ARRM's Daily Dispatch

60 visits in 60 days

Hello ARRM members!

Our 60 visits in 60 days campaign is off to a great start. We are almost 30 days in and have conducted or met with almost 20 legislators. The work your doing is truly remarkable. With only a month left however, we need to really ramp it up. There are lots of different ways you can contact your legislator.

First, as we have been talking about in the past, conduct a site visit. This may be harder to do since legislators are now back in session, but try and plan it far enough in advance and you can catch the legislator while they are home in their district.

Second, visit your legislator at the capitol. Many of you will be doing this as part of ARRM's Day at the Capitol, if you can't attend Day at the Capitol however, try and find another day to visit your legislator.

Third, attend a townhall meeting or coffee session. These meetings are held right in the legislators home district and can be a great opportunity for some one on one time. Many times, these meetings are not well attended, giving you some great time to chat with your legislator. ARRM has a grassroots calendar on their homepage that we are working to keep up to date with townhall meetings and coffee sessions as we find out about them.

As always, it is important to let us know when you have met with your legislator. The information you gather is important for Bruce and Bob to use in their direct lobbying. You can use the online form, located on our webpage for reporting or just send an email to myself at Skrogman@arrm.orgor Barb Brynstad at BBrynstad@arrm.org

--Sara Krogman

DHS Licensing Presents at ARRM Board Meeting

Jerry Kerber and Michelle Long from DHS Licensing attended the February Board of Directors Meeting.This was another opportunity for ARRM to build on the relationship that has been developed.

Jerry reviewed the anticipated 2010 Licensing Bill, which includes language to clarify a number of issues.  ARRM will report more on the details of the bill once it has been introduced.

Jerry also provided an update on the alternative license for Adult Foster Care.  There have been two applications made and approval is close.  This continues to be a learning experience for both the providers and DHS Licensing. 

The last topic Jerry presented on was "e-licensing".  E-licensing has been piloted with two state agencies.  DHS Licensing is the first agency that will come on board not as a pilot.  There is much excitement about the possibilities.  DHS has agreed to include ARRM as it works on the details and we will provide members with updates as the project moves forward.

Barb Jacobson COO

bjacobson@arrm.org

ARRM’s 2010 Transformation Bill introduced

ARRM’s 2010 bill is mostly clean-up from last year with a few new provisions. Like last year, the authors are Rep. Paul Thissen in the House And Sen. Tony Lourey in the Senate. The bill numbers are H.F. 2938 and S.F. 2689. These and other bills of interest to disability providers appear on the “My Bills” link. The user name is ARRM Advocates and the password is reforms. See our Feb. 9th Dispatch to learn more about how this tool works.

In the meantime ARRM is meeting with other disability lobbyists and legislators regarding the 2.5% rate cut proposed by the governor (see Monday’s Alert). Stay tuned.

The link to ARRM’s bill is: H.F.2938, as introduced.

As the bill works through the stakeholder and committee process it will be amended. Here is ARRM’s summary of how the bill looks today:

ARRM’s 2010 Transformation Bill and Road Map for 2011 and 2012
H.F. 2938 (Thissen) and S.F. 2639 (Lourey)

Note: The Bill is subject to amendment and changes as we work it through with DHS, legislators and advocates.

This year’s bill focuses on clean-up items from our 2009 legislation with the intent to be budget neutral and thus go straight to the floor. We have taken out most items that may be controversial, but negotiations will be needed with our shelter needy and technology provisions.

Section 1: Foster care licensing moratorium. Adds an exception to the foster care development moratorium for the new alternative license that allows technology in lieu of human overnight supervision (the focus of our technology provisions last year). This is needed if the new alternative license doesn’t work out so the person/provider can go back to the original 245A license. (We will rewrite to open capacity more if we can do it without a fiscal note.)

Section 2: Alternative overnight supervision technology change. Makes choosing technology for overnight supervision the same as any other service – i.e. the provider doesn’t have to obtain consent from every consumer in the foster care setting. The unanimous consent requirement came in during conference committee and may be controversial with some advocates. (We will delete this section in an author’s amendment.)

Section 3: Alternative overnight supervision technology change. The new law limits the time video and audio recordings can be stored to five days. This provision would allow longer storage if the recording is pertinent to investigating a reported abuse or neglect incident or if requested by the recipient for a reported incident.

