Homecare

Who we are…
SEIU Local 503 represents more than 20,000 homecare workers in the state of Oregon. Close to 12,500 workers care for seniors and people with physical disabilities, and 7,500 care for people with developmental disabilities, mental health needs and medically fragile children.


Update: DHS proposed cap on hours and changes to live-in program

Dear fellow care providers,

Recently the Oregon Department of Human Services (DHS) proposed new policy concepts relating to a proposed cap on Homecare Workers’ hours and changes to live-in program for consumers in the Aging and Physical Disability (APD) program. These changes are being proposed to keep program costs within the state budget.

We will be working on this issue over the next few months, and we need to hear from you: What are your concerns about the State’s proposal? Please click here to share your thoughts and story with us.

Overview of the new DHS proposalsclick here for more information on these proposals:

  1. Cap on Hourly Workers: DHS is proposing a cap of 52 hours per week—up from 40 before—for all hourly workers (not live-in workers).
  2. Travel Time between Service Recipients: DHS is proposing that our new travel time paid between consumers’ homes and mileage cannot exceed more that 10% of hours paid per week.
  3. Changes to the APD Live-in Program: DHS is proposing multiple changes to the live in program. First consumers in the live-in program who need fewer than 12 hours a day of services and have fewer than 135 hours per month of 24-hour availability—be moved into the hourly program (no longer be in the live-in program). For these workers, all ADL and IADL hours would instead be paid at the $13/hr rate (no longer $6.50/ hr).
  4. Emergency Overtime Concept: This DHS policy option would apply for consumers who need 12-24 hours of services a day.

Many of these proposed policy changes cannot be legally implemented by the State without first bargaining with our Union. We will be doing this over the next few months as we start bargaining and our work at the state capitol—and we need to hear from you to win the best agreement possible.

Please click here to share your thoughts on these important issues!

In unity,

Rebecca Sandoval

Live-In Care Provider, Medford

President of the Homecare & Personal Support Workers’ Union

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Important: OHP Renewal Letters

Dear Homecare/Personal Support Worker,

If you received a renewal letter from the Oregon Health Plan that stated your coverage is scheduled to end on December 31, 2014 please reach out to us right away for enrollment assistance. If you no longer qualify for the Oregon Health Plan and you are currently a Trust eligible participant, you may qualify for benefits through the Trust.

If you received this letter, please call your SEIU Healthcare Enrollment team at 1-855-437-2694 right away so that you do not lose health coverage.

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2015 Health Plan Changes

Dear Homecare Worker,

Exciting changes are underway for the 2015 medical insurance plan year! Based on feedback from surveys and other input, Trust eligible workers* will have plan updates for 2015. Here are some of the highlights; please visit www.seiu503.org/enrollment-materials for more information!

  • Exchange Plan Choice Expansion. Trust-eligible participants who qualify for benefits through the Exchanges will now have a great new option in a plan from Oregon’s Health Co-op:
    • Participants who reside within the Kaiser service area can choose from either the Kaiser Permanente $1500 Deductible Silver plan or the Oregon Health Co-op $3000 Deductible Simple Silver HSA Broad plan.
    • Participants who reside outside of the Kaiser service area can choose from either the MODA $1150 Deductible Be Prepared Silver plan or the Oregon Health Co-op $3000 Deductible Simple Silver HSA Broad plan.
  • Deductibles, Copayments and Coinsurance. Starting January 1, 2015, reimbursement cap is increasing from $2,500 to $3,000 per calendar year for Trust-approved plans and Medicare plan eligible expenses incurred in 2015. Also, more types of expenses will be eligible for reimbursement in 2015, including co-payments and co-insurance relating to services you receive through Trust-approved plans.
  • Medicare Supplemental, Advantage or Drug Plan premiums. Starting January 1, 2015, the maximum monthly premium reimbursement amount for Medicare Supplemental, Advantage, or Drug Plan is increasing from $39 to $41.
  • Dental Benefits.  In partnership with Kaiser Permanente Dental, the coinsurance charge for Major Restorative Services will decrease from 50% to 40% effective January 1, 2015.

To prevent a gap in your Exchange medical coverage, you need to schedule a phone appointment to re-enroll by December 15, 2014. There are three ways to schedule your appointment:

  • Online. Visit www.seiu503.org/scheduler (preferred)
  • By email. Email us at acahotline@seiuoregon.org immediately!
  • By phone. Contact your SEIU ACA Team at 1-855-437-2694. Because your SEIU ACA Team is currently experiencing a high volume of calls, you will need to leave a message and wait for a return call.

