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Legislators press department on whether rate increases reached direct‑care staff; agency monitoring and KW settlement work ongoing
Summary
Lawmakers asked whether recent Medicaid provider rate increases and hospital assessment revenue reached direct‑care workers in home and community‑based services; the department said audits and follow‑up surveys are under way and also described work related to the KW federal lawsuit and a new resource allocation tool.
Legislators pressed Department of Health and Welfare officials Thursday on whether rate increases intended for home‑ and community‑based services are reaching frontline direct‑care staff, and on progress toward implementing a new resource allocation tool required under a federal settlement in the long‑running KW lawsuit.
Senator Maryanne Wintrow and other appropriators noted large rate investments for community‑based providers in recent years and asked what portion of those dollars increased wages or staffing. Deputy Director Juliette Sharon said the department conducted provider audits and a follow‑up cost survey; initial audit work identified that only a small percentage of some payments were reaching direct‑care staff. The department is evaluating authority to require stronger reporting or guidelines to ensure funds flow to direct‑care compensation while balancing regulatory burdens on small provider businesses.
“We have taken some provider audit work,” Sharon told the committee, and the department is “still concerned about if those funds are truly being driven down to direct care staff.” She said a follow‑up cost survey was underway and results would be made public, likely in March.
Sharon also updated senators on the KW lawsuit settlement and related work: the department is negotiating a new resource allocation tool with a contractor (Human Services Research Institute was named earlier in budget requests), and the settlement requires federal‑court compliance activities, including attorney‑fee obligations. The department requested ongoing funding to support the contract and legal obligations tied to the settlement.
On family personal care services, Sharon said the department has submitted an amendment to CMS to suspend that optional service; families will remain able to access personal care through paid direct‑care staff and trained family caregivers may provide services to other community members, but the department will monitor access after the change.
Committee members asked for continued updates on the KW tool, survey results on direct‑care wage pass‑through and any authority the department believes the Legislature could grant to strengthen accountability for rate increases reaching staff.
