ICIE Iowa and Federal Updates

5:19PM Feb 18, 2021

Speakers:

Kari Tietjen

Julie Christensen

Amy Desenberg-Wines, ICIE

Bill Stumpf

Keywords:

support

iowa

providers

people

disabilities

minimum wage increase

piece

stimulus package

phased

pandemic

wage

job

senate

thinking

funding

appropriation

stimulus

bill

julie

state

Hi, this is Julie Christensen with APSE see, we're excited to launch the app, see employment, first employment for all podcast as a new way to connect with you. This podcast is a way to provide updates, real time advocacy alerts, and information related to all things employment. First, be sure to subscribe so you don't miss an episode. And thanks for listening.

So I think we all know, I hope that there has been a change in the president a change in the majority Well, not sort of, in the in the Senate. It's a 5050 split in the Senate, which makes it technically democratic lead, because we have a democratic president and vice president. And if the Senate is tied, it's the vice president who breaks that tie, and the Vice President is a Democrat. So theoretically, you can say that the Senate is democratic LED, the house remains democratically led as it was the last session, but with a much narrower margin than it was what we are learning over the past six weeks or so is that in some respects, congressional action is going to be even harder to navigate than it was the last couple of years. The good news is that philosophically, some of the issues that we've been talking about over the last couple of years, you know, from a disability rights standpoint, and and certainly in promoting employment, first, we've been very much on the defensive with trying to just kind of move, trying to stop dismantling of the laws that we have in place and dismantling of some of the funding streams that we rely on that piece is better. We feel pretty confident, you know, that this administration is going to be fully supporting, you know, full moving forward on the laws that we have in place for ADA compliance, that moving forward on implementation of wi o A, which is up for reauthorization, but we're cautiously optimistic that we won't take that on this year.

IDEA's enforcement's certainly, you know, thinking about CMS and HTTPS compliance, you know, these are all pieces and parts that have been a little fuzzy the last couple of years. And so now it's an issue of sort of compliance and what we what states need, recognizing that we're also in a pandemic and a fiscal crisis. So lots to do. That being said, the the temperature in DC is completely partisan.

All

decisions are along party lines. And it there does not seem to be at least right now a heck of a lot of willingness for bipartisan compromise in communication. Hopefully, that'll change as people get their, you know, sea legs, so to speak. But that is definitely the culture right now. And that certainly impacts some of the work that we're trying to accomplish.

And so let me just kind of explain, you know, kind of where we're at. So, so far, there's only two federal bills that have been introduced, that we are that national APSE anyway, is supporting. One is the National apprenticeship act.

It has passed in the House but is now stalled because there is no companion Senate Bill. But this particular legislation, we were really excited to have the authors specifically reach out to the disability community to say, you know, when we think about expanding apprenticeships, what do we need to be thinking about in terms of pathways for especially youth with disabilities into apprenticeship programs. So that I think is kind of a bigger sign of certainly from Department of Labor and others who are pushing these issues that they really are thinking about broader inclusion in apprenticeships at large. So we're keeping an eye on that. But right now, it doesn't look like the Senate has much will to move forward on that piece of legislation. So it might just sit well, we'll have to kind of see where that is going.

Raise the wage act is the other big piece. So the raise the wage Act has been introduced both in the House and the Senate. And to just kind of reorient folks, this is the same legislation that was introduced in the last Congress, that does a couple of things. One is it phases a minimum wage increase from currently 725 an hour to $15 an hour. So sometimes the media calls it raise to 15.

Say same sort of thing. And it also raise the wage act phases out the use of 14 c certificates and sub minimum wage for people with disabilities. So this is where I'm like, I don't even know what to say, because it's complicated. So that that legislation has been introduced. However, as you are probably hearing in the news, there is an effort to address the minimum wage through the stimulus package, which involves complicated things around budget reconciliation that I just, you know, have friends that understand, and I trust what they tell me, because it hurts my brain.

