Since August of 2014, the Adult Family Home Council and the State of Washington have been engaged in a legal battle over the Council’s right to negotiate with the state over certain issues of compensation. The issues began when the Council proposed add-on rates for items not currently impacting the classification and corresponding rates in the DSHS assessment process. The state accused the Council of illegally manipulating the clients’ benefit level and refused to negotiate these issues. The Council states that these are issues of basic economic compensation and are mandatory subjects to be bargained under RCW 41.56.029. The state filed an action known as an Unfair Labor Practice against the Council barring us from brining these issues forward. The case has been heard twice by the Public Employees Relation Commission and the Council has prevailed every time. The state has continued to appeal this case.
Friday April 14, 2017, the case was heard in Thurston County Superior Court. This time the results were no different. The Judge ruled quickly and decisively for the right of adult family homes to negotiate these real and relevant issues impacting your ability to provide care.
This win is critical in establishing a fair and meaningful reimbursement structure under Medicaid. This will allow us to present all issues that relate to costs as a part of the negotiating process. This win does not guarantee new rates yet. It improves the negotiating position of the Council, and will allow us to present these issues for arbitration if needed. The state has the right to appeal this case to the Court of Appeals. If they do, the Council will be there to defend the rights of adult family homes.
Membership drives our ability to hold DSHS accountable. Join us in the fight for fair pay. Become a member of the Council today.
Below are the original proposals under dispute:
- When a CARE assessment identifies and the negotiated care plan requires that an adult family home is to provide a resident with ADL support coded as “Two plus persons physical assist” the provider shall receive an add on to the daily rate.
- When a CARE assessment identifies and the negotiated care plan requires that an adult family home is to provide a resident with awake staff at night the provider shall receive an add on to the daily rate.
- When a resident is classified in a C, D or E group by the CARE assessment tool and the resident’s assessment reflect that they would meet the criteria for the mood and behavior group as described in WAC 388-106, the adult family home owner shall receive an add on to the daily rate.
- Adult family home providers shall be compensated for the use of their personal vehicles to provide services to their residents (such as essential shopping and travel to medical providers) and as authorized under the care or service plans for individual residents. Such compensation shall be paid on a per-mile-driven basis at the standard mileage rate as recognized by the Internal Revenue Service, up to a maximum of one hundred (100) per month per resident.
- Adult family home providers shall be compensated for the time they spend transporting, supervising, and monitoring their residents outside of the adult family home (such as essential shopping and travel to medical providers) and as authorized under the care or service plan for an individual resident. The State shall reimburse the provider at a rate of $X.XX per quarter hour unit, with a maximum number of units as defined in the care or service plan.
- A capital add-on rate will be applied to those adult family homes contracting with the Department that have a Medicaid occupancy percentage of sixty percent (60%) or greater. For purposes of this section, to determine a facility’s Medicaid occupancy percentage, the State shall use the last six months’ Medicaid resident days from the preceding calendar year divided by the product of all its licensed adult family home beds, irrespective of use, times calendar days for the six-month period. Medicaid resident days include those clients who are enrolled in a Medicaid managed long-term care program, including, but not limited to, the program for all-inclusive care and the Medicaid integration project.
