ResCoalition Year In Review

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ResCo Year in Review

State Taskforces

ResCoalition participated in the DDS taskforce group to work on parameters for new residential enhanced behavior and crisis programs.  In this process we had representation at all three meetings - Fresno, Sacramento, and Los Angeles.  In Los Angeles, we invited our colleagues at SOCCO to participate.

 

The second taskforce is much more significant and has the potential to make changes for each and every one of you.  Last year, there was a provision in the budget that forced DDS to review, assess, and modify rates by January of 2015.  The Governor vetoed this part of the budget but did not ignore the issue.  Instead he put together a blue ribbon panel of entities/people from across the state.  This panel is called the Developmental Services Taskforce.   This panel is tasked with looking at five areas of the DD system:

·        Service Rates - rate setting structure and sustainability

·        Regional Center, Provider, and Other Community Services

·        Employment and Higher Education Opportunities

·        Medical, Dental, Mental Health, and Durable Medical Equipment

·        Housing

We are proud to announce that ResCoalition was chosen as the only ARM residential representative to be a member of this important taskforce.  We have already had an impact, getting labor issues, the minimum wage increase, and rates on the Urgent Action area of the agenda.  Taking it a step further, DSS had planned no meetings to discuss these issues until 2015 but we were able to illustrate the significance of these issues to the point that they called a meeting in December to address the rate issue and new CMS regulations.  If you would like to follow along or see the diversity of issues on the table for this taskforce, please to go to www.chhs.ca.gov/pages/DCsTaskForce.aspx where everything is posted. 

ResCoalition has also been invited be a participant on the DDS/DSS taskforce to implement the new medi-caide waiver rules.  This meas we'll be at the table and having a voice as California writes the regulations that will impact every residential care provider over the next few years.  

The Minimum Wage Battle

ResCoalition achieved significant success with the minimum wage increase.  When the minimum wage law was padded we immediately reached out to the administration about including provisions in the budget to pass this along to ARM residential providers.  Initially, DDS/Governor’s office was going to follow the previous minimum wage increase (which was 3% for certain levels).   Through significant dialogue and support from the Lanterman Coalition we were able to get them to reassess their position and agree all levels should get an increase.  We were able to then illustrate that the minimum wage increase was more significant because virtually all direct care hours are paid at minimum wage.  To do this we argued and illustrated through data that if we paid all hours required in Title 17, we would be insolvent.   Not only did they agree but we were able to give them a formula to calculate the minimum wage increase.  They followed our formula (with the exception of only crediting 17% indirect costs vs our 27%).  This resulted in the single biggest ARM rate increase that has ever occurred.   We recognize this is not enough to make ARM program viable and continue to work aggressively on this front - including to ensure that a second minimum wage increase occurs.   As this was being drafted,  We've got confirmation that there is a minimum wage increase in the budget for us.  DDS has confirmed they are using the same formula as the first increase so they will be using our formula but they have not actual figures at this time.   We have an already scheduled meeting with DDS on Wed the 14th so will confirm more then.    A secondary issue that we're pushing at DDS is the local minimum wage problem.  It seems cities are racing to see who can have the highest local ordinance minimum wage.  Some cities like LA, currently only have higher minimum wages set for specific industries but our peers in Northern CA seem to have city leaders who think it's okay to blanket higher minimum wages for everyone doing business in the city.  It IS a trend and the state must address the issue before the only programs left are in unincorporated areas of the state. 

Labor Law

As most of you are aware, ResCoalition has been meeting with the U.S. Department of Labor regarding the labor audits for well over a year.   We have been very strong in our advocacy that these audits will only stop when the most people are in compliance and the audits are coming back without violations.   We respect that some have wanted a moratorium but have been consistent in our message that everyone needs to get into compliance or the audits will not stop.  To this end we have worked with DOL on making sure all of our employee contracts are correct and complete - this includes the overnight sleep time/live-in agreements, the mealtime waiver, the rest period waiver, etc.  This past year we did ten labor law trainings to walk residential care providers through the difficult process of melding federal laws, state laws, Title 17, and Title 22 together.  

Sacramento Presence

At the forefront of ResCoalition's  goals and objectives is to be a presence in Sacramento so when policy or legislative issues arise that impact residential care programs for the developmentally disabled we will be considered the experts and consulted.  This past year has been an excellent example of this strategy working for us.  Normally, October through December is a period where Sacramento is silent - the bills have all gone through and there is nothing more to do until January.   This year, we have been in Sacramento and been consulted on policy and legislative issues by both legislative staff and DDS almost weekly.  There has not been our usual downtime.  This has also allowed us to shape legislation such as the fire sprinkler bill (we got ARF's pulled out again and the bill subsequently died) and the new civil penalties for a client death due to negligence or physical abuse. 

Networking

One of the foundations of ResCoalition’s commitment to the residential community is to collaborate with other groups if at all possible.  This year SOCCO has restructured and we have been happy to work with them on a number of fronts.  We are also an active partner in the Lanterman Coalition.

Ongoing Issues

As we look to 2015, ResCoalition is already actively engaged on a number of issues.   One issue that is coming to the forefront is the 4 bed vs 6 bed concern.  While we have not had a problem when people choose to open 4 bed facilities, we are now understanding that some Regional Centers are saying they are down leveling 6 bed programs to 4 beds.  They are doing this by refusing to fill the 5th and 6th beds as they become vacant.   Some Regional Centers have gone so far as to state that DDS and or the new waiver regulations are requiring this.   We have met with DDS and they have assured us that this is not something coming from a state level.  DDS has also been clear that there is no federal language that makes 4 beds a part of the waiver process now or in the future.   If you would like some interesting reading, our position paper on the 4 bed vs. 6 bed illustrates a number of significant weaknesses with the 4 bed model - including higher costs for less care per client.   It should be clearly noted that we are not against 4 bed programs if they are funded to be viable and are structured to get the consumers the services they need.

 

We are almost in a perfect storm with regards to getting the rates/rate structure changed.  This is because the DOL audits are showing problems, the minimum wage debate has illustrated how shaky residential care finances are, and there is the Developmental Services Taskforce - which a number of key legislative staff attend.  We have been working to getting data together and educating people.  As the discussions are now occurring key people are beginning to understand and get the significance and severity of the ARM funding crisis. 

Do not forget that every business in California - including residential care facilities - must now offer sick leave to your employees beginning July 1, 2015.  To that effect, ResCoalition has created a template you can use as an employer policy to implement this new law. 

Several members have reached out to ask our position on Assemblymember Calderon's bill to change CCL's visits.  We are neutral and will not be addressing his concerns.  This is because ARM facilities are already Medicaid waiver programs.  Under state and federal agreement, 100% of Medicaid programs already are subject to annual unannounced visits. 

From a housekeeping perspective, ResCoalition has a new website - www.rescoalition.com.  We were able to finally get the most preferred domain name so have put up a new website.  The website includes all of the labor templates free to paying members.  Also, you can pay your dues via the website now!  available