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Evers directs DHS to invest $258M in HCBS funds toward minimum fee schedule

In Business Madison
By In Business Madison
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Gov. Tony Evers today announced in a press release today that he is directing the Wisconsin Department of Health Services (DHS) to invest $258 million in funding already designated for home and community-based services (HCBS) to create and fund a minimum fee schedule, effectively raising wages for direct care workers and providers serving older adults and individuals with disabilities. With Evers’ action, Wisconsin will join 20 other states that have a minimum fee schedule for HCBS providers, including the neighboring Midwest states of Illinois, Iowa, Minnesota, and Michigan.

The minimum fee schedule will establish minimum amounts managed care organizations (MCOs) must pay providers for certain adult long-term care services. According to DHS, the affected Medicaid programs include Family Care, Family Care Partnership, and Program of All-Inclusive Care for the Elderly, and these programs serve nearly 57,000 older adults and adults with disabilities. DHS estimates this funding and the creation of the minimum fee schedule, together, will provide a 15% rate increase for most supportive home care services and a 40.5% rate increase for most of the services provided at residential facilities, among other rate increases.

The HCBS minimum fee schedule will direct $258 million from DHS’ allocation of American Rescue Plan Act (ARPA) funds designated specifically for HCBS programs and services. DHS estimates $350 million is available in ARPA HCBS funding to strengthen the state’s HCBS programs, address direct care workforce issues, and develop strategies to delay the need for long-term care. The minimum fee schedule applies to services for which no specific rates exist in fee-for-service Medicaid, and consequently, each MCO establishes a rate through its contract with the provider. These services include:

  • Adult family homes; 

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  • Community-based residential facilities; 

  • Residential apartment complexes; 

  • Supportive home care (SHC) agencies; and  

  • Self-directed SHC. 

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The minimum rates will go into effect Oct. 1, and DHS will systematically monitor that MCOs are paying providers at or above the minimums and will have contractual penalties if the MCOs fail to pay providers the minimums.

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