The Rhode Island Center for Freedom & Prosperity has submitted a public comment on the proposed change to prevent portions of Medicaid payments to third parties for benefits. This change would have dramatic results on the home care unionization rule.

Center Submits Public Comment On Rule Change To Protect The Home Care Industry From Attempted Unionization

The Rhode Island Center for Freedom & Prosperity has submitted a public comment on the proposed rule that would remove a state’s ability to reassign portions of Medicaid payments to third parties for benefits such as health insurance, skills training, and other benefits customary for employees. 

From: “no-reply@regulations.gov” <no-reply@regulations.gov>
To: mstenhouse@rifreedom.org
Sent: 8/6/2018 12:24:20 PM
Subject: Your Comment Submitted on Regulations.gov (ID: CMS-2018-0090-0001)

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Comment Tracking Number: 1k2-94p4-ty5d

Agency: Centers for Medicare Medicaid Services (CMS)

Document Type: Rulemaking
Title: Medicaid Program: Reassignment of Medicaid Provider Claims: CMS-2413-P
Document ID: CMS-2018-0090-0001

Comment:
The Rhode Island Center for Freedom & Prosperity, a 501-C-3 public policy think tank in Rhode Island, respectfully submits comment in support of the proposed rule that would remove the regulatory text at 42 CFR 447.10(g)(4) that allows a state to reassign portions of a provider’s payment to third parties for benefits such as health insurance, skills training, and other benefits customary for employees.

Our comment uses as an example a real-life scenario made possible by 2018 Rhode Island legislation that was signed into law earlier this year … allowing for attempted unionization of the home care industry. This private industry in our state, which now successfully provides vital services, could be decimated.

This proposed Medicaid Provider Reassignment Regulation Proposed Rule, would mean that the government can no longer aid unions in their attempt to skim dues from precious Medicaid dollars, intended for the care of our loved ones.


In Rhode Island, about 7500 or so private home care workers are already represented by about 45 private-employer agencies as well as by a statewide association, the RI Partnership for Homecare. These service providers do not consider themselves to be government workers and most of these workers do NOT want to become a quasi-government employee.

The Rhode Island Partnership for Home Care, which oversees most of these private agencies, believes that government-run home care would destabilize the industry.
It is also morally unjust that federal dollars, earmarked for home care services, could have dues automatically siphoned-off by state government unions from workers’ paychecks, then transferred to the unions, with some of the funds ending-up in the political campaign coffers of SEIU. If the proposed rule is enacted, it would be just and proper that 100% of the allocated federal funding for home care services should first go to the workers; and it would then be up to the unions to collect dues – on their own – from those who freely choose to join.Earlier this summer, after a major push by SEIU and other progressive activists, legislation that had been on the back burner was rammed through Rhode Island’s General Assembly and signed by the Governor. This new law could transfer control of the home care services industry from the private sector to the government and its union allies. This proposed rule, by removing the government as its potential partner, would create less of an incentive for SEIU to attempt to unionize this industry.At the same time, the burden on state taxpayers would rise, as the government would surely provide frivolous and unnecessary benefits to allow unions to offer a more compelling reason to unionize.

The new law in Rhode Island seeks to lure home care workers, most of whom are now employed under a successfully operating private ‘agency’ system, to register with the government, becoming quasi-public employees, with their names and other personal information then to be turned over to SEIU labor bosses for the purposes of unionization efforts. A very similar approach was taken in 2013 to unionize the home child care industry; since then, union negotiated – and taxpayer funded – costs to support this industry have since risen dramatically.

This new Rhode Island law is a blatant money and power grab by unions that would crush a smoothly performing private agency system that is providing high quality home care to elderly, Medicaid, and other patients; and essentially turn over control of this industry to overly politicized and incompetent government bureaucrats. The training standards and strict oversight now required of nursing and other home care professionals would be greatly diminished.

Implementation of this proposed federal rule would remove the likelihood that government could insert itself between patients and their home care service providers.

The Center also points out how implementation of this proposed rule would create additional synergy with the direction that the nation is now heading, following landmark Janus decision, which would end the forced unionization and fee payments by public employees. As our country moves towards more freedom and less governmental control over our lives, Americans are experiencing renewed levels of prosperity. Enactment of this rule would maintain this momentum by keeping our state’s home care industry smoothly running under private management and away from the inefficiencies of the political elite and their special-interest allies.

