ARRM's Daily Dispatch

Feb. 1 hearing on unintended consequences cancelled

A House Health and Human Services Finance Committee hearing scheduled for Feb. 1 on the unintended consequences of provisions adopted during the special session has been cancelled. At the invitation of Rep. Jim Abeler, ARRM was scheduled to testify about the 10 percent congregate care rate cut and the bed delicensing provisions.

As soon as we get information about the rescheduled hearing which will likely take place later in February, ARRM will pass it on to you. Meanwhile, keep telling your legislators about the negative consequences of the 10 percent rate cut and bed delicensing, and please share these stories with ARRM, too.

ARRM staff off and running as 2012 Legislative Session opens

If you happened to stop by the ARRM office last week, it may have seemed a bit empty. The legislative session began on Tuesday and the week was filled with back-to-back meetings to advance our legislative reforms and manage emerging issues. Here's a quick rundown:

• a meeting with the Governor's staff and nearly a dozen meetings with legislators and others about ARRM's reform bill;
• two meetings with stakeholders about a bill that would make neglecting a vulnerable adult a felony and another on the issue of risk;
• four meetings with DHS, including one with senior-level management that lasted for over three hours;
• two meetings with ARRM members, including one with those working on the rate setting methodology legislation and a special meeting of the Executive Committee to discuss the DHS provider enrollment process and standards for unlicensed services (more information on this later this week).

Needless to say, it was a busy and productive week.

ARRM feels we are positioned well with our reform bill, although there is much work left to do as it makes its way through six committees. We will continue to keep members updated during this fast-paced session.

If you have any questions feel free to contact Barb Turner bturner@arrm.org or 651-291-1086 ext. 3

--Barb Turner, COO

ARRM puts our issues in motion on first day of legislative session

ARRM worked with a number of key legislators, legislative staff, DHS officials, members of the media and other disability advocates Tuesday, the first day of the 2012 session.  Here are some of the key meetings and upshots:

House authors for our Blueprint for Reform legislation are almost finalized with Rep. Joe Schomacker as chief author, and Health and Human Service Finance Committee chair Rep. Jim Abeler and DFL Committee lead Tom Huntley on the bill. More may be added Wednesday.  It will be introduced on Thursday.

In the Senate, Health and Human Service Finance Committee chair Sen. David Hann told ARRM he is committed to working closely with us on moving the reform bill. He signed on as second author and said he would help us secure a chief author.

Moving the reform bill though the legislative process will be complicated as it needs to go to through many committees in both bodies. On Wednesday, ARRM is meeting with Rep. Schomacker to discuss strategies to move the bill forward and provide additional detail on the bill’s provisions. Meanwhile, we talked to DHS about coordinating its licensing bill (which has many good provisions) with our licensing issues to ensure committee deadlines are met so the provisions we support can eventually become law. 

We are also meeting with Governor Dayton’s staff Wednesday about the reform bill, buying back the 10 percent lower needs rate reduction, and the delicensing provision passed in special session. In recent meetings with legislators, we have been advancing our reform bill as a much better alternative to the delicensing and lower need provisions. 

While meeting with Sen. Hann, we also discussed ARRM’s position on rate methodologies. Sen. Hann has been helpful in moving our bill through the drafting process and should be a strong ally on that issue. DHS will introduce its proposed methodology as part of a larger continuing care policy bill. There are many problematic provisions for providers in DHS’s bill that ARRM’s bill addresses. This is an issue we expect will be the subject of intense debate and negotiation with the department throughout the 2012 session. See our blog post from January 24, 2012 for additional details on DHS's initial proposal.

An ARRM delegation also met at DHS about initiatives coming from the department. We’ll update you as those issues are more clearly defined. 

In addition to our legislative efforts, we are also taking ARRM's reform message beyond the capitol. ARRM laid out the basics of our Blueprint for Reform with the Star Tribune and continued talking with advocates. We will continue discussions in the days and weeks ahead.

Finally, we started discussions Tuesday with Minnesota Dept. of Health officials on relatively small provisions in our reform bill.

-- Bruce Nelson, CEO        

DHS releases information on rate setting methodology

Last week, ARRM attended a meeting with staff from the Department of Human Services Rate Methodology Initiative. At that meeting, DHS staff shared with us for the first time their initial values for populating their rate frameworks. A PDF of the document they shared with us is available here.

The figures DHS has released will be used to populate the frameworks and generate shadow rates. They are not final – they are going to be used to analyze the new system and will be changed. The figure members will be more interested to know is the base wage for direct care staff, which DHS initially set at $11.20 per hour. Their model also includes a bump in the base wage of $2.38 per hour if the individual being served qualifies as having high medical, high behavioral, or high mental health needs.