So at this point, here's what we know, the house bill will include does include both the $15 minimum wage increase, broadly, and the elimination of 14 c that is in the house package for the stimulus slash budget reconciliation, that has a couple of pieces that has us, you know, kind of paying close attention. One is, you know, obviously, the 14 c pieces is what it is. But $15 minimum wage increase also has implications for the provider community that relies on reimbursement from Medicaid and VR. And so raising the minimum wages of job coaches and job developers and personal care folks, and all of that to $15 an hour without a simultaneous increase in available funding through Medicaid and other sources is going to be problematic. So we are working on kind of the parallel piece of what is needed in legislation to adjust for that. important to know though that this is a phasing, it does not happen immediately. It's a phased in over a five year period of time. So it does give some time to figure out kind of how we simultaneously look at corresponding funding increases that would be needed to sustain the workforce from APSE perspective, we fully support raise the wage. It's a little bit controversial, and we're one of the few national organizations that has taken this position. Some of you may remember there's a transition to competitive employment act that was introduced in the last Congress that includes some additional funding for states and providers. And so previously, you know, APSE supported that bill, because it theoretically would involve an additional $300 million worth of appropriations. At this point, APSE, he has shifted its stance and we are fully supporting, raise the wage even without that appropriation for a couple of reasons. One is that fundamentally, we believe that people with disabilities being exempted from the federal minimum wage is a civil rights violation.

Secondly, that we believe very strongly in the need to compensate professionals in our field who do amazing work and are not always seen as the credible workforce that they are. And so the minimum wage increase is something that we support as well recognizing the need to figure out how to wrap and support the system around making that happen. And we also know we are also working separately with Congress on thinking about ABLE Act expansion. mechanisms for benefits advisement, that would also need to be considered, because the minimum wage increase from 725 to $15 an hour for individuals with disabilities working is something we need to consider.

So as an example, if somebody is working, let's say 10 hours a week at 725 an hour, and that keeps them below their benefits threshold, and then all of a sudden, they're making $15 an hour and they're over their benefits threshold, it is highly unlikely that the average business is going to say sure, you can work five hours a week that works for us. So there are some pieces and parts we need to be thinking about as we look at this from a broader perspective. So I would say the minimum wage increase with the simultaneous a 14 C is taking up the majority of the oxygen in the disability policy space.

And we're taking a look at it it is entirely possible that all of this will be pulled out of the final stimulus package on the Senate side.

Senator Sanders feels very strongly that he has made the legal case for why it should stay in. But ultimately the parliamentarian is going to need to make a call on that. So if right now there is not a huge push on raise the wage because we're waiting to see whether we have to think about 14 c separately from the stimulus package, at In which case, if if the stimulus package moves through as it's currently written in 14, C is phased out, then it's going to be full court press for passing the transition to competitive employment Act, which has not yet been reintroduced, but has been rewritten, and is pending the decision of all of this, in terms of thinking about the added appropriations, we need to support providers to transition to new business models, and away from 14 C. So that is all of that.

What else there is in the stimulus in the current version of the stimulus, a f map increase? And does it needed home and community based services funding?

Which we absolutely support, it does look like in some way, shape or form there will be HCBS funding included in the stimulus package. If you are saying yeah, sure heard that before. I don't believe you I completely sympathize, because this is what round four of COVID stimulus and we've yet to see it happen. But the White House is really pushing this. Both sides of Congress are really pushing this as a priority. So we're we're cautiously optimistic, with the caveat that from APSE perspective, we are not holding our breath that any of that funding will trickle down to employment services and supports, because there's incredible need across all of HCBS services. So we'll have to see where we went with that. So that's kind of what's happening on the federal level, I'm just going to do a quick screen share, because in the midst of all this, we know we do still have a pandemic and a crisis that is seems to not be going away. I'm sorry, I just shared and then we'll have to unshare because I did things in the wrong order. So I'm just going to quickly give you a little bit of highlights of APSE COVID impact survey. I know we presented on this to you guys once before, but we needed to get some 2021 data to inform the stimulus package negotiations. So just wanted to share a couple of highlights. I'm not going to go through all of this. But I will send the slides to Amy and just so she can get them out to you.

