ARRM's Daily Dispatch

Rate Increase Prospects Unclear With Three Weeks To Go

How a rate increase fares at the legislature is unclear – as is every major issue.  The House and Senate, which staked out their positions on major tax and spend issues this week, are light years apart on four key issues:

• Transportation:  The House spends $300 million out of the general fund; the Senate majority is adamantly opposed to using general fund money for roads and bridges.

• Tax relief:  The House gives the lion’s share of the $900 million surplus back in tax cuts, while the Senate approach is much more limited.

• Bonding:  The two bodies will differ widely on how much to borrow and spend for capital building projects.

• HCBS rate increase:  The House grabs savings from MN Sure for a one-time five percent rate increase; The Senate has no increase.  The House provision gets the issue on the table for consideration of a permanent increase for some unknown amount.

Two things happen next.  House and Senate leaders and Governor Dayton negotiate a global deal and conference committees work out differences on all spending proposals.  Until – and if – the leaders work out a global deal, the conference committees will have little to do. 

How our rate increase fares depends in large part on how it plays into discussions on transportation spending and tax relief.  Our direct and grassroots advocacy will focus on legislators who can influence the global talks and conference committee.

If ARRM or the Best Life Alliance asks you to contact your legislator it is because that person can influence the big decisions.  In the end, the interaction of those big issues – including bonding – may have bearing on getting some kind of rate increase. 

The pathway to getting an increase this year is uncertain, depending on day-to-day developments at the capitol.  We simply don’t know yet what will shake out in the end, so we need to keep shaking the tree if we are to prevail.  Stay tuned, especially for calls to action.  We have three weeks until the legislature adjourns on May 23^rd.

- Bruce Nelson, CEO

DHS Releases Updated MHCP Provider Manual Page Regarding Payment of Leave Days

Minnesota Department of Human Services has revised the provider manual effective 4-26-16 to include a revision to the language regarding billing for leave days.  The revised language clarifies that for individuals funded by the CADI, CAC, BI or DD waivers, a provider may bill a daily rate for any day that the individual receives services for any portion of the day. You can find the link here:

http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=DHS-285724

Contact Luana Slayton lslayton@arrm.org with any questions.

 

--Barb Turner, COO

Weekly Wrap

ARRM staff recently traveled to Washington D.C. to meet with members of the Minnesota Congressional Delegation about the proposed Department of Labor Overtime rule.

That rule change would raise the salary level to which employees qualify for overtime pay from $23,660 annually to $50,440 annually. The rule was sent to the Office of Management and Budget on March 14^th with a 90 day deadline to review and finalize. We anticipate the rule being finalized before this 90 day deadline expires.

ANCOR and ARRM support the intent of the rule- we want to pay our workers more however, the fact that our industry is almost completely funded by Medicaid dollars creates unique challenges for our field.

Two asks were presented to Congressional leaders:

1. We are asking the Department of Labor and the Administration for more time for implementation. There is precedence. The Department of Labor determined that with the Home Care rule of 2013 an extended implementation date was appropriate. The Department stated:

“The Department believes an extended effective date allows time for regulated community to avoid disruptions to home care services because of the restrictions of federal or state budget processes.”

The Department was concerned that such an effective date would not be sufficient for federal, state and local agencies as well as private entities to implement new protocols, apply for changes to their Medicaid programs, adjust funding streams and legislatively address budgetary and program changes.

1. ANCOR has begun circulating the Disability Community Act of 2016. The proposal would ask for three year temporary funding in the form of Medicaid Federal Medical Assistance Percentage (FMAP) bump that will allow providers to comply with major unfunded rules while providing state budgets time to include these new rules in their budget planning process.

Both of these asks were presented to the MN Congressional Delegation with the assurance that they will look into these issues further.

The underlining theme of all of the meetings was the workforce crisis that we as an industry are facing in Minnesota, and the critical need for additional funding. ARRM will continue to follow up with those we met with, and all were seemingly responsive to our concerns.

As more information becomes available about the final DOL Overtime Rule ARRM will continue to keep you updated.

