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Lawmakers press agency on whether rate increases reached direct-care workers as Medicaid home-care demand grows
Summary
Committee members asked how recent rate increases and hospital assessment funding have affected pay for direct-care staff and how program changes — including suspension of family personal care services and work on a new resource allocation tool tied to the KW settlement — will affect access to home- and community-based services
Lawmakers pressed Department of Health and Welfare officials Feb. 26 for more information about whether recent provider rate increases and assessment-driven funds have flowed to direct-care workers in home- and community-based services (HCBS), and what the department is doing to track that flow.
Juliette Sharon, the department’s deputy director, told the Joint Finance-Appropriations Committee the legislature has invested significantly in community-based services over recent years, but the department’s audits showed only a portion of provider revenue increases had reached direct-care staff. Sharon said the department conducted a follow-up cost survey and is evaluating whether it has authority to adopt more specific guidance to ensure funds reach direct-care workers while being mindful of small-business provider burdens.
“We are still continuing to see access challenges in terms of individuals not having access to direct care staff for all of their hours needed,” Sharon said. She said the department sees a roughly 10% increase in direct-care staff for personal care services but remains concerned about access and service reliability.
Sharon also described department plans related to the KW lawsuit settlement. The agency requested ongoing funds to maintain contractual work with the Human Services Research Institute and pay related attorney fees tied to the federal district court order; the department is developing a new resource-allocation tool that the court ordered as part of the settlement.
On family personal care services, Sharon said the department has sought federal approval to terminate or suspend that optional Medicaid benefit; families trained as caregivers could continue to provide services but not to their own child or spouse under the proposed change. She said the department will monitor service access and is prepared to return to the legislature with policy or budget options if gaps appear.
Committee members asked for written follow-up on results from the department’s cost survey and a progress update on the KW resource allocation tool. Lawmakers emphasized the trade-off between directing funds to frontline caregivers and minimizing regulatory burdens on small providers.
Ending note: The department committed to further reporting to the legislature on the distribution of rate increases, the outcomes of the cost survey, and next steps on implementation of the KW settlement resource-allocation tool.
