As communications director, Sharon Militello is responsible for the design, development, and maintenance of the association website and social media pages; editing and preparation of communications; preparing and running webcasts; cultivating media relations; and maintaining relationships with technology support vendors.
A Texas federal judge has struck down a US Department of Labor rule that would have expanded overtime eligibility to four million new workers. The new rule, which began July 1, was issued under the Biden administration and tweaked the test used to determine whether a worker should be subject to an exemption to overtime pay requirements.
Judge Sean D. Jordan of the US District Court for the Eastern District of Texas granted summary judgment against the rule Friday, finding that it went beyond the agency’s authority and exceeded its statutory jurisdiction.
The decision is a win for the State of Texas and a coalition of business groups who sued over the rule, arguing that the policy would drastically increase payroll costs for employers, resulting in fewer jobs and fewer shifts for workers. This order now applies nationwide.
Under the Fair Labor Standards Act, certain “white-collar” workers can be exempt from overtime pay requirements if they are salaried, make more than a certain amount each year, and work in a “bona fide executive, administrative, or professional capacity.”
The new Biden rule updated the salary portion of the test so that workers making less than $58,656 a year would be automatically eligible for overtime pay any time they worked more than 40 hours a week. It also would update that salary threshold every three years.
The DOL said the rule was necessary to ensure the lowest earning workers were being properly paid for their time.
Ultimately, the court found that the overtime rule set the salary piece of the test so high it made other pieces of the analysis irrelevant, like the consideration of a worker’s job duties. That same legal argument was used by Eastern District of Texas to sink an Obama-era DOL rule in 2017, that similarly sought to expand overtime pay eligibility to more workers.
The court ruling landed just weeks before the second and largest phase of the rule was due to take effect on Jan. 1.
The first phase of the rule, which went into effect July 1, increased the salary threshold for overtime eligibility to $43,888 from its current $35,568. That number was then scheduled to go all the way up to $58,656 in the new year.
RCPA will continue to apprise members of any updates related to the FLSA overtime regulation as more details emerge, including potential retroactivity as well as responses from the Federal Department of Labor and State entities.
You are receiving this communication because you or your group have been identified as someone who works in a health care setting, and we hope you will participate in and disseminate this survey. We are a combined research group representing a relationship between the Penn State College of Medicine and ASERT (Autism Services, Education, Resources, and Training). Through this survey, we hope to gain insight into the feasibility of developing a training/autism friendly certification program for medical staff and health care providers. The program would indicate to patients that staff within the health care setting are knowledgeable and supportive of people with autism. Your feedback is invaluable to us, and all responses will be kept confidential. Should you have any questions, please feel free to reach out. The survey should take approximately 5–10 minutes to complete. The deadline to complete the survey is January 10, 2025. View the flyer for more details. To take the survey, please use this link.
For your next business meeting/event in the Harrisburg area, consider using RCPA’s facility, located at 777 East Park Drive, Harrisburg, PA. Close to downtown, local hotels, and restaurants, making it a convenient location for your organization’s needs. View flyer for details and pricing.
Congratulations to our very own Richard S. Edley, PhD, President and CEO of the Rehabilitation and Community Providers Association (RCPA). Richard is among an exclusive list of difference-makers named by City & State for their work in politics, policy, and beyond. Congratulations to Richard! Check out his profile here.
Improving access and quality of care for individuals with intellectual and developmental disabilities (I/DD) has been a challenge of policy and practice. On the policy side, there is a lack of a comprehensive framework to address the gaps in services—and funding for I/DD services can be inconsistent and insufficient.
In a recently published consensus statement, “National Goals to Advance IDD Health Outcomes That Matter”, 43 national goals were set to address the policy gaps leading the practice performance problems (see Advancing Health Policy and Outcomes For People With Intellectual Or Developmental Disabilities). The goals address 3 major areas for new policy to improve practice: data collection and quality measurement, coverage and payment for services, and development of the clinical workforce and shared infrastructure. The consensus statement was developed with more than 180 contributors including people with an I/DD, caregivers/partners, family members, (or others who support someone with IDD), clinicians, payers, and regulators.
