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Lawmakers press DHW on whether Medicaid rate increases reached direct-care workers
Summary
Legislators asked Department of Health and Welfare officials on Feb. 26 whether recent provider rate increases intended to shore up the direct-care workforce are reaching front-line workers; department officials said audits and a follow-up cost survey are under way and that authority to require how dollars are spent may be limited.
Boise — At the Joint Finance-Appropriations Committee hearing on Feb. 26, legislators pressed Department of Health and Welfare leaders for evidence that recent provider-rate increases are translating into higher pay for direct-care workers who provide home- and community-based services.
“I think there have been significant investments made by the legislature over the past several years in community-based services providers,” Juliette Sharon, deputy director for the Department of Health and Welfare, said. Sharon told the committee the department performed audits and found only a small portion of earlier rate increases tracked directly to front-line wages; staff have since conducted a follow-up cost survey.
What the department reported
Sharon said the department’s follow-up cost survey was expected to be public in March and that the agency is evaluating whether it has the authority to require more specific routing of rate increases to direct-care staff. She noted concern for small business providers and the potential effects of prescriptive mandates on their operations.
On a related program change, Sharon told the committee the department has filed a state-plan amendment with the Centers for Medicare & Medicaid Services to terminate or suspend the family personal care services option. That change is intended to shift support toward paid direct-care staff; Sharon said families who have been trained to provide care may continue serving others in the community but that access will be monitored.
Senators asked for more detail
Senator Wintrow and other members requested an update on the KW lawsuit and the department’s work on a new resource-allocation tool required under the settlement. Sharon said the department is negotiating vendor contracts and working to comply with the federal district court order tied to that case.
Ending
Legislators asked the department for more detailed, public results from the cost survey and for possible policy options to ensure rate increases benefit direct-care workers. Sharon said the agency will continue auditing, surveying and reporting back to the Legislature as needed.
