The need to address Minnesota’s care worker shortage, calls for Medical Assistance (MA) reform and continued work on business accessibility are among issues headed for the 2017 Minnesota Legislature. The Minnesota State Council on Disability’s annual legislative forum December 5 provided an opportunity to hear legislative priorities from several groups.
One common theme of the session is that Minnesotans with disabilities need to share their stories with state and federal lawmakers, to protect the services they have and to bring badly needed improvements.
The 2017 session starts January 3. Familiar issues, some with renewed urgency, will be back at the capitol. The “acute” staff crisis, with unfilled work shifts, high turnover and inadequate training, was described by longtime advocate Jeff Bangsberg. In May and August, two of his friends died due to a lack of qualify service from caregivers.
“Some people are without care evenings and weekends,” Bangsberg said. Volunteers, friends and family members have to step in. Or, people find themselves hospitalized or in institutional settings.
When the personal care attendant (PCA) program began in 1978, only about 200 people needed services. In 2015 40,600 children and adults needed PCS services, with 43,500 people providing service that year.
Proposals on reimbursements were outlined. One wrinkle is that federal rules now require overtime pay after 40 hours’ work. Gov. Mark Dayton’s s proposed rate increase for overtime in 2016 wasn’t adopted by state lawmakers. Including it in the governor’s budget for the next biennium would cost about $40 million.
Another reimbursement proposal centers on complex care, including situations where people utilize ventilators or need respiratory assistance or qualify for more than eight hours per day of staffing. Developing a complex PCA level is proposed, which would require more training and demonstration of competency. It would also require more pay and additional funding from legislators.
The current rate for PCA is $17.12 per hour, said Bangsberg. That may sound like a good wage but once agency expenses, taxes and unemployment are taken out, the workers get $10 to $12 an hour. “That’s not a lot of money,” he said.
The Minnesota Department of Human Services (DHS) policy bill contains language to watch including definition of roles in Community First Services and Supports (CFSS), a self-directed home and community-based service being developed by the state to replace the PCA program. One recommendation is to increase the notice period when PCA services are terminated, to 30 days. Another is to increase PCA work hours from 275 to 320 per month, which will be a plus.
More self-directed budgeting and changes to staff time allotments are also part of CFSS. But CFSS approval is still pending at the federal level, and could be affected by President-Elect Donald Trump’s pending changes to the Affordable Care Act. Trump and the new Congress also support changing Medicaid entitlements to a state block grant, which could bring its own set of problems and complexity.
Deputy DHS Commissioner Claire Wilson said the PCA crisis is being tracked closely by state officials. “We already know that it is a life and death crisis in the community.” She reminded the group that negotiations between state officials and the PCAs’ union are ongoing.
The group heard a number of other legislative updates. The Minnesota Consortium for Citizens with Disabilities will be back seeking reforms to MA income and asset limits. Current regulations are forcing people to live well below the poverty level, said Erica Schmiel of Brain Injury Alliance of Minnesota and self-advocate Rebecca Preston.
Changes must be made so people can continue to qualify for waiver service and yet meet basic needs, the women said. “I’m talking rent, I’m talking food, I’m talking toilet paper,” said Schmiel.
Other updates included were from groups ranging from agriculture-related issues and self-driving motor vehicles to the state council’s work on improved business access for people with disabilities, changes to the state statue on disability license plates and other issues. Look for more legislative coverage in the January issue of Access Press.