Bill Summary – FastDemocracy

Senate File 2305 - Introduced
                                  SENATE FILE 2305
                                  BY CELSI, DONAHUE, DOTZLER,
                                      BISIGNANO, BOULTON,
                                      T. TAYLOR, PETERSEN,
                                      WEINER, QUIRMBACH, JOCHUM,
                                      TRONE GARRIOTT, WINCKLER,
                                      KNOX, WAHLS, and BENNETT
                            A BILL FOR
An Act relating to support of direct care services and the
  direct care workforce, establishing a state minimum hourly
  wage for direct care workers under the Medicaid program, and
  including applicability provisions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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                            DIVISION I
     DIRECT CARE WORKER MINIMUM WAGE REQUIREMENTS —— MEDICAID
                             PROGRAM
    Section 1. DIRECT CARE WORKER MINIMUM WAGE REQUIREMENTS ——
 MEDICAID PROGRAM.
    1. a. Notwithstanding section 91D.1, the state hourly wage
 for an employee employed as a direct care worker by a provider
 reimbursed under the Medicaid program shall be at least $15.00
 beginning July 1, 2025; at least $16.00 beginning July 1,
 2026; at least $17.00 beginning July 1, 2027; at least $18.00
 beginning July 1, 2028; at least $19.00 beginning July 1, 2029;
 and at least $20.00 beginning July 1, 2030. On or after July
 1, 2031, the state hourly wage for an employee employed as a
 direct care worker by a provider reimbursed under the Medicaid
 program shall be increased by a cost-of-living adjustment as
 determined by applying the percent change in the consumer price
 index for urban wage earners and clerical workers, United
 States city average, as published annually in October in the
 federal register by the federal department of labor, bureau of
 labor statistics.
    b. Paragraph “a” shall not be construed to authorize a
 provider that employs a direct care worker whose current hourly
 wage is above the minimum wage pursuant to paragraph “a”, to
 decrease the direct care worker’s current hourly wage.
    2. For the purposes of this section, “direct care worker”
 means an individual who provides supportive services and care
 in home-based, community-based, or facility settings to people
 experiencing health conditions, illness, or a disability,
 and who receives compensation for such services. “Direct
 care worker” includes but is not limited to direct support
 professionals, supported community living workers, home health
 aides, universal workers, hospice aides, personal assistants,
 patient care technicians, consumer directed attendant care
 providers, senior helpers or companions, and certified nursing
 assistants.
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                                S.F. 2305
    Sec. 2. CONTINGENT EFFECTIVE DATE. This division of this
 Act takes effect upon the effective date of an increased
 appropriation to the department of health and human services
 for the Medicaid program to provide a reimbursement rate
 increase to Medicaid providers who are subject to payment of
 the required minimum wage for direct care workers under this
 division of this Act in an amount that offsets the increase in
 the required minimum wage paid by such Medicaid providers.
                            DIVISION II
              DIRECT CARE WORKFORCE SUPPORT PROGRAMS
    Sec. 3. NURSING FACILITY FUNDING —— REVIEW AND
 REPORTING. The department of health and human services shall
 do all of the following:
    1. Review the appropriation made pursuant to 2023 Iowa
 Acts, chapter 112, section 30, subsection 1, paragraph “a”,
 subparagraph (1), subparagraph division (a), for the fiscal
 period beginning July 1, 2023, and ending June 30, 2025, for
 rebasing of case-mix nursing facilities including the fifteen
 million dollars provided for this purpose, to identify how the
 additional funding was utilized by the nursing facilities and
 the extent to which the wages of direct care workers as defined
 in section 249L.2 were increased as a result of the additional
 funding. The department shall report initial findings and
 recommendations by December 15, 2024, and final findings and
 recommendations by December 15, 2025, to the governor and the
 general assembly.
    2. Review the outcomes of initiatives funded through the
 federal American Rescue Plan Act of 2021, Pub. L. No. 117-2, to
 support the health care workforce including use of the funds to
 increase the pay and benefits of direct support professionals,
 and train, recruit, retain, and expand the direct support
 professional workforce, to determine if the initiatives
 should be continued. The department shall report findings and
 recommendations to the governor and the general assembly by
 December 15, 2024.
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                                        S.F. 2305
    Sec. 4. IOWA WORKFORCE DEVELOPMENT SURVEY OF DIRECT
 CARE WORKERS —— DEPARTMENT OF HEALTH AND HUMAN SERVICES
 DETERMINATION OF IMPACT OF MINIMUM WAGE INCREASE.