The until-recently unimaginable 4+% growth in national GDP report today should provide a beacon and a wake-up call to voters and to all Rhode Island candidates for office this fall.

Center Challenges Gubernatorial Candidates Following Dynamic 4.1% U.S. GDP Report

Conservative Polices Produce Rapid Economic Growth

Will politicians recognize and learn lessons from federal reforms?

Providence, RI – The until-recently unimaginable 4+% growth in national GDP report today should provide a beacon and a wake-up call to voters and to all candidates for office this fall, according to the Rhode Island Center for Freedom & Prosperity.

“For eight years, progressive-left politicians have told us that the ‘new normal’ for economic growth would be limited to the 2% range,” said Mike Stenhouse, the Center’s CEO. “And for years, our Center and other free-market advocates argued that major tax and regulatory reductions would reverse this course and lead to rapid economic growth; meaning more money and prosperity for families. After today’s 4.1% GDP growth report, there can no longer be any doubt that we were right.”

The Center has repeatedly challenged state lawmakers to #WalkAway from the leftist polices that have kept our Ocean State in the bottom-six on many broad national indexes, including the CNBC business climate, the Family Prosperity Index, and the Jobs & Opportunity Index.

Over the past 18 months, the optimism and growth resulting from the implementation of pro-business and conservative policies at the federal level stand in stark contrast to the stagnation we experienced from liberal and progressive policies: Unemployment rates among virtually all demographic groups are at or near all time lows; personal incomes are rising; and manufacturing jobs that the the left told us were extinct are roaring back by the hundreds of thousands.

We can amplify these results in Rhode Island if we adopt similar polices. However, the Center is concerned that no gubernatorial candidate is providing the bold vision and leadership to achieve this goal. Instead, some candidates offer timid prescriptions, while others seek to take our state backward with failed progressive-socialist schemes.

The Center also challenges voters to demand that candidates clearly articulate their core philosophies: “Are they in favor of rowing our state’s boat with the successful national tide … or against it? Are they for more freedom & unbounded opportunity for prosperity … or are they for more government-control and limited expectations,” suggested Stenhouse.

Center Warns of Litigation in Effort to Unionize Home Care Professionals

Government and Unions Must Comply with New Legal Realities

As nation moves toward freedom, Rhode Island seeks to increase government control over our lives

Political Money & Power Grab by Unions Would Threaten Patient Safety

FOR IMMEDIATE RELEASE: July 26, 2018

Providence, RI – The Rhode Island Center for Freedom & Prosperity warns SEIU and the state government that it could face legal peril if they do not fully comply with the new federal restrictions expected to be in place this fall, as it pertains to the attempted unionization of the home care industry.

“The landmark Janus decision by the US Supreme Court, combined with the expected implementation of the Medicaid Provider Reassignment Regulation Proposed Rule by the federal government, means public employees can no longer be forced to support the political agenda of their designated union. It also means the government can no longer aid unions in their attempt to skim dues from precious Medicaid dollars, intended for the care of our loved ones.” explained Mike Stenhouse, CEO for the Center.

Stenhouse, earlier this month, attended a national symposium in Washington, DC, where it was highlighted that many legal organizations are actively looking for precedent-setting lawsuit cases if unions or their government allies do not comply with the new restrictions on how government unions may collect dues.

Outrageously, in the past and for now, federal dollars earmarked for home care services, could have dues automatically siphoned-off by the state government unions from workers’ paychecks, then transferred to the unions, with some of the funds ending-up in the political campaign coffers of SEIU. If the proposed rule is enacted, 100% of the allocated home care funding must first go to the workers; and it would then be up to the unions to collect dues – on their own – from those who freely choose to join.

“It’s a whole new ballgame,” continued Stenhouse. “And history has demonstrated in other states, unions and their bought-and-owned politician friends, will seek to bend the rules to their advantage. However, many of us are now on watch, and doing so could lead to serious legal ramifications.”

Earlier this summer, after a major push by SEIU and other progressive activists, legislation  was rammed through the General Assembly and signed by the Governor, that would transfer control of the home care services industry from the private sector to the government and its union allies.

