Last February, the Minnesota Department of Human Services received notification from the federal Centers for Medicare and Medicaid Services (CMS) of a problem with Minnesota’s rate setting policy for Minnesotans receiving home- and community-based services (HCBS). This resulted in a 7 percent cut to reimbursement rates for services received by several thousand Minnesotans with disabilities. As of July 1, 2018, services for individuals whose rates were not banded sustained a 7 percent cut. If the legislature does not act to fix this problem in 2019, all services funded through the disability waiver rate system will receive a 7 percent cut at the end of 2019.
This is unacceptable. These are hardworking and dedicated people who work with Minnesota’s most vulnerable populations. Their work allows people with intellectual and physical disabilities to receive vital services – whether that means help getting to work or complex 24/7 medical care. These essential services foster skills development, provide medical care, ensure health and safety, and allow people with disabilities to stay as active and independent as possible.
The cuts are jeopardizing the state’s efforts to improve access to community services for people with disabilities and comply with a landmark 1999 Supreme Court ruling, known as the Olmstead decision, which requires states to ensure that people live and work in the most integrated settings possible. A requirement of Minnesota’s Olmstead Plan is adequate funding to support the staffing and services necessary to achieve its goals. These cuts have pushed an already straining system beyond its capacity.
In 2014, I was responsible for including inflationary increases embedded in law. Last session, as the author of legislation to provide a solution to restore this funding, I joined disability advocates, trade groups, and providers in an aggressive push to prevent the 7 percent cut. Unfortunately, the negotiated fix that included funding for disability service providers failed to survive because it was part of a 990-page budget vetoed by Gov. Mark Dayton because it was full of unrelated and controversial measures he opposed. The result between the increase I fought hard for and the cut still going through means there is $110 million sitting in our surplus that belongs to people living with disabilities.
Caregiver pay depends on state and federal reimbursements for services, which is why advocates have lobbied lawmakers over the years to increase reimbursement rates to give workers raises. These highly skilled and professional caregivers only earn $11.50 to $12.22 an hour on average, according to the Government Accountability Office. Rural caregivers typically make less than similar workers in the metro area, with some making a little more than $9 an hour. This pay is directly tied to state reimbursement rates set by lawmakers, and it has not kept up with rising costs over the past decade. Due to these low wages, more than 8,700 unfilled caregiver and staff jobs exist in Minnesota today.
Across the state, group homes, personal care agencies, and day activity centers for people with disabilities are struggling to find and retain professional caregivers. Caregiver businesses also must deal with high turnover, as employees can find better paying jobs in other professions. Across the state, caregivers have a roughly 45 percent turnover rate, with 60 percent of caregivers in their first year quitting to find a different job. The number of unfilled caregiving jobs across the state is at its highest level in more than 15 years, according to the state workforce agency.
This year, I am co-author of SF 6, which is legislation to modify our disability waiver rate system to restore funding cut last year in addition to providing a path to review the competitive workforce factors every two years to make sure these important workers’ pay is stable and fair in the future. Our caregiving support personnel deserve to be paid fairly for the work they do – it’s a matter of values. We can and should do better.
To contact me with your ideas and feedback, you can reach me by phone at 651-296-4154 or by email at email@example.com. You can also mail letters or pay me a visit in the Minnesota Senate Building, Room 2231, right across the street from the Capitol.
This column was first published in the Hometown Source.