All Oregonians that enrolled last year onto a private plan through the Cover Oregon Exchange need to re-enroll into the Healthcare.gov Exchange, regardless of Trust eligibility, and we are here to help!  To learn more about open enrollment, please visit www.seiu503.org/ACAMedical today.

* All benefits listed are only provided to Trust eligible Participants as long as they are eligible. If you have questions as to whether or not you are eligible for these benefits, please contact your Trust office at 1-844-507-7554 Option 3, then Option 2 or via email at OHCWT@bsitpa.com. To learn more about what benefits you may be eligible for, please visit https://orhomecaretrust.org.

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Member Benefits

Important Notice for Homecare Workers

Administration of the Oregon Homecare Workers Supplemental and Benefits Trust to change on May 1, 2014.

Starting May 1, 2014, Benefit Solutions, Inc. (BSI) will be responsible for handling and processing all premium payments and member reimbursement payments for the Oregon Homecare Workers Trusts.

Should you need to contract BSI directly:

Phone: 844-507-7554
Email: OHCWT@bsitpa.com
Fax: 866-459-4623
Mail: P.O. Box 6, Mukilteo, Washington 98275

 

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Over $24 Million in Waste Cut from 2015 Health Insurance Premiums

Close scrutiny of proposed health insurance premiums for 2015 has cut over $24 million in waste and unjustified costs from premiums for Oregon consumers and small businesses, according to an OSPIRG Foundation report released in September. The cuts come after OSPIRG Foundation’s analysis questioned the justifications of four major rate proposals. Taken together with cuts made since new standards were implemented, state officials have required insurers to cut $179 million in waste since 2010.

“We all know that health care still costs too much, and that there is too much waste in the health care system,” said Jesse O’Brien, OSPIRG Foundation Health Care Advocate. “Health insurance rate review is a key backstop to protect Oregon consumers and small businesses from paying too much for health care.”

Under the Oregon Insurance Division’s (OID) health insurance rate review program, health insurers seeking to increase their rates on small businesses or people purchasing coverage on their own must submit a written justification. The OID then evaluates whether the proposal is reasonable and goes on to approve, disapprove or cut back the proposed rate. OSPIRG Foundation’s analysis focuses on the OID’s recent decisions for health insurance rates for 2015.

Key findings of OSPIRG Foundation’s report:

  • The Oregon Insurance Division took action to make sure Oregon’s insurers pass along the savings from reductions in uncompensated care for the uninsured due to the expansion of access to health coverage under the Affordable Care Act (ACA). In the past year, 400,000 Oregonians have signed up for coverage under the ACA, and we have already started to see rates of uncompensated care go down. Since commercial insurers wind up footing the bill for uncompensated care, this reduction should be reflected in reduced premium rates, but few Oregon insurers incorporated these savings into their rate proposals. The OID took corrective action and cut many insurers’ proposed rates by 2% to ensure that they accurately reflected the changes underway in health care in Oregon.
  • One Oregon’s biggest insurers, PacificSource, made a major error in its initial filing. After admitting to this error, the insurer suggested a sizable cut to their proposed rates, and the final decisions cut rates back even further. All together, the cuts applied to PacificSource’s rates amount to over $14 million.
  • Some insurers overstated trends in medical costs. A number of national studies have demonstrated a slowdown in health care cost growth, yet several insurers projected accelerating cost growth in the year ahead. In some cases, the OID questioned these projections, and cut back those proposals accordingly.

“Without Oregon’s robust rate review program, consumers and small businesses would be paying millions more for coverage,” said O’Brien. “But with study after study demonstrating that a third or more of health care spending is waste, we know we can do better.”

With direction from Governor John Kitzhaber, the state has begun implementing a plan to strengthen Oregon’s health insurance rate review program, including new cost, quality and utilization metrics to help regulators evaluate insurers’ efforts to contain costs and improve quality of care. The report highlights a number of opportunities to learn from the recent review process to continue improving the program.

Key recommendations of the report:

  • Insurers should be required to reveal more information to justify their projections of increases in medical costs.
  • Insurers should be required to provide more information to justify the cost differences between their plans to protect consumers from price discrimination and other unjustified pricing practices.
  • New data on cost, utilization and quality should be expanded, improved and used to inform decisions on health insurance rates

Prior to the recent rate decisions, OSPIRG Foundation conducted an in-depth analysis of rate proposals from four of Oregon’s top insurers: ModaPacificSourceUnited and Health Net. All rate filing documentation, including the OID’s decisions, is available on the OID’s rate review website, www.oregonhealthrates.org

Background on Oregon’s health insurance rate review program

In 2010, new rules went into effect strengthening the standards that health insurance companies must meet before raising premiums. Insurers must justify rate hikes in writing, showing that they are not excessive and explaining how the insurer is working to reduce costs. All rate filings are public information, available online, and open to public comment. The Oregon Insurance Division evaluates these justifications, and must take public input into consideration. In 2011, the Insurance Division began to hold public hearings on significant rate increases.