Section 4: Cashing out GRH money for Shelter Needy dollars to facilitate the utilization of less expensive services in alternative settings. The intent of last year’s provision was to address the main barrier – housing funding – in allowing high functioning consumers to access the services they need in alternative settings (e.g. assisted living), rather than some services they don’t need in their current foster care settings. The 2010 provisions would:

1. Make permanent to allowance for the housing and service provider to be the same entity,

2. Allow consumers’ relatives to own or control the housing,

3. Eliminate the requirement that the buildings be multi-family with six or more units and

4. Eliminate the requirement that no more than 50% of the units be used by recipients in this program.

Items 3 and 4 were added in conference committee in order to make the provision budget neutral. ARRM believes that fuller use of shelter needy will reduce service costs and result in a net savings to the state.

Section 5: ICF/MR plumbing inspections. Currently all ICFs/MR are required to undergo state plumbing inspections like larger institutions in new construction and when remodeling. This section eliminates that requirement for ICFs/MR with home-like settings that have seven or fewer residents.

Section 6: Renaming Single Set of Standards. The standards – to be brought to the legislature in 2012 – shall be called “Quality Outcome Standards.”

Section 7: Housing options study. The new language would require that the assumption of risk and issues pertaining to financial liability be added to the considerations covered in the preparation of the study. This housing options study was an amendment from Rep. Loeffler to our bill last year. These issues must be addressed in order to open up options for consumer owned and consumer controlled housing. (We are working with DHS and Rep. Loeffler on alternative language.)

Future road map

2011 

• Report to the legislature on the combined Residential Support Service and Quality Outcome Standards with these specifics delayed from 2010

• Rule 40 behavior management

• Psych med rule

• ICF/MR – SLF rule and 245B

• Risk Management changes

2012

• Legislation defining the new system as expansively as possible

-- Bruce Nelson

CEO Bruce Nelson quoted in Pioneer Press story

Bruce Nelson, ARRM's chief executive officer, was quoted in an article in today's Pioneer Press  about Gov. Pawlenty's $1.2 billion state budget cuts.

His quote:

"My disappointment is that the last two years, we've been working very hard with the governor's own department to transform the system to make it much, much more effective. And he did not recognize that work," said Bruce Nelson, chief executive officer of ARRM, a disability rights advocacy group.

Click on the link below to read the entire story.

Pawlenty plan: federal funds and deep cuts

--Barb Brynstad

Pawlenty budget would cut rates by 2.5%

Gov. Tim Pawlenty’s proposed budget would cut continuing care provider rates – including nursing homes – by 2.5%. The cut would slash $32.3 million off rates effective July 1, 2010. Overall, health and human services cuts would be $347 million of the state’s $1.2 billion deficit.

However, the budget appears to book another $387 million in federal dollars through and extension of the Federal Medical Assistance Percentage (FMAP), which has not yet been adopted by Congress. Should that economic stimulus provision fail to pass, there would be a significant hole in Pawlenty’s budget. We’ll dig deeper into this and other provisions.

The next biggest overall cut would reduce aid to local government by $250 million.

In the disabilities area Pawlenty’s budget would also:

• Place a temporary cap on CADI and DD waiver slots with by allowing 60 new CADI and 6 new DD slots a month. The CADI limits would be effective July 1st and DD waiver effective Jan. 1st – both for one year.

• Reduce child mental health case management grants, adult mental health day treatment hours, grant funds for adults with serious mental illness, mental health crisis intervention and critical access dental.

Others with big hits in health and human services include:

• A 3% cut in DHS administration with an estimated loss of 80 FTEs. The 3% cut includes virtually all agencies./li>

• A delay in hospital rebasing, saving $8.1 million and a hospital ratable reduction of $9.1 million.

In a separate Minnesota Care account, the governor would reduce eligibility for health care for adults without children by $129.7 million.

The proposal would make permanent most of the cuts he made though unallotment. Interestingly, the elimination of ICF/MR variable rates was not on the list of permanent changes. ARRM has been working with the governor’s office and DHS to figure out an administrative solution for ICFs that would be forced to close due to insufficient new rates under that unallotment, which goes into effect July 1, 2010.