This is the first time that we've kind of looked historically. So we now have three data points. We've collected data in August, October, sorry, October and June, sorry, I'm doing this backwards. We collected data in sort of July, August timeframe, then again in September, October and then again in January. So when you look at kind of the trends over time, what we are seeing is that day habilitation programs in general, whether they're facility based or community based, have taken the biggest hit in terms of service closures.

Early on in the pandemic, we saw huge closures in supported employment, but that has recovered quite a bit largely due to greater flexibility in remote services. And in working some of those kinks out with Medicaid and vocational rehabilitation. But these are things that we are keeping an eye on.

Interestingly, we are now starting to see in the January data, a slight uptick in provoke community based revoke, while simultaneously a decline in facility based day habilitation programs. So we're keeping an eye on this because this is obviously the trajectory we want to go in. But unclear what is causing that. And there certainly is a lot of concern, especially with 14 c phase out. Are there going to be programs and services for people with significant disabilities. And what does that look like. But we'll keep an eye on that moving forward. The other piece that is concerning to us is that we've been tracking the net, what the anticipated net job loss of direct support professionals and employment services so job coaches and job developers specifically. And this is starting to trend a little bit upwards. In our June and August time points. It was consistent that so what we're looking at is the number of positions that have been lost during the pandemic. And comparing that to provider reporting. The unlikelihood of rehiring those positions back as the economy recovers And so that kind of gives us a net sense of positions lost in the field. And it was steady at 22% in June and in September. But moving forward into January, we're seeing that that's starting to trend upwards, which is alarming. Because simultaneously, we also know that providers have had more access to relief funding through the PPP loan and through some other mechanisms. And so that's not good news, um, job loss for people with disabilities, we're seeing some recovery from the very early stages. But I want to talk a little bit about job gains, because this is actually exciting to me to take a look at. Because we are seeing steady increases for job gains for people with disabilities. And what I am happy to see is that some of the sectors that have become sort of the booms in this economy are sectors that supported employment providers and others are successfully building strong relationships with and developing pathways for people with disabilities to be successful. So we're, you know, the growth is in retail distribution, in frontline, retail, specifically grocery, you know, that type of thing, but also manufacturing and healthcare services.

So those job sectors are growing exponentially right now. And people with disabilities are successfully getting connected to those types of jobs, which is good news, but also speaks to the reason why the support structure of you know, the service structure is so important, critically important, and we need to make sure that we get relief sooner than later. So speaking of relief, this has been I think, the good news, over the course of the pandemic, we were looking at the PPP loans, which right now is the only relief available to disability employment providers.

And in the beginning of the pandemic, we were seeing only 50% of providers applying and of that 50%, only 45 actually successfully getting alone. Fast forward to January, where we now see that 95 96% of organizations that have applied for a loan received alone. What's good about that is that APSE II and other organizations have worked really hard on the advocacy behind the scenes on the implementation of the PPP loan, making the application process easier, making the loan forgiveness process clearer, as well as the forgiveness application process, which has just rolled out. So so this is good news in terms of just taking advantage of the the stimulus that is available and making sure that our community has access to it and is gaining from that. But this is where we're at. So without further relief, what we are hearing across the country, 41% of providers are saying that they are concerned about the long term sustainability of the organization, and 84% are 84% believe that current events as they are right now are going to result in widespread closures of crps across the country. And this is why we need Congress to really take action and think about the service supports for people with disabilities broadly, but also specifically for employment services and supports, because the way that we recover as an economy is getting people to work. And that includes people with disabilities who we've already shown in the job growth slides are able absolutely able to fill emerging available positions and in do so safely and successfully. So I will stop there. What questions can I answer?

Oh, no, I'm just depressed everybody.

Well, Julie

Hi, it's gonna be I just put in the chat that it sounds like we should also be advocating for higher asset limits right now, if minimum wage is going up. And I also was thinking about some of the data you've shared before with me, and then conversation is where jobs are going to come back. And what what jobs are not going to come back that the last year has done 10 years of advancement in terms of technological work, and jobs being replaced by automation. You mentioned retail, and so I just see some concerning numbers and trends. But if those jobs are coming back, what does that look like in Iowa? And I'm curious what crps are seeing for which jobs are coming back?