--Sara Grafstrom, Director of Advocacy and Community Relations

HCBS Leave Day Update

ARRM received an update on the issue of the definition of leave days.  DSD has requested a revision to the page in the provider manual that deals with this definition and had provided suggested language.  The page is controlled by provider enrollment and billing.  They are currently working on this.  They are reviewing the proposed language and confirming continuity with the CMS rule.

If providers are having issues with billing for leave days it is recommended that they contact provider enrollment.

ARRM will provide updated information when this issue is resolved.

 

--Barb Turner, COO 

Shared Staffing DWRS Worksheets Now Available

Shared Staffing is a topic which ARRM, providers, and DHS have been working on for a number of months.  On April 20th, the Disability Services Division posted business rules, training videos, and worksheets for the calculation of Shared Staffing hours, and Awake Overnight Staffing. 

Please visit the link below for the Quick Reference Guide on Business Rules for Residential Staffing.  At this site, there are links to the business rules on shared staffing, the supplemental worksheets for the shared staffing hours calculations, training videos on the business rules and on the worksheets.  This site also provides the link to exception requests information for awake overnight staffing, as well as the exception request form.  Also, the details from the DHS Elist email, including relevant links, are located beneath my signature.

Shared Staffing Hours for RMS Input

The new calculations and worksheets are effective immediately and apply to service authorizations renewing after April 1st.

 

Please feel free to contact me with any questions or feedback on the business rules and worksheets at lslayton@arrm.org

-- Luana Slayton, Chief Fiscal Analyst

 

Email from DHS

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RMS User Manual updates

The DSD rate policy staff added the following to the RMS User Manual:

• Additional training videos
• A new quick reference guide on business rules for residential staffing
• Two new daytime staffing hours worksheets for residential services.

Training videos

We created three new courses that include a total of 26 videos:

• How to complete a DHS-6790 worksheet (DWRS 201, eight videos)
• How to calculate a rate in RMS (DWRS 202, 14 videos)
• How to use the DWRS supplemental worksheets (DWRS 203, four videos).

To view the videos, see RMS - Training modules.

Quick reference guide on business rules for residential staffing

These rules guide lead agencies and provider agencies as they determine individuals' staffing levels for residential services. See RMS – Quick reference guide on business rules for residential staffing for more information.

Daytime staffing hours worksheets

Use these worksheets to help you calculate daytime staffing hours for a person who receives residential services. Access the daytime staffing hours worksheets (.XLS) directly, or see RMS – Quick reference guide on residential shared staffing hours for RMS input for more information.

Keynote Speakers Focus on Enhancing Work and Life During Annual Conference

The ARRM annual conference, "What's Trending? #ARRM2K16", is less than a month away and we are excited to present two keynote speakers who will provide information that can enhance any workplace and potentially change how many of us approach our daily lives.

Doctor Amy Tolbert is the opening keynote on Wednesday, "Communicating Across Styles – Adapting for Increased Effectiveness." Her focus is to understand our own behavioral strengths, and learn how to identify and value behavioral strengths in others. Through this, we can improve the way we work with others, discover viable solutions to resolve conflict, and relieve stress that comes with miscommunication and frustration. 

Learn more about Doctor Tolbert at http://eccointernational.com

Our Thursday keynote is Doctor Cindra Kamphoff with “I will…I can…I am. How to Master Your Mindset to Reach Your Potential.” In this, she will discuss how to become a master of your thoughts to reach your potential. She will discuss the power of positivity in your life, work and play, and the best ways to talk to yourself instead of listening. You will walk away with tangible strategies to better your life and performance.

Information about Doctor Kamphoff is available at www.cindrakamphoff.com.

Information and registration for the conference is here.

We hope to see you next month!!

-- Nancy Peterson     Director of Member Services and Education

Tuesday's Rally to Renew Energy for Best Life Alliance Bill

If faces and voices spark change, Tuesday is our chance to reignite energy and optimism and send a loud message that the need is urgent for a five percent rate increase for Home and Community-Based service professionals.  So much is riding on this legislation, and the Best Life Alliance encourages everyone to be a part of the process by participating in a short rally on Tuesday, April 19.

Here are a couple reasons to come to the Capitol tomorrow:

• One, the House and Senate have each presented the Health and Human Services bills and will move on them this week. The House Health and Human Service bill, HF 3476 does include a one-time, five percent increase but uses funds from MNsure to pay for it.  The Senate has over $40 million in new money for HHS but does not include a rate increase.