The legislation would seek to lure home care workers, most of whom are now employed under a successfully operating private ‘agency’ system, to register with the government, becoming quasi-public employees, with their names and other personal information then to be turned over to SEIU labor bosses for the purposes of unionization efforts. A very similar approach was taken in 2013 to unionize the home child care industry; since then, union negotiated – and taxpayer funded – costs to support this industry have risen dramatically.

The Rhode Island Partnership for Home Care, which oversees most of these private agencies, believes that government-run home care would destabilize the industry.

“This is a blatant money and power grab by unions that would crush a smoothly performing private agency system that is providing high quality home care to elderly, Medicaid, and other patients; and essentially turn over control of this industry to overly politicized and incompetent government bureaucrats,”said Stenhouse in June. “The training standards and strict oversight now required of nursing and other home care professionals would be greatly diminished. Why would we want to put government in between patients and their home care service providers?”

The Center also pointed out the incongruity of this legislation and the direction that the nation is heading, following landmark Janus decision, which would end the forced unionization and fee payments of public employees. “Once again, while America is moving towards more freedom and less governmental control over our lives, Rhode Island wants to move in the opposite direction, consolidating centralized-control and planning under the political elite and their special-interest allies,” concluded Stenhouse.

Media Release: Jobs & Opportunity Index June 2018

Jobs & Opportunity Index (47th in JOI) Employment Without Profit June 2018

Providence, RI – Once again, Rhode Island’s positive numbers related to employment weren’t enough to get the Ocean State out of 47th place on the RI Center for Freedom & Prosperity‘s Jobs & Opportunity Index (JOI). However, the Freedom Factor, which gauges Rhode Islanders’ employment against reliance on welfare, did improve by one spot, to 41st.
Overall, seven of the 12 data points of the index changed for this iteration. However, data for SNAP (food stamps) has still not changed for Rhode Island since January 2017, owing to the failure of the Unified Health Infrastructure Project (UHIP) to work as advertised.
 
“In this month’s report, we are greatly concerned that, despite increased employment, Rhode Islanders’ personal income number is actually down by $307 million,” said the Center’s research director, Justin Katz. “That state and local taxes still managed to increase by $53 million is an additional red flag.”
Despite an improvement in rank on the Freedom Index, Rhode Island’s JOI number lost ground against the  U.S. average and is even farther behind the average for New England.
Additional charts and details of each of JOI’s three sub-factors can be  viewed here.
Jobs & Opportunity Index June 2018

Jobs & Opportunity Index (JOI), June 2018: Employment Without Profit

Rhode Island’s 47th place ranking on the Rhode Island Center for Freedom & Prosperity’s Jobs & Opportunity Index (JOI) remains intact. However, of the seven (of 12) datapoints that were updated for the June report, only the three related to Bureau of Labor Statistics jobs and employment research were positive. Additionally, SNAP (foodstamp) data remains unchanged for Rhode Island because of “system reporting issues” since January 2017.

On the positive side, employment was up from the first-reported number for May by 1,631, while labor force was up 860. The larger growth of employment than labor force translated into a drop of the unemployment rate to 4.3%. RI-based jobs increased by 2,100.

On the negative side, Medicaid enrollment increased 956. Annualized personal income (including investments) fell $307 million, while state and local taxes increased $53 million. Rhode Islnad was one of only four states to see personal income actually fall with the latest report.

These discouraging results, however, were not enough to bring down any sub-index rankings, and the Freedom Factor went up (see below).

The first chart shows RI still in the last position in New England, 47th on the in the country on the Jobs & Opportunity Index June 2018. New Hampshire still leads the region, but fell to 3rd place, nationally, with Utah joining Wyoming in the top 2. Every other New England state held steady, with Maine at 15th, Vermont at 21st, Massachusetts at 34th, and Connecticut at 37th.

Jobs & Opportunity Index June 2018

The second chart shows the gap between RI and New England and the United States on JOI. The third chart shows the gaps in the official unemployment rate. In all cases, the Ocean State lost ground.

Jobs & Opportunity Index June 2018

Results for the three underlying JOI factors were:

  • Job Outlook Factor (optimism that adequate work is available): RI remained 22nd.
  • Freedom Factor (the level of work against reliance on welfare programs): RI improved one place,
    to 41st.
  • Prosperity Factor (the financial motivation of income versus taxes): RI remained 47th.

Click here for the corresponding employment post on the Ocean State Current.

