12.37% Rate Increase for Community Alternatives Program for Disabled Adults (CAP-DA)

Great news for BAYADA clients and the many North Carolinian disabled adults that wish to remain at home with the help of in-home caregivers! The Medicaid CAP-DA program will see a rate increase from $13.88 to $15.60, effective January 1, 2019.  This increase brings parity between the three Medicaid aide programs, Personal Care Services (PCS), CAP-C for Children and CAP-DA for disabled adults.

This much needed increase will  enable BAYADA to hire and retain more quality caregivers to serve the many adults with disabilities in North Carolina. Thus, our service offices that serve CAP-DA eligible clients will be able to staff the necessary cases and keep families together and keeping clients whether they want to be – at home.

BAYADA’s Government Affairs Office (GAO), collaboratively with the Association for Home & Hospice Care, worked behinds the scenes with both Medicaid and key lawmakers to ensure this provision was adopted this session. Additionally, we made great strides towards this increase during our 2018 Legislative Day in which several client advocates came to share their stories with lawmakers and talk about the necessity of such increases. Thank you to those who came and shared their voices! We will continue to fight for higher rates to ensure that all North Carolinians will be able to access high-quality, reliable in-home care.

 

NC Legislative Update: Looking Back, Planning Forward

Last month the GAO Advisory Committee met to evaluate our 2017 efforts and to plan for 2018. The Advisory Committee is made up of representation of every practice in NC as well as representation from CMO and GAO. Below is a summary of their findings and the priorities for 2018.

2017 Legislative Accomplishments
With your help we accomplished the following:

• Secured an increase for Medicaid aide services under the Personal Care Services (PCS) Program and the Community Alternatives Program for Children (CAP-C) from $13.88 to $15.52, effective August 1, 2017, and to $15.60 effective January 1, 2018. BAYADA impact: $300K annually. These increases will allow us to hire and retain more quality staff.
• Protected Certificate of Need (CON) and prevented its elimination from health care. Also prevented the Continuing Care Retirement Communities (CCRCs) from operating a home health agency without a CON. The CCRCs were seeking a carve-out from CON statute. Four separate bills were filed to eliminate this statute. BAYADA impact: Protected 5 service offices that serve Medicare clients. This issue is likely to re-surface in 2018.
• Secured a 7.5% tax exclusion for health care services on all revenue.
BAYADA impact: All 54 NC service offices will save a collective $12.6M annually.

2018 Key Legislative Priorities:

• Amend the Community Alternatives Program for Disabled Adults (CAP-DA) budget neutrality language to allow the aide rate to be increased from $13.88 to $15.60 to align with the PCS and CAP-C rate increases effective Oct. 1, 2018, by Q4-2018.
• Secure a $1.40 increase for all Medicaid aide services from $15.60 to $17.00 effective Jan. 1, 2019, by Q3-2018.
• Prevent the elimination of Certificate of Need (CON) for home health or hospice by Q3-2018.
• Ensure that the Medicaid Transformation waiver includes a rate floor provision and language that ensures access to quality care and minimal administrative burden by Q4-2018.

North Carolina Budget Released

Submitted by Lee Dobson, Area Director, NC Government Affairs (GAO)

On June 19, lawmakers released a $23 billion budget for 2017-2019. Below are some of the provisions impacting us:

  • Increased Personal Care Services Rate: This provision increases the Medicaid rate for aide services under the Personal Care Services (PCS) program and the Community Alternatives Program for Children (CAP-C). The rate will increase from $13.88 to $15.50 (July 1, 2017) and $15.60 (January 1, 2018) pending approval from the Centers for Medicare & Medicaid Services (CMS). Much to our disappointment, CAP-DA was left out of the budget. A technical issue made it difficult to increase the CAP-DA rate within the established budget neutrality requirement. A rate increase would have meant fewer authorized hours for clients to stay within overall program requirements. BAYADA’s Government Affairs Office continues to work on a solution.
  • Protected the certificate of need (CON) for home health care from being eliminated.
  • Expanded Innovations Waiver slots: This provision added 400 additional Innovations Waiver slots across the state.

NC Budget Writers are Behind Closed Doors

Submitted by Lee Dobson, Area Director, NC Government Affairs (GAO)

Budget negotiations are underway between the House and Senate to iron out the differences between their respective budget bills. Both contain funds for an increase to the Personal Care Services (PCS) program aide rate from $13.88 to between $15.52 and $15.78. BAYADA’s Government Affairs Office (GAO) continues to work with key lawmakers to garner support for an amendment to add funds to cover aide services under the Community Alternative Programs for Children (CAP-C) and Disabled Adults (CAP-DA). Language has been drafted and is being circulated. Budget writers are working behind closed doors as House Speaker Tim Moore and Senate President Pro Tempore Phil Berger have instructed conference chairs to have their committee reports completed by the end week.

Making The Rounds in North Carolina

Submitted by Lee Dobson, Area Director, NC Government Affairs (GAO)

BAYADA Chief Government Affairs Officer Dave Totaro and I met with key lawmakers this past week, seeking their support for a rate increase for aide services under three Medicaid programs – Personal Care Services, Community Alternatives Program for Disabled Adults (CAP-DA), and CAP for Children (CAP-C)- in two different settings: in-home care and adult care homes.  While the lift is heavy, $47.8 million to bring the rate from $13.88 to $17.00 over two years, our conversations were positive.  We also met with the newly appointed but not yet confirmed Secretary of Health & Human Services, Dr. Mandy Cohen.  A good round of meetings!

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Dave Totaro, Lee and Dobson Rep. Carla Cunningham, who is a nurse