• Two, the 8,700 job vacancies in HCBS and related areas state-wide, we can not wait for another legislative session to fill these positions.  Low wages are a key factor for the openings, and people with disabilities deserve consistent, professional care.

Tomorrow is your opportunity to tell Minnesota lawmakers to please pass this rate increase now.  We will gather on the front steps of the State Office Building at 11 a.m. and then, after a few words from key lawmakers and other stakeholders, everyone is encouraged to break away and visit their legislators and hand-deliver a letter of support for the Best Life Alliance bill. 

We hope to see you Tuesday!!!

--Julie Bartkey, Communications Director

 

 

Weekly Wrap

At the capitol this week, ARRM focused on the House of Representatives, which is moving first on the omnibus Health and Human Services funding bill.  The bill did not contain three provisions that we hoped would be excluded yet were in the governor’s recommendations:

• A license fee increase was not included.  We argued that a fee increase when providers are scrambling to find resources to retain and recruit staff would make a bad situation worse.
• A provision that would allow DHS to take a bed from one provider in one geographic area and give it to another provider in another geographic area was not included.
• A requirement for some providers to report exhaustive employee data for analyses and reports was not included.

The House bill addresses the rate increase by including a mechanism to capture savings in MNsure, the state’s health care exchange, to provide a one-time five percent increase when those funds become available.  Future increases would depend on future legislatures.  This mechanism will likely not become law.  The important and positive thing about this provision is that it keeps the Best Life Alliance request for five percent rate increase on the table when legislative leaders and the governor negotiate other big issues like taxes, transportation and bonding. 

The Senate is expected to roll out and mark up its health and human services funding bill early next week. 

The Best Life Alliance is holding a rally next Tuesday, April 19^th at 11:00 am on the steps of the State Office Building. This rally is intended to help push negotiations happening between both the House and Senate Leadership and Governor Dayton in our direction. It is critical that we demonstrate to legislators the large number of people that are supporting the Best Life Alliance. Please plan to attend the rally on Tuesday and please bring copies of the one page document telling legislators why 5% can't wait.

We hope to see you there!

--Bruce Nelson    CEO 

Gathering Planned to Urge Lawmakers to Pass a 5% Increase

The momentum we gained at the legislature to pass a five percent rate increase for Home and Community-Based Services is beginning to slow following the March 15 ARRM/MOHR Day at the Capitol.  That rally, which brought roughly 1500 people to the St. Paul Armory, resulted in dozens of lawmakers signing on to the Best Life Alliance bill.  We want to renew that energy and are asking you to come to the Capitol Tuesday, April 19th to show support for the Best Life Alliance.

The Best Life Alliance will hold a rally on the east-facing stairs of the State Office Building, directly west from the Capitol on Martin Luther King Junior Boulevard.  The plan is to gather on the stairs at 11 am until 11:30, and then head to the offices of lawmakers to meet with them or hand-deliver a letter of support explaining why 5% can't wait.  Several lawmakers who support the legislation are expected to speak and provide encouragement to visit with your Representative or Senator.  Appointments can be made with lawmakers by contacting them at the Minnesota House and the Minnesota Senate. We encourage you to fill out a letter of support for both your Senator and Representative prior to coming to the Capitol.

With roughly a month left in this legislative session, the time is now to show a strong presence in supporting this legislation.  The Best Life Alliance, ARRM, and all stakeholders hope to see you Tuesday.

Thanks!

-- Sara Grafstrom      Director of Advocacy and Community Relations

 

 

Conference Early Bird Registration Extended

The ARRM staff continues to settle in, following a move last week one floor down from our former offices to suite 302.  With any move, there are some glitches.  One of those has been our intermittent internet connection. We understand it must be frustrating for those of you who wanted to register for the ARRM Annual Conference over the weekend, to meet the original Monday deadline to receive the early bird discount.

Fear not!  We are extending the deadline to 5 p.m. Tuesday, April 12, to accommodate your busy schedules and to thank you for your patience. 

Information and registration for this year's "What's Trending? #ARRM2K16" can be found here.

Thanks again for your patience and we are very excited to see all of you at next month's conference.

--Nancy Peterson    Director of Education and Membership