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Senate
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530
-
Introduced
SENATE
FILE
530
BY
CELSI
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
a
contingent
effective
date.
4
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
5
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530
DIVISION
I
1
DIRECT
CARE
WORKFORCE
SUPPORT
PROGRAMS
2
Section
1.
NEW
SECTION
.
84A.22
Direct
care
workers
——
wage
3
survey.
4
Beginning
January
1,
2027,
and
each
odd-numbered
year
5
thereafter,
the
department
of
workforce
development
shall
6
replicate
the
survey
entitled
“Direct
Care
Workers
of
Iowa
7
2019
Wage
&
Benefit
Survey”,
released
in
June
2019,
to
survey
8
wages
and
benefits
for
direct
care
workers.
The
survey
shall
9
measure
the
wages
and
benefits
of
direct
care
workers
employed
10
through
temporary
staffing
agencies
separately
from
direct
care
11
workers
employed
directly
by
a
facility
or
employer,
and
shall
12
measure
wages
and
benefits
delineated
by
direct
care
workers’
13
years
of
experience
to
determine
the
effect
of
seniority
on
14
current
wages
and
benefits.
A
report
containing
the
results
of
15
the
survey
shall
be
published
on
the
department
of
workforce
16
development’s
internet
site
no
later
than
December
15.
17
Sec.
2.
NURSING
FACILITY
FUNDING
——
REVIEW
AND
18
REPORTING.
The
department
of
health
and
human
services
shall
19
do
all
of
the
following:
20
1.
Review
the
appropriation
made
pursuant
to
2023
Iowa
21
Acts,
chapter
112,
section
30,
subsection
1,
paragraph
“a”,
22
subparagraph
(1),
subparagraph
division
(a),
for
the
fiscal
23
period
beginning
July
1,
2023,
and
ending
June
30,
2025,
for
24
rebasing
of
case-mix
nursing
facilities
including
the
fifteen
25
million
dollars
provided
for
this
purpose,
to
identify
how
the
26
additional
funding
was
utilized
by
the
nursing
facilities
and
27
the
extent
to
which
the
wages
of
direct
care
workers
as
defined
28
in
section
249L.2
were
increased
as
a
result
of
the
additional
29
funding.
The
department
shall
report
initial
findings
and
30
recommendations
by
December
15,
2025,
and
final
findings
and
31
recommendations
by
December
15,
2026,
to
the
governor
and
the
32
general
assembly.
33
2.
Review
the
outcomes
of
initiatives
funded
through
the
34
federal
American
Rescue
Plan
Act
of
2021,
Pub.
L.
No.
117-2,
to
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support
the
health
care
workforce
including
use
of
the
funds
to
1
increase
the
pay
and
benefits
of
direct
support
professionals,
2
and
train,
recruit,
retain,
and
expand
the
direct
support
3
professional
workforce,
to
determine
if
the
initiatives
4
should
be
continued.
The
department
shall
report
findings
and
5
recommendations
to
the
governor
and
the
general
assembly
by
6
December
15,
2025.
7
DIVISION
II
8
DIRECT
CARE
WORKER
MINIMUM
WAGE
REQUIREMENTS
——
MEDICAID
9
PROGRAM
10
Sec.
3.
DIRECT
CARE
WORKER
MINIMUM
WAGE
REQUIREMENTS
——
11
MEDICAID
PROGRAM.
12
1.
a.
Notwithstanding
section
91D.1,
the
state
hourly
wage
13
for
an
employee
employed
as
a
direct
care
worker
by
a
provider
14
reimbursed
under
the
Medicaid
program
shall
be
at
least
$15.00
15
beginning
July
1,
2026;
at
least
$16.00
beginning
July
1,
16
2027;
at
least
$17.00
beginning
July
1,
2028;
at
least
$18.00
17
beginning
July
1,
2029;
at
least
$19.00
beginning
July
1,
2030;
18
and
at
least
$20.00
beginning
July
1,
2031.
On
or
after
July
19
1,
2032,
the
state
hourly
wage
for
an
employee
employed
as
a
20
direct
care
worker
by
a
provider
reimbursed
under
the
Medicaid
21
program
shall
be
increased
by
a
cost-of-living
adjustment
as
22
determined
by
applying
the
percent
change
in
the
consumer
price
23
index
for
urban
wage
earners
and
clerical
workers,
United
24
States
city
average,
as
published
annually
in
October
in
the
25
federal
register
by
the
federal
department
of
labor,
bureau
of
26
labor
statistics.
27
b.
Paragraph
“a”
shall
not
be
construed
to
authorize
a
28
provider
that
employs
a
direct
care
worker
whose
current
hourly
29
wage
is
above
the
minimum
wage
pursuant
to
paragraph
“a”,
to
30
decrease
the
direct
care
worker’s
current
hourly
wage.
31
2.
