ARRM's Daily Dispatch

Legislation moving at both the State and Federal Level: What it means for providers

Legislation has been moving at both the State and Federal level in an effort to offer some relief to individuals and organizations as we continue to navigate through the COVID-19 pandemic.

Below is a summary of what has passed and what is anticipated to be passed and the impact on providers.

State Level COVID-19 Legislation

House File 4531 was passed by the Minnesota legislature on Thursday. The bill is the state’s second package of relief funding and totals $330 million in spending. You can review the full bill text here, items that are of particular impact to providers include:

COVID-19 Minnesota Fund

A COVID-19 fund is created to pay expenditures related to the peacetime emergency declared by the governor. Money may be disbursed to agencies to:

• Protect Minnesota citizens from the COVID-19 outbreak
• Maintain state government operations throughout the duration of the peacetime emergency

Transfers to Small Business Emergency Loan Program

$30 million is transferred to the Small Business Emergency Loan Program to make loans as set forth in Governor’s Executive Order 2015, Providing Immediate Relief to Small Businesses During the COVID-19 Peacetime Emergency.

Delayed Submission of Fingerprints Authorized

Upon a declaration of a peacetime emergency, the superintendent of the Bureau of Criminal Apprehension may delay the submission of fingerprints needed to perform a statutorily authorized background check on an essential worker.

An essential worker granted a delay in the submission of fingerprints must submit fingerprints in compliance with the applicable statute within 30 days after the peacetime emergency ceases or the temporary dealy granted under the section expires, whichever occurs earlier.

Peacetime Emergency Child Care Grants

The legislation allocates $30 million in grants to child care eligible programs. In order for programs to receive these dollars they must prioritize space in their programs for children of essential workers as identified in Executive Order 20-19.

As a reminder, ARRM was able to confirm with the Department of Human Services that children of Direct Support Professionals would qualify for childcare under this Executive Order.

Federal COVID-19 CARES Act

In addition to the activity happening on the state level, late Wednesday evening the United States Senate passed the COVID-19 relief CARES Act legislation. It is anticipated that the House will convene at 9:00 am on Friday to vote on the bill.

Below is a brief summary, prepared by ANCOR, of items that are included in the bill that will have an impact on providers. We will be providing more detail as soon as we receive it.

• Money Follows the Person extended through 11/30/2020
• ANCOR’s Hospital bill, which would allow states to authorize the payment of Direct Support Professionals to be reimbursed when supporting individuals during hospital stays is included and expanded to all 1915 and all 1115 waivers
• Emergency Small Business Administration 7(a) loans of up to $10M available to help maintain operations (payroll, mortgage, rent, utilities and certain debt payments) for entities that existed on March 1, 2020. Employers that maintain employment between March 1 and June 30 would be eligible to have their loans forgiven. Available to small businesses, Section 501(c)(3)s, Section 501(c)(19)s and Tribal businesses of 500 total employees or fewer.
• $100B Public Health Emergency Fund – We have heard from multiple offices that Congressional intent was for DSPs to be included in this pot of money. We are working on an immediate regulatory strategy to make sure this is codified in guidance.
• $200M in ACL grants to supportive services to prepare for and respond to COVID-19 – In conversations with ACL, they have signaled their intent to use these funds for DSP stabilization.
• The U.S. Department of Treasury's Exchange Stabilization Fund to create a loan guarantee program for major industries. Over $400B would be available to an eligible business, defined as "a United States business that has not otherwise received economic relief in the form of loans or loan guarantees provided under" the CARES Act, and employs 501-10,000 people. It is possible certain nonprofits will qualify for this aid but we have not yet confirmed.
• The final agreement includes more than $150 billion that includes increased funding for hospitals and health systems, and billions more into critical investments such as personal and protective equipment for health care workers, testing supplies, increased workforce and training, new construction to house patients, an increase of the Strategic National Stockpile, medical research into COVID-19.

COVID-19 Update

It’s only been a week or two of the COVID-19 chaos, but it certainly feels much longer. ARRM is continuing to pull together important information and resources for your members. They can be found on a special website we set up for you – www.ARRMcovid19.com

Executive Order
Executive Order 20-12 was issued on Friday, March 20^th by Governor Tim Walz called for preserving access to human services programs during the COVID-19 Peacetime Emergency.  Shortly thereafter, Commissioner Jodi Harpstead issued a press release found here starting to provide information on how DHS will be easing restrictions, regulations and provide additional guidance.  We are in constant communication with DHS so we will keep you up-to-date when new information comes out from DHS.  We have also created a ARRM/MOHR leadership team who are meeting to share information and problem solve.

Weekly call
ARRM has secured a commitment from DHS to participate in a weekly briefing with ARRM members every Wednesday at 11:00 am.  ARRM invited MOHR members to participate as well because we’re all in this together.  Our first call was March 18 and it got off to a rocky start with some profound technology glitches.  Kevin got it figured out, and when the call went live we had over 630 lines connected.  We expect a strong presence at future meetings.

Waivers under peacetime emergency authority, Executive Order 20-12

Under the Governor’s Emergency Executive Order 20-12, the Minnesota Department of Human Services has temporary authority to waive or modify requirements so that the agency and its partners can continue to provide essential programs and services to Minnesotans safely and without undue delay during the COVID-19 pandemic.

A list of all waivers and modifications currently in effect is posted at the DHS website.  It will be updated as necessary. We encourage you to monitor the DHS website and DHS bulletins.

