ARRM's Daily Dispatch

Today the Minnesota legislature moved one step closer to adopting a 5% rate increase

Senate:

During the Senate Health and Human Services Finance Committee, Chair Sen. Tony Lourey released his Omnibus Health and Human Services Finance bill. Within the bill was a 5% rate increase provided for HCBS.  The language does not include the quality add-on component that both the Governor and the House have proposed, however it does include an 80% encumbrance. This number is higher than the 75% that The 5% Campaign is proposing.

The Committee will begin taking public testimony on the bill this afternoon, and will work to amend the bill following that. The Chair has stated that the bill will be passed out of committee by the end of the day today and passed on to the Senate Finance Committee.

House:

As we have previously reported, the House Health and Human Services Omnibus Finance Bill included a 4% rate increase for Home and Community-Based Services. This lower number was due in part with the target the committee was given of $75 million.

Today, the House Ways and Means Committee amended that budget target by $16 million to make the new target $91 million. Following this amendment, the Health and Human Services Omnibus Finance bill was amended to fully fund the 5% rate increase. The bill was then adopted into the broader House Omnibus Finance bill.

Next Steps:

With both the Senate and the House moving quickly, we could see the Omnibus Finance bills on the floor for a vote by the end of the week. ARRM will keep you updated as things develop.

Your advocacy has truly made a difference on this important issue. Thank you for reaching out to legislators and encouraging others to do the same.

--Sara Grafstrom, Director of Advocacy and Community Relations

ARRM issues in play as legislature heads for final committee deadline

ARRM bills continued to move ahead today as the legislature hit its second deadline. This is the date by which all bills must have cleared policy committees in both the House and Senate. By next Friday, April 4^th, all funding bills must be passed out of committee.

We’ll find out by Monday morning how much the Senate will spend on Health and Human Services – critical to having enough to spend for a five percent rate increase.  Also Monday morning, the House Ways and Means Committee will make adjustments to its funding targets and take up the Health and Human Service Finance Bill that was passed out of the Health and Human Services Committee Thursday night. 

Issue by issue update:

Rate increase:  The Governor’s recommendation for a four percent increase was included in the House HHS bill Thursday night.  The Ways and Means Committee could amend that Monday, depending possible adjustments in the HHS funding target.  The Senate HHS funding target has not been released to the public.  We’ll find out by Monday morning when the Senate HHS funding committee takes up its omnibus funding package.  We’re hopeful that there will be enough to fund a five percent increase in one or both bodies.  Keep in mind the Senate will also address other funding requests – all out of the HHS funding target. 

We’ll let you know Monday what happened in the House and Senate committees.

DWRS:  The Coalition’s bill to make needed changes to the Disability Waiver Rate System was amended today and then laid over to be included in the Omnibus HHS finance bill Monday.  In order to move the bill forward in the Omnibus bill, the coalition had to demonstrate that there were no new costs in the bill.  After a midday meeting with DHS, the provisions with a cost were removed from the bill, but the bill does remain basically intact.  Negotiations on these and other provisions in the bill will resume Monday and continue as the omnibus bill works its way through the process.  Ultimately, the DWRS provisions will be considered a House/Senate conference committee as the provisions are only in the Senate bill.

245D:  Changes to 245D that were negotiated with many stakeholders were adopted in the House Omnibus HHS Policy Bill.  Those changes will be on the table in a different conference committee on the policy bill. 

Bed closures:  The target number of beds that remain to be closed is down from 128 to 35, according to DHS.  While we continue efforts on other fronts to get that number to zero by July 1^st, ARRM amended the House Omnibus Finance Bill yesterday to make sure that, if any beds were to be involuntarily closed, DHS would have to work with providers and counties first.  The amendment also establishes criteria so that we can identify beds that have been open for more than a year in service sites with adequate funding, despite the open bed. 

Keep in mind that DHS has said it has ”no interest in pursuing forced bed closures. Bed closures will be done as part of a planned process with individuals and providers who are interested in participating.” Sen. Kent Eken will offer the same amendment in Monday’s Senate hearing; Rep. Jim Abeler offered the amendment in the House.

Minimum wage:  Negotiations between the House and Senate are hung up over whether to “index” future increases according to changes in the inflation rate.  This minimum wage issue will be likely decided by legislative leaders, who are aware of ARRM’s sleep time issues – whether to keep that wage at $7.25 or pay providers for the new cost. 

Addressing the sleep time issue is a long shot at this point.  Should it not be addressed we will be in a good position next year to ask for covering not only sleep time hours, but the compression of wages with awake staff that would occur with a higher minimum wage.  We have also become aware that some daytime staff among the membership are paid below the anticipated new minimum wage of $9.50 an hour (after a three year phase-in).  After collecting and analyzing data over the summer, our legislation next year could also address impacts beyond sleep time hours.

Stay tuned Monday for breaking news on The 5% Campaign.

