Overview

This State Policy Focus is dedicated to state legislative action in 2007 surrounding cost of living adjustments (COLA) and rate increases for mental health, substance abuse, health services and community service providers. Almost 20 states considered 48 pieces of legislation on this issue in 2007, the results of which are a wide array of approaches to funding and administering COLA and rate increases across the country.
 
The research team at KSE Focus was able to compile a list of 19 states that considered COLA or rate increase legislation in 2007. From the summary below, you will be able to see the following:

· 17 states passed 19 pieces of legislation on COLA or rate increases
· 4 states are still considering legislation
· 5 states plan to carry over legislation into 2008
· 3 states saw legislation die due to veto or legislative adjournment

The types of providers covered under COLA and rate increase legislation passed in 2007 vary greatly.  In Nebraska, their rate increase covers behavioral health care service providers of children, youth or adult populations, under the Medicaid program or other state-funded behavioral health programs.  Meanwhile, Illinois’ COLA is for  community-based developmental disability providers, and Minnesota’s rate adjustment covers Intermediate Care and Mental Retardation Facilities and includes funds to pay for staff wage increases. 
 
Additionally, many pieces of legislation require state agencies to submit reports before funds may be allocated.  In Arizona, the Division of Development Disabilities must submit a report to the Joint Legislative Budget Committee that includes the estimated cost of the provider rate increase and identifies an ongoing source of funding for the increase.  In Massachusetts, the Executive Office of Health and Human Services and the Executive Office of Elder Affairs are required to submit a report to the House and Senate Committees on Ways and Means that provides information on the number of employees (by job title and average salary) receiving a COLA in FY 08, the total payroll expenditures in each contract, and the average percentage adjustment that is being funded. 
 
By looking at the different pieces of legislation, it becomes evident that providers are forced to engage in annual or semi-annual campaigns to address historic inequities in wages and historic reimbursement rates. Providers have made efforts to address this structural problem by crafting legislation that would institute automatic increases to keep pace with medical inflation, secure large increases to bring rates and/or wages more into line with comparable services and salaries, and introducing cost-based reimbursement. In Nebraska, for example, the legislature is carrying over a bill that would create a Provider Reimbursement Rate Commission. This commission would need to complete a review of the status of behavioral health care reimbursement rates and the cost of care for services and identify necessary market adjustments for reimbursement rates above and beyond the consumer price index.
 
While there are varying amounts of funds allocating to COLA/rate increases throughout the country, some states have attempted to infuse educational components into their legislation as a way of acknowledging larger workforce concerns.  In New Hampshire, for example, the legislation requires that the Department of Health and Human Services convenes a committee to develop a plan to improve long-term workforce issues.  This plan must be submitted by December 1, 2007. The New York legislature is debating two pieces of legislation that would establish the “Quality Workforce Act of 2007”.  This Act would, among other things, provide education and training opportunities for direct service personnel. 
 
For a detailed description of COLA/rate increase legislative movement in 2007, please see the description below. 
 
Tammy Seltzer
Director of State Policy

Register Now for NC Live: Successful Strategies for Securing COLAs and Rate Increases in Difficult Times

Register now for the next policy-themed NC Live webinar on November 13 at 2:00 pm Eastern time.
 
"Successful Strategies for Securing COLAs and Rate Increases in Difficult Times"
 
Presenters:

· Tammy Seltzer, Director of State Policy, National Council
· Ron Brand, Executive Director, Minnesota Association of Community Mental Health Programs
· Terry Edelstein, President and CEO, Connecticut Community Providers Association

In behavioral healthcare, salaries and reimbursement rates generally lag behind those in other healthcare and related fields. Every legislative session, providers are waging battles to obtain minimal cost of living adjustments (COLAs) and rate increases--and they often come away empty handed. Winning these battles is essential to the ability of community behavioral health organizations to provide accessible, quality services to those in need.
 
In Minnesota, Ron Brand led a campaign that succeeded in obtaining a  23.7% rate increase for certain services provided by community mental health centers. Terry Edelstein developed and refined an impressive public relations campaign in Connecticut to address COLAs. They will share their strategies for success, what messages and tools have worked, and lessons they've learned about what doesn't work. Tammy Seltzer will provide a brief overview of COLA and rate increase activity across the country.
 
