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Agenda

Executive Order No. 536: Establishing the Chapter 257 of the Acts of 2008 Provider and Consumer Advisory Council May 23, 2013 www.mass.gov/hhs/chapter257. Agenda. Chapter 257 Implementation Status Update Chapter 257 PCAC Member Discussion Rate of Staff Turnover

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Agenda

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  1. Executive Order No. 536: Establishing the Chapter 257 of the Acts of 2008 Provider and Consumer Advisory CouncilMay 23, 2013www.mass.gov/hhs/chapter257

  2. Agenda • Chapter 257 Implementation Status Update • Chapter 257 PCAC Member Discussion • Rate of Staff Turnover • Understand Variations and Base Components in Provider Costs • Confirming Impact of Chapter 257 • Direct Care Salaries

  3. Chapter 257 Status Update • The revised statutory implementation milestones are as follows – • As of today, CHIA, EOHHS, and purchasing departments have developed rate regulations for 72% of total POS spending (~ $1.67B). • EOHHS has adopted rate regulations for 41% (~ $941M) of POS spending. • Public hearings have been held for an additional 28% of POS spending, which includes regulated rates for DDS/MCB/MRC Adult Long Term Residential and DCF/DPH Family Transitional Support services. Public comment and testimony is under review and EOHHS anticipates adopting rate regulations for these services shortly. • On Friday, EOHHS will post a Notice of Public Hearing for Placement & Adoption Supports (3% of total POS spending) as purchased by DCF, DYS, DMH, DDS, MCB and MRC. The public hearing will be held on July 9th. • EOHHS has begun work on developing rates for Community Based Flexible Supports at DMH (11.5% of total spending), and anticipates proposing rates in the Fall.

  4. Ch. 257 Regulated Rates – Reviews Planned • The following regulations are in place, and rate reviews are underway or planned –

  5. Agenda • Chapter 257 Implementation Status Update • Chapter 257 PCAC Member Discussion • Rate of Staff Turnover • Understand Variations and Base Components in Provider Costs • Confirming Impact of Chapter 257 • Direct Care Salaries

  6. Rate of Staff Turnover • Per request, EHS HR provided analysis for one State Operations title that is comparable to some provider staff.

  7. Variations in Costs for Health Insurance and Other Benefits • Discussion – • Health insurance, ACA • Dental insurance • Life insurance • Short-term and Long-term disability • Workers’ Compensation • Social Security • Unemployment • Pension / 401(k) or 403(b) match • Other benefits • There is a recognized need to develop a consistent approach to incorporating the costs of employer-sponsored benefits in POS rates. • A looming change that will impact these costs is implementation of the Affordable Care Act (ACA). • Other benefits may also be offered by some providers. • Need to understand these cost components better, including factors like the ACA that will impact ongoing benefit packages.

  8. Agenda • Chapter 257 Implementation Status Update • Chapter 257 PCAC Member Discussion • Rate of Staff Turnover • Understand Variations and Base Components in Provider Costs • Confirming Impact of Chapter 257 • Direct Care Salaries

  9. Direct Care Salaries – Confirming Impact • A major policy focus of the Patrick Administration has been to direct Ch. 257 rate increases to enhance direct care worker salaries. • It will be important to measure the extent of that impact over time as a way of supporting additional directed increases. • Need to plan now for how to monitor this impact. • UFR is an imperfect tool, but is the one most readily available. How can that be leveraged to address future analysis? • Other suggestions?

  10. Wrap-up, Next Meetings • Next Scheduled Meetings, Matta Conference Room • September 12, 2013 – 3:00-4:30 • December 12, 2013 – 3:00-4:30

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