SENIOR AND LONG TERM CARE DIVISION
FY 2008 DIRECT CARE WAGE INITIATIVE
Worker Category Summary Reports
March 4, 2008
The 2007 Montana legislature authorized $15.2 million total funds over the biennium, including $2.3 million general funds and $2.7 million state special revenue from the health and Medicaid initiatives account to the Senior and Long Term Care Division for the purpose of increasing direct care worker wages to $8.50 per hour, including benefits, for certified nurse aides and personal care attendants and to increase wages of other direct care workers by up to $.70 cents per hour including benefits, such as, federal and state income taxes and workers’ compensation.
The Direct Care Worker Wage Increase funding must first to be used to raise the certified nursing aide wages under the Nursing Facility Services Program and personal care attendants in the Community Services Bureau to $8.50 an hour with related benefits. Any remaining funds from the funds allotted for moving workers to $8.50 were then used in conjunction with the funding for the $.70 cents per hour to raise wages, and related benefits, for all direct care workers in these programs.
A new requirement for the direct care wage distribution this biennium was that funds in the Direct Care Worker Wage Increase appropriation could not be used to offset any other wage increase mandated by any other laws, contracts, or written agreements, which went into effect at the same time as or after implementation of the Direct Care Worker Wage Increase. Providers were required to certify that they understood and would comply with this provision when they submitted the forms required for participation
To receive Direct Care Worker Wage increase funds, nursing facilities and personal assistance agencies were required to submit to the Division for approval an authorization request which indicated how the total annualized amount of funding attributed to the direct care wage add-on would be spent by each category of service provider. The request included two forms; Form A for CNA’s and PCA’s earning under $8.50 which required specific information about these workers and their rate of pay, and Form B which was used to document increases to other facility direct care workers in each of these programs to insure that the total appropriated funding would be distributed in the form of wage increases.
Any provider receiving wage funding will be required to maintain appropriate records documenting the expenditure of the funds and will be subject to additional reporting and ongoing review of these expenditures to insure compliance with the funding guidelines.
Total funds in the amount of $5,107,142 were distributed for the Direct Care Worker Wage increases to nursing facility providers and $ 2,800,381 was distributed for direct care worker wage increases for personal assistance provider in FY 2008. These direct care wage funding increases were effective July 1, 2007 for all of the programs in the Senior and Long Term Care Division.
Nursing Facility Direct Care Worker Break Down
Sixteen (16) total nursing facilities had CNA’s being paid under the $8.50 limit. Those facilities received on average of $1.53 per day increase in their Medicaid payment rate for the purpose of bringing approximately 170 workers up to the $8.50 amount. On average these workers received $.56 cents in increased wages from the $8.50 funding pool.
The additional funding for wage increases up to $.70 cents was distributed to 85 total nursing facilities to provide increased wages for approximately 4,227 direct care workers who worked in nursing facilities including certified nursing assistants, licensed practical nurses, registered nurses, and other direct care workers such as activities, dietary, housekeeping and laundry.
The average hourly wage (w/o benefits) for CNA’s went from $10.35 to $10.96 or a $.61 cent increase. The average entry wage for CNA’s went from $9.26 to $9.79 for a $.53 cent increase.
Personal Assistance Direct Care Worker Break Down
Nineteen (19) total personal assistance and home and community based waiver agencies had direct care workers being paid under the $8.50 limit. Those agencies received on average 19 cents per 15 minute unit rate increase in their Medicaid payment rate for the purpose of bringing approximately 135 workers up to the $8.50 amount. On average these workers received $0.87 cents in increased wages from the $8.50 funding pool.
The additional funding for wage increases up to $0.70 cents was distributed to 28 total agencies to provide increased wages for approximately 1,091 direct care full time equivalents in personal assistance and home and community based waiver agencies including personal assistance and self-direct workers, HCBS waiver personal assistance, respite, homemaker and habilitation aid. With the remaining funding available for community services providers the division was able to increase personal assistance workers up to approximately $1.12 in wages and benefits.
The average hourly wage (w/o benefits) for direct care workers in Personal Assistant and Home and Community Based services went from $9.21 to $10.10 for a $.89 cent increase. The average entry wage for direct care workers in Personal Assistant and Home and Community Based services went from $9.03 to $9.98 for a $.95 cent increase.