To register for the webinar, open free of charge to all National Council members, go to: http://registration.intercall.com/view/261-0

Nineteen states and the District of Columbia considered 48 pieces of legislation in 2007 relating to cost of living adjustments and rate increases for mental health, substance abuse, health services and community service providers. Nineteen bills have been enacted to date.

Arkansas HB 1292, now Act 1279, was signed by Democratic Gov. Mike Beebe on April 5. This bill requires the Department of Health and Human Services (DHHS) to pay hazardous duty pay to eligible personnel to compensate for the increased risk of personal injury. The hazardous duty pay can not exceed an amount equal to 5.5 percent of the annual salary authorized by law to any eligible employee and can only be made available to the personnel occupying high risk positions in special treatment units.

The director of DHHS will need to identify the facility and/or unit, location and eligible classifications within the facility or unit that are eligible to receive hazardous duty pay. The positions will be certified by the DHHS director as having been assigned to a work environment that poses an increased risk of personal injury. Those positions will be submitted to the Office of Personnel Management for approval by the Chief Fiscal Officer (CFO) of the state after review and approval by the Arkansas Legislative Council.

The bill does specify that the payments will be optional, at the discretion of the CFO and the Director of DHHS and, dependant upon sufficient revenues, can not be implemented using funds specifically set aside for other programs within the department. The provisions of this bill are effective from July 1, 2007 through June 30, 2009.

Arizona HB 2781 was signed by Democratic Gov. Janet Napolitano on June 25 and became Chapter 255 of the 2007 Session Laws. This bill appropriates $6,998,700 from the general fund and $11,624,900 from the matching federal expenditure authority to raise rates of community service providers and independent service agreement providers who contract with the Division of Developmental Disabilities for fiscal year 2007-2008. 

The bill also specifies that prior to the implementation of any developmentally disabled or long term care statewide provider rate increases (not already specifically authorized by the legislature, court mandates or changes to federal law) the department will need to submit a report for review by the Joint Legislative Budget Committee. The report will include, at a minimum, the estimated cost of the provider rate increase and the ongoing source of funding for the increase.

Colorado SB 165 was signed by Democratic Gov. Bill Ritter on March 22. This supplemental appropriations bill included a 3.25 percent rate increase for mental health services providers to be distributed during the fiscal year which began July 1, 2006 and ended June 30, 2007.

Connecticut HB 8001x was signed by Republican Gov. Jodi Rell on June 26. This bill appropriates $39 million to the Office of Policy and Management’s Private Providers Account. The monies will provide a three percent COLA in fiscal year 2008 for most private providers who contract with the Departments of Mental Retardation, Mental Health and Addiction Services, Children and Families, Social Services, Public Health and Correction, the Judicial Department and the Council to Administer the Children’s Trust Fund.

District of Columbia PR17-390 and PR17-391 were enacted on July 10. These resolutions will make changes to the compensation system to remedy serious pay inequities that exist for both non-collective bargaining clinical and non-clinical staff within the Department of Mental Health. The resolutions took effect immediately.

Illinois HB 3866 was signed by Democratic Gov. Rod Blagojevich on August 23 and became Public Act 95-0348. This bill contained many line-item vetoes which were overturned by the legislature.

HB 3866 appropriates $29.3 million from the General Revenue Fund to the Department of Human Services for all costs associated with a 2.5 percent COLA for community-based developmental disability providers for fiscal year 2008.

Massachusetts HB 4141 was signed, in part, by Democratic Gov. Deval Patrick on July 12. This bill appropriates $23 million to adjust wages, compensation or salary, and associated employee-related costs to personnel earning less than $40,000 in annual compensation who are employed by private human service providers that deliver human and social services under contracts with departments within the executive office of health and human services and the executive office of elder affairs. Home care workers who fit the salary requirements are eligible for the increase as well. The funds can not be allocated for special education programs, contracts for early education and care services or contracts funded exclusively by federal grants.

HB 4141 requires, not later than January 15, 2008, the executive office to submit to the House and Senate Committees on Ways and Means a report delineating the number of employees, by job title and average salary, receiving the adjustment in fiscal year 2008, the total payroll expenditures in each contract and the average percentage adjustment funded by this reserve.

