Approximately 30,000 Minnesotans with intellectual and developmental disabilities have had to take a back seat in obtaining services that they are entitled to for many years. The COVID-19 crisis has put them at the end of the line, again. Where is the leadership that should be moving them up in priority? Gov. Tim Walz and the Minnesota Department of Human Services (DHS) need to support emergency COVID-19 funding for disability services providers to survive until they are allowed to provide services again.
A new rate system was implemented several years ago that was supposed to level out the large variability in the daily service rates for day, employment and residential programs being provided to this population. The new rate system is very complex, but the first impacts clearly showed that rates would decrease dramatically especially for day and employment programs in the metropolitan area. Numerous bills were put forward over the last several legislative sessions to fix the numerous flaws and to address profound wage disparities for front line workers. Most of these bills failed to get passed for a variety of reasons, so even before COVID-19, the situation for service providers was desperate.
DHS released a labor study early this year, which demonstrates just how desperate the situation has become. There are 93,000 front-line worker positions across the state, serving this population with intellectual and developmental disabilities. The pay rates are 17 percent under comparable and competitive positions, resulting in a vacancy rate of 19 percent and turnover of more than 50 percent per year. Can you imagine how hard it is to find and retain quality workers in this situation? The rate system is clearly failing!
What has been the response from DHS to fix this problem? In 2018 DHS implemented a rate CUT of 7.1 percent. They failed to properly implement rate improvements that the legislature approved a few years years previous to 2018, so had to revoke them. In 2019 the legislature approved a rate increase of 4.7 percent to take back some of what was lost in 2018, but will DHS find a way to disqualify this one too?
The 2020 legislative session started out with some hope to improve the rate system, but then COVID-19 hit, moving this population to the back of the line again. The legislature quickly responded by drafting some bills to provide some sustaining funds to day and employment service providers, as they were categorically closed down in late March 2020. Then Walz issued Executive Orders 20-11 and 20-12 which reflected many of the points drafted in the bills. These orders contain language that clearly gave the Commissioner of DHS the authority to provide some level of sustaining funds to service providers, so that they might survive. So far DHS has failed to utilize this temporary emergency authority, and day and employment service providers are getting virtually nothing.
There are more than 100 providers for these vital services across the state, and they are in significant financial distress. Even before COVID-19, many were receiving revenue at the same level they were 20 years ago. Most of this population utilize center-based services and there is no timeline for them to reopen, even though they have been proposing various procedures to DHS in line with the restrictions.
We have seen strong support from the legislature, especially from Sen. Jim Abeler, Sen. John Hoffman and the 32 other senators who recently signed a letter to Walz, asking for his support. But the fact is, the legislature could easily authorize the use of previously-approved funds to cover the basic fixed costs that disability programs continue to incur while they are unable to operate and generate revenue. But legislative leaders have balked, and nothing has happened.
With a second special session on the horizon, we sincerely hope the game is not over. The legislature could still take action. There is also an opportunity for some funds to get to these service providers in the form of federal money from the Provider Relief Fund as part of the Health Care Enhancement Act. The legislature, particularly the Senate Human Services Reform Policy and Finance Committee, are already reviewing how these funds will be distributed. Will these needs be addressed in a special session? Will DHS and Walz step up and quickly support distribution of these federal funds to service providers for Minnesotans with intellectual and developmental disabilities?
Minnesota Families and Advocates Coalition, a non-profit advocacy organization for Minnesotans with Intellectual and Developmental Disabilities. James Clapper is one of the group’s leaders.