising taxes – will likely be vetoed. Once they’re vetoed it is likely that Huntley and Berglin will have to find additional cuts. We have also provided language that, if adopted, would tell counties that they can’t require the same level of services with less money.

Increased DHS licensing fee: We continue to work on ways to offset the increased fee. Our coalition meets again this afternoon.

Slots limits: It appears that CMS won’t allow the state to reduce slot numbers due to a provision in the federal stimulus law that requires states – when accepting the money – to maintain the same levels of eligibility required in existing law. Given that there will be some kind of rate cut, this should help reduce the number of open beds – helping some members cope with reduced rates.

County foster care fee: We presented committee chairs and members with a run of unspent money in the various waivers with the argument and language that would allow counties to reimburse providers paying the fee before that unspent money is returned to the state’s general fund and lost for use in the waivers. 

Investing in technology: Huntley is also looking at the possibility of using those unspent waiver dollars to provide temporary rate increases to providers to invest in technology infrastructure. We had asked Sen. Berglin and Rep. Huntley to use stimulus money for this purpose, but those dollars had already been used to reduce their targets – the amount of overall cuts the have to make.

Technology in lieu of over night supervision: Language worked out by stakeholders is now in ARRM’s Transformation/Reform Bill (waiting for inclusion in the Omnibus Bills) and DHS’s licensing bill. The provision has no cost so it may be pulled from the Omnibus Bill and sent to the floor with other non-cost provisions in our bill.

GRH and MSA Shelter Needy dollars: One of the key provisions in our Transformation Bill is an allowance for service providers to also own or control consumers’ housing in alternative settings to foster care. This provision also may emerge in the omnibus bills – and we may also move it to another bill. In fact, as many of the provisions in our Transformation bill as possible will be moved to other no-cost bills to avoid being in a vetoed bill.

Single set of standards: Another big element in our Transformation Bill did get a fiscal note with a modest cost. The authors’ of our Transformation Bill, Rep. Paul Thissen and Sen. Toney Lourey, are working on getting that provision into the omnibus bills.

Payment methodologies: We have proposed an amendment to the Governor’s call for new waivered services payment methodologies that would add needed principles and protections into any new methodologies.

Moratorium on the development of shift staff services: We have vigorously opposed this provision in the Governor’s Bill, calling instead for innovation in foster care (e.g. technology) and ways to utilize alternative services (e.g. Shelter Needy money).

Dental and OP/PT cuts: The Governor proposed virtually wiping out funding for these services. There has been strong push back from both Democrats and Republicans so that any cuts here will be much less drastic.

Were also supporting others who are leading efforts to minimize MnDHO cuts, minimize PCA cuts and eliminate the Region 10 Commission.

More later on the Omnibus Bills and other bills of concern to ARRM members as things get sorted out in the next few days at the capitol.

Daily Dispatch, April 14, 2009: Join ARRM's Facebook, Twitter communities

As a part of ARRM's grassroots advocacy plan for the 2009 legislative session, we are asking members, professional caregivers and families to join our Facebook group, called "ARRM's Advocates," or to follow ARRM on Twitter. Both are accessible by computer or cell phone.

We recently launched our Facebook and Twitter pages so you can find up-to-the-minute information on issues, events, and grassroots advocacy news. You'll also have the chance to communicate with other ARRM supporters by becoming a part of our online community.

This is a great way for us to mobilize the grassroots to be more involved in the legislative process.

• Join ARRM's Advocates on Facebook. This link should take you directly to our group.
• Follow ARRM on Twitter. Look for "ARRM."

Feel free to contact ARRM's PR Director, Barb Brynstad at bbrynstad@arrm.org or (651) 291-1086, ext. 4 if you have questions.

Daily Dispatch, April 3, 2009: Members affected by flooding provide updates

As we mentioned in a blog post here last week, several ARRM members had program sites in areas recently affected by the historic flooding in the Red River Valley. Fortunately, our members in the Fargo-Moorhead area had planned well, evacuating their program sites sufficiently in advance of the cresting river.

As the flood waters recede (for now) and reconstruction looms, ARRM's Bruce Nelson has been speaking to Minnesota legislators about flood relief for ARRM members. We'll be sure to keep you updated on these and other efforts related to the flood crisis. Meanwhile, we have news from four ARRM members who have program sites in the Fargo-Moorhead area.

REM

State Director Connie Menne reports that REM initially evacuated and have now returned to all three REM homes. They experienced some minor -- but not significant -- damage in the basement. REM is currently in the process of replacing the sheetrock, etc.

Creative Care for Reaching Independence, Inc. (CCRI)

Executive Director Rhonda King reports that all residents are moving back into 42 program sites today. CCRI didn’t lose any property and had moved all the furniture up in the event they got water.

Rhonda further says that the river is down to 36 feet, but hydrologists are predicting a second crest sometime in the next two weeks. Within the city limits of Fargo-Moorhead very few homes were actually destroyed; the devastating pictures you’ve seen are South and North of the city limits and weren’t protected by the dikes built by the city. Hundreds of homes were reportedly lost in those developments.

Habilitative Services, Inc. (HSI)

Regional Administrator Curt Bossert reports that HSI has 4 homes and 1 apartment setting in Moorhead and Dilworth. It appears that at this point, there was no damage to those sites. The 3 homes in Moorhead were not in the flood zone and were only at risk if the dikes failed, however, the residents of those homes were evacuated to Detroit Lakes, MN and Wahpeton, ND. 

Lutheran Social Service (LSS)

John Brooberg, the LSS area director in Moorhead reports that they did not experience any damage in any LSS homes. While the homes were all evacuated for safety, there have been no instances of water invasion in any of them. He adds that the cost of relocating the people LSS supports has been very expensive. 

The residents expect to be back home by the end of this week.

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