In that meeting, DHS also shared with us their initial calculation of overall spending under the new payment system. For residential services, spending came out 10.5 percent lower than actual spending for FY 2010. Spending for day services was 19.2 percent lower than actual and hourly services were 9.3 percent higher. Because the payment system is required to be budget neutral, DHS is going to have to adjust their model to increase spending on residential and day program services in order to meet that requirement. To do that, in its implementing legislation, the department is asking for broad authority to change components of the payment system to ensure it is budget neutral.

We’ve begun analyzing the proposal from DHS to see how it impacts ARRM members. Under the initial DHS proposal, we believe payments for providers would be significantly lower. That cannot be allowed. To address that and other provider concerns, ARRM created its own payment methodology workgroup to develop legislation, which will be introduced in a few days. ARRM’s bill will be largely based on the work completed earlier this year by the rate setting methodology intensive workgroup, which included a variety of disability services providers. Our legislation includes a higher wage for direct care staff, tying the wages to standardized data sources and not giving leeway to the department to unilaterally change wages. It also includes higher percentage for components like employee-related costs and client programming and supports.

ARRM has been very involved in the development of the new payment methodology system, and we will continue to do so as the process moves forward. If you have any questions about recent developments or about ARRM’s payment methodology legislation, please contact me via email at cwieber@arrm.org, or by phone at (651) 291-1086 x9.

--Craig Wieber, Chief Fiscal Analyst

2012 Legislative Session starts tomorrow

As many of you know, the 2012 Legislative Session begins Tuesday, January 24. During the past couple of months, ARRM has been working hard to prepare our reform bill, with an ambitious plan to get it passed in what is rumored to be a shorter than usual session.

Since late 2011, ARRM members and staff have been meeting with various stakeholders -- including legislators, advocates and DHS staff -- to share ARRM's Blueprint for Reform. Overall, the response has been positive. Each stakeholder group has provided us with their insight and feedback, which ARRM takes into account as we refine our bill. And as our bill moves through the legislative process, we’ll keep ARRM members up-to-date in a variety of ways.

Website

We have devoted a section of ARRM's website, arrm.org/reform, entirely to ARRM's reform plan. It includes the most recent version of the bill, a section-by-section bill summary, helpful documents to help you explain the bill to your legislators and staff, and a list of ARRM members who can answer your questions about the Blueprint for Reform.

Social media: Twitter, ARRM's Blog and Facebook

During session, ARRM staff are at the Capitol every day. We’ve learned that one of the fastest ways to get information to our members is using Twitter. In fact, members of the media and legislators follow our Twitter feed to get ARRM’s analysis of legislative developments. So if you are familiar with -- or curious about -- this micro-blogging medium, be sure to follow ARRM on Twitter. Also, we update our Facebook page several times a week.

And of course, we’ll be blogging about legislative events as they happen, so be sure to subscribe to this blog, the Daily Dispatch, if you haven't done so already.

Other advocacy news

On February 1, ARRM is scheduled to testify before the House Health and Human Services Finance Committee about the unintended consequences of provisions passed during the 2011 Special Session. Namely, we’ll be testifying about bed delicensing and the 10 percent congregate rate cut.

We urge members who have representatives on the House Health and Human Services Finance Committee to contact your legislators and let them know about the negative impacts of bed delicensing and the 10 percent rate cut. Our main message will be to repeal these provisions and adopt ARRM’s Blueprint for Reform legislation, which takes a better approach to finding savings and facilitating transition to other community services.

Finally, our grassroots messages for CEOs and management focus on reform this year. We encourage DSPs, families, and self-advocates to attend ARRM’s Day at the Capitol on March 1, talk about the impact of past cuts, and if they can, discuss our reform plan.

--Barb Brynstad and Barb Turner

SNBC expansion begins this month

Enrollment of fee-for-service Medical Assistance (MA) clients into Special Needs Basic Care (SNBC) health plans is occurring in stages. Anyone can choose to opt out, information and opt-out forms will be mailed to those affected 40-60 days prior to enrollment. Enrollment of anyone who in in the home and community based waiver program will not begin until at least March 1, 2012.

Phase 1 Coverage beginning January 1, 2012
The first phase is in counties where Medica, PrimeWest Health or South Country Health Alliance is the only SNBC health plan option. Information was mailed in mid-November to approximately 8,700 adults who:

• were not enrolled ina home and community-based waiver program, and
• live in one these counties: Aitken, Becker, Beltrami, Big Stone, Brown, Cass, Clay, Clearwater, Crow Wing, Dodge, Douglas, Freeborn, Goodhue, Grant, Hubbard, Kanabec, Koochiching, McLeod, Meeker, Lake, Mahnomen, Norman, Otter Tail, Pipestone, Polk, Pope, Renville, Sibley, Steele, Stevens, Traverse, Wabasha, Waseca or Wilkin.

