Bill Text: IA SF2305 | 2023-2024 | 90th General Assembly | Introduced
Bill Title: 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.
Spectrum: Partisan Bill (Democrat 15-0)
Status: (Introduced) 2024-02-15 - Subcommittee: Edler, Costello, and Trone Garriott. S.J. 307. [SF2305 Detail]
Download: Iowa-2023-SF2305-Introduced.html
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
1
direct
care
workforce,
establishing
a
state
minimum
hourly
2
wage
for
direct
care
workers
under
the
Medicaid
program,
and
3
including
applicability
provisions.
4
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
5
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2305
DIVISION
I
1
DIRECT
CARE
WORKER
MINIMUM
WAGE
REQUIREMENTS
——
MEDICAID
2
PROGRAM
3
Section
1.
DIRECT
CARE
WORKER
MINIMUM
WAGE
REQUIREMENTS
——
4
MEDICAID
PROGRAM.
5
1.
a.
Notwithstanding
section
91D.1,
the
state
hourly
wage
6
for
an
employee
employed
as
a
direct
care
worker
by
a
provider
7
reimbursed
under
the
Medicaid
program
shall
be
at
least
$15.00
8
beginning
July
1,
2025;
at
least
$16.00
beginning
July
1,
9
2026;
at
least
$17.00
beginning
July
1,
2027;
at
least
$18.00
10
beginning
July
1,
2028;
at
least
$19.00
beginning
July
1,
2029;
11
and
at
least
$20.00
beginning
July
1,
2030.
On
or
after
July
12
1,
2031,
the
state
hourly
wage
for
an
employee
employed
as
a
13
direct
care
worker
by
a
provider
reimbursed
under
the
Medicaid
14
program
shall
be
increased
by
a
cost-of-living
adjustment
as
15
determined
by
applying
the
percent
change
in
the
consumer
price
16
index
for
urban
wage
earners
and
clerical
workers,
United
17
States
city
average,
as
published
annually
in
October
in
the
18
federal
register
by
the
federal
department
of
labor,
bureau
of
19
labor
statistics.
20
b.
Paragraph
“a”
shall
not
be
construed
to
authorize
a
21
provider
that
employs
a
direct
care
worker
whose
current
hourly
22
wage
is
above
the
minimum
wage
pursuant
to
paragraph
“a”,
to
23
decrease
the
direct
care
worker’s
current
hourly
wage.
24
2.
For
the
purposes
of
this
section,
“direct
care
worker”
25
means
an
individual
who
provides
supportive
services
and
care
26
in
home-based,
community-based,
or
facility
settings
to
people
27
experiencing
health
conditions,
illness,
or
a
disability,
28
and
who
receives
compensation
for
such
services.
“Direct
29
care
worker”
includes
but
is
not
limited
to
direct
support
30
professionals,
supported
community
living
workers,
home
health
31
aides,
universal
workers,
hospice
aides,
personal
assistants,
32
patient
care
technicians,
consumer
directed
attendant
care
33
providers,
senior
helpers
or
companions,
and
certified
nursing
34
assistants.
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Sec.
2.
CONTINGENT
EFFECTIVE
DATE.
This
division
of
this
1
Act
takes
effect
upon
the
effective
date
of
an
increased
2
appropriation
to
the
department
of
health
and
human
services
3
for
the
Medicaid
program
to
provide
a
reimbursement
rate
4
increase
to
Medicaid
providers
who
are
subject
to
payment
of
5
the
required
minimum
wage
for
direct
care
workers
under
this
6
division
of
this
Act
in
an
amount
that
offsets
the
increase
in
7
the
required
minimum
wage
paid
by
such
Medicaid
providers.
8
DIVISION
II
9
DIRECT
CARE
WORKFORCE
SUPPORT
PROGRAMS
10
Sec.
3.
NURSING
FACILITY
FUNDING
——
REVIEW
AND
11
REPORTING.
The
department
of
health
and
human
services
shall
12
do
all
of
the
following:
13
1.
