Closeup of $15 with $5 and $10 bills
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A planned $15 hourly minimum wage requirement for home- and community-based service workers set to take effect Oct. 1 in Florida has some senior living providers concerned about how they will cover the increased costs.

The Sunshine State’s fiscal year 2022-2023 budget provided more than $600 million to the state’s Agency for Health Care Administration, or AHCA, to increase the minimum wage for employees of Medicaid providers to at least $15 per hour. 

As part of that budget, Florida lawmakers earmarked $135.9 million for Medicaid managed care long-term care plans to cover the increased salary costs of all direct care providers they contract with, including assisted living communities and home health agencies. 

But HCBS providers that contract with the managed care plans said they may not see those additional dollars until Jan. 1, 2023, when managed care plans are required to increase their provider rates to cover the increased hourly wages.

In addition, they said, AHCA is pressuring providers to sign new agreements attesting that they will pay the $15 hourly wage to their direct care workers. Providers that do not sign the supplemental wage agreement will be subject to recoupment of funds associated with the wage increase and potential litigation from staff members, who can file a civil action against their employers for noncompliance.

In a letter to Gov. Ron DeSantis (R), Florida Assisted Living Association CEO Veronica Catoe said that members that serve Medicaid beneficiaries “are still very concerned about conflicting guidance both within the budget provision language and the agency website.”

She asked for DeSantis’ help in obtaining clarification from AHCA before the Oct. 1 deadline on the definition of direct care employee, whether all employees are affected, when the $15 hourly minimum wage goes into effect, how facilities can ensure that reimbursements will be passed on to them, and whether the cost of assistive care services was considered.

Catoe said that FALA is “more than willing” to be “at the table” to discuss the topic.

LeadingAge Florida Director of Communications Nick Van Der Linden said that the organization’s members also have raised concerns about signing an attestation that “will lead to an immediate increase in costs, without the answer of when they will receive the additional funding.”

“While providers will ultimately receive an increase in reimbursement, this implementation timeline puts short-term immediate pressure on them,” Van Der Linden told McKnight’s Senior Living. “LeadingAge Florida continues to support increased funding for home- and community-based service providers — including assisted living — that would allow for greater access to services by the Medicaid population and enable the delivery of care in the most appropriate, cost-effective setting.”

More work needs to be done to address workforce challenges faced by providers, however, he added.

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