Yeah, and I would carry to that point, I would really encourage all of you and I'm glad you have Brian on this call because he's your part.

In this in really starting to track where the opportunities are in your state, because they are going to be there, it's going to vary state to state, we kind of have some sense of trends from a national perspective. But that's not overly useful. You know, to those of you who are living and working in Iowa, knowing your own specific economy?

Of course I do. Right, but I wasn't going to. But I, the shift is interesting to me, because I've really haven't educated myself on the, you know, the 14 seat stuff in the last few years. And you know, Kyle and I have been advocating for that really strongly.

But I guess I feel like I'm stepping back a bit because I am concerned, I do work for a provider, and I just know their mentality. And they're just gonna balk at this. And I and I worry about their lobbying groups, because they're powerful. In fact, just this week, in the Iowa house, we fortunately, were able to move some legislation out of a subcommittee that would create a registry for people but just that the provider networks and and their lobbyists are dead set against it. And the nursing home lobby is huge. And their concern, quite frankly, is that it's going to lead to them having to pay more wages, which we want. But without those supports. And I just wonder if as they do the markup on the raise the wage Act, or however this proceeds, will there be some good negotiations to get some of that transformation language in there to support the States? I just feel like we're gonna be hitting a brick wall with this if we don't.

Sorry, that's just kind of, you're right. And we've had a lot of conversations about this. And so there's a couple of answers, depending on what lens you want to use. Your your final end question about, you know, will there be added resources on the sort of 30,000 foot view level of raising the wage? That is part of the discussion? It is, and it's important to note that this is a phased in? It's not a $15 an hour starts tomorrow.

And that's part of the difficulty with the messaging is that everyone's projecting, Oh, my gosh, I have to pay somebody $15 an hour, you know, next week, and that's not accurate. It's over a period of time with thinking about subsequent other supports and services.

I will be honest, that that the transformation language that I think you're referring to, specifically related to the employment services sector, will not be part of the negotiations for raise the wage.

It will need to be a separate bill. And in a in a separate appropriation. It's just so one of the messaging pieces that we're trying to really get across is that when we are talking about 14 C, currently, according to our data, which only reports active certificates, of which we know there are many pending, but there's 55,000 individuals in 14 c across the country. That is a significant decrease in even where it was six months ago, where it was over 100,000. So 14 c is a pretty in the grand scheme of things. It's a pretty small population. Where it's hard to have these conversations within our space is the commingling of 14 SSI with Medicaid funded prebook. Medicaid funded pre boek is not changing. 14 C has nothing to do with settings. It doesn't close, for lack of a better term sheltered workshops. It only applies to those individuals who are being paid below the minimum wage. And we have that data for how many of those individuals there are in iOS. So you could look at that impact. But that's what gets conflated in some of these conversations.

And makes it hard to kind of think it through and also the reason, quite frankly, that APSE, he shifted our position to support raise the wage in full, because we are seeing dramatic decreases in utilization of 14 c anyway. As young people are moving out of school they don't want 14 see as an option. And it's really hard to have legitimate policy and funding conversations about what the service industry needs. When we have this commingling of two different systems that don't relate to each other. Because the average person does not understand that the average provider struggles with it. God knows the average parent has no idea. And so they're hearing working see thing and thinking my son or daughter is not going to have a place to go next week.

That's not accurate. That's so there from APSE's perspective, we want to just get the 14 C piece done. Because then we can really look at the Medicaid system broadly. Figure out what needs to happen in order to support people where they need to be, and we can't have that conversation claiming right now. Absolutely. And, you know, I support I mean, I just, but I also and, you know, our story, and our story is that I was afraid of what would happen and, and, and he was safe, and everything was hunky dory. And that's not uncommon among parents. What worries me, completely important to think about in the midst of a global healthcare crisis. Right. So that layer? Yeah, exactly. And people want to know, that they're taking care of and they're safe.

