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.