FYI- Marianne
Marianne Taylor
Senior Project Director
Human Services Research Institute
2336 Massachusetts Ave.
Cambridge, MA 02140
617.844.2330
617.876.0426. x2330
taylor@...
www.hsri.org
-----Original Message-----
From: David Miller [mailto:
dwmiller@...]
Sent: Thursday, August 26, 2004 3:06 PM
To: Peg DuBord; Jim Cremeans (E-mail); Marianne Taylor (E-mail); Steve
Wiseman (E-mail); Suellen Galbraith (E-mail); Loren Garneau (E-mail)
Subject: FW: Quality Jobs/Quality Care
FYI. Interesting reading. Case will set a prescient for the future.
David
-----Original Message-----
From: Jane Ketcham
Sent: Wednesday, August 25, 2004 5:08 PM
To: Tamika Miller; Heather Moran; Frank Crook; Jason Umstot; Jason
Lynch; Ross Mason; Shelia Bell; Sherry Hopkins; Rosemary Wilshire;
Brenda Page; Holly Bond; Kim George
Cc: David Miller; Neil Brendmoen
Subject: FW: Quality Jobs/Quality Care
To all: As we discussed today, this is our year for mobilizing our forces
to accomplish a Waiver rate increase. Please read the article below. The
"livable wages" issue is hot throughout the United States. We must be
similar to Arizona in reimbursement rates; we're similar in pay scales.
Jane
-----Original Message-----
From: Marcus Canaday [mailto:
marcus@...]
Sent: Monday, August 23, 2004 11:40 AM
To: Sally Burchfiel; 'David Horvath'; Jeanne Grimm; 'Ruth Burgess';
'Julie Shelton'
Subject: FW: Quality Jobs/Quality Care
FYI ....
Marcus Canaday, Program Manager
Quality Assurance & Improvement Project
Center for Excellence in Disabilities at West Virginia University
4510 Pennsylvania Avenue, Suite G
Charleston, WV 25302
Phone: (304) 720-3200, Extension 218
E-mail:
Marcus@...
-----Original Message-----
From:
news@...
[mailto:
directcare@...]
Sent: Friday, August 20, 2004 4:15 PM
To:
marcus@...
Subject: Quality Jobs/Quality Care
Quality Jobs/Quality Care
August 20, 2004
________________________________________________________________________
________________________________________________
Quality Jobs/Quality Care is a free e-mail newsletter that covers issues
concerning direct-care workers in long-term care. It's published twice a
month by the National Clearinghouse on the Direct Care Workforce
(www.directcareclearinghouse.org), which provides reliable, up-to-date
information related to the direct-care workforce nationwide. The
Clearinghouse is a project of the Paraprofessional Healthcare Institute
(www.paraprofessional.org)
________________________________________________________________________
________________________________________________
Dear Friend:
Today's edition is a special alert devoted to just one story: a landmark
ruling by a federal judge in Arizona. We'll be back with a standard
edition of the newsletter next week.
JUDGE ORDERS ARIZONA TO RAISE HOME CARE PAY RATES
A federal district judge has ruled that Arizona must raise wages for
attendant care workers and personal care workers in order to ensure that
Medicaid beneficiaries receive the home- and community-based services
they are entitled to.
The Court's decision in Ball v. Biedess follows four and a half years of
litigation in a statewide class action lawsuit on behalf of a group of
elderly and disabled Medicaid recipients. The suit was brought against
the Arizona Health Care Cost Containment System (AHCCCS), which
administers the state's Medicaid programs, by lawyers from the Arizona
Center for Disability Law, AARP Foundation Litigation, and DNA Peoples
Legal Services.
The plaintiffs are Medicaid long-term care recipients who are legally
entitled to home-based attendant care, personal care, homemaker services
and respite services, but have been unable to obtain some or all of the
services they qualified for. Their lawyers argued that there are too few
home care workers available to supply the authorized services, largely
because the workers employed in the state's Medicaid system in 1999
typically earned between $6.50 and $8.50 an hour, while those who worked
for private paying clients typically earned between $10 and $12.
"This case started years ago," notes Jane Perkins, legal director for
the National Health Law Program. "There was a lot of testimony and
minutiae to it, but when you read the decision, it's really quite
straightforward. The judge said: Here's what Medicaid home care workers
are getting paid, here's what privately paid home care workers are
getting paid. There's a big difference. We have evidence to show that
when people are getting paid more, the supply of these providers
increases."
