AGING AND DISABILITY SERVICES ADMINISTRATION
September 11, 2001
AASA:? BH # 2001-019
SUBJECT:? Vendor Rate Increases
Dear Boarding Home Providers,
Effective July 1, 2001, the department increased the Medicaid rates that it pays AFH and boarding home providers.? The rate increases resulted from two separate appropriations in the 01-03 budget passed by the legislature.? First, the department raised the rates overall by 2.1%.? Second, the department raised the rates by an additional amount to enable providers to raise the wages of the low wage long-term care workers.
Previously, you received letters and charts showing the new rates that include these two increases.? The purpose of this letter is to explain what is required of you regarding the amount of the rate increase provided to cover staff wage increases.
The Appropriations Bill Engrossed Substitute Senate Bill (ESSB) 6153 stated that funds:
?are provided solely for prospective rate increases intended to increase compensation by an average of fifty cents per hour for low-wage workers in agencies which contract with the state to provide community residential services for persons with functional disabilities.? In consultation with the statewide associations representing such agencies, the department shall establish a mechanism for testing the extent to which funds have been used for this purpose, and report the results to the fiscal committees of the legislature by February 2002.? The amounts in this subsection also include the funds needed for the employer share of unemployment and social security taxes on the amount of the wage increase.
The Senate Ways and Means Committee notes on the Omnibus Operating Budget stated the following:
Long Term Care Worker Wages - Funding is provided to increase pay for low-wage workers who provide direct care for elderly and disabled persons in their own homes, in nursing homes, and in community residential programs.? When combined with the vendor rate increases?funding is sufficient to increase hourly wages an average of 50 cents effective July 1, 2001?.
The legislature?s appropriation covers only the Medicaid share of any wage increases that you provide.? For instance, if 50% of the residents at your facility typically are covered by Medicaid, then the amount by which your rate was increased may be sufficient to cover one-half of the intended wage increase.?
The legislature left it to your discretion which direct care staff positions that you apply the wage increases to and the amount that you increase the hourly wages for those positions.? Direct care staff positions provide services directly to or for individual residents.? The department developed its budget by estimating the number of direct care workers that are paid less than $10 an hour.? However, facilities are not required to limit wage increases to staff currently receiving less than $10 an hour.
The legislature expects some quantitative proof that low wage long-term care direct care worker wages were increased.? The department may contact you to determine the staff positions you identified as providing direct care and receiving low wages and the wage changes you implemented.? The legislature will review this information during future budget deliberations.? Failure to use the rate increase for the purpose that the legislature intended could affect the legislature?s willingness to fund rate increases in the future.
?The following charts indicate the portions of the Medicaid resident per day rate enhancements that are referenced in the legislation and budget notes.? By averaging the number of Medicaid clients you typically serve at the various payment levels, you can estimate the amount of funds available to you to apply to wage increases.?? Since the number of residents that are Medicaid or private pay constantly fluctuates along with the number of staff, it is impossible to provide you with more specific guidance on how much you should increase your staffs? wages.
Adult Residential Care, Enhanced Adult Residential Care, Adult Family Home
Rate Increases for 2.1% inflation Increase and Wage Enhancement Funds (per resident per day)
|
Level 1
|
Level 2?
|
Level 3?
|
Level 4
|
|||||
|---|---|---|---|---|---|---|---|---|
|
?
|
2.1%
|
Wage
|
2.1%
|
Wage
|
2.1%
|
Wage
|
2.1%
|
Wage
|
|
King County
|
$.76
|
$1.63
|
$.85
|
$1.83?
|
$.95
|
$2.03
|
$1.04
|
$2.24
|
|
MSA*
|
.68
|
1.63?
|
.77?
|
1.83
|
.86
|
2.03
|
.94
|
2.24
|
|
NMSA**?
|
.65
|
1.63
|
.73
|
1.83
|
.82
|
2.03
|
.90
|
2.24
|
Assisted Living
|
Level 1
|
Level 2?
|
Level 3?
|
||||
|---|---|---|---|---|---|---|
|
?
|
2.1%
|
Wage
|
2.1%
|
Wage
|
2.1%
|
Wage
|
|
King County
|
$.21
|
$.39
|
$.28
|
$.53?
|
$.36
|
$.69
|
|
MSA*
|
.20
|
.44
|
.26
|
.58
|
.33
|
.74
|
|
NMSA**?
|
.17
|
.44
|
.22
|
.58
|
.28
|
.74
|
* Benton, Clark, Franklin, Island, Kitsap, Pierce, Snohomish, Spokane,
Thurston, Whatcom, and Yakima Counties.
** All remaining counties.
For example, you contract with the state to provide enhanced adult residential care services in a facility located in a metropolitan statistical area (MSA).? You typically serve ten Medicaid residents, five of which are at level two and five of which are at level three and you apply both portions of the rate enhancement to low wage worker wages.? You would estimate the monthly amount available for this purpose as follows:
|
No. of Residents
|
Payment Rate/Day?
|
30.4 Days/Month
|
Totals
|
|
5 X
|
.77 + 1.83
(level 2)? X |
30.4
|
?= $395.20?
|
|
5 X
|
.86 + 2.03
(level 3) X |
30.4
|
= $439.28
|
|
Total Month = $834.48
|
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If you have additional questions regarding this subject, please contact Dick Rosage at (360) 725-2442.
Sincerely,
Tom Kearns, Chief
Office of Rates Management
Aging and Disability Services Administration
