Editor's Column - January 2014

As we look ahead to 2014, I want to thank everyone for your financial generosity this past year to Access Press. Also, I want to thank everyone for your confidence in Access Press’ work to get the news to you as soon as it happens. It’s our goal at Access Press to keep you informed on important public issues for people with disabilities.

For years the state’s Department of Human Services has continuously tried new tactics to improve the quality of Home- and Community-Based Services (HCBS), and for years the department has overlooked what I consider to be the quality elephant in the room: wage reimbursement rates for care professionals. How can the quality of care improve when being a caregiver is so poorly compensated? Where is the incentive to do well and be professional? Because members understand that wages have a direct relationship to quality, the Minnesota Consortium for People with Disabilities (MNCCD) is working on the 5% Campaign, a request to the Minnesota Legislature to increase the reimbursement rate for Personal Care Attendants (PCA) and Direct Support Professionals (DSP). If we want to increase the quality of care provided in the community by PCAs and DSPs, reimbursement to the agencies that employ direct caregivers needs at least to match what is offered in institutions like hospitals and nursing homes. Home health agencies, like other businesses, have to find some profit in order to provide quality services to their employees and in turn to their clients. While nursing homes are often highly profitable, even the best agencies—the ones that provide good workers, appropriate training and good backup support and also maintain high standards for fraud control—are not making financial ends meet. All of us who use HCBS have had our best care providers move on because there are no incentives or proper compensation packages for them to continue providing good care. Too often, PCAs are struggling to make a living even as they help us to live our lives. I know of some who are going to food shelves to provide food for their own families. Five percent can make a difference, and we need to make legislators understand that.

In other important legislative news, in the last week of 2013, we were notified about the DHS formal request to the federal government to continue using the 1115 Medicaid Waiver for Minnesota. The waiver currently allows the state, when determining Medicaid eligibility, to exclude spousal income for a married couple with one spouse using an HCBS waiver. The Affordable Care Act’s rules and financial standards on spousal anti-impoverishment are good, especially for seniors. For individuals whose home state did not have a spousal disregard prior to the Affordable Care Act, this policy will be an improvement. But Minnesota’s existing policy is fairer, especially for any married couple under age 65 that has already been using Minnesota’s existing policies and planning their future accordingly. They should not be forced to lose assets in mid-life or as they are closing in on retirement. Remember, this only affects married couples with one spouse using HCBS’s waiver services for persons under age 65 with disabilities. It’s not a lot of us, but it’s a fair number who could lose homes, retirement accounts and many of the assets that people have worked very hard to get.

Just a couple years ago, we were fighting to help Chuck Van Heuveln to protect the assets he’d built up over a lifetime of work. Like too many Americans, we have to repeatedly fight to gain and protect the same rights. It’s a good thing we’re a determined community.

It’s a new year and it’s starting with record low temperatures. The meteorologists are saying that it has been more than a decade since we’ve had these kinds of cold temperatures. Well, we can probably count on a warm-up—in the weather and in politics.

Stay warm and we’ll talk soon.


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