Sure, right. And that that's where we were and, and, and, but yet, I tend to have a little more of an open mind. But there's a lot of folks that don't, but I'm still trying to educate. But I guess going back to an I don't want to take up all the time, the oxygen but the, the the $15 an hour minimum wage, and I think you've got to look at what has happened. And and I'll use the Illinois as an example. And I get the phase and I get it, a lot of providers are just going to look at it, and they're going to hear that. But they're still going to hear that end game. And now there was a rehab agency, and I won't name the name because they're in Iowa too. But they immediately fired a bunch of people because they because they they raise the minimum wage, and oh, no, I but that was a phased in as well. So it just worries me. So be ready for the backlash. And I'm sure y'all are, I mean, but also have talking points for people to, to try to get through that, because I just can feel people already coming to me and say, Hi, Bill, I told you. So that's why this was gonna roll you know. And, and, but that's the reality for me. And I don't know if others that work for agencies run and provide some input to that, but I get it, and I'm for it. But also, we've got to get some good talking points to push the story. Yeah.

And they're not easy talking points, which is all part of the issue. And, and so take it a step back, because we all all of us look at public policy from our own day to day lens, right? Like, yeah, exactly we do in the work that we do every day and where our paycheck is coming from, and can we pay that paycheck, if you but from a federal policy perspective, if you can take a larger step back one way or the other, we pay for this, right, like, so if people are, you know, laid off, then we're paying for it through unemployment benefits and other things. And so, you know, we have a bigger crisis in the country around poverty, that, quite frankly, has been at the forefront of disability forever, since the dawn of time, that now the broader country is starting to understand in new ways, because we haven't had this type of unemployment and fiscal insecurity since the Great Depression.

And so, you know, there's a bigger economic piece around, you know, doing what we need to do for people with disabilities and people without to make sure that people are, are able to live so that we can save in other places. And those are those are not easy. Let me put this in a bullet point. Bullet talking point for you.

Yeah, Julie, I want to, I want to add a comment. And then I have a question for you as well.

So recently, excuse me, Gayla did in partnership with our ivrs work, and the coalition outreach and had conversations with all of the 14 seed providers in Iowa. And kind of looking at sort of where they're at. And and we've done support and engagement now for a number of years with the 14 c certificate holders in the state. And I think as you look at those numbers, which I'm sure you're aware of, but one of the things that that we're seeing, which is really concerning is that even though the numbers of folks maybe engaged in 14 C are much lower than they were when WIOA was implemented. There's huge numbers of people who were shifted into day habilitation.

So those numbers aren't necessarily representative of people who would be working or went to work but maybe for a number of reasons. Sometimes because of the settings rules looking like they were on the horizon or because of regions stepping away from supporting some of those services. But it's really concerning that folks are just being shifted.

And then that the question I had for you, there was a number of things that you shared that was just really rich, I think and so important that, and I think you might have kind of touched on this in your last comment before I started talking, but what can we do? What can we do? You?

There's sort of a number of different pieces. But one, the data that you're showing about providers and the impact of providers and the providers might close,you know, what can we do about that? And as well as then, you know, are there ways to engage even if not a lots been introduced, but the kinds of things you and Bill were just discussing? Is it is it a matter of just reaching out and asking, and, and truthfully, I don't know, in those last few years, I felt like that hasn't made a damn bit of difference.

So, so sorry, um, what would you recommend being somebody who's kind of in the trenches there clearly, with APSE See, you guys have kind of this larger voice, but what can we as individuals do, that you think, is worthwhile?

Thanks for asking easy questions to me. I'm sorry. Well, um, I mean, the answer is we just we need to keep advocating, with our elected officials, you all in Iowa have a challenge, in that you have two senators who are not probably going to do anything that isn't strictly party line.

That's, that's the political reality. That doesn't mean, though, that we're off the hook in continuing to put pressure on them To let them know what's important. You have a little bit more support a lot more support on the House side, but the house has already pushed this through the issue in the Senate. Right.