As the budget gets scrutiny in the House and Senate, several larger issues will be in the discussion, including:

• The governor does not cut K-12 education, veterans or public safety – which account for well over 40% of the state’s general fund budget. That leaves human services as the next biggest target with 29.3% of that budget. We expect the Senate to make some kind of across the board cuts, which should reduce the hit on health and human services. House leadership has not indicated whether that body will make K-12 cuts.

• The governor has recommended some tax cuts and credits – including a reduction in the corporate tax rate from 9.8% to 7.8%. While the new tax expenditure would be small, DFL leaders have already criticized this proposal that, they say, would give tax breaks to businesses located outside the state.

• At the same time, legislative efforts to raise taxes would almost certainly fail this year with the House unable to override a certain Pawlenty veto.

We’ll be further analyzing the budget documents in the next few days as we obtain more details. 

The next important round in the budget debate will House and Senate funding targets in the core areas of government, like education and health and human services.

To access the governor’s documents go to www.finance.state.mn.us and click on the two documents under 2010 Governor’s Supplemental Budget.

--Bruce Nelson

ARRM hires HHS insider as new Research Director

We are exciting to announce that ARRM has hired Craig Wieber, currently an Executive Budget Officer at Minnesota Management and Budget (MMB) – formerly called the Finance Department.

Craig has a strong working knowledge of all DHS fiscal accounts and knows all the fiscal players at DHS and the legislature. 

Craig, who joins the ARRM staff March 1st, will be a great asset to ARRM – and the entire disability community – in reacting to administration and legislative proposals and fiscal notes on bills of concern to us. Moreover, he will help us craft and cost out our own proposals to the governor and legislature.

He spent the past five years at MMB and before that worked on Capitol Hill in Washington for Rep. Mark Green and for former Wisconsin Governor Scott McCallum.

ARRM has been searching for the past six months for someone with Craig’s insider knowledge of funding streams and relationships with the key players. 

His knowledge will add significantly to our ability to shape policy and funding decision at the capitol and with DHS.

--Bruce Nelson

This week at the capitol

ARRM is working several issues at the capitol this week as we await the Governor’s Budget, said to be released later in the week. When it comes out we will immediately contact you and have talking points for the media. We expect it to include an additional rate cut.

Other items:

ARRM’s Transformation Bill: Rep. Paul Thissen has agreed to author the bill in the House and we have three co-authors. We will drop the bill in this week. We meet with Rep. Thissen Thursday. In the Senate Sen. Tony Lourey will likely author the bill. In the meantime we are talking with other stakeholders about the provisions in the bill.

Fee surcharge: We are talking with commissioners and deputy commissioners in two agencies and a division director in a third about the fairness of the new few that may unfairly impact providers with licenses in several counties.

Shelter needy: We’re talking with advocates, DHS and legislators to make it easier to cash in GRH funding for shelter needy funds in order for people to move out of foster care and into less expensive alternative settings. This is part of our 2010 System Transformation Bill.

Day at the Capitol: We have begun to line up speakers for our rally on March 2nd at 1 p.m. in the capitol rotunda. So far we have Sen. Lourey, House Majority Leader Tony Sertich and Rep. Rod Hamilton. 

CCD: A group of providers, including ARRM and ARRM members, and advocates are meeting to find ways to offset disability funding cuts that we expect the governor to propose. CCD is a broad-based coalition – called Consortium for Citizens with Disabilities.

Lobbyist coalition: Last Friday ARRM convened a group of disability lobbyists who are at the capitol everyday. We’ll continue to meet every Friday to plot strategies.

CDCS: Yesterday the House Health Care and Human Services Oversight and Policy Committee heard an overview of consumer directed supports.

--Bruce Nelson

New bill tracking tool available

Hello ARRM Members:

We have recently added a new advocacy tool that I wanted to make you aware of. It is called "My Bills" and it is a tracking devise to follow different legislation as it makes it's way through the legislative process.

You can access this tool on ARRM's Web site by following this link: http://arrm.org/advocacy/links.html; scroll down to "Bill tracker". Or, go directly to the page on the Minnesota State Legislature's site here: http://www.house.leg.state.mn.us/leg/billsublogin.asp

The username is ARRM Advocates and the password is reforms.

By using this link you will be able to see the status of the bill in the House and Senate as well as any recorded roll call votes, the text of the bill, conference committee reports and any fiscal notes.

If you have any questions about using the bill tracker or about the bills that are currently listed please let me know, by emailing me at skrogman@arrm.org.

--Sara Krogman