Medicaid overtime ban clears state panel

A rule prohibiting home health aides from receiving Medicaid reimbursement for more than 40 hours of work per week cleared a legislative committee Friday despite complaints from lawmakers and advocacy groups that the restriction has placed a hardship on some families.

Craig Cloud, director of the state Department of Human Services' Division of Aging and Adult Services, said the rule, which went into effect Jan. 1, was required because of a U.S. Department of Labor regulation extending minimum wage and overtime requirements to workers who help the disabled with daily living tasks such as dressing, bathing and eating.

The Medicaid regulation affects about 400 people with disabilities who hire their own home health care workers under the program's "self-directed care" model, Cloud said.

Previously, the Medicaid program had reimbursed families who hired such workers for up to 56 hours of services per week, but did not pay overtime for more than 40 hours per week, Cloud said.

The Labor Department rule would require the Medicaid program to pay the overtime rate for workers who work more than 40 hours a week, but federal Medicaid rules prohibit the state Medicaid program from paying overtime, Cloud said.

Although a federal judge struck down parts of the Labor Department regulation in rulings in December and January, agency officials have appealed the judge's ruling and have said they will apply the regulation retroactively if the appeal is successful, Cloud said.

In the meantime, the state Human Services Department is seeking a change that would once again exempt the workers from the overtime requirement.

Under the change, which the department hopes to have in place by this fall, the Medicaid program would no longer be considered a "third party employer" of the workers. Instead, the workers would be employed solely by the families who hire them and would be exempt from the overtime requirement under a "companionship" exemption.

Until that change takes place, people with disabilities still can receive reimbursement for up to 56 hours of care per week but can't pay a single worker for more than 40 hours per week.

The average worker makes a normal wage of $9.76 per hour. Providing overtime wages for those Medicaid recipients would cost the state an estimated $1.9 million to $2.5 million, Cloud said.

Although some legislators said they weren't happy with the rule, the House and Senate public health committees deemed it "reviewed" in a voice vote, with no members audibly dissenting.

Sen. Missy Irvin, R-Mountain View, said the Labor Department regulation has caused difficulties for one of her constituents who has a daughter with severe disabilities.

"There aren't enough caregivers that are trustworthy for these types of individuals in a lot of rural places of Arkansas, so it provides a huge problem for a lot of families out there," Irvin said.

Cloud said his agency was working to make sure services aren't disrupted for any recipients. He said after the meeting that he wasn't aware of any recipient who was unable to receive the services they needed because of the change.

Rep. John Payton, R-Wilburn, said the state should pay the overtime. Hiring additional workers brings additional administrative expenses for the state, he said. And, he added, workers who receive higher wages through overtime might come off of taxpayer-funded assistance programs.

"I think the benefit of the state -- by having a higher quality employee, by letting them make the overtime -- could far outweigh the expense," Payton said.

Metro on 05/30/2015

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