February 23, 2024

As a follow up to the Direct Support Pay Increase Memorandum dated June 29, 2023, ADMH has asked providers to submit questions they may have regarding the new rates, billings, etc. by close of business, Friday, July 21, 2023. 

ASPA is submitting the following questions/comments regarding this memo.

• As announced at the DD Subcommittee/Rate Setting Committee on Tuesday, July 18, ADMH is not adopting the HMA recommended rates for Personal Care and Companion Services.  Dr. Mills presented another rate model that does not include productivity adjustments to allow staff time for travel, attend planning meetings, recordkeeping/reporting, missed appointments, supervision/employer time, and paid time off. These are real costs the providers incur and therefore the rate will not support a Direct Care Worker median wage of $14.51 for these services. 
• The adopted HMA Residential Rate model does not provide any exceptions for individuals who require specialized staffing for behavioral or medical needs. HMA’s Residential Rate model is based on house capacity (# beds) and acuity level (ICAP score). Therefore, it is very likely that the rate for a person requiring 1:1 supervision will not be enough to cover the 24 hour 1:1 staffing cost. In addition, the HMA Rate Model is based on the assumption that ALL individuals are in activities outside the home 20 hours a week, and therefore does not need residential staff support for those 20 hours. This is an unfair assumption because there are many individuals that are retired from work or day services. 
• HMA Rate Models did not include the cost of the Nurse Delegation Program. This is a significant expense to providers and this needs to be addressed as soon as possible.

Below: slide deck of recommendations from the workgroup re: proposed ADMH Personal Care & Companion Care rates presented Tuesday.