Summer is moving out fast. Hope you’re enjoying the last few days of warm, sunny weather. They all seem more treasured in September than they did in July. I guess that’s like so many things in life: when they become rare, and we can see their end coming, we treasure them all the more.
Good news came from the Department of Human Services; they announced they would end their Medicaid Preferred Incontinence Product Program just before Ramsey County District Court Judge Leonardo Castro made his ruling to stop the state’s collective bidding and purchasing of incontinence products. The disability community has been concerned over the past year about how this program would affect the thousands of people who use these products. The suppliers felt it was a bad idea as well. A group of medical goods companies, called Medical Equipment Services and Supplies (MAMES), brought the lawsuit that Judge Castro ruled on. They knew that MPIPP would likely result in only a single supplier that could meet the state’s requirements, and that the supplier would in the end provide a lesser quality and reliability of supplies to the elderly and people with disabilities on Medical Assistance. The federal government’s Department of Health and Human Services and Minnesota’s Department of Human Services saw MPIPP as cost savings, but it would’ve resulted in very limited savings, considering that the total spending on these items represents about 8/100ths of 1 percent of the state budget for health and human services. While all dollar savings can be a good thing, the human cost in this case might have been considerable for these goods that are the most personally essential for DHS clients.
The PCA crisis is still causing problems for anyone who needs homecare workers, including the state’s elderly, a population that will almost double in the next 5 to 10 years. It seems there might be some light at the end of the tunnel, in the broader recognition of this problem, but there’s a long way to go. A lot will depend on our new governor and legislature. It’s going to take a strong governor to support a bill that is large enough to solve this massive crisis in the senior and disability community. No matter which party ends up in power on the hill in St. Paul, if something isn’t done about home care, there is going to be a much larger cost down the road when people are institutionalized, and the institutions are having a hard time finding qualified workers. The isolated stories about people dying from lack of quality care will increase.
One sign of conversation and early planning is DHS starting to survey its clients who receive PCA services. I was interviewed a couple weeks ago and was asked by the interviewer if I thought of my full-time job as my hobby. It offended me, of course, but it also scares me that at least one of the people conducting this study didn’t understand disability and our work in real jobs, making contributions to society and earning income. He seemed to imply that I was working as a volunteer just trying to pass the time, maybe out of boredom with disability. No wonder it’s still the case that only 48 percent of people with disabilities participate in the workforce (versus 79 percent of those without disabilities). We have hobbies, sure, but we also have and want jobs. We need work, not pity or condescension.
One component in home care programs that’s been in the works for several years is increased reimbursement from the state to agencies for their clients with complex care needs (meaning clients who have over 12 hours a day of PCA needs). There is also a provision for a one-time $500 stipend for such caregivers, but it seems to be available only through the SEIU union and only for members. Both components went into effect July 1, but I’ve heard that very few agencies have tried to get the increased reimbursement rate, possibly because DHS doesn’t yet have all the billing codes set up.
The Olmstead Plan seems to be moving along and I think that is what is pushing a lot of planning for revitalizing home care supports. The Olmstead Plan clearly and simply states that there is “a broad series of key activities our state must accomplish to ensure people with disabilities are living, learning, working, and enjoying life in the most integrated setting. The Plan will help achieve a better Minnesota for all Minnesotans, because it will help Minnesotans with disabilities have the opportunity, both now and in the future to: live close to their family and friends, live more independently, engage in productive employment, participate in community life.”
We need your commitment to activism from today, through the election, and until the end of the 2019 Legislative Session. We need the commitment from your PCAs to get involved in this session. If you have more than 12 hours of PCA care a day, you need to get your PCAs enrolled for the enhanced reimbursement rate. Many of the disability advocacy organizations have already begun starting to talk to key legislators about investing in the PCA care program.
Hope you had a good summer and enjoyed its beauty. Before next month’s issue, we’ll see the trees turn into the beautiful yellows and oranges and reds that make Minnesota so beautiful in the fall.