-- Bruce Nelson, CEO

First committee deadline comes and goes; where ARRM legislation stands

The first committee deadline of Friday, March 21^st has come and gone. This means if legislation has not had a hearing in either the House or Senate it can no longer move forward. As we have stated in past blog posts, we have been working with committee leadership to ensure that our legislation met this deadline.

DWRS

The DWRS coalition bill was heard in the Senate on Wednesday evening. The hearing simply moved the bill to the Senate Health and Human Service Finance committee. With the second committee deadline scheduled for next Friday, March 28, we are busy working with committee leadership in the House to secure a hearing next week. Discussions started yesterday with DHS to hopefully find a good agreement.

5% Campaign

The 5% rate increase bill has been through all necessary committees and is now laid over for possible inclusion in both the Senate and House Finance bills.

We did see some debate on the 5% rate increase during the House floor session on both Wednesday and Thursday. Rep. Hamilton made motions that would call the bill to the House floor for an immediate vote. The motion was not successful, however there was passionate testimony from both sides of the aisle, demonstrating the strong bi-partisan support that the 5% campaign has generated.

As we move forward, we urge you to continue contacting your legislators about why the full 5% rate increase is so important to fund.

245D

Our 245D bill was drafted into an amendment for the House Health and Human Service Policy Omnibus bill. The amendment was adopted during the committee meeting on Friday and is now part of the broader omnibus bill. Any changes moving forward will be worked out between the Senate and House during conference committee.

Minimum wage

Rep. Tom Ancelz introduced a bill H. F. 3252, today that would have government pay for the cost of increasing wages for sleep time staff as a result a higher minimum wage.  Sen. Kent Eken will introduce the companion bill in the Senate early next week.

ARRM Bills with Hearings This Week

With the first legislative deadline approaching this Friday, March 21,  ARRM has been diligently working with legislative leaders to ensure that our legislative priorities meet the appropriate deadlines.

5% Rate Increase:

The 5% rate increase legislation was heard in the House Health and Human Services Finance Committee this morning.

Representatives from both the aging and disability communities provided testimony.  Jody Fischer, a self-advocate from Rochester who is supported by ARRM member Hiawatha Homes, told the story of developing a traumatic brain injury when he was 17. DSP Kim Macinnes spoke of working in the field for 19 years and at the same home for the past 15 years. Without a rate increase, she said that she will be forced to look at changing careers.

Committee members spoke passionately about the need for an increase for Home and Community-Based services, and addressed their concerns with the budget target that the committee was given.  The bill was laid over for possible inclusion in the omnibus finance bill.

DWRS:

The DWRS Coalition bill will be heard in the Senate Health, Human Services and Housing Committee Wednesday night.  We anticipate that the time on the bill will be very brief with the bill then being referred to the Health and Human Services Finance Division.  The intent of the hearing is to send a strong signal to DHS and the coalition to negotiate and bring an agreement to the Finance Division.

245D:

Rep. Jim Abeler, along with Rep. Tom Huntley, will offer an amendment to the House Health and Human Services Policy Omnibus bill that will include ARRM’s 245D language. The committee will walk through the bill tonight, hear testimony Wednesday, and take amendments Friday. 

--Sara Grafstrom, Director of Advocacy and Community Relations

House budget target falls short and 5% hearing in the House scheduled

The House released their budget targets for the 2014 legislative session last Friday.

Included in the targets was $75 million in spending for Health and Human Services along with $550 million in tax cuts, $172 million in targeted investments in job creation, $92 million in targeted investments in education and $50 million in transportation funding.

ARRM is very concerned with the Health and Human Services target number and the capability of funding the complete 5% rate increase. Through a coordinated effort with The 5% Campaign, we will be releasing an action alert today, asking folks to re-iterate the importance of funding the full 5% rate increase.

Looking ahead, the 5% bill will be heard in the Health and Human Services Finance Committee tomorrow, Tuesday, March 18^th at 10:00 AM. The hearing will be in room 200 of the State Office Building.

--Sara Grafstrom, Director of Advocacy and Community Relations

5% Campaign Legislation Updates

Senate Bill

The 5% rate increase bill (S. F. 1993) was heard in the Senate Health and Human Service Finance committee this morning.

Our Senate Author, Senator Kent Eken (04) presented the bill along with Steve Larson, 5% Campaign co-chair and Paula Hart, President and CEO of Volunteers of America. Steve Larson testified that high staff turnover is the single biggest threat to quality care. Testimony was also offered from representatives from the aging and disability communities, outlining the complex, difficult work that is done and the overdue need for a rate increase.

During the hearing an amendment was added on to the bill, funding an increase for nursing homes to pay for the proposed minimum wage increase of $9.50. ARRM is addressing the minimum wage issue for sleep time staff through other funding bills and/or in the minimum wage conference committee.

The bill passed on a voice vote and was laid over for possible inclusion in the Senate Omnibus Finance bill.

House Bill

The 5% House bill (H.F. 2408) had its first hearing last week in the Health and Human Services Policy Committee. The bill was passed out of committee and referred to the Health and Human Services Finance committee. We are currently waiting for a hearing to be scheduled.

