HF3442 (Hosch) was introduced today in the House.  Although it is being introduced to generate discussion and promote reform, there are a number of problematic provisions in the legislation.

HF3442 is being heard this Thursday in the House Health Care and Human Services Policy and Oversight Committee.

This bill includes the following provisions, which Aging Services is strongly opposed to:

  • Mandatory transitional consultation (“diversion”) for private pay individuals seeking to move into a HWS setting.  Individuals would need to have a certificate proving they have had this counseling before being allowed to move into HWS.  This was proposed last year by Senator Bergling in conference committee and successfully defeated.
  • Cuts to Elderly Waiver customized living based on the density of HWS per 1000 individuals aged 65 and over within a certain geographic area, with rate cuts tiered by “high concentration “, “medium concentration”, and “low concentration”.
  • Cuts to care centers based on payor mix.  The amount of private pay would determine the amount of the MA rate cut.
  • Medicare “carve-out” within rebasing.
  • Nearly doubling the fees for a Class F license.
  • Raising the HWS registration fee to $2000.

HF 3442 also includes the phase out of rate equalization and unfreezes rebasing.

This bill has been introduced based on the following assumptions:

  1. The state should choose which part of the service continuum can absorb cuts and which part can’t, because of the need to preserve some sort of infrastructure in a time of on-going budget deficits.
  2. HWS is too overbuilt, too expensive and causing spend down, and consumers don’t have adequate information about their other options.

There is also simply a lack of understanding about how HWS plays an important role in the service continuum.  Without home and community-based services like HWS, individuals unnecessarily wind up in more expensive care.  HWS provides the right care, at the right time, in the setting of an individual’s choice.  The state should not be determining that choice.

In short, this is not the kind of reform that serves Minnesotans well.  The best ways to reform the system are to continue funding cost-effective HCBS; provide incentives to individuals to save for their long-term care needs; and support a range of options for consumer to choose from.  HF3442 goes in the opposite direction.