The Minnesota legislative session is in full swing and moving at a very rapid pace, with deadlines for legislation to be heard in both chamber committees by March 10. “The first committee deadlines were adopted in 1971 as part of the Permanent Joint Rules. There were two deadlines, one for bills in the house of origin and one for bills in the other house.” These early deadlines keep things moving, and help to ensure that talk gets going toward action.
There are several legislative bills that are being heard to raise the reimbursement rate for direct support providers, or personal care assistants (PCAs).
The Best Life Alliance is asking, in its bill, SF 669/HF 873, for a reimbursement increase that would result in a 4 percent wage hike beginning July 1, 2017 with a second 4 percent increase starting on July 1, 2018, plus an all inclusive permanent solution to provide healthcare insurance for hands-on support providers. This increase would be a very good start to slowing the devastating impacts of the home care crisis.
The Complex Care Coalition (CCC) is asking for a higher reimbursement rate for individuals with higher needs; the bills it is sponsoring are SF 393/HF 481. The CCC is requesting a two-tier reimbursement rate for PCAs, providing one rate for individuals with 10 hours or less of daily home care, and a higher rate for individuals who require more than 10 hours, based on the finding that individuals with more than 10 hours of daily care have more complex needs. The number of hours a person needing home care is assessed at directly parallels the level of complex health needs and requirements for sophisticated support in activities of daily living. PCAs providing “high needs, complex services” would be trained at a much higher practical level of health knowledge and be required to have an amount of training, competency and experience possibly the equivalent to a nursing assistant. The CCC is urging legislators to authorize at least a 20 percent reimbursement rate increase for these higher-skill level PCAs. Gov. Mark Dayton’s budget has a similar plan, proposing a 10 percent increase for PCAs working for individuals with 12 hours or more of assessed home and community-based services.
Personal care assistants provide aid that permits people with disabilities to live at home by assisting with dressing, eating, toileting, bathing, grooming and transferring out of bed into a wheelchair, and for many, to prepare for the work day. Some individuals require more complex assistance with respiratory issues, feeding tubes and other medical needs. These individuals with complex needs, many supported by a new era of health technology, are the ones the CCC legislation, and the governor’s budget, are providing for.
Minnesota’s PCA program was created 40 years ago so that people with severe physical disabilities could direct their own care and move out of institutions, so that they could live in the community and potentially find employment. Over the years, the program has been expanded to include individuals with many types of disabilities. The PCA program is the most cost-effective approach to enable children, adults and seniors with disabilities to remain in their homes and avoid high-priced alternatives. Because of these indispensable public services, thousands of Minnesota citizens are able to contribute to their families and communities. A significant number of people who receive PCA services do work and pay taxes.
As our economy has progressed following the recession, fewer people have been willing to work as PCAs because the pay and benefits are lower than in almost every other job. Although this work can be a rewarding profession, it is not stress-free. Jobs such as fast-food work and other entry level positions often pay a more supportable wage and benefits and offer opportunities for advancements.
Now, with the new federal administration, there is a general sense of alarm about abolishment of the Affordable Care Act (Obamacare), among both its advocates and critics. In some off the related discussion about Medicaid, one alternative plan is to replace it with state block grants. The state block grants would be a set amount of funding that each state would receive to cover all of their Medicaid expenses. Today, Medicaid is a federal matching-funds program which allow the states to have an appropriate, reliable source of support for their overall costs.
News about healthcare policy and funding is going to be high-profile for all Americans in coming months. Stay tuned to Access Press for all the ways it will be affecting the disability community.