Governor's Budget

Hearings have also been held outlining the Governor’s budget proposal for Health and Human Services. The Governor is proposing a 4% rate increase for Home and Community-Based Services (HCBS) with 1% of that rate increase dedicated to quality. The new quality standard would require providers to complete an online form, documenting a quality improvement effort they will undertake.

Committee Deadlines

The first committee deadline is March 21^st with the second deadline the following week on March 28^th. ARRM is diligently working on assuring that all of our proposed legislation meet the appropriate deadlines.

We will work to keep you updated, as things continue to move at an accelerated pace this legislative session. You can contact Sara Grafstrom at sgrafstrom@arrm.org with any questions you may have.

--Sara Grafstrom, Director of Advocacy and Community Relations

Legislative Update

During the past week ARRM has been in many meeting with legislators, DHS and other stakeholders concerning a number of bills proposed by ARRM and others as we move to pass our initiatives and appropriately respond to others.  Here’s a quick update:

Five percent rate increase HF2408 and SF1993:  The Governor proposed funding for a four percent rate increase in his supplemental budget release late last week.  ARRM will testify on his budget this Wednesday in the Senate and Thursday in the House-voicing appreciation for the funding the Governor proposed while maintaining our ask for five percent.  The 5% Campaign will also testify in that vein.

Minimum wage: The House and Senate bills are being negotiated in a conference committee (side-by-side comparison of Minimum Wage bills).  The Senate acceded to the House bill’s $9.50 an hour phased in over three years, but not to the House’s automatic increases tied to inflation after the $9.50 target is hit.  The Senate’s last offer also included keeping sleep time hours in our services at $7.25. 

If you haven’t responded to our alert calling for the legislature to adopt the $7.25 or pay for the increase outside the five (or four) percent increase, please do so.  We are concerned that the Health and Human Services Committees in the House may not have enough money in their funding targets to pay this cost.  ARRM will bring up this issue in our testimony on the Governor’s budget.

DWRS:  The Disability Waiver Rate System bill is still being worked on by attorneys in the Revisor’s office, but we expect it to be ready for author signatures and introduction at any moment.  We’ll keep you updated on this important bill.

245D: ARRM’s bill was introduced in the Senate (SF2456) and will be introduced in the House this Wednesday.  Provisions in the bill have been negotiated with DHS and many stakeholders.  We expect a hearing by the end of next week and provisions in the bill will be amended in committee.

Other bills: 

• ARRM will testify today on HF2169 (foster home training for people with mental illness).  We have concerns that we brought to the author’s attention with her promise to address them as the bill progresses. 
• A bill to repeal the 25 percent limit on residents receiving services in a multi-family dwelling (HF1992) is moving toward a compromise with DHS and some stakeholders. ARRM supports the bill. Opening up service options to people in the community was part of our Blueprint for Reform legislation two years ago.
• ARRM supports the direction of DHS’s background studies bill (HF2467), but will testify today that many details need to be worked out in subsequent years’ legislation.
• ARRM supports funding for the State Quality Council (HF1897).  Work of the Quality Council may be important to address issues related to quality in the governor’s budget regarding a rate increase.

We’ll keep you posted as these and other issues develop.

-- Bruce Nelson, CEO

ARRM's 245D Bill

ARRM's 245D revisions bill (S.F. 2456) is moving ahead and was referrred to the Health and Human Services Committee today.  You can view this bill online here. 

We will continue to work on tweaking some of the language included, but do not anticipate any push-back on the overall contents of the bill.  If you have any questions, please feel free to contact me at bturner@arrm.org.

--Barb Turner, COO

DWRS Update

ARRM continues to work on the very important issue of rate setting (DWRS).  Several ARRM members have agreed to enhance their already tremendous efforts as we work on legislation with the other coalition members to attempt to resolve a number of issues.  When the bill is complete we will provide a link to it.

DHS recently posted the 15 minute SLS framework.  There was no official announcement from DHS, but it is now on the main DHS ratesetting page.  It can be found in the third column of frameworks under the "Residential" heading- not in the unit based column.  ARRM has also posted a link to this specific framework on the ARRM rate setting information webpage.

You can continue to send your rate setting questions to Barb Turner bturner@arrm.org.

--Barb Turner, COO

DHS DSD Stakeholder Information Available

DHS Disability Services Division (DSD) continues to hold webinars on Positive Support Community of Practice every other Tuesday from 10:00 am-12:00 p.m. Some ARRM members have been having problems getting the information to register for these webinars.  DHS has a number of email groups and it may be that you have subscribed to some, but not to the one that sends out the information on these webinars.  Below are two links that can be used to subscribe to the DSD Stakeholder list. 

DSD E-list subscription page

Sometimes the above link doesn’t work for people when the go to it directly, so here is another link to the e-list instructions, which users can link from.

Contact Barb Turner with questions bturner@arrm.org.

--Barb Turner, COO