Phase 2 Coverage beginning Feb. 1, 2012
This phase is in counties where UCare is the only SNBC health plan option. Information was mailed in early December to approximately 6,300 adults who:

• are not enrolled in a home and community-based waiver program, and
• live in one of these counties: Blue Earth, Chippewa, Cottonwood, Faribault, Houston, Jackson, Kandiyohi, Lac Qui Parle, Le Suer, Lincoln, Lyon, Marti , Mower, Murray, Nicollet, Nobles, Olmsted, Redwood, Rock, Watibwabm Winona, or Yellow Medicine.

Phase 3 Coverage beginning March 1, 2012
This phase will include 78 counties and people who receive waiver services. In early January 2012 information will be mailed to approximately 20,600 adults who:

• are enrolled in one of the waiver programs and
• live in any county other than Cook, Itasca, Kittson, Lake of the Woods, Marshall, Pennington, Red Lake, Roseau, and Swift

Phase 4 Coverage beginning April 1, 2012
This phase will be in counties where there is more than one SNBC health plan from which individuals may choose. In early February 2012, information will be mailed to approximately 41,000 adults who:

• are not enrolled in a home and community-based waiver program, and
• live in one of these counties: Anoka, Benton, Carlton, Carver, Chisago, Dakota, Hennepin, Isanti, Mille Lacs, Morrison, Pine, Ramsey, Rice, St. Louis, Scott, Sherburne, Stearns, Todd, Washington, Wadena or Wright

Phase 5 Coverage beginning July 1, 2012
The final phase will include:

• all adults (approximately 1,900) in the nine counties for which SNBC contracts need to be negotiated with the health care plans (Cook, Itasca, Kittson, Lake of the Woods, Marshall, Pennington, Red Lake, Roseau, and Swift)
• all eligible children (approximately 11,000) statewide

Information will be mailed to this group in early May, 2012.

The decision to opt out of SNBC must be made by the person or the person's legal guardian. If information is received at the home of an individual who is not their own guardian, providers should assist consumers in getting the information to the person who will be able to make the decision. Providers should use their normal practices to help individuals who are their own guardians in making the decision to complete the opt-out form.

If you have questions feel free to contact Barb Turner bturner@arrm.org or 651-291-1086 ext. 3.

--Barb Turner, COO

Advocacy update: Get ready for January 24th legislative session

The 2012 Legislative Session is just under two weeks away, with the second half of the 2011-2013 biennium beginning on Tuesday, January 24^th. ARRM is eager to continue its work with legislators reforming, rebalancing, and reshaping our state’s disability system. Grassroots advocates are critical to this work, and ARRM's advocacy program, which has become a cornerstone of ARRM’s legislative efforts, will continue to grow and expand.

To support your grassroots efforts, ARRM has developed a myriad of tools and resources for members.

Messages

As in previous years, ARRM has created new grassroots messages for this session. We realize that direct support professionals have a different story to tell than family members, and self-advocates have a different story than upper-level management. With that in mind, we have unique grassroots messages for each constituency. You can find these messages in ARRM’s Advocacy Arsenal located here.

Tools

Also in the Advocacy Arsenal, you will find tools kits and templates to help you craft and tell your story.

Time and again we hear from legislators that personal stories are the most effective way to put a human face on a complicated issue. That's why we ask that you do one more thing than you did last year: contact your legislator by phone, email, or letter, or invite them to a program site to see firsthand the work you do every day. To find your legislator you can visit the state’s district finder tool by clicking here.

Communications

Word from the Capitol is that the 2012 session will be short. To stay up-to-date as things move quickly through the legislature, become a friend of ARRM’s on Facebook, visit our advocacy calendar and follow us on Twitter. Each month, I'll also be highlighting an Advocacy Partner in a blog post, so be sure to subscribe to ARRM's What's News blog to learn what other members  are doing.

Events

Mark March 1^st, 2012 on your calendars as ARRM’s Day at the Capitol. The rally in the Rotunda begins at 10:30 a.m., and once again, we'll set up meetings with your legislators on your behalf. Look for more information and registration early next week.

Last year we have almost 1,000 people registered to attend our Day at the Capitol, and we're hoping to meet and surpass that number this year. We're also hosting a MN-CCD "Tuesday at the Capitol" on March 27th, so attend that event too if can you can.

Training

Finally, the Minnesota Council of Non-Profits (MCN) will offer a variety of workshops on the rules related to nonprofit advocacy and the upcoming legislative session. Visit MCN's website to learn more about advocacy training around the state.