The framework’s goals for data collection include national EHR standards and performance reporting standards for I/DD consumer services. In the area of benefit coverage, goals included mandating enhanced benefits (to include dental, vision, and mental health coverage) for I/DD consumers and requiring care integration. Another goal is the designation of the I/DD population as medically underserved, providing financial incentives for clinicians to have specialized training.
While policy goals like these serve as a ‘north star’ for the field, provider organization managers are working through the reality of I/DD system changes on the ground. We got a first-hand look at how one executive team addressed a changing I/DD services landscape in the session, Navigating The Move To Waiver Programs In The Managed Care Era: The Rock Creek Foundation Case Study during The 2024 OPEN MINDS I/DD Executive Summit. Najla Wortham, President at Rock Creek Foundation, told the story of how Rock Creek navigated the transition to a new fee-for-service (FFS) payment model in three separate Medicaid waivers (Community Pathways, the Family Supports Waiver, and Community Supports Waiver) of the Maryland Disabilities Administration.
Ms. Wortham said that detailed advance planning for this change in reimbursement was critical to Rock Creek’s success. She outlined three key elements in their transition plan: assessing the current service lines, preparing for the administrative infrastructure necessary to adopt the new payment model, and planning a phased implementation.
To move from cost-based reimbursement to FFS for the waiver program, each consumer’s person-centered plan (PCP) needed to be approved for the entire year. So, Rock Creek had to be sure families were aware of all the available services so they could project what additional services the consumer might need throughout the year. To do this, they developed a visual of the inventory of Rock Creek service lines to ensure all state coordinators, staff, family members, and consumers knew about all available services from the outset.
“It was critical to provide a visual to families depicting the services and supports that we offered when we were developing their PCP”, said Ms. Wortham. “Prior to the transition to FFS, the annual goal development process was exactly that—you met with the individual and their team, and you developed goals to track for the upcoming year. But with the PCP came service authorization based on the plan year, so we needed to project any additional services that the person may need throughout the plan year.”
Second, the Rock Creek team planned in detail for changes to the administrative infrastructure required for moving to FFS reimbursement. “We had to align all of our organizational documentation with DDA’s and with the rules and regulations of their long-term supports and services (LTSS) program. We enhanced our electronic medical records to system to make sure that it had the capabilities and capacity to bill to batch and to audit the staff’s documentation,” Ms. Wortham commented. “Plan for how you’ll comply with new procedures, regulations, and paperwork, such as EHR revisions, documentation/reporting, permissions adjustments, and compliance processes.”
One area of focus was working with their direct service providers on how to create quality documentation and provider notes. As Ms. Wortham explained, “That note becomes your bill—it gets submitted into the system, and if there’s any deviation from alignment with the PCP, any deviation in time, if your staff’s time sheet does not align with the claim that you submitted, if the trainings that your staff have are not adequate or are not in line with the new service definitions, then you are subject to claw-backs of claims.”
Lastly, Rock Creek took a staggered approach to transitioning services. “We decided to transition our residential services first because we felt that in the FFS payment model, that that was the service most easily controlled. We didn’t really have to deal with issues of utilization or staff productivity, so we knew that we could safeguard our revenue, mitigate any financial risk, and review any lessons learned. We did this before we transitioned our remaining services, which were much more reliant on productivity, documentation, requirements, utilization, and acuity.”
Ms. Wortham also emphasized the importance of an internal transition team. “Our team included staff from across our organization, so our admin teams associated with our DDA programs, our compliance department, our finance department, as well as our outside consultant worked tirelessly to make sure they were looking across all of our services, to ensure all of our business collateral was in line and could support the transition.”
And Rock Creek met weekly with their DDA regional transition team to ensure all of the changes that they were making and at the organization level were in line with the state requirements and matched what the state had in their system. “Every time we made a change internally, we met with our DDA regional office.”
Above all, said Ms. Wortham, it was a major cultural shift for Rock Creek Foundation. How did they handle that? “We were very transparent across the entire organization as the why behind the shift—we have a lot of DSPs that have been with us for a very long time, and they felt like this new level of documentation was taking away their interactions the individuals they supported and have built these connections with. It was very important that we started with the “why”. We have to do this. The state is transforming. The state is enforcing this. So, in order for Rock Creek to be sustainable, here’s what we’re going to have to we’re going to need from you, but here’s the ways we can support you.”
For more on I/DD services, check out these resources in the OPEN MINDS Industry Library:
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