    1. Iowa workforce development shall replicate the survey
 entitled “Direct Care Workers of Iowa 2019 Wage & Benefit
 Survey”, released in June 2019, to survey wages and benefits
 for direct care workers in 2024. The survey shall measure the
 wages and benefits of direct care workers employed through
 temporary staffing agencies separately from direct care workers
 employed directly by a facility or employer, and shall measure
 wages and benefits delineated by direct care workers’ years
 of experience to determine the effect of seniority on current
 wages and benefits. A final report of the results of the
 survey shall be published by January 15, 2025.
    2. The department of health and human services shall use
 the results of the survey published pursuant to subsection
 1 to determine the appropriate increase in the Medicaid
 reimbursement rate for Medicaid providers to offset payment of
 the required minimum wage for direct care workers as specified
 in division I of this Act, and shall report the reimbursement
 rate recommendations to the general assembly by March 15, 2025.
    3. Following implementation of the minimum wage requirement
 for direct care workers as specified in division I of this
 Act, the department of health and human services shall use the
 final report of the results of the survey published pursuant to
 subsection 1 to develop an ongoing tracking system to determine
 if the required minimum wage for direct care workers under the
 Medicaid program is effective in increasing the wages Medicaid
 providers pay direct care workers, including the extent of the
 impact of the required minimum wage on wages considering the
 years of experience of the direct care worker.
                           EXPLANATION
         The inclusion of this explanation does not constitute agreement with
          the explanation’s substance by the members of the general assembly.
   This bill includes measures to support direct care services
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                                S.F. 2305
 and the direct care workforce.
    DIVISION I. Division I of the bill requires Medicaid
 providers to comply with direct care worker minimum wage
 requirements. The bill provides that notwithstanding Code
 section 91D.1 (minimum wage requirements —— exceptions), the
 state hourly wage for an employee employed as a direct care
 worker, as defined in the bill, by a Medicaid provider shall be
 at least $15.00 beginning July 1, 2025, and the minimum shall
 increase by $1.00 per year to at least $20.00 beginning July 1,
 2030. The bill provides that the setting of a minimum hourly
 wage under the bill does not authorize a Medicaid provider
 who is paying a direct care worker an hourly wage above the
 required minimum to decrease the direct care worker’s current
 hourly wage. On or after July 1, 2031, this state hourly
 wage shall be increased by a cost-of-living adjustment amount
 as determined by applying the percent change in the consumer
 price index for urban wage earners and clerical workers, United
 States city average, as published annually in October in the
 federal register by the federal department of labor, bureau
 of labor statistics. This division of the bill takes effect
 upon the effective date of an increased appropriation to the
 department of health and human services (HHS) for the Medicaid
 program to provide a reimbursement rate increase to Medicaid
 providers who are subject to payment of the required minimum
 wage for direct care workers in an amount that offsets the
 increase in the required minimum wage paid by such Medicaid
 providers.
    DIVISION II. Division II of the bill includes provisions
 relating to support of the direct care workforce.
    The bill requires HHS to review the funding appropriated
 for the fiscal period beginning July 1, 2023, and ending
 June 30, 2025, for rebasing of case-mix nursing facilities
 to identify how the additional funding was utilized, and the
 extent to which direct care worker wages were increased as a
 result of the additional funding. HHS must report initial and
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                                S.F. 2305
 final findings and recommendations to the governor and the
 general assembly. HHS is also required to review the outcomes
 of initiatives funded through the federal American Rescue
 Plan Act to support the health care workforce including the
 use of the funds to increase the pay and benefits of direct
 support professionals, and train, recruit, retain, and expand
 the direct support professional workforce, to determine if
 the initiatives should be continued, and report findings and
 recommendations to the governor and the general assembly by
 December 15, 2024.
    The bill also requires Iowa workforce development to
 replicate the survey entitled “Direct Care Workers of Iowa
 2019 Wage & Benefit Survey”, released in June 2019, to survey
 wages and benefits for direct care workers in 2024, and
 publish a final report of the results of the survey by January
 15, 2025. The bill requires HHS to use the results of the
 published survey to determine the appropriate increase in the
 Medicaid reimbursement rate for Medicaid providers to offset
 payment of the required minimum wage for direct care workers
 as specified in the bill, and report the reimbursement rate
 recommendations to the general assembly by March 15, 2025.
 Following implementation of the minimum wage requirement as
 specified in the bill, HHS shall use the report to develop an
 ongoing tracking system to determine if the required minimum
 wage is effective in increasing the wages Medicaid providers
 pay direct care workers, including the extent of the impact of
 the required minimum wage on such wages considering the years
 of experience of the direct care worker.
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