Since these changes have taken effect, the Oregon Insurance Division has significantly stepped up their scrutiny of health insurers’ rate hike requests. Since 2010, it made cuts to a majority of requests, cutting over $80 million in waste and unjustified costs from consumers’ and small businesses’ premiums from 2010-2013. Last year’s review of rates for 2014 cut over $69 million.

OSPIRG Foundation is a non-profit, non-partisan statewide consumer organization. You can visit them at www.ospirgfoundation.org

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Homecare and Personal Support Workers win basic federal workers’ protections

State implementation still a question

Some historic changes mean that homecare workers and personal support workers will finally share legal protections that have been enjoyed by most other American workers for over 75 years.

Until recently, homecare and personal support workers were not covered under the Fair Labor Standards Act (FLSA), the federal law that protects worker hours and pay. That will change on January 1, 2015, when FLSA is extended to personal support and homecare workers. The new rules significantly narrow the “companionship exemption” that has excluded homecare and personal support workers from basic federal wage and hour protections.

Our union, along with other worker and consumer advocates, is working with the State of Oregon to determine how to bring state wage and hour laws up to speed with the national standard.

Oregon’s homecare program is one of the best in the nation, and we want to make sure it stays that way. That’s why our union’s primary concerns include:

  • Ensuring funding for in-home care programs;
  • Protecting consumer choice in selecting services and providers;
  • Growing our workforce to meet the increasing need for in-home care programs; and
  • No worker gets a pay decrease.

The State of Oregon’s main concern is how many hours per week can an individual safely work and provide services. Department of Human Services staff use Oregon’s firefighters and police officers as an example: All Oregon firefighters must be given 48 consecutive hours off-duty during each seven-day period, and Oregon State Police officers must have 10 hours off-duty between work shifts.

With this in mind, the State of Oregon is considering:

  • Possible changes to the live-in program; and
  • A possible limit of 40 work hours per week hours with no overtime accrual permitted.

Next steps:

Extending FLSA rights to homecare and personal support workers is a huge victory, but it is a work in progress on the state level. Our union leaders continue to meet with key lawmakers to ensure that implementation runs as smoothly as possible, and that the homecare system our union has helped build over the years continues to be a model for the rest of the country.

As a personal support or homecare worker, you can help by taking this very brief survey to share your thoughts and experience with us.

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Victory on health insurance rates: many Oregonians will see premium reductions

SEIU members spoke, and the Insurance Division listened.

Thousands of Oregonians, including many SEIU care providers, sent messages to the Oregon Insurance Division to comment on proposed rate increases for 2015.  As a result, many (though not all) Oregonians will see reductions in their premiums next year.

Today, the Oregon Insurance Division—the state’s insurance regulator—announced its decisions on health insurers’ rate proposals for 2015. These decisions come after OSPIRG Foundation’s in-depth analysis raised numerous questions about some of the larger proposed rate increases, including proposals from ModaPacificSourceUnited and Health Net. Over 4,000 Oregonians also weighed in with public comment.

Oregon’s health insurers must get permission from state officials before they can raise premiums on individuals and small businesses. For several years, OSPIRG Foundation has put a magnifying glass to premium hike proposals, and thousands of OSPIRG members have emailed and called the state’s Insurance Division. All this additional scrutiny has helped cut over $155 million in waste from health insurance premiums since 2010.

OSPIRG is just beginning their analysis of today’s decisions, but here are some of their findings so far:

  • The Insurance Division shared our concern that few of Oregon’s insurers had a workable plan to pass along the savings from reductions in uncompensated care for the uninsured due to the expansion of access to health coverage under the Affordable Care Act (ACA). In the past year, 400,000 Oregonians have signed up for coverage under the ACA, and we have already started to see rates of uncompensated care go down. Since commercial insurers wind up footing the bill for uncompensated care, this reduction should be reflected in reduced premium rates, but few Oregon insurers incorporated these savings into their rates. The Oregon Insurance Division took corrective action and cut many insurers’ proposed rates by 2% to ensure that they accurately reflected the changes underway in health care in Oregon.
  • Many of the largest proposed rate increases were scaled back. PacificSource, which initially proposed a 15.9% increase—and walked that back to 10.8% shortly after—will only be raising rates by 3.9%. Moda’s proposed 12.5% increase will be cut back to 10.6%, largely on the basis of reductions in uncompensated care.
  • For many Oregonians, rates will be going down. The Insurance Division estimates that the average premium for a 40-year-old Portlander on the Oregon Standard Silver plan will go down by about $12 per month, and many Oregonians will see rates decline by 10% or more. For Oregonians who have seen rate increase every year for decades, this is a welcome development.

