ARRM's Daily Dispatch

Legislative Update & Call to Action: ARRM bills on track, budget plans announced

Contact Legislators During Their Break

The legislature is now entering a week-long break, with session scheduled to resume on Tuesday, April 7^th. Key funding decisions are being made now and will continue on through the final six weeks of session.

ARRM, along with The 5% Campaign, is encouraging folks to be in contact with their legislators during this critical time.  We are relying on our grassroots advocates to deliver the message that consistent staff is the foundation for quality care and now is the time to ensure that quality community services for people with disabilities and older adults are available, stable and sustainable.

There are a couple ways to be in contact with your legislators in the coming week:

• The 5% Campaign has put together a calendar of upcoming town hall forums that are happening around the state. These events, hosted by community partners as well as legislators themselves, are a great opportunity to show your support for The 5% Campaign and meet with your legislators in your district. View the calendar to see if there is an event near you.

• On Monday, March 30^th, The 5% Campaign will be sending out a new Action Item for folks to use when contacting their legislators. This email will feature a hand template and will ask folks to write about the important work that their hands do in providing quality care. The goal is to have hundreds of these hands mailed to legislators for them to receive when they return on April 7^th. Look for more information next week.

Session Update:

ARRM’s five bills have cleared policy committees while the House and Senate released their budget targets this week and Gov. Dayton unveiled his supplemental budget proposals last week.

Targets and Budgets:  The House spending targets for committees included a $1.1 billion Health and Human Services (HHS) reduction from forecasted general fund spending for the next two years, starting July 1, 2015.  The last forecast predicted how much would be spent if no laws changed.  For the past couple months House Health and Human Services leaders have made commitments to increase rates for Home and Community-Based Services (HCBS) and nursing homes. 

So how can HCBS rates be increased with $1.1 billion in reduced HHS spending?  There are many general fund accounts within HHS and some accounts – notably Minnesota Care – are booked separately from the general fund.  So don’t be surprised to see reductions in some general fund programs and transfers from other funds.

The just-released Senate targets spend an additional $341 million in Health and Human Services in the next biennium.  Resolving the wide difference between the House and Senate will include how other areas of government are funded, including E-12 education, higher education, transportation and tax relief.

Governor’s Budget Proposal:  As reported earlier, Gov. Dayton’s budget doesn’t include additional funds for Home and Community-Based Services, but it does include $25 million for nursing home workers- much less funding than requested by the nursing home industry.

5% Campaign:  The House and Senate bills will be heard in each body’s Health and Human Services finance committee. At the close of those hearings the bills will be laid over for possible inclusion and funding in the Omnibus Health and Human Services Finance Bills.  By April 24^th the chairs of these committees will make recommendations to their committee members on funding many HHS programs – within the funding “targets” set this week.  Committee action may change who gets how much within that target.

Expectations:  We’ve received a lot of bipartisan support from legislators, but no one has promised to deliver 5% increases in each of the next two years, as requested in our bill.  And, to be honest, a rate increase won’t reach that level of funding.  We are optimistic that a rate increase will be adopted, but how much and when it would go into effect are unknowns.

Minimum Wage:  ARRM’s bill to pay for increased costs due to minimum wage increases for sleep time employees also await hearings in the HHS finance committees.  They will follow the same process as the rate increase bill.

DWRS (Disability Waiver Rate Setting):  Two versions of the DWRS bill were passed in the House and Senate HHS policy committees and referred to the Finance Committees with the understanding that the negotiated agreement between the DWRS Coalition and DHS will be presented as an amendment in the Finance Committees.  Negotiations are ongoing with meetings as recent as yesterday.

245A/D Changes:  The mostly technical bill to add clarity to 245A and 245D sections of law passed two House committees and awaits final action by the full House.  The Senate companion passed the HHS policy committee Wednesday and was referred to the Finance Committee, although the bill has no cost.

Investigations/Sanctions:  The amended bill would rein-in the issuance of conditional licenses to apply to the affected facility rather than an entire company and would clarify providers’ ability to “settle” on sanctions and instead of pursuing litigation. Other provisions in the introduced bill were dropped in negotiations with several of those issues being addressed administratively by DHS.

-- Bruce Nelson, CEO

HCBS Final Rule provider self-assessments required

The Minnesota Department of Human Services (DHS) has submitted a transition plan to Centers for Medicare & Medicaid Services (CMS) regarding the Home & Community-Based Services (HCBS) Final Rule. 

Part of their plan includes having providers complete and submit a self-assessment for each of their services/settings.  Each provider owned or controlled setting needs to have an assessment completed.  This means that if you operate 10 AFC/CRS sites you will need to complete 10 assessments. 

DHS plans to have the assessments sent out on April 1,  2015 and they will need to be completed by May 15, 2015.  The link will be sent to the PRVLTR file in your MN-ITS mailbox.

The following link will take you to the DHS webpage that includes more about the self-assessment, self-assessment training, and general information.

http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_193357

If you have questions, please contact Barb Turner at bturner@arrm.org.

--Barb Turner, COO

ARRM Bills Progress in House of Representatives

Three ARRM bills passed in the House Health and Human Services Reform Committee Friday and were re-referred to funding committees:

House File 1199:  A bill to cover the cost of minimum wage increases for sleep time workers was passed and referred to a finance committee.  Devin Nelson of Habilitative Services testified for ARRM.  The bill was warmly received, but the finance committee will determine whether to fund the proposal. 