Minnesota HF 1078 was signed by Republican Gov. Tim Pawlenty on May 25 and became Chapter 147 of the 2007 Session Laws. This bill increases the operating payment rate adjustment for Intermediate Care and Mental Retardation Facilities by two percent for rate periods October 1, 2007 and October 1, 2008. Seventy-five percent of the money resulting from the rate adjustment must be used for increases in compensation-related costs for employees. Compensation related costs include:

• Wages and salaries.
• FICA taxes, Medicare taxes, state and federal unemployment taxes.
• Workers’ compensation.
• The employer’s share of health and dental insurance, life insurance, disability insurance, long-term care insurance, uniform allowance and pensions.
• Other benefits provided.

Mississippi SB 3148 was signed by Democratic Gov. Haley Barbour on April 21. This bill appropriates $242,041,063 from the General Fund and $294,760,035 from special source funds for fiscal year 2008. The funds will be used for support and maintenance, including salaries, wages and fringe benefits for Department of Mental Health staff of the following facilities:

· Central Office.
· Services Budget.
· East Mississippi State Hospital.
· Ellisville State School and Farm.
· Mississippi State Hospital.
· Central Mississippi Residential Center.
· Brookhaven Juvenile Rehabilitation Facility.
· Specialized Treatment Facility.
· Division of Alcohol and Drug Abuse.
· Boswell Regional Center.
· North Mississippi State Hospital.
· North Mississippi Regional Center.
· Hudspeth Regional Center.
· South Mississippi Regional Center.
· South Mississippi State Hospital.

SB 3148 also specifies that funds provided in the bill will adjust the Variable Compensation Plan to ensure that all full-time employees receive a pay increase equal to the realignment component of the Variable Compensation Plan or $1,500, whichever is greater (awarded July 1, 2007).

Mississippi SB 3147 was signed by Governor Barbour on April 25. This bill appropriates, to the Department of Mental Health, over $21 million from the State General Fund ($16,778,343), the Health Care Expandable Fund ($636,374) and the Crisis Intervention Mental Health Fund ($4,368,178) for the operation and maintenance of the seven mental health crisis centers for the fiscal year that began on July 1, 2007 and will end on June 30, 2008. This appropriation also funds 337 permanent full-time staff positions.

Like SB 3148, the bill also specifies that funds provided in the bill will adjust the Variable Compensation Plan to ensure that all full-time employees receive a pay increase equal to the realignment component of the Variable Compensation Plan or $1,500, whichever is greater (awarded July 1, 2007).

Nebraska LB 321 was signed by Republican Gov. Dave Heineman after using the line item veto to cut an increase in the appropriation for provider rate increases. The bill sent to the governor contained General Fund provider rate increases totaling $7,538,577 in FY 2007-08 and $15,451,387 in FY 2008-09 within the Department of Health and Human Services.

The governor cut the appropriation in half. He vetoed $3,616,652 in General Funds for FY 2007-08 and $7,415,076 for FY 2008-09. The legislature did not override the governor’s line item veto. The finalized bill appropriates $3,921,925 for provider rate increase in FY 2007-08 and $8,036,311 for provider rate increase FY 2008-09.

New Hampshire SB 138 was signed by Democratic Gov. John Lynch on July 17. The bill, which became Chapter 363 of the 2007 Session Laws, was effective immediately upon the governor’s signature.

This bill increases the average salary for direct support staff employed by area agencies or providers with which area agencies contract who support persons with developmental disabilities and acquired brain disorders. HB 138 defines “direct support staff” as any person employed by an area agency or contract provider in which at least 50 percent of the person’s time is providing direct care or support to a client.

Staff and provider salaries will increase by at least two percent beginning July 1, 2007 and by at least two percent on January 1, 2009. The bill will also increase the reimbursement rate for enhanced family care providers by at least two percent beginning on July 1, 2008.

SB 138 also requires that, within 30 days of the bill’s effective date, the Department of Health and Human Services convene a committee to develop a plan to address long-term workforce and related human resources issues. The plan will need to:

· Provide for annual or periodic salary increases and recommendations for salary differentials or increments based on amount of experience or other factors for all staff positions at the area agency and provider level, in addition to the salary increases for direct support staff positions. The plan will need to provide a method for direct support staff to increase their salaries so that they are at least at parity with the mental health worker “I” position at the “New Hampshire Hospital” by July 1, 2011. The New Hampshire Hospital is a state-operated, publicly funded hospital providing a range of specialized psychiatric services.
· Provide for increased enhanced family care rates and rate structure, in addition to the two percent rate increase required by this bill.
· Address whether and how free college tuition programs should be made available or increased to help attract and retain a qualified workforce.
· Address whether and how affordable health insurance should be made available to workers employed at the area agency or provider level as well as to enhanced family care providers.

