Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Direct Care Workforce topic
No spam. Unsubscribe anytime.
Lawmakers press agency on direct‑care workforce, KW lawsuit tool and postpartum coverage appeal
Summary
Legislators pressed the Department of Health and Welfare on whether recent provider rate increases are reaching direct-care staff, asked for progress on the KW resource-allocation tool, and heard the department has appealed a federal decision on postpartum coverage tied to abortion-related coverage questions.
Legislators used the Feb. 26 JFAC Medicaid hearing to press the Department of Health and Welfare for evidence that provider rate increases are improving pay and staffing for direct-care workers, to request a status update on the KW lawsuit resource-allocation tool, and to seek clarity about the department’s postpartum coverage state plan amendment.
Deputy Director Juliette Sharon told the committee the legislature has made "significant investments" in community-based services and home- and community-based provider rates in recent years. The department conducted a provider audit that found only a portion of rate increases had been confirmed to reach direct-care staff and has conducted a follow-up cost survey; Sharon said the department is evaluating whether it has authority to require more specific spending guidelines while being mindful of providers that operate as small businesses.
"We have undertaken some provider audit work… Last year, we presented on a provider audit that we did identifying that a rather small percentage was identified actually going to direct care staff. We've done a follow-up cost survey this year," Sharon said, and added the department will provide results to the legislature as they are finalized.
Sharon said the department submitted an amendment to CMS related to family personal care services and is considering suspending that optional benefit; trained family caregivers would still be able to provide care, but the department plans to restrict paid family personal care to non-legally responsible family members or other community members under the proposed change.
On the KW lawsuit, Williamson told members the department has requested ongoing funding to pay attorney fees and to develop a new resource-allocation tool as part of the settlement. The ongoing request includes funds to contract with Human Services Research Institute (HSRI) and to continue work under the settlement agreement.
Representative Price asked about postpartum coverage recently implemented in Idaho. Director Adams said the state plan amendment for extended postpartum coverage is "fully live, fully operational" and that about 2,800 women had used the benefit as of his latest update. He also said a federal decision rejected part of the state's interpretation about how abortion-related care interacts with postpartum coverage; the department appealed and had been granted a hearing on that appeal.
Why it matters: Workforce capacity in home and community-based services affects individuals’ ability to remain in community settings rather than institutions. The KW lawsuit and a new resource allocation tool relate to long-running litigation and settlement obligations for developmental disability services. Postpartum coverage affects a time-limited population and has immediate fiscal and clinical effects.
What’s next: The department will provide the committee with audit follow-up and the status of the KW resource-allocation work; it will also continue to update legislators on the federal appeal related to postpartum coverage.