H.F. 980: ARRM’s bill that makes mostly technical – but nonetheless important – changes to Minnesota Statutes 245A (licensing) and 245D (standards) was passed and referred to a finance committee. (ARRM will ask that the bill go straight to the full House as it doesn’t involved funding.)  A few minor amendments were negotiated prior to the hearing due to concerns from one Representative.  ARRM COO Barb Turner testified.

H.F. 1211:  The DWRS Coalition bill to make needed changes in implementing the Disability Waiver Rate System was passed and referred to a finance committee.  Don Priebe of Homeward Bound testified on behalf of ARRM.   Earlier in the week, members of the Coalition – including ARRM staff– started discussions with DHS on the bill’s provisions.  Those negotiations will likely continue through April to find agreements to be included in the bill before final passage.

These three bills have met the first legislative committee deadline by clearing policy committees in the House.  They must be passed out of Senate policy committees by March 27^th to meet the second committee deadline.

Two other ARRM bills have hearings scheduled in House policy committees:

H.F. 564:  The 5% Campaign’s bill asking for a rate increase will be heard in the House Aging and Long Term Care Committee March 18^th.  From there it will likely go to the Health and Human Services Finance Committee where decisions will be made on whether to provide a rate increase and at what percentage.

H.F. 1272:  ARRM’s bill to match the severity of sanctions with citations will likely be heard Friday March 13^th in the House Health and Human Services Reform Committee.  Barb Turner is working on amendments to the introduced bill with the Inspector General and other stakeholders.

We’re focusing our attention on getting the five bills heard in Senate Committees while continue working to keep the bills alive and moving in the House. 

ARRM is also monitoring bills from the Governor/DHS and others.  Last night Barb testified in the Senate on sections of the DHS policy bill and will propose amendments as the bill works its way through various committees.  

--  Bruce Nelson, CEO

Correction on GRH/Shelter Needy Update

Last week communication was sent out from DHS on the proposed reform for GRH/Shelter Needy.  In that communication, incorrect information was provided regarding the required qualifications for staff.  

The  correct information is “Staff and volunteers of providers with licenses other than only a 'board and lodging' license would be exempt from additional qualifications.”  

DHS has posted a correct version of the information. View the corrected update.
 
Contact Barb Turner at bturner@arrm.org with questions.

--Barb Turner, COO

'Positive Behavior Supports' testimony

Last week, ARRM presented public testimony on the proposed new rule on positive behavior supports (what many are calling “the new Rule 40”). 

The issues emphasized at in that testimony were: costs to the provider, lack of exceptions, and unintended consequences.  ARRM will also be submitting more detailed written testimony. 

The public comment period, during which written statements may be submitted, is open until March 16, 2015.  Submissions should be emailed to rulecomments.oah@state.mn.us.   A copy of the proposed rule can be found at http://www.dhs.state.mn.us/dhs16_189734.pdf.

Please contact Barb Turner at bturner@arrm.org with any questions.

--Barb Turner, COO

Full steam ahead: legislative update

We’re gearing-up for a lot of action at the Capitol this week.  Hearings for four of ARRM’s bills are scheduled for this Friday, March 6^th.  With our partners and members we are finalizing strategies and talking points, amendments, testifiers, and handouts.  We are also preparing for the release of the Governor’s supplemental budget which is expected sometime next week.   Below is a quick run-down on our current legislative activities.

The 5% Campaign   – HF 564 and SF 646/647

ARRM staff attended a meeting at the Governor’s office recently regarding the 5% increase bill, and are in communication with his staff to provide follow-up information.

After Friday’s February Forecast projecting a $1.9 billion state budget surplus, The 5% Campaign issued this news release calling on Governor Dayton to include a 5% rate increase in his supplemental budget.  A quote by Bruce was included in a Star Tribune article Friday, and the need for an increase was mentioned in the paper’s Saturday editorial as well.  

Sen. Eken and Rep. Hamilton filmed a new video about the need for 5% last Monday, and it will be distributed in the coming weeks.

On Wednesday, March 18^th at 8:15am the House Aging and Long Term Care Committee will hold a hearing on the coalition’s 5% rate increase bill.  We encourage self-advocates, caregivers, providers and other supporters to attend to demonstrate the importance of the issue to committee members.   A Senate hearing date for the 5% is to-be-determined.  

The following bills have House hearings set for this Friday, starting at 10am. ARRM is working to arrange hearings on these bills in the Senate by the end of the month.   

245A & D technical reform bill – HF 980 (SF 706)

This bill will amend licensing and standards statutes.  All changes are needed but should not be controversial.  Our chief author in the House is Rep. Halvorson.  Barb Turner will testify and after the hearing, it will move to the House floor.  

DWRS bill – HF 1211 (SF 1062)

The Disability Waiver Rate System (DWRS) Coalition bill addresses many complex implementation issues to assure transparency and consistency across the state.  Its chief author in the House is Rep. Peterson.  After the hearing in the House Friday, it will move to the House Finance Committee.

Investigations / sanctions bill  – HF  1272  (SF 1181)

The bill realigns the severity of the sanction with the seriousness of the violation, establishes boundaries to the issuance of conditional licenses, and creates a mediation process.  Rep. Mack is the chief House author. Testifiers for this hearing will include Barb Turner and the Office of the Inspector General, then the bill will head to the Public Safety Committee.  

Minimum wage bill  – HF 1199 (SF 958)

This legislation pays for increases in the minimum wage for sleep time employees and the chief author is Rep. Pierson.   After its hearing, this bill will move on to the House Finance Committee.

--Amy Wartick, Communications Director