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S.F. No. 669 - Intermediate Care Facilities for Persons with Developmental Disabilities and Home and Community-Based Providers Reimbursement Rates Medical Assistance Adjustments
 
Author: Senator Gary H. Dahms
 
Prepared By: Liam Monahan, Senate Analyst (651/296-1791)
 
Date: February 10, 2017



 

SF 669 increases by four percent on July 1, 2017, and by another four percent on July 1, 2018, the individual reimbursement rates under the disability waivers, operating payment rates for intermediate care facilities for persons with developmental disabilities, and rates for various home and community-based services available through the state Medicaid plan and grants.  The two rate increases are not additive, but multiplicative, resulting in a cumulative rate increase between June 30, 2016, and July 1, 2018, of 8.16 percent.

Section 1 [256B.4915 – Disability Waiver Reimbursement Rate Adjustments] places into statute prior rate increases that currently appear only in session law.  In addition, section 1 applies the new rate increases in this bill to the historical rates that apply to disability waiver services during the disability waiver rate system banding period.

Section 2 [256B.4919 – Home and Community-Based Service Provider Rate and Grant Adjustments] increases by four percent on July 1, 2017, and by another four percent on July 1, 2018, the individual reimbursement rates under the disability waivers and rates for various home and community-based services available through the state Medicaid plan and grants.

Subdivision 1 (Definitions) provides definitions for “employee,” “rates,” and “services.” The definition of “employee” specifies who must receive a wage increase as a result of a rate increase.  The definition of services specifies which services are eligible for a rate increase. These services are:

  1. Disability waiver services;
  2. Nursing services and home health services;
  3. Personal care assistance services and qualified professional supervision of personal care assistance services;
  4. Home care nursing services;
  5. Community first services and supports;
  6. Essential community supports;
  7. Day training and habilitation services for adults with developmental disabilities provided outside of the disability waiver program; and
  8. Semi-independent living services.

And services under the following grants:

  1. Consumer support grants;
  2. Housing access grants;
  3. Self-advocacy grants;
  4. Deaf and hard-of-hearing grants;
  5. Employment support grants; and
  6. Grants to people who are eligible for the Housing Opportunities for Persons with AIDS program.

Subdivision 2 (Rate and grant adjustments) increases rates by four percent on July 1, 2017, and by another four percent on July 1, 2018, for services as defined in subdivision 1.

Subdivision 3 (Wage increases) requires providers to increase employee wages by a percentage equal to the percent increase in rates.

Subdivision 4 (Certification of wage increases) requires providers to certify to the commissioner that eligible employees received the required wage increases.  Subdivision 4 also requires providers to post the certification in a manner accessible to employees and provide employees with instructions for contacting the commissioner if an employee believes the wage increases have not been received.

Subdivision 5 (Employees represented by an exclusive bargaining representative) requires providers to obtain from an exclusive bargaining representative a letter of acceptance of the wage certification.  The provider must submit the letter of acceptance with the wage certification provided to the commissioner. 

Subdivision 6 (Public employees under collective bargaining agreement) permits public employers to apply the rate increase to wage increases, but only in a manner consistent with laws governing public employees’ collective bargaining.

Subdivision 7 (Lead agency waiver budget allocations) requires the commissioner on the effective date of each rate adjustment to adjust the home and community-based waivered service budget allocations to reflect to the rate adjustments.

Subdivision 8 (State grant contracts) requires the commissioner to amend grant contracts to pass through, within 60 days, the rate increases.

Subdivision 9 (Managed care and county-based purchasing plans) requires the commissioner to increase capitation rates for eligible services and requires managed care and county-based purchasing plans to pass through the rate adjustment as increased payments to providers.

Subdivision 10 (Consumer–directed community supports) requires counties, on the effective date of each rate adjustment, to increase individual budgets for consumer-directed community supports to reflect the rate increase.

Subdivision 11 (County and tribal contracts) requires the counties and tribes to amend service contracts to pass through, within 60 days, the rate increases.

Subdivision 12 (Direct care worker health care coverage) requires the commissioner to increase each provider’s rates, beginning July 1, 2019, and annually thereafter, by an amount equal to the annualized cost to that provider for providing single health care coverage for its employees two years earlier.

Section 3 [256B.5012, subdivision 17] increases operating payment rates by four percent on July 1, 2017, and by another four percent on July 1, 2018, for intermediate care facilities for persons with developmental disabilities.

            Paragraph (a) increases rates.

             Paragraph (b) specifies how the rate increases will be applied to existing rates.

Paragraph (c) defines “employee” and requires facilities to increase wages of its employees by a percentage equal to the percent increase in its operating payment rate.

Paragraph (d) requires facilities to certify to the commissioner that eligible employees received the required wage increases. 

Paragraph (e) requires facilities to post the certification in a manner accessible to employees and provide employees with instructions for contacting the commissioner if an employee believes the wage increases have not been received.

Paragraph (f) requires facilities to obtain from an exclusive bargaining representative a letter of acceptance of the wage certification.  The provider must submit the letter of acceptance with the wage certification provided to the commissioner. 

Paragraph (g) permits public employers to apply the rate increase to wage increases, but only in a manner consistent with laws governing public employees’ collective bargaining.

Paragraph (h) requires the commissioner to amend state grant contracts to pass through, within 60 days, the rate increases retroactively to the effective date of the rate increase.

Paragraph (i) requires the commissioner to increase each facility’s operating payment rate, beginning July 1, 2019, and annually thereafter, by an amount equal to the annualized cost to that facility for providing single health care coverage for its employees two years earlier.

Section 4 [Revisor’s Instruction] is an instruction to the Revisor to move existing statutory language pertaining to similar rate increases for home and community-based services.

 

 

 
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