Review
the
appropriation
made
pursuant
to
2023
Iowa
14
Acts,
chapter
112,
section
30,
subsection
1,
paragraph
“a”,
15
subparagraph
(1),
subparagraph
division
(a),
for
the
fiscal
16
period
beginning
July
1,
2023,
and
ending
June
30,
2025,
for
17
rebasing
of
case-mix
nursing
facilities
including
the
fifteen
18
million
dollars
provided
for
this
purpose,
to
identify
how
the
19
additional
funding
was
utilized
by
the
nursing
facilities
and
20
the
extent
to
which
the
wages
of
direct
care
workers
as
defined
21
in
section
249L.2
were
increased
as
a
result
of
the
additional
22
funding.
The
department
shall
report
initial
findings
and
23
recommendations
by
December
15,
2024,
and
final
findings
and
24
recommendations
by
December
15,
2025,
to
the
governor
and
the
25
general
assembly.
26
2.
Review
the
outcomes
of
initiatives
funded
through
the
27
federal
American
Rescue
Plan
Act
of
2021,
Pub.
L.
No.
117-2,
to
28
support
the
health
care
workforce
including
use
of
the
funds
to
29
increase
the
pay
and
benefits
of
direct
support
professionals,
30
and
train,
recruit,
retain,
and
expand
the
direct
support
31
professional
workforce,
to
determine
if
the
initiatives
32
should
be
continued.
The
department
shall
report
findings
and
33
recommendations
to
the
governor
and
the
general
assembly
by
34
December
15,
2024.
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Sec.
4.
IOWA
WORKFORCE
DEVELOPMENT
SURVEY
OF
DIRECT
1
CARE
WORKERS
——
DEPARTMENT
OF
HEALTH
AND
HUMAN
SERVICES
2
DETERMINATION
OF
IMPACT
OF
MINIMUM
WAGE
INCREASE.
3
1.
Iowa
workforce
development
shall
replicate
the
survey
4
entitled
“Direct
Care
Workers
of
Iowa
2019
Wage
&
Benefit
5
Survey”,
released
in
June
2019,
to
survey
wages
and
benefits
6
for
direct
care
workers
in
2024.
The
survey
shall
measure
the
7
wages
and
benefits
of
direct
care
workers
employed
through
8
temporary
staffing
agencies
separately
from
direct
care
workers
9
employed
directly
by
a
facility
or
employer,
and
shall
measure
10
wages
and
benefits
delineated
by
direct
care
workers’
years
11
of
experience
to
determine
the
effect
of
seniority
on
current
12
wages
and
benefits.
A
final
report
of
the
results
of
the
13
survey
shall
be
published
by
January
15,
2025.
14
2.
The
department
of
health
and
human
services
shall
use
15
the
results
of
the
survey
published
pursuant
to
subsection
16
1
to
determine
the
appropriate
increase
in
the
Medicaid
17
reimbursement
rate
for
Medicaid
providers
to
offset
payment
of
18
the
required
minimum
wage
for
direct
care
workers
as
specified
19
in
division
I
of
this
Act,
and
shall
report
the
reimbursement
20
rate
recommendations
to
the
general
assembly
by
March
15,
2025.
21
3.
Following
implementation
of
the
minimum
wage
requirement
22
for
direct
care
workers
as
specified
in
division
I
of
this
23
Act,
the
department
of
health
and
human
services
shall
use
the
24
final
report
of
the
results
of
the
survey
published
pursuant
to
25
subsection
1
to
develop
an
ongoing
tracking
system
to
determine
26
if
the
required
minimum
wage
for
direct
care
workers
under
the
27
Medicaid
program
is
effective
in
increasing
the
wages
Medicaid
28
providers
pay
direct
care
workers,
including
the
extent
of
the
29
impact
of
the
required
minimum
wage
on
wages
considering
the
30
years
of
experience
of
the
direct
care
worker.
31
EXPLANATION
32
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
33
the
explanation’s
substance
by
the
members
of
the
general
assembly.
34
This
bill
includes
measures
to
support
direct
care
services
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and
the
direct
care
workforce.
1
DIVISION
I.
Division
I
of
the
bill
requires
Medicaid
2
providers
to
comply
with
direct
care
worker
minimum
wage
3
requirements.