Click here to see a chart with a rundown of all of the major rate decisions announced today.

It’s important to note that many Oregonians will still see large rate hikes.

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Important information from your Homecare Workers Supplemental Trust

Dear Homecare or Personal Support Worker,
We received notice that Kaiser Permanente sent invoices to Oregon Exchange members who had never received invoices or only a portion of their invoices in 2014.
You may have received in the mail a premium bill from Kaiser asking for payment, potentially in error.
If you have received a premium bill and you are a Trust eligible homecare or personal support worker that was enrolled individually through Cover Oregon into the Kaiser Silver Plan with no family members on your plan, you can ignore this bill.
If you have any questions as to whether or not you are Trust eligible, please contact the Trust office at ohcwt@bsitpa.com or 1-844-507-7554 Option 3, Option 2.
Kaiser will also be reaching out to you to confirm this information in the near future.
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Important Message About DD System Changes and PSW Payments

Personal Support Workers:

Below is the email that DD Services recently sent out regarding the movement to a centralized payroll starting in July.  We wanted to share it with Personal Support Workers in case you didn’t receive it.

———- Forwarded message ———-
From: BAXTER Patricia E <patricia.e.baxter@state.or.us>
Date: Fri, Jun 27, 2014 at 11:32 AM
Subject: Important Message About DD System Changes and PSW Payments
To: BAXTER Patricia E <patricia.e.baxter@state.or.us>
Dear Personal Support Worker,

As you know, our state is making a number of changes throughout the programs supporting individuals with intellectual and developmental disabilities.  These changes are needed to be in compliance with federal regulations and our collective bargaining agreement, as well as to improve service delivery.  The Department of Human Services has been working collaboratively with SEIU, Brokerages, Community Developmental Disability Programs (CDDP), providers and other advocates in making sure these changes do not negatively impact the people we serve or our workers.

The most immediate and direct change, coming up on July 1, is how you will be paid.  Beginning in July, we are moving to a centralized state payment system, with TNT Fiscal Intermediary Services, Inc., with common payroll dates twice a month.  This is going to help streamline eligibility for medical, dental and vision benefits.  As we have previously communicated, there is a delay to other program changes, specifically around the Plan of Care functionality in eXPRS. We will be sharing more information around those timelines as it becomes available.

You may have recently been contacted by the CDDP and/or brokerage that you work with to complete information required for the transition to TNT Fiscal Intermediary Services for the purpose of processing payroll on July 1. Please complete and return any paperwork you have been provided so that we can ensure you are paid timely. Once you have completed and submitted your paperwork you have nothing else to worry about – TNT will contact you, through your CDDP or brokerage, should additional information be needed. TNT has indicated that if paperwork is delayed, they will still do everything in their power to ensure timely payments, even to the point of running an extra payroll cycle if needed. It is important to us that you are paid accurately and timely. You will need to sign a new direct deposit form if you chose direct deposit.  This form was included in the information you received from your CDDP or brokerage. If you need another copy of the form, please contact the CDDP or brokerage, or you can contact TNT directly at (503) 463-0134.

In accordance with the collective bargaining agreement, beginning with services provided after July 1, 2014, claims for payment should be submitted to the Brokerage or CDDP no later than three (3) business days (excluding Oregon and Federal holidays) before the eighth (8th) and/or the twenty-third (23rd) of each month.  You will be paid three (3) business days (excluding Oregon and Federal holidays) after the eighth (8th) and/or the twenty-third (23rd) of each month.  Click here to see the full details http://www.seiu503.org/wp-content/blogs.dir/10/files/2014/03/SEIU-OHCC-2013-2015-Collective-Bargaining-Agreement-FINAL-SIGNED-COVER-LETTER.pdf. Payment for June or earlier services will be paid in accordance with current practice.

If you have questions regarding this transition, please contact your CDDP, Brokerage, or TNT. Be watching for additional information over the next couple of weeks, including a calendar outlining payment dates, options for payment, and other information for your reference.

Trisha Baxter, Interim DD Program Director
Chief Operating Officer
Aging and Disability Programs
Department of Human Services
500 Summer Street NE
Salem, OR 97301

503-945-5858 (desk)
503-580-7853 (cell)

 

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SEIU 503 response to Harris v. Quinn

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