For
the
purposes
of
this
section,
“direct
care
worker”
32
means
an
individual
who
provides
supportive
services
and
care
33
in
home-based,
community-based,
or
facility
settings
to
people
34
experiencing
health
conditions,
illness,
or
a
disability,
35
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and
who
receives
compensation
for
such
services.
“Direct
1
care
worker”
includes
but
is
not
limited
to
direct
support
2
professionals,
supported
community
living
workers,
home
health
3
aides,
universal
workers,
hospice
aides,
personal
assistants,
4
patient
care
technicians,
consumer
directed
attendant
care
5
providers,
senior
helpers
or
companions,
and
certified
nursing
6
assistants.
7
Sec.
4.
CONTINGENT
EFFECTIVE
DATE.
This
division
of
this
8
Act
takes
effect
upon
the
effective
date
of
an
increased
9
appropriation
to
the
department
of
health
and
human
services
10
for
the
Medicaid
program
to
provide
a
reimbursement
rate
11
increase
to
Medicaid
providers
who
are
subject
to
payment
of
12
the
required
minimum
wage
for
direct
care
workers
under
this
13
division
of
this
Act
in
an
amount
that
offsets
the
increase
in
14
the
required
minimum
wage
paid
by
such
Medicaid
providers.
15
EXPLANATION
16
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
17
the
explanation’s
substance
by
the
members
of
the
general
assembly.
18
This
bill
includes
measures
to
support
direct
care
services
19
and
the
direct
care
workforce.
20
DIVISION
I.
Division
I
of
the
bill
includes
provisions
21
relating
to
support
of
the
direct
care
workforce.
22
Beginning
January
1,
2027,
and
each
odd-numbered
year
23
thereafter,
Iowa
workforce
development
shall
replicate
the
24
survey
entitled
“Direct
Care
Workers
of
Iowa
2019
Wage
&
25
Benefit
Survey”,
released
in
June
2019,
to
survey
wages
and
26
benefits
for
direct
care
workers,
and
publish
the
results
of
27
the
survey
on
Iowa
workforce
development’s
internet
site
no
28
later
than
December
15.
29
The
bill
requires
the
department
of
health
and
human
30
services
(HHS)
to
review
the
funding
appropriated
for
the
31
fiscal
period
beginning
July
1,
2023,
and
ending
June
30,
2025,
32
for
rebasing
of
case-mix
nursing
facilities
to
identify
how
the
33
additional
funding
was
utilized,
and
the
extent
to
which
direct
34
care
worker
wages
were
increased
as
a
result
of
the
additional
35
-3-
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1469XS
(3)
91
lh/ko
3/
4
S.F.
530
funding.
HHS
must
report
initial
and
final
findings
and
1
recommendations
to
the
governor
and
the
general
assembly.
HHS
2
is
also
required
to
review
the
outcomes
of
initiatives
funded
3
through
the
federal
American
Rescue
Plan
Act
to
support
the
4
health
care
workforce
and
report
findings
and
recommendations
5
to
the
governor
and
the
general
assembly
by
December
15,
2025.
6
DIVISION
II.
Division
II
of
the
bill
requires
Medicaid
7
providers
to
comply
with
direct
care
worker
minimum
wage
8
requirements.
The
bill
provides
that
notwithstanding
Code
9
section
91D.1
(minimum
wage
requirements
——
exceptions),
the
10
state
hourly
wage
for
an
employee
employed
as
a
direct
care
11
worker,
as
defined
in
the
bill,
by
a
Medicaid
provider
shall
12
be
at
least
$15.00
beginning
July
1,
2026,
and
the
minimum
13
shall
increase
by
$1.00
per
year
to
at
least
$20.00
beginning
14
July
1,
2031.
The
bill
does
not
authorize
a
Medicaid
provider
15
who
is
paying
a
direct
care
worker
an
hourly
wage
above
the
16
required
minimum
to
decrease
the
direct
care
worker’s
current
17
hourly
wage.
On
or
after
July
1,
2032,
this
state
hourly
18
wage
shall
be
increased
by
a
cost-of-living
adjustment
amount
19
as
determined
by
applying
the
percent
change
in
the
consumer
20
price
index
for
urban
wage
earners
and
clerical
workers,
United
21
States
city
average,
as
published
annually
in
October
in
the
22
federal
register
by
the
federal
department
of
labor,
bureau
of
23
labor
statistics.
This
division
of
the
bill
takes
effect
upon
24
the
effective
date
of
an
increased
appropriation
to
HHS
for
the
25
Medicaid
program
to
provide
a
reimbursement
rate
increase
to
26
Medicaid
providers
who
are
subject
to
payment
of
the
required
27
minimum
wage
for
direct
care
workers
in
an
amount
that
offsets
28
the
increase
in
the
required
minimum
wage
paid
by
such
Medicaid
29
providers.
30
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