The
bill
provides
that
notwithstanding
Code
4
section
91D.1
(minimum
wage
requirements
——
exceptions),
the
5
state
hourly
wage
for
an
employee
employed
as
a
direct
care
6
worker,
as
defined
in
the
bill,
by
a
Medicaid
provider
shall
be
7
at
least
$15.00
beginning
July
1,
2025,
and
the
minimum
shall
8
increase
by
$1.00
per
year
to
at
least
$20.00
beginning
July
1,
9
2030.
The
bill
provides
that
the
setting
of
a
minimum
hourly
10
wage
under
the
bill
does
not
authorize
a
Medicaid
provider
11
who
is
paying
a
direct
care
worker
an
hourly
wage
above
the
12
required
minimum
to
decrease
the
direct
care
worker’s
current
13
hourly
wage.
On
or
after
July
1,
2031,
this
state
hourly
14
wage
shall
be
increased
by
a
cost-of-living
adjustment
amount
15
as
determined
by
applying
the
percent
change
in
the
consumer
16
price
index
for
urban
wage
earners
and
clerical
workers,
United
17
States
city
average,
as
published
annually
in
October
in
the
18
federal
register
by
the
federal
department
of
labor,
bureau
19
of
labor
statistics.
This
division
of
the
bill
takes
effect
20
upon
the
effective
date
of
an
increased
appropriation
to
the
21
department
of
health
and
human
services
(HHS)
for
the
Medicaid
22
program
to
provide
a
reimbursement
rate
increase
to
Medicaid
23
providers
who
are
subject
to
payment
of
the
required
minimum
24
wage
for
direct
care
workers
in
an
amount
that
offsets
the
25
increase
in
the
required
minimum
wage
paid
by
such
Medicaid
26
providers.
27
DIVISION
II.
Division
II
of
the
bill
includes
provisions
28
relating
to
support
of
the
direct
care
workforce.
29
The
bill
requires
HHS
to
review
the
funding
appropriated
30
for
the
fiscal
period
beginning
July
1,
2023,
and
ending
31
June
30,
2025,
for
rebasing
of
case-mix
nursing
facilities
32
to
identify
how
the
additional
funding
was
utilized,
and
the
33
extent
to
which
direct
care
worker
wages
were
increased
as
a
34
result
of
the
additional
funding.
HHS
must
report
initial
and
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5
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2305
final
findings
and
recommendations
to
the
governor
and
the
1
general
assembly.
HHS
is
also
required
to
review
the
outcomes
2
of
initiatives
funded
through
the
federal
American
Rescue
3
Plan
Act
to
support
the
health
care
workforce
including
the
4
use
of
the
funds
to
increase
the
pay
and
benefits
of
direct
5
support
professionals,
and
train,
recruit,
retain,
and
expand
6
the
direct
support
professional
workforce,
to
determine
if
7
the
initiatives
should
be
continued,
and
report
findings
and
8
recommendations
to
the
governor
and
the
general
assembly
by
9
December
15,
2024.
10
The
bill
also
requires
Iowa
workforce
development
to
11
replicate
the
survey
entitled
“Direct
Care
Workers
of
Iowa
12
2019
Wage
&
Benefit
Survey”,
released
in
June
2019,
to
survey
13
wages
and
benefits
for
direct
care
workers
in
2024,
and
14
publish
a
final
report
of
the
results
of
the
survey
by
January
15
15,
2025.
The
bill
requires
HHS
to
use
the
results
of
the
16
published
survey
to
determine
the
appropriate
increase
in
the
17
Medicaid
reimbursement
rate
for
Medicaid
providers
to
offset
18
payment
of
the
required
minimum
wage
for
direct
care
workers
19
as
specified
in
the
bill,
and
report
the
reimbursement
rate
20
recommendations
to
the
general
assembly
by
March
15,
2025.
21
Following
implementation
of
the
minimum
wage
requirement
as
22
specified
in
the
bill,
HHS
shall
use
the
report
to
develop
an
23
ongoing
tracking
system
to
determine
if
the
required
minimum
24
wage
is
effective
in
increasing
the
wages
Medicaid
providers
25
pay
direct
care
workers,
including
the
extent
of
the
impact
of
26
the
required
minimum
wage
on
such
wages
considering
the
years
27
of
experience
of
the
direct
care
worker.
28
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