The department will need to submit the plan to the oversight committee by December 1, 2007.

New Mexico HB 2 was signed by Democratic Gov. Bill Richardson on March 15. This bill, known as the General Appropriations Act of 2007, appropriates $2.4 million to the Department of Health to provide rate increases for developmental disabilities and medically fragile Medicaid waiver providers for fiscal year 2008.

North Carolina HB 1473 was signed by Democratic Gov. Mike Easley on July 31. This bill appropriates $4,631,101,397 for 2007-2008 and $5,100,200,353 for 2008-2009 to the Department of Health and Human Services.

With the approval of the Office of State Budget and Management, the department will be able to use the appropriated funds for across-the-board salary increases and performance pay to offset similar increases in the costs of contracting with private and independent universities for the provision of physician services to clients in facilities operated by the Division of Mental Health, Developmental Disabilities and Substance Abuse Services.

Oklahoma Democratic Gov. Brad Henry signed SB 334 on June 4. This bill appropriates $207,529,129 to the Department of Mental Health and Substance Abuse Services for the fiscal year that began on July 1, 2007, and will end on June 30, 2008. Of the appropriated funds, $750,000 will go toward FY 2007 provider rate increases. For a look at the complete summary of the general appropriations bill, please use the link provided: 2007 Legislative Summary.

Pennsylvania HB 1286 was approved by Democratic Gov. Edward Rendell on July 17. This bill appropriates the following amounts to the Department of Public Welfare for fiscal year 2007-2008. The state funding will go toward a three percent cost-of-living increase:
 
· $723,659,000 for mental health services.
· $45,300,000 for behavioral health services.
· $868,061,000 for community mental retardation.

This bill also appropriates $685,455,000 in federal funds to the Department of Public Welfare for fiscal year 2007-2008. These funds will go toward a two percent cost-of-living increase for mental health services.

Rhode Island HB 5300 became effective without Republican Gov. Don Carcieri’s signature on June 21. This bill provides funding for COLAs, medical and other fringe benefits for staff within the Department of Mental Health, Retardation and Hospitals for the fiscal year ending June 30, 2008. To see a breakdown of the funding please use the link provided: Budget as Enacted (refer to pages 139-151).

Wyoming SF 76 was signed by Democratic Gov. Dave Freudenthal on March 9. This bill appropriates the following amounts from the General Fund for the fiscal year that began on July 1, 2007 and will end June 30, 2008:

· $1,359,522 to the Department of Health/Substance Abuse Division to increase the salaries of direct care personnel in community substance abuse treatment centers under contract with the division.
· $1,826,148 to the Department of Health/Mental Health Division to increase the salaries of direct care personnel in community mental health centers under contract with the division.

Pending Legislation

Illinois, Massachusetts, New York and Pennsylvania are still in session and have five bills pending. Illinois HB 3860, which is similar to HB 3866 reported above, would appropriate $29.3 million to the Department of Human Services for fiscal year 2008 for all costs associated with a three percent COLA for community based developmental disability providers. The bill would take effect immediately upon the governor’s signature.

Massachusetts HB 1863 would appropriate no more than $20 million to the Executive Office of Health and Human Services for fiscal year 2008 for cost of salary adjustments for the following employees:

· Private human services providers who deliver nonresidential mental health and developmental disability services and receive non-contractual payments through the State Medicaid program.
· Non-managerial personnel who are employed by private human service providers that deliver human and social services.
· Private human service providers that deliver human and social services under contracts with managed care mental health organizations under the MassHealth program.

The bill would require the executive office to submit an allocation schedule to the House and Senate Ways and Means Committees not less than 30 days after disbursement of funds. HB 1863 also specifies that the raises can not exceed $2 per hour per employee.

Identical New York bills AB 6619 and SB 3979 would establish the “Quality Workforce Act of 2007” to provide salary enhancements, education and training opportunities, and benefit stimulus for direct services personnel working within the state’s not-for-profit developmental disabilities, mental health and substance abuse service system.

All direct services staff members employed within the not-for-profit community developmental disabilities, mental health and substance abuse fields would receive a three year COLA. These employees would receive a three percent COLA in 2007, a four percent COLA in 2008 and a five percent COLA in 2009.

