SF 530 (LSB 1469XS (3) 91)

SENATE FILE 530

BY  CELSI

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 a contingent effective date.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

DIVISION I
DIRECT CARE WORKFORCE SUPPORT PROGRAMS

    Section 1.  NEW SECTION.  84A.22  Direct care workers —— wage survey.
   Beginning January 1, 2027, and each odd-numbered year thereafter, the department of workforce development shall replicate the survey entitled “Direct Care Workers of Iowa 2019 Wage & Benefit Survey”, released in June 2019, to survey wages and benefits for direct care workers. The survey shall measure the wages and benefits of direct care workers employed through temporary staffing agencies separately from direct care workers employed directly by a facility or employer, and shall measure wages and benefits delineated by direct care workers’ years of experience to determine the effect of seniority on current wages and benefits. A report containing the results of the survey shall be published on the department of workforce development’s internet site no later than December 15.
    Sec. 2.  NURSING FACILITY FUNDING —— REVIEW AND REPORTING.  The department of health and human services shall do all of the following:
   1.  Review the appropriation made pursuant to 2023 Iowa Acts, chapter 112, section 30, subsection 1, paragraph “a”, subparagraph (1), subparagraph division (a), for the fiscal period beginning July 1, 2023, and ending June 30, 2025, for rebasing of case-mix nursing facilities including the fifteen million dollars provided for this purpose, to identify how the additional funding was utilized by the nursing facilities and the extent to which the wages of direct care workers as defined in section 249L.2 were increased as a result of the additional funding. The department shall report initial findings and recommendations by December 15, 2025, and final findings and recommendations by December 15, 2026, to the governor and the general assembly.
   2.  Review the outcomes of initiatives funded through the federal American Rescue Plan Act of 2021, Pub. L. No. 117-2, to support the health care workforce including use of the funds to increase the pay and benefits of direct support professionals, and train, recruit, retain, and expand the direct support professional workforce, to determine if the initiatives should be continued. The department shall report findings and recommendations to the governor and the general assembly by December 15, 2025.
DIVISION II
DIRECT CARE WORKER MINIMUM WAGE REQUIREMENTS —— MEDICAID PROGRAM

    Sec. 3.  DIRECT CARE WORKER MINIMUM WAGE REQUIREMENTS —— MEDICAID PROGRAM.
   1.  a.  Notwithstanding section 91D.1, the state hourly wage for an employee employed as a direct care worker by a provider reimbursed under the Medicaid program shall be at least $15.00 beginning July 1, 2026; at least $16.00 beginning July 1, 2027; at least $17.00 beginning July 1, 2028; at least $18.00 beginning July 1, 2029; at least $19.00 beginning July 1, 2030; and at least $20.00 beginning July 1, 2031. On or after July 1, 2032, the state hourly wage for an employee employed as a direct care worker by a provider reimbursed under the Medicaid program shall be increased by a cost-of-living adjustment as determined by applying the percent change in the consumer price index for urban wage earners and clerical workers, United States city average, as published annually in October in the federal register by the federal department of labor, bureau of labor statistics.
   b.  Paragraph “a” shall not be construed to authorize a provider that employs a direct care worker whose current hourly wage is above the minimum wage pursuant to paragraph “a”, to decrease the direct care worker’s current hourly wage.
   2.  For the purposes of this section, “direct care worker” means an individual who provides supportive services and care in home-based, community-based, or facility settings to people experiencing health conditions, illness, or a disability, and who receives compensation for such services. “Direct care worker” includes but is not limited to direct support professionals, supported community living workers, home health aides, universal workers, hospice aides, personal assistants, patient care technicians, consumer directed attendant care providers, senior helpers or companions, and certified nursing assistants.
    Sec. 4.  CONTINGENT EFFECTIVE DATE.  This division of this Act takes effect upon the effective date of an increased appropriation to the department of health and human services for the Medicaid program to provide a reimbursement rate increase to Medicaid providers who are subject to payment of the required minimum wage for direct care workers under this division of this Act in an amount that offsets the increase in the required minimum wage paid by such Medicaid providers.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill includes measures to support direct care services and the direct care workforce.
   DIVISION I. Division I of the bill includes provisions relating to support of the direct care workforce.
   Beginning January 1, 2027, and each odd-numbered year thereafter, Iowa workforce development shall replicate the survey entitled “Direct Care Workers of Iowa 2019 Wage & Benefit Survey”, released in June 2019, to survey wages and benefits for direct care workers, and publish the results of the survey on Iowa workforce development’s internet site no later than December 15.
   The bill requires the department of health and human services (HHS) to review the funding appropriated for the fiscal period beginning July 1, 2023, and ending June 30, 2025, for rebasing of case-mix nursing facilities to identify how the additional funding was utilized, and the extent to which direct care worker wages were increased as a result of the additional funding. HHS must report initial and final findings and recommendations to the governor and the general assembly. HHS is also required to review the outcomes of initiatives funded through the federal American Rescue Plan Act to support the health care workforce and report findings and recommendations to the governor and the general assembly by December 15, 2025. 
   DIVISION II. Division II of the bill requires Medicaid providers to comply with direct care worker minimum wage requirements. The bill provides that notwithstanding Code section 91D.1 (minimum wage requirements —— exceptions), the state hourly wage for an employee employed as a direct care worker, as defined in the bill, by a Medicaid provider shall be at least $15.00 beginning July 1, 2026, and the minimum shall increase by $1.00 per year to at least $20.00 beginning July 1, 2031. The bill does not authorize a Medicaid provider who is paying a direct care worker an hourly wage above the required minimum to decrease the direct care worker’s current hourly wage. On or after July 1, 2032, this state hourly wage shall be increased by a cost-of-living adjustment amount as determined by applying the percent change in the consumer price index for urban wage earners and clerical workers, United States city average, as published annually in October in the federal register by the federal department of labor, bureau of labor statistics. This division of the bill takes effect upon the effective date of an increased appropriation to HHS for the Medicaid program to provide a reimbursement rate increase to Medicaid providers who are subject to payment of the required minimum wage for direct care workers in an amount that offsets the increase in the required minimum wage paid by such Medicaid providers.