Retirement tribute Page 9
Volume 30, Number 6
June 10, 2019
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Session had victories and defeats
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Incontinence products
Medical supplies and equipment providers were hard-hit in recent years by restrictions from the federal Centers for Medicare and Medicaid Services, as well as state laws. The restrictions have made it difficult for people with disabilities to get the products they need, and has forced longtime supply companies out of business. Lawmakers repealed the unpopular Preferred Incontinence Purchasing Program (PIPP). The program, adopted in 2017, was widely criticized for not providing choice and flexibility for consumers. Some feared negative health impacts from inferior personal care products. Legislation has also restricted the Department of Human Services from using its competitive bidding authority on this category of products in the future. Those are big wins for providers involved in the Midwest Association for Medical Equipment Services and Supplies (MAMES). Also, the legislature chose to comply with the federal 21st Century Cures Act by reducing payments to certain durable medical equipment subject to Medicare's competitive bidding program. The payments will be reduced as of July 1 to the Medicare rate. This is a 25-50 percent reduction for most if not all of these codes. The change affects dozens of items. More on this change will be in the July issue of Access Press.
Insulin
One of the session’s biggest disappointments is the failure to pass an
SESSION To page 3
"You have to be taught to be a second class citizen; you're not born that way." Lena Horne
NEWS DIGEST
Aya from St. Cloud, foreground, raised her cane during a TakeAction Minnesota teach-in held in response to proposed Senate health care cuts.
Health care provider tax is trimmed, but remains in place indefinitely One of the most contentious issues before the 2019 Minnesota Legislature was the health care provider tax. The tax, which was to sunset at year’s end, was trimmed but saved after being a focus of debate all session. What was a 2 percent tax will now be 1.8 percent. It will continue indefinitely, but it’s not clear what the long-term impacts of the reduction will be. Still, Gov. Tim Walz, the DFL-dominated House and the Republican-led Senate hailed that as a compromise. The provider tax was originally set up in the 1990s to cover costs of
MinnesotaCare. It since has been used to cover other health care needs for some of the state’s poorest residents. Walz and Democrats said that important source of funding should continue. Republicans seized the chance to try to eliminate a tax. The final decision on the provider tax was one of many compromises this session. Another big focused was the health and human services (HHS) bill itself. The 650-page HHS bill didn’t come forward until late in the day May 24.
BUDGET To page 15
Attend the ADA Celebration Page 10 Provider tax effort Page 4 Robotics team a winner Page 6 The Arc gives awards Page 7
At long last, advocates see big wins on staff wages After years of effort and frustration, an increase in wages for direct support providers is one of the biggest gains at the capitol. The health and human services budget bill signed in May by Gov. Tim Walz includes workforce-related items that the disability community has clamored for. Walz’s promise to make home and community-based services a priority came true with the passage of legislation including a competitive workforce factor for the Disability Waiver Rate System (DWRS). Getting the 4.7 percent competitive workforce factor was seen as a crucial move toward resolving the 17 percent gap in wages between care workers and other employment sectors. The decision and signing of the health and human services legislation prompted an outpouring of thank you messages. ARRM posted a YouTube video of thanks to mark the session’s end and the gains made. The Best Life Alliance, a coalition of more than 130 organizations, people with disabilities, families and their supporters, prepared and distributed thank you letterhead. Advocates this session hammered home the message that the severe workforce shortage has had profoundly negative impacts on more than 30,000 Minnesotans who rely on support services. More than 100,000 direct support providers work in Minnesota. At any given time, the state has several thousand support staff vacancies. Having a competitive workforce factor is seen as way to make wages attractive, and keep workers from going into other fields. Another effort to address the workforce shortage is changes in Consumer-Directed Community Supports (CDCS), which
SEIU HEALTHCARE MINNESOTA
Do you visit a state park? Do you travel on Metro Mobility? Do you have a child in the Medical Assistance Tax Equity and Fiscal Responsibility Act program, known as MA - TEFRA? Do you or a family member use incontinence product? If you answered yes to any of these questions, you were likely following the work of state lawmakers this session. For Minnesotans with disabilities, the end of the Minnesota Legislature’s 2019 session brought decidedly mixed results. While there is happiness over many gains this year, including additional wages for support staff and preservation of the health care provider tax, there’s also the disappointment over measures that didn’t pass. The shelved priorities range from improved local government website access to legalizing marijuana plants for medicinal use. The 2019 Minnesota Legislature met for five months and then held a special session, completing its work the morning of May 25 after a 21-hour marathon. The main event for 2019 was the $48.3 billion two-year budget, which is encompassed by several bills. Health and human services (HHS) spending is the largest share, at about 40 percent. Here’s an overview of disabilityrelated legislation wins and losses. It was very different from 2018, when a contentious fight between state lawmakers and Gov. Mark Dayton resulted in almost everything falling to the veto pen.
PARTNERS IN POLICYMAKING TAKEACTION MINNESOTA
by Jane McClure
SEIU Healthcare Minnesota members turned out in force for a "Care Not Cuts" rally during the 2019 session.
are seen as providing more shared services options for clients, to potentially reduce the staff time needed. But the centerpiece this session was addressing worker wages. When Walz released his budget, it included the competitive wage factor. That is expected to increase the part of Medicaid waiver reimbursement rates dedicated to support staff wages, and a more frequent rate adjustment based on Bureau of Labor Statistic data. Much of the testimony this session in House and Senate committees focused on how very difficult it is to attract and retain employees. At one hearing, Lynn Noren, president and CEO of RISE Inc., said that
while she is supportive of the bill’s intent to improve wages and benefits for direct care providers, she has “great concern” over the lack of a competitive workforce factor. This would make it “very difficult” to compete with other employers, she said. Any changes to DWRS require federal review. Minnesota has had DWRS in place since the early 1980s, as a way to provide people with disabilities with the chance to live in their home communities, not institutions institutions. The “waiver” part of DWRS is because some federal requirements for the use of Medicaid are waived. For a long time, counties ran the DWRS WAGES To page 4