Both bills would also require the Office of Mental Health, the Office of Mental Retardation and Developmental Disabilities, and the Office of Alcoholism and Substance Abuse Services to reserve and accumulate funds from year to year for the following:

· To provide a benefits enhancement and stimulus to provide a minimum of a six percent pension plan for all direct services staff members working in the developmental disabilities, mental health and substance abuse fields.
· To create a three year scholarship training incentive program to provide annual funding in the amount of $1,200 per employee for up to 10 percent of the state’s not-for-profit direct services workforce in the areas of developmental disabilities, mental health and substance abuse. Employees who benefit from this program would need to commit to remaining employed in the identified fields of practice for a one year period for each $1,200 scholarship received by the employee. Employees unable to honor such an employment commitment would need to reimburse the state $100 per month of his or her remaining obligation term.

AB 6619 and SB 3979 would become effective immediately upon the governor’s signature.

Pennsylvania SB 846 would amend P.L.1640, No.2A which provided funds for the fiscal year that began on July 1, 2006 and ended June 30, 2007. This bill would appropriate the following funds to the Department of Public Welfare to increase state appropriations to provide a two percent cost-of-living increase:

· $685,455,000 for direct care staff of mental health services.
· $103,022,000 for direct care staff of early intervention services.
· $52,203,000 for direct care staff of services provided to persons with disabilities.
· $67,586,000 for direct care staff of attendant care services for physically disabled adults.

Bills Carried Over

California, Minnesota, Nebraska, North Carolina and Rhode Island will carry over 20 bills to 2008. California AB 308 would increase the annual appropriation to the Medical Providers Interim Payment Fund to an amount not to exceed $2 billion. The fund pays for providers of drug treatment services for persons infected with HIV and providers of services for the developmentally disabled.

Minnesota lawmakers considered several bills related to reimbursement rates:

· Identical bills HF 221 and SF 700 would require a rate reimbursement increase that equals eight percent of a day training and habilitation provider’s current reimbursement rate in Meeker County. The bills would also require the Commissioner of Human Services, in conjunction with community services providers, to prepare legislation to correct the disparity in per diem rate reimbursements between community service providers across the state
· Identical bills HF 196 and SF 148 would require the commissioner to increase reimbursement rates or rate limits for mental health services providers by a certain percentage for the rate periods beginning October 1, 2007 and October 1, 2008. A specific percentage was not written in the bills. Both bills also state that providers who receive a rate increase must use 75 percent of the additional revenue to increase wages and benefits, and pay associated costs for all employees. Providers of children’s therapeutic services and supports and adult rehabilitative mental health services would be eligible for the annual rate increase.
· HF 922 and SF 903, which carries the same provisions as HF 196 and SF 148, would increase the reimbursement rates or rate limits for mental health services providers by 2.2553 percent for the same rate period.
· HF 721 would increase the operating payment rate adjustment for Intermediate Care and Mental Retardation Facilities (ICF/MR) by five percent for rate periods October 1, 2007 and October 1, 2008. Seventy-five percent of the money resulting from the rate adjustment must be used for increases in compensation-related costs for employees. Compensation related costs include wages and salaries, various taxes, workers’ compensation, health insurance, pensions and other benefits. The bill would also increase community service provider rates by five percent for rate periods October 1, 2007 and October 1, 2008, with 75 percent of new money going to increases in wages, benefits and associated costs for all employees. Community services include, but are not limited to:
· Home and community-based waiver services for persons with developmental disabilities or related conditions.
· Waiver services under community alternatives for disabled individuals.
· Traumatic brain injury waiver services.
· Day training and habilitation services for adults with developmental disabilities or related conditions.
· Adult residential program grants.
· Adult and children’s mental health grants.
· Adult mental health integrated fund grants.
· Community support services for deaf and hard-of-hearing adults with mental illness who use or wish to use sign language as their primary means of communication.
· Children’s therapeutic services and supports.
· Tier I chemical health services.
· Identical bills HF 842 and SF 888 also include rate increases for ICF/MR facilities and community services providers with the same provisions. The percentage of increase would be two percent instead of five percent. Similar bill, SF 679, includes rate increases for ICF/MR facilities and community services providers with the same provisions for the same rate period. The bill does not give a specific percentage for the rate increase. HF 1395 and SF 1691 would include a seven percent rate increases for ICF/MR facilities and a six percent rate increase for community services providers for the same rate period.
· HF 972 and SF 843 include rate increases for ICF/MR facilities and community services providers with the same provision as listed above. The bill does not give a specific percentage for the rate increase and the rate periods are July 1, 2007 and July 1, 2008 instead of October 2007-2008. HF 1297 and SF 1122 would include a rate increase of seven percent for rate periods July 1, 2007 and July 1, 2008. All four bills would also require the commissioner to provide an additional rate increase for overnight sleep staff employed by ICF/MR facilities and community service providers.