The Janus case could provide right-to-work protection for all public employees in the country. Right-to-work means a union cannot get a worker fired for not paying dues or fees.

STATEMENT: Center Applauds SCOTUS Ruling on Janus case; Public Education to Benefit

More Worker Freedom From Janus Case Will Lead to Reduction in Union Power

Public Education Should be Greatest Beneficiary of Janus Case

Providence, RI — According to the Rhode Island Center for Freedom & Prosperity, today’s landmark decision in the Janus case, which grants workplace freedom to public employees, means that public unions will have significantly less power and money to block legislation and influence elections. “The greatest public benefit will be improvement in public education,” said Mike Stenhouse, the Center’s CEO. “Many education reforms that would improve schools in disadvantaged communities are prevented by union collective bargaining agreements. If unions are no longer able to force teachers who disagree with them to fund their bargaining positions, unions will have less power to impose ineffective policies into contracts.”

#WorkerFreedom

Jobs & Opportunity Index (JOI), May 2018: What There Is Is Positive

Although Rhode Island remained in 47th place on the RI Center for Freedom & Prosperity’s Jobs & Opportunity Index (JOI), the four (of 12) datapoints that were updated for the May report were positive. Unfortunately, one datapoint was not updated for Rhode Island even though it was updated for every other state. The latest SNAP (foodstamp) table from the federal Food and Nutrition Service added a new footnote highlighting that “system reporting issues” have meant no new RI numbers since January 2017.

Turning to the numbers that are available: Employment was up from the first-reported number for April, by 1,489, while labor force was up 1,117. RI-based jobs increased, as well, by 1,000. Medicaid enrollment improved from the previously reported number, with a decrease of 1,281.

The first chart right shows RI still in the last position in New England, 47th in the country. Regional leader New Hampshire is still in 2nd place, nationally, behind Wyoming. Maine made progress toward the nation’s top 10, up two steps to 15th, while Vermont remained in 21st place. Massachusetts managed to return to the 34th slot that it had lost last month. Meanwhile, Connecticut held on to 37th.

Rhode Island remained in 47th place on the Jobs & Opportunity Index May 2018. Unfortunately, one datapoint was not updated for Rhode Island even though it was updated for every other state. The latest SNAP (foodstamp) table added a new footnote highlighting that “system reporting issues” have meant no new RI numbers.

The second chart shows the gap between RI and New England and the United States on Jobs & Opportunity Index May 2018. In both cases, the Ocean State gained a little ground. The same was true of the official unemployment rate, shown in the third chart.

Rhode Island remained in 47th place on the Jobs & Opportunity Index May 2018. Unfortunately, one datapoint was not updated for Rhode Island even though it was updated for every other state. The latest SNAP (foodstamp) table added a new footnote highlighting that “system reporting issues” have meant no new RI numbers.

Rhode Island remained in 47th place on the Jobs & Opportunity Index May 2018. Unfortunately, one datapoint was not updated for Rhode Island even though it was updated for every other state. The latest SNAP (foodstamp) table added a new footnote highlighting that “system reporting issues” have meant no new RI numbers.

Results for the three underlying Jobs & Opportunity Index May 2018 factors were:

  • Job Outlook Factor (optimism that adequate work is available): RI improved one place, to 22nd.
  • Freedom Factor (the level of work against reliance on welfare programs): RI remained 42nd.
  • Prosperity Factor (the financial motivation of income versus taxes): RI remained 47th.

Click here for the corresponding employment post on the Ocean State Current.

Civil forfeiture laws represent one of the most serious assaults on cars, cash, and other private property by government today.  According to the Institute for Justice, the Ocean State received a D- for its asset forfeiture laws. Please watch the new asset forfeiture video from the Center now.

Why Rhode Island Needs Civil Asset Forfeiture Reform

“It is absolutely mind-boggling… that people that feed you, in one of the most historical oldest industries in this country, can’t go to sea and land that fish that feeds you without being treated like criminals,” said Richard Fuka, President of RI Fishermen’s Alliance

Civil forfeiture laws represent one of the most serious assaults on cars, cash, and other private property by government today.  According to the Institute for Justice, which produces a state-by-state report card, the Ocean State received a D- for its asset forfeiture laws. Please watch the new asset forfeiture video from the Center now.

