Mark Hassemer

Dear Friends of ACT,

Sometimes you take two steps forward, then one step back. That may be what’s happening with funding for providers like ACT.

About a year ago we were celebrating an unprecedented funding increase resulting from action taken by the Missouri legislature. ACT and other agencies like us received a cost of living adjustment (COLA) and increased revenues as a result of “rebasing” providers’ rates. It came at a very important, perhaps critical, time.

Rebasing sets a new base level for the compensation percentage to providers. And as I’ve said here before, the job’s not done. We still need to cover more ground to meet the recommended standard.

But what a difference a year makes. It looks like the other shoe might drop.

In his first budget, newly elected Missouri Governor Eric Greitens has proposed to end State-funded care for more than 20,000 Missouri residents by requiring people to display more severe disabilities to qualify for in-home care or nursing home services.

That would save over $50 million in State revenues, as well as more Federal dollars. The Governor’s budget also proposes a 3% rate cut to service providers like ACT.

As we’re being reminded by events playing out at the Federal level, the chief executive does not set the budget. The legislature does.

To add yet another metaphor to this discussion, the ball is now in the Missouri legislature’s court. Members of the House Budget Committee have offered budget bill substitutes, including a move that would reduce the proposed rate cut from 3% to 1.5%. Another proposal would add $5 million in new funding for Developmental Disabilities (DD) Provider Rate Rebasing.

These are bills. Not laws. Once the Budget Committee is done, the bills go on to other committees, the full House, and then the Senate.

In other words, we have a long way to go. But appropriations are important, usually a top priority for the General Assembly.

And that’s just Missouri. Even though Friday’s expected vote on the American Health Care Act (AHCA) of 2017 didn’t happen, change may still come at the Federal level, too.

As I’m sure you know, the replacement bill was pulled because Congress could not get the votes to pass it. For now, the Affordable Care Act (Obamacare) stands. Medicaid remains unchanged at this time.

We are close to the day-to-day action. We see what’s being done under Medicaid. I’m not blind to the problems. Medicaid needs reform; but not on the backs of our most vulnerable citizens.

ACT has experienced much-needed change in recent years. Rebasing and COLA have helped a lot. We’ve been able to take two major steps by adjusting the pay of all ACT employees and aligning other salaries to be closer to comparable salaries nationwide.

But more adjustments in how we compensate staff are needed and, in fact, planned. But we can’t forge ahead without stability. Plans are on hold until we know whether we really will take one step back.

I’ll watch closely as final actions are taken and report back to you as we are able to advance the cause of better providing services needed by people with disabilities.


Until Next Month,

Mark Hassemer