The decision, which was released this Tuesday, is "very significant,"
according to Perkins, in part because "it acknowledges that if a state
is going to participate in Medicaid, it has to live up to all parts of
the bargain, and one those parts is that rates be sufficient to ensure
that services are available."
The plaintiffs, who entered the courtroom on gurneys and in wheelchairs
to testify, clearly made an impression on U.S. District Court Judge Earl
Carroll. "Each of them testified to being trapped in bed unable to
change position or care for personal hygiene, abandoned for hours in a
bathroom, left without food or water, or similar experiences, due to the
lack or absence of health care providers," he wrote in a footnote to his
decision. "It is the intent of the Court to do whatever is available to
prevent any AHCCCS recipients from experiencing the kind of frustration,
embarrassment, and discomfort experienced by the representative class
members of this class action."
In his decision, Judge Carroll found evidence of "multiple studies and
reports [which] indicated a shortage of attendant care workers in
Arizona" and of "difficulty recruiting attendant care workers due to low
wages." He also relied on reports and testimony from expert witness
Dorie Seavey, a labor economist and national policy specialist for the
Paraprofessional Healthcare Institute, quoting her testimony that
payment rates for home health workers are too low to attract the number
of workers needed. Judge Carroll also cited Dr. Seavey's testimony that
"[t]here is serious evidence that there are people who have care hours
authorized who are not receiving them and that there are not methods and
procedures in place to measure that gap in services."
The judge ruled that AHCCCS "failed to provide the representative class
members with the equal access, quality of care, and freedom of choice to
which they are entitled." He ordered the agency to raise payment rates
to workers (referred to in the decision as "providers") to levels that
attract the needed candidates. In addition, he ordered the state to
develop systems to monitor and report gaps in service, and to eliminate
any gap reported by a recipient within four hours.
"That's a very systemic approach," says Elizabeth Priaulx, senior
disability legal specialist for the National Association of Protection
and Advocacy Services, "and it's written with a respect for the
professionalism of providers."
Perkins thinks the Court's decision could serve as a blueprint for other
states. "The decision here envisions a process for getting this
situation addressed in a timely way," she says. "If what the court
envisions occurs, then that's the kind of thing that I think other
states will latch onto. They're looking for what works."
According to Sally Hart of the Arizona Center for Disability Law, a lead
attorney for the plaintiffs, the decision is significant partly because
"it identifies wages as a problem in securing services for people who
are entitled to home- and community-based services, and it orders the
state to ensure that wages are adequate. The state had argued for years
that the problem in securing an adequate and a good workforce had
nothing to do with lack of wages or benefits."
What's more, says Hart, the state had argued that it was not responsible
for setting pay rates for home care providers after converting its
Medicaid program to managed care several years ago. Instead, the state
said, it was up to the agencies it contracted with to set those rates.
Judge Carroll disagreed, saying it was AHCCCS's responsibility to offer
a rate of pay high enough "to attract enough health care workers to
deliver all of the services for which an individual qualifies."
Judge Carroll has ordered the parties involved in the lawsuit to present
him with a timetable for implementing his orders by September 30.
However, Hart notes, the state is likely to appeal the decision.
Meanwhile, advocates for Medicaid beneficiaries nationwide are lauding
the ruling. "Across the country, people remain inappropriately
institutionalized simply because there are not sufficient
community-based providers," says Priaulx. "The [Arizona District] Court
recognizes the states' obligation to provide rates that are sufficient
to actually attract enough providers."
To read the decision, go to
http://directcare.c.topica.com/maaczpDaa9lqkbexRGzb/
- - - - - - - - - -
To comment on this newsletter or provide ideas for future issues, please
contact Elise Nakhnikian (
elise@...; 609-430-1881).
When forwarding material from Quality Jobs/Quality Care, please credit
the National Clearinghouse on the Direct Care Workforce. Do not
reproduce without permission. To subscribe, visit the Clearinghouse
website at www.directcareclearinghouse.org and look for "Free E-mail
Alerts."
====================================================================
Update Your Profile:
http://directcare.f.topica.com/f/?a84tsY.bexRGz.bWFyY3Vz
Unsubscribe:
http://directcare.f.topica.com/f/?a84tsY.bexRGz.bWFyY3Vz.u
Confirm Your Subscription:
http://directcare.f.topica.com/f/?a84tsY.bexRGz.bWFyY3Vz.c
Delivered by Topica:
http://www.topica.com/?p=T3FOOTER
Having problems with message search?
Fill out this form to ensure your group is one of the first to be migrated to the new message search system.
Offline 
Send Email