So you know, so that that is, that is a piece of it. Um, I will also say that, you know, one of the things that absolutely, National APSE he is doing is shifting some priorities in our funding to get some additional resources to support state chapters, to do more targeted work in states. Because, quite frankly, you might need to be doing more in terms of your state legislature to address the issues of Iowa. And that might be a better use of your time. I hate to say that, because my my federal answer is always keep telling your members of Congress that, you know, they work for you. But you guys are in a unique situation with your particular two senators.

And, you know, I don't mean that as a partisan, anything, it's just a reality that, you know, there are there's a line in the sand that's been drawn politically right now. And everything that is happening is happening based on tribal lines, and not on philosophy. Senator Grassley, and Senator Ernst, quite frankly, with her, her support of the veteran community have been allies on the disability front.

But that is over run by the fiscal reality of the partisan divide in Congress right now.

So but, Julie, have you looked at Iowa's makeup in politics lately?

Quite frankly, there's nothing really significant that's going to come out of the Iowa legislature or the governor at this point. I don't want to sound like a Donnie downer. But we at least we got, we're looking for little victories. And I think if we can work and get that, that little piece that that registration there, you know, that you know, for for, for caregivers, but that's small, but it there's a lot of bills in there, but they're not going anywhere

And you know, Bill, this is a long game. And you know, as we think about some of these federal initiatives, you know, it's an opportunity for you guys to be really getting the message out about what this is going to mean for Iowa Governor's up for election in two years. Right. You know, you could have a very different administration within your state willing to look at different types of problems that need to be solved, but you need to start doing that messaging now.

And use use what is happening federally, as a reason why Iowa needs to figure it out, you know, because if these are decisions that are going to be made on high, you know, and we all know that it takes the federal government forever to, you know, figure out how to support decisions from on high, you know, Iowa and other states are going to have to be at the forefront of figuring out what that all means.

Sorry, Donnie downer. I mean, I just, I look at the reality of it. And, and, and we are working on a lot of things right now in terms of, you know, but it's just really, it's gonna take a while I and I get, it's a long game. But in Iowa, quite frankly, it's gonna take a long, long time. It just is.

You know, I think the best thing that we could hope for at this point is a change in the governor's mansion. You know, as far as the the Senate and the House, I think it's a long, long way. But just looking at the numbers, I don't know if anybody else wants to, and I don't want to take up all the time, I just, you know, it's, it's, I'm in here, I'm in there. I know you can be real honest about, you know, what I feel like we're up against. So we'll get there.

And so one thing we all can do, and one of the reasons why I love coming to these ICIE meetings, and I'm so honored that you guys keep inviting me is that we just have to support each other, because this is going to get worse before it gets better. And it is really easy to go down the rabbit hole of nothing we do is going to matter. And that's probably true in the short term on many of these things. But it is a long game. And so you know, creating these spaces, where where people, you know, can come together and lift each other up.

Because at the end of the day, it's people with disabilities that we care about and are trying to make sure you know, have a better outlook for living self determined lives. And none of that in the bubble.

Thank you. And Amy pulled me out of that rabbit hole long time ago, and I'm not about to go back in anytime soon. So you guys are stuck with me.

Julie,

Do we have any other questions or comments for Julie?

Which bill?

For the 15 minimum? The Federal bill? Oh, oh, hang on. I'm not on it. Okay, so let's see raise the wage federally the house bill is hr 603. And the Senate Bill is S 53. I can throw that in the chat too.

Other questions or comments?

Julie, thank you so so much.

Oh, you're welcome. You're welcome.

Really good information. Great. We appreciate your time and your work. I appreciate all

work.

I appreciate all

But I did want to take a moment to thank e constants for hosting the webinar today. also wanted to thank Dale and khari for their great presentation. And thank you to all you for being here and watching. If you don't mind, it would be really appreciated if you could fill out our feedback form. So you, we can get some feedback about how we did today and get some input from you about some topics that might be of interest to you in the future. Please tune in next month for our implement first Community of Practice webinar. It'll be about an online dialogue that Oh, that's held deaf in October and about the strategies that providers are using during this pandemic that we find ourselves in right now. So again, thank you and if you're not already subscribed, please subscribe to our community of practice so you can stay up to date on everything that's happening. Take care everyone, have a good day.