Operational instructions for counties, tribes, managed care organizations and providers related to these changes will be communicated separately to people affected by specific temporary changes

PPE Needs

We know that personal protective equipment (PPE) are hard to come by.  We have communicated this need to DHS on multiple occasions.  ARRM will be investigating other alternatives early this week and will keep you updated.

We know that this is a scary time for many folks, both personally and professionally.  We here that from you and we are doing what we can to support you.

Sue Schettle, CEO

 

Through our national partner, ANCOR, we are working with members of Congress to urge their support of various emergency funding requests that are working their way through the process.  Many of you have participate in our Action Alerts.  I’m thankful that we purchased a new grassroots program that allows you to very easily connect with your legislators. 

We urge governors to take the following actions as soon as possible:

1. Issue an executive order designating direct support professionals as "essential workers." Currently, home health aides and personal care attendants are considered essential, but direct support professionals (DSPs)-despite fulfilling all the same roles as these other professionals plus much more-aren't identified as essential. Designating them as such will ensure their unfettered ability to get where they need to go to support our neighbors with disabilities who are relying on their support. Other positions or roles essential to continuing community-based disability supports that should also be deemed essential and may not be able to work remotely include administrative managers/supervisors, medication technicians, clinical support staff, therapists, case managers, housekeeping, maintenance and others.

2. Encourage displaced workers to consider applying for jobs as Direct Support Professionals. Before COVID-19, turnover rates within our workforce averaged 51%, and high vacancy rates are certain to be exacerbated by the coronavirus and the havoc it is wreaking on the health care system, schools and more. Meanwhile, millions of workers are being laid off as bars, restaurants, stores, airlines and other industries see demand plummet. To alleviate the DSP workforce crisis and mitigate the impacts of rampant unemployment, governors can coordinate with state health, labor and education to encourage those currently without work to consider this rewarding, meaningful career opportunity.

3. Publicly recognize the important work direct support professionals do in the community. Ohio Governor Mike DeWine led the way on this front by specifically acknowledging the lengths to which DSPs are going to ensure the most vulnerable populations in our community are being cared for in the midst of this crisis. Following Gov. DeWine's lead, efforts by governors to praise the work of DSPs would legitimize the DSP workforce, ensuring they are considered frontline workers in need of personal protective equipment, and would help these unsung heroes feel appreciated at a time when they are operating under unprecedented stress.

Blue Ribbon Commission Meeting Update #9

Blue Ribbon Commission Meeting 9

The latest meeting of the Governor's Blue Ribbon Commission was recently heard on March 6th at DHS. This meeting focused again on cost-savings strategies—this time not directly related to disability services.  Even though the conversation didn't directly focus on disability services, we wanted to make sure ARRM members were still represented at the table as part of the larger, overall conversation and mission of the BRC.

There was a lot of discussion about the pros and cons of each of the ideas listed below: 

• Add an enhanced home care benefit in Medicare supplement plans
• Guidelines to access customized living services
• Value-based reimbursement in nursing facilities
• Repeal nursing facilities first 30 days rate adjustment

Care Providers of MN and Leading Age were front and center during these important discussions and weighed in with their recommendations. 

More to come next posting. 

Legislative Session Week 4: Bill introductions signal move to independent living

While this week did not see any of ARRM’s legislative priorities get scheduled for committee hearings, there were some notable bills introduced in the Senate that ARRM is closely monitoring.

These bills, being chief authored by Senator Jim Abeler (35) and co-authored by Senator John Hoffman (36) signal the direction that Senator Abeler, chair of the Human Services Reform Finance and Policy committee envisions services for people with disabilities going, towards more independent living outside of a traditional four person group home.

Legislation includes:

SF 3782: Creates policy statements in statute for the following categories:

• Employment First: Supports the presumption that all working-age Minnesotans with disabilities can work, want to work and can achieve competitive integrated employment.
• Independent Living First: Supports the presumption that all adult Minnesotans with disabilities can and want to live independently with proper serves and supports.
• Self-directed options First: Supports the presumption that all adult Minnesotans with disabilities and all families of children with disabilities can and want to use self-directed services and supports, including self-directed funding options.

SF 3923: Creates a new requirement within 245D that at least once per year, providers, in coordination with the person’s support team must discuss option for transitioning from residential supports and services. This legislation also requires that the CSSP addendum include a summary of the discussion and a statement about any decision made.

SF 3987: Allocates $1 million in grant funding toward the development of permanent supportive housing for people with disabilities and the elderly.

In addition to these bills that were introduced in the Senate. The Department of Human Services policy bill (HF 3390) also contains new requirements for the 45 Day planning meetings that include:

• Discuss opportunities to develop and maintain essential and life-enriching skills, abilities, strengths, interests and preferences
• Discuss opportunities for community access, participation, and inclusion in preferred community activities
• Discuss opportunities to develop and strengthen personal relationships with preferred people in the community
• Discuss opportunities to seek competitive employment and work at competitively paying jobs in the community

ARRM will continue to monitor these key pieces of legislation as well as other legislation as it is introduced and ensure that our legislative priorities remain part of the global conversation around disabilities services.

Looking ahead to next week, we are excited for a record setting attendance day at Day at the Capitol- I am looking forward to seeing you all on March 10^th!

Please reach out with any questions.

--Sara Grafstrom, Director of State and Federal Policy