Despite some positive numbers, Rhode Island couldn’t shake its 47th place ranking on the Rhode Island Center for Freedom & Prosperity’s Jobs & Opportunity Index (JOI) in April 2018

Jobs & Opportunity Index (JOI), April 2018: The Bottom of the Rising Tide

Despite some positive numbers, Rhode Island couldn’t shake its 47th place ranking on the Rhode Island Center for Freedom & Prosperity’s Jobs & Opportunity Index (JOI) in April 2018, and even slipped on one of the three subfactors of the index. On the Job Outlook Factor, which gauges Rhode Islanders’ optimism about job opportunities, the Ocean State fell five spots, to 22nd in the country. Overall, eight of the 12 data points of the index changed for this iteration.

Employment was up from the first-reported number for March, by 975, while labor force was up 842. RI-based jobs increased, as well, by 1,000. Medicaid enrollment improved from the previously reported number, with a decrease of 907, while SNAP (food stamps) showed no change. (Reporting problems related to the Unified Health Infrastructure Project may be an issue, here.)

Alternative measures of unemployment were also updated. Long-term unemployment (15 weeks or more) fell a little, by 200 people, while significantly fewer people (1,300) say they are involuntarily working only part time. Another 800 Rhode Islanders say they are “marginally attached,” meaning that they would potentially like to work, although the data does not indicate whether this change of attitude represents a move toward or away from job searches.

The first chart at shows RI still in the last position in New England, 47th in the country. Regional leader New Hampshire is still in 2nd place, nationally, behind Wyoming. Maine and Vermont remained in place, at 17th and 21st, respectively. Again, Massachusetts fell one, to 35th, while Connecticut held on to 37th.

The second chart shows the gap between RI and New England and the United States on JOI. In both cases, the Ocean State lost a little ground. The same was true of the official unemployment rate, shown in the third chart.

Results for the three underlying JOI factors were:

  • Job Outlook Factor (optimism that adequate work is available): RI fell five slots to 23rd.
  • Freedom Factor (the level of work against reliance on welfare programs): RI remained 42nd.
  • Prosperity Factor (the financial motivation of income versus taxes): RI remained 47th.
This week’s “Progressive Land of Make Believe Bad Bills of the Week” are the so-called Fair Employment Practices legislation; House bill 7427 and Senate bill 2475. The legislation that could impose the most extreme employment burdens on Rhode Island businesses than in any other state in the nation.

Progressive Land of Make Believe Bad Bills of the Week: The So-Called Fair Employment Practices Legislation H7427 & S2475.

Once again, legislation is being advanced in the General Assembly based on a progressive-contrived myth; legislation that could impose the most extreme employment burdens on Rhode Island businesses than in any other state in the nation.

This week’s “Progressive Land of Make Believe Bad Bills of the Week” are the so-called Fair Employment Practices legislation; House bill 7427 and Senate bill 2475.

The Rhode Island business community is comprised not just of good business people, but also generous and fair employers. However, in the progressive land of make believe, Ocean State employers regularly practice discriminatory and bigoted compensatory practices against women and other politically-protected groups.

Progressive lawmakers and activists pretend that a multitude of state and federal protections against wage discrimination, enforced by the federal Equal Employment Opportunity Commission (EEOC), do not already exist.

Currently, Rhode Island law clearly prohibits wage discrimination for “equal work” on “the same operations”. Who can disagree with this? However, the proposed legislation would blur this clear language and change the standard to “comparable work” under “similar working conditions”.

These fuzzy and divisive new regulations would be harmful to businesses, leading to frivolous complaint after frivolous complaint filed by employees against employers. Already with one of the most hostile business climates in America, Rhode Island should not impose more burdens on its valued job-producers.

Without documenting any evidence of systematic discrimination, not covered by existing law, this #Unfair2Employers legislation would set new, highly subjective wage-discrimination standards that are wholly unfair to job-producers. With ridiculous new definitions of acceptable wage determination practices, severe employer penalties will be devised and meted out by unelected government bureaucrats at the Department of Labor and Training.

Supporters of the legislation also pretends this is a “women’s rights” issue, when in fact a whole litany of politically-correct groups, favored by progressive politicians, are included in the new definitions. Existing laws cover these groups as well.

In the real world Rhode Island does not need more job-killing regulation … we simply need more education and better enforcement of existing laws.