--Sara Grafstrom, Director of Advocacy and Community Relations

Blueprint for Reform update: bill goes to Revisor, plan continues to to be circulated

ARRM met yesterday with Reps. Jim Abeler and Steve Gottwalt, the chairs of the two House Health and Human Services Committees and got positive feedback on ARRM’s Blueprint for Reform legislation. ARRM members joining ARRM staff at the meeting were Karin Stockwell (Dungarvin) and Steve Liston (Mary T).

During the next two weeks we’ll be meeting on various bill issues with advocates through the Minnesota Consortium for Citizens with Disabilities (MN-CCD), DHS, other legislators, the governor’s staff and media.

This Friday we’ll get an update from DHS’s Disability Services Division on policy items they plan to bring to the legislature. We’ll report on that meeting next Monday and keep you posted on legislative developments as they occur. Session starts January 24^th.

Below are the links to the bill that went to the Revisor of Statutes, who may make small changes, and a section-by-section summary of the bill.

Download Section By Section Summary

Download the Reform Bill to the Revisor

-- Bruce Nelson, CEO

Save the date for ARRM’s 2012 Technology Showcase

Learn how technology is transforming services and supports for people with disabilities during this two-day conference.

Mark your calendars for March 20^th and 21^st, when ARRM’s Technology Showcase will demonstrate how technology is being used to deliver innovative, person-centered supports to people with disabilities.

As providers of disability services grapple with workforce shortages and state budget shortfalls, technology has become a viable, cost-saving solution to these ongoing challenges. Indeed, a key element of ARRM’s Blueprint for Reform plan is leveraging technology to increase efficiency in the current corporate foster care model.

ARRM's Technology Showcase will bring together people who care about maintaining quality services: Minnesota providers (mid to upper level management and administrators), case managers, county and state staff, self-advocates, guardians, and family members. In recent months, national conferences have showcased technology trends in disability services, but no comparable workshops have been offered here in Minnesota.

That’s why ARRM is bringing a cadre of nationally-known experts to our state in March. These industry leaders -- who have extensive experience providing solutions to the elderly and individuals with cognitive and physical disabilities  -- will deliver keynotes and lead break-out sessions, panels, and roundtable discussions on an array of relevant topics, including:

• monitoring technology (sensors and cameras),
• adaptive equipment and devices,
• enterprise applications (work schedules, keyless entries, time cards).

In addition, Minnesota providers will share their technology success stories and experiences.

Outcomes:
Conference attendees will learn about the latest technology solutions, and will get a glimpse of what disability services may look like in the future. Attendees will also be able to exchange ideas with their peers, meet vendors of technology services, and create new partnerships and alliances. 

There are still opportunities to sponsor this event; please go to ARRM’s website to review our sponsorships and sign up today.

Save the date:
Be sure to block off March 20st and 21st, 2012. The Technology Showcase will be held at the Radisson Hotel Roseville.

In February, watch for blog posts and email blasts about registration, speaker biographies and hotel rates. The maximum number of attendees for this conference will be limited to 250, so be sure to register early.

Stay tuned!
We offer a variety of ways to get information about ARRM events: follow us on Twitter, join our Facebook page and read ARRM’s blogs.

--Barb Brynstad, Communications Director

DHS requests residential provider staffing data by Jan. 20

Last week, DHS sent out a notice to each county to collect data on the average number of shared staffing hours in residential facilities. A copy of the instructions is available here. As part of the instructions sent to counties, DHS directs county staff to contact each provider in their county and ask them to provide the average weekly shared staffing hours for each of their facilities.

They are requesting this information for three types of staffing: direct care staff, nursing staff, and supervisory staff. Providers will have to submit this information electronically, by filling out a spreadsheet and returning it to each county they provide foster care services. DHS is collecting this information to complete the residential framework portion of the Rate Setting Methodologies Initiative (RSMI). 

Because it will be used as part of that process, we are encouraging all members to complete the survey. Some counties have collected data on staffing in the past, but many have not. And, some counties have used this data as part of their own rate setting methodologies. When completing this most recent survey, we encourage members to report actual hours provided to clients. If you operate in a county with limits on certain type of hours, ignore those constraints and report what you actually provide.

If you haven’t been contacted by your county yet to complete one, we suggest doing so as soon as possible. In its instructions to counties, DHS requested the data be completed and returned to them by January 20^th.

As always, please contact either Craig Wieber (email: cwieber@arrm.org, phone: (651) 291-1086 x9) or Barb Turner (email: bturner@arrm.org, phone: (651)291-1086 x3) if you have any questions or need additional clarification.

--Craig Wieber, Chief Fiscal Analyst