Nebraska LB 576 would provide the funding necessary for an annual rate increase for behavioral health care service providers of children, youth or adult populations, under the Medicaid program or other state-funded behavioral health programs.

The bill states that behavioral health care services include “psychiatric, mental health, developmental, behavioral, substance abuse and chemical dependency services and all such services provided as part of child welfare, child protection and safety, and juvenile justice services.”

LB 576 would also create a Provider Reimbursement Rate Commission. This commission would need to complete a review of the status of behavioral health care reimbursement rates and the cost of care for services and identify necessary market adjustments for reimbursement rates above and beyond the consumer price index.

North Carolina SB 1433 states that the Director of the Budget and the Department of Health and Human Services would need to comply with G.S. 143 10.1A, which requires the state budget to include funds for expansion costs related to employee compensation. The director and the department would need to include, in its continuation budget request, funding for COLAs for local management entities that provide for mental health, developmental disabilities and substance abuse services for group homes for mentally retarded individuals.

For fiscal year 2008, Rhode Island HB 6040 would allow private community-based health and human service organizations to receive a COLA equivalent to the percentage prescribed by the Consumer Price Index. As of September the current increase would be 3.4 percent.

The bill defines the private community-based health and human service organizations as:

· Home health services.
· Children’s residential programs contracted with the state to provide residential services for youth.
· Mental health treatment and substance abuse treatment and prevention services provided by community-based organizations.
· Organizations providing vocational, residential, rehabilitation and evaluation services to persons with developmental disabilities, but not including early intervention services.
· Services of Adult Day Health Centers, which provide a safe, medically supervised environment and therapeutic day services to disabled adults, frail elders and victims of Alzheimer’s Disease or related disorders.

One bill relating to provider COLAs was vetoed in 2007.

Minnesota SF 2171 was vetoed by Governor Pawlenty on May 8. This bill would have increased the operating payment rate adjustment for ICF/MR facilities by three percent. Seventy-five percent of the money resulting from the rate adjustment would have been used for increases in compensation-related costs for employees, including wages, salaries, workers’ compensations and health insurance.

Three bills relating to rate increases died pursuant to legislative adjournment in 2007.
 
Connecticut SB 1294 would have required, on and after July 1, 2008, the wages paid on an hourly basis to any employee of a contracted “required human services employer” to be at a rate not less than the standard rate for the janitor occupational classification determined by the Labor Commissioner – which is currently $11.13 an hour. “Required human services employer” included:

· Nonprofit organizations providing services to alcohol-dependent or drug-dependent persons.
· Organizations providing services to children transferred or committed to the Department of Children and Families.
· Psychiatric clinics and day treatment centers.
· Youth service bureaus.
· Organizations receiving grants for programs for the treatment and prevention of child abuse and neglect and for programs for juvenile criminal diversion.
· Organizations establishing or maintaining programs for children and adults with mental retardation.
· Community-based residential facilities for persons with mental retardation.
· Organizations providing programs of employment opportunities and day services for adults with mental retardation.
· Private facilities licensed to provide for the lodging, care or treatment of persons with mental retardation or autistic persons.

Connecticut SB 1338 would have increased the compensation rate paid to private providers of health and human services under contract with the Departments of Social Services, Children and Families, Mental Health and Addiction Services, Mental Retardation, Public Health, Correction, Education, the Labor and Judicial Departments and the Children’s Trust Fund Council by not less than seven percent of the contracted rate in effect for such providers on June 30, 2007. The bill would have also increased the rate by five percent of the contracted rate in effect for such providers on June 30, 2008.

West Virginia HB 2984 would have authorized a COLA of two percent or more (not to exceed five percent) for comprehensive community mental health providers.