Editor’s Column – April 2016

The sporadic warm temperatures over the last few weeks have been welcome. I think this is the earliest I’ve been out running […]

Tim BenjaminThe sporadic warm temperatures over the last few weeks have been welcome. I think this is the earliest I’ve been out running the dog on the trails. But even though it’s 50 degrees, the wind chills can catch you off-guard without enough layers, so be careful going out and always plan on it getting colder before you get home.

A March 29 legislative hearing on the Best Life Alliance (previously known as The 5% Campaign) bill saw a lot of discussion about the effects of the five percent increase on the Personal Care Attendant program. Several legislators voiced concern that their intent wasn’t fulfilled after they passed the five percent increase two years ago. Many members of the House Health and Human Services Finance Committee seemed a little taken aback by the fact that only 2.9 percent went to the direct care providers, while two percent went to the agencies, and .1% is being spent to research better ways to give quality care. Rep. Diane Loeffler (DFL-Minneapolis) is one of the concerned lawmakers, and after questioning testifiers, she made an amendment to raise the five percent request to seven percent, with five percent going directly to the direct support providers—which, she said, was her original intent two years ago. It was a strong response, and it was said by some that it might have been some political posturing but…who knows? Loeffler has been an ally to disability action bills in the past.

On March 31, Sen. Jim Carlson (DFL-Eagan) introduced an interesting bill (SF: 3359 & HF: 3751), creating an “activities of daily living (ADL) reimbursement system pilot program to address personal care assistant (PCA) shortage.” Sen. John Marty (DFL-Roseville) authored the language, along with co-authors Sen. Katie Sieben (DFL-Newport) and Carlson. In the House, Rep. Connie Bernardy (DFL-Fridley) and Rep. Karen Clark (DFL-Minneapolis) also signed on and sponsored companion legislation. The amendment would create a pilot program for people on Medical Assistance who receive complex cares and community supports from personal care assistants. PCAs would receive a higher reimbursement rate depending on the number and kind of Activities of Daily Living (ADLs) they support. A recipient would have to have at least six ADLs to be eligible. The intent of the amendment would be to create a more stable workforce for high-care-need individuals at a time when staffing shortages are at a crisis stage.

Many believe—and I’m one of them—that just as nursing homes got a significant increase in reimbursement, providers of complex-care services need competitive compensation to ensure the health and safety of those in non-institutionalized settings. With the Olmstead Act, the state of Minnesota requires that people be allowed to live in the least restrictive environment of their choice and a nursing home or hospital is usually not the least restricted environment. It’s no surprise to most readers of Access Press that  there is a huge shortage of staffing of semi-professional caregivers, possibly caused by the state’s low unemployment rate. It is becoming a critical situation for those whose independence, and in some cases, lives, depend upon home care. I have heard from several individuals who cannot find qualified staffing to do their complex cares, and with agencies that are unwilling to take on the responsibility of staffing 24-hour-a-day and other complex cases.

While skilled healthcare workers (LPNs and RNs) receive a higher rate of pay for complex care of high-ADL clients the semi-professionals or PCAs do not. In the long run, there could be a significant savings for Minnesota because rather than using RNs or LPNs for complex clients, PCAs could be trained to do much of the complex care, for fair wages but at a lesser overall cost to the taxpayer.

Another interesting bill was introduced on March 29 date concerning caregivers’ background checks (SF: 3361 and HF: 3756). The language would allow any caregiver to work for a client under emergency situations or if there was a successful background check on a caregiver from another organization. This would not eliminate doing background checks; it would just allow caregivers the ability to start working before the background check has been totally completed.

What I’ve always known as the spousal disregard in Medical Assistance is now known in the MA reform bill (SF: 3332) as “Assessment of spousal share” and “Community spouse asset allowance.” It is a muddled mess. I wish I could explain it to you, but unfortunately, it is very difficult to understand. A sampling: An institutionalized spouse can transfer $119,220 to the community spouse (“$119,220 subject to an annual adjustment equal to the percentage increase in the Consumer Price Index for All Urban Consumers (all items; United States city average) between the two previous Septembers.”) What? I just don’t get that and much more. While we wait to see how this turns out and what it means, some may have to worry about how not to impoverish a spouse who has stuck by them through years of dedication, headaches and expense to keep a disabled loved one healthy and alive and living in an independent setting where that person can work, pay taxes and be a productive part of society.

Everything is moving so fast at the capitol. It’s very hard to keep track. I hope that each of you are following bills that are closest to your own interests (the MN-CCD website provides great resources for this). Also, do make it to some of these hearings. This is how we make change, through action at the capitol and then in the streets.

Stay safe and soon we’ll be in short sleeves.