Minnesota Families and Advocates Coalition through MOHR

This past January, a volunteer organization made up of parents and family members was created to protect the rights of individuals with intellectual, physical and developmental disabilities in Minnesota. Disability services are experiencing historic transition and change. MNFAC members have an interest to learn, understand, embrace or change the implementations of several initiates that will impact people with disabilities receiving day services and/or residential care services in various settings.

The mission of the organization is to ADVOCATE, in a grassroots effort, to help ensure that quality services, supports, and true choice continue for people with disabilities and their families.

This group wants to promote statewide advocacy, awareness and advisement. You can be a part of this group by joining as a member or an associate. For more information click here. Or, keep reading for more detailed information:

Mn Family Advocacy Coalition

MNFAC is a volunteer organization formed in January 2016 by parents and family members to protect the rights of individuals with intellectual, physical, and developmental disabilities in Minnesota.

Mission: MNFAC’s mission is faithful to the US Supreme Court’s Olmstead decision and the Americans with Disabilities Act (ADA). Olmstead clearly states individual desires are paramount in determining residential and day placement. It is with this legal foundation that MNFAC asserts that the Minnesota Department of Human Services must offer a range of residential, habilitation, and employment options to meet the diverse needs of individuals with intellectual, physical, and developmental disabilities.

Goals: Statewide Advocacy, Awareness, and Advisement

Current Focus: Mn Disability Waiver Rate System implementation and Healthcare Workforce crisis

Structure: General meetings every 2-3 months, 1 steering committee, 3 subcommittees:

• Communications subcommittee
• Legislative subcommittee
• DWRS Legislative Audit development subcommittee

Why focus on DWRS?

1. In 2007, the Centers for Medicare and Medicaid Services (CMS) notified Minnesota DHS that its four disability waivers were out of compliance with federal requirements for uniform rate-determination methods and standards.
2. Disability Waiver Rate System was finalized in the 2013 legislative session. This new system transferred responsibility of setting service rates from counties and tribes to the state. This allowed for the federal renewal of Minnesota’s disability waivers. Rates will be established by individual instead of by program. Also fundamental in the legislation, was “Budget Neutrality” – a promise that the new rate system will not reduce overall spending for waivered services.
3. Implementation was planned over a five-year period, ending in 2019. During the implementation period, the Rate Management System (RMS) rate framework within DWRS was/is being developed. Also rate banding was instituted that limited rate changes from 0.5% to 1% depending on the year. A one-year extension to the banded rates has been requested but not approved yet by CMS.
4. MnDHS issued a report to the Legislature in January 2016, reporting the progress of the implementation of DWRS. “The estimated impact of DWRS is a 1% increase in projected spending for disability waiver services.” It continues to report that, “spending for residential services is projected to increase 2.4%, while spending for day services is projected to decrease 4.8%.”
5. Issues with the new rates are significant:
   1. Center based program facility rates are way too low – not realistic
   2. Transportation rate calculations are extremely flawed
   3. Utilization assumptions (97%) and parameters are very aggressive – particularly impacting medically fragile and significantly disabled individuals.
   4. Budget neutrality is not being instituted as agreed
   5. Staffing ratios and pay rates are totally unrealistic. Base pay rate for direct care staff = $13.33/hr. Direct supervision rate = $17.43. At the current time, 9500 Healthcare workforce openings are going unfilled, and turnover is extremely high.
   6. Regional variance is also flawed because relevant cost factors are not considered.
   7. Administrative effort to comply with DWRS will increase dramatically, further penalizing service providers to no client benefit.
   8. New Rates are NOT being proactively communicated to those that will be impacted, as required by law and reinforced by a CMS memo published June 24, 2016
6. Many residential and day services providers are running profiles to see what the rates will be after full implementation and finding significant reductions.
   1. DTHx: of 376 clients, 18% will see rate increases and 82% will see a rate reduction. Overall revenue reduction will be at least $680,000.
   2. DTHy: 375 clients, overall revenue reduction will be $900,000.
   3. DTHz: Double-digit revenue reduction in spite of significant success in placing clients in community based employment and other community-based activities.

Bottom Line: DWRS is probably the largest and most eminent threat to people with Intellectual and Developmental Disabilities in Minnesota. Many Residential and Day Services providers will not be able to survive. The DWRS Legislative Report is in stark contradiction to the studies that many service providers and affected individuals are doing. MnDHS has created yet another overly complicated and expensive system to administer rates, and are hiding the real facts, and not honoring the commitment to “budget neutrality.”

Current Tactics underway – not in any particular order, and only a partial list:

1. Establish a website – to hold our content and receive new members and associates
2. Emulate effective parent/guardian/family member advocacy organizations that might exist in other states
   1. Disability Advocacy Alliance of Ohio
   2. VOR – national association based in Washington DC
3. Stay close to the DWRS committees with other stakeholders, to keep informed on development of DWRS/RMS and take advantage of the data gathering others are doing concerning upcoming impacts.
4. Attend regional meetings to develop membership statewide. Lack of knowledge is widespread.
5. Find and mobilize key legislators to help us get something going in the 2017 Legislative session to fix or stop DWRS
6. Get a full Legislative hearing or Audit commissioned to expose the disconnect between the DWRS Legislative Report of January 2016 and the real facts that are emerging.
7. Get a new DHS advisory council established, comprised of parents, guardians, and family members of persons with Intellectual and Developmental Disabilities only, to get a communication channel going with Commissioner Piper.

How to become a member or associate:

Email you name and email address to:

Kara Jennings-Boyd at Partnership Resources, Inc.

kjennings-boyd@partnershipresources.org

952-925-1404

 

Co-chairs:

Jim Clapper                                     Julie St Marie-Bingham

j.s.clapper@comcast.net                   juliestmarie01@gmail.com