July 1, 2016

Session Closing Chaos: Special Session in the Wings?

In the waning hours of the 2016 legislative session, lawmakers wrapped up a supplemental budget bill and a tax bill, but failed to pass a comprehensive transportation package, a bonding bill, or a plan for implementing federal Real ID requirements. The breakdown came after hours of negotiations and lengthy floor sessions. The tax bill passed by the Legislature was ultimately pocket vetoed by Governor Mark Dayton on June 6.

Supplemental Budget

On June 1, Governor Dayton signed HF 2747, the supplemental appropriations bill for the 2016 legislative session, into law. While attention has focused on items that did not pass, including a bonding bill funding public building projects and a transportation package, some very positive things –made it through the legislative process. There is still uncertainty whether the governor will call a special session to address the unresolved tax, bonding and transportation issues.

The budget bill conference committee approved an overall bottom line of $182 million in supplemental spending for the biennium. The House had previously proposed just $3.2 million in supplemental spending, compared to the Senate’s $454.8 million. The bill provides funding for a wide range of programs, including $25 million for prekindergarten, $35 million for broadband expansion, and $35 million for equity programs – all of which were priorities for Governor Dayton.

Recognizing that 2016 was scheduled to be a short legislative session with minimal new expenditures being added to last year’s biennial health and human services budget, the summary of 2016 changes is short, but includes some important initiatives:

Passage of the Excellence in Mental Health Act
The Excellence in Mental Health Act, which was included in the final supplemental budget bill. This legislation will improve mental health and addiction treatment by creating a “one-stop-shop” model of certified community behavioral health clinics providing comprehensive, coordinated and integrated care for both adults and children. Minnesota is competing with 23 other states to be selected as one of eight states for this national demonstration project. Without the state’s funding, Minnesota’s selection would have been unlikely. The bill includes an initial $188,000 for FY 2017 and $8.433 million for FY 2018-2019.

New funding to increase capacity at Community Behavioral Health Hospitals (CBHHs)
The supplemental appropriation bill includes funding to allow six of the state’s CBHHs to operate at their full capacity by serving 16 patients each. These facilities have been operating at a 10-bed capacity. The bill provides an additional $19.815 million in FY 2017 and $47 million in FY 2018-2019.

New funding for competency restoration services
One of the biggest challenges facing Minnesota’s hospitals and health systems is the shortage of capacity at the Anoka Metro Regional Treatment Center (AMRTC). The appropriation bill includes $6.754 million in FY 2017 and $16.846 million in FY 2018-2019 to fund a stand-alone competency restoration program, which would allow for the transfer of patients from AMRTC who no longer need that level of service but who do need competency restoration services to a new facility in St. Peter. This has the potential for AMRTC to treat approximately 20 more patients.

While these provisions will not solve all the challenges with the delivery of mental health services, these supplemental appropriations will improve Minnesota’s ability to address the growing mental health needs of our state.

Long Term Care:

  • disappointing thing for our home and community based waiver providers was the lack of a rate increase for the home and community based services.
  •  Nursing Home Moratorium money was included,
  •  Elderly Waiver Data Collection provision was omitted.
  • Re-Codification of Nursing Home Statutes
  • Technical Corrections to Value Based Reimbursement

Other Items included in the Supplemental Finance Bill include:

  • Provides a 5 percent Medical Assistance rate increase for rural ambulance providers.
  • Restores funding of $1.035 million to the Greater Minnesota family medicine residency program, beginning in 2017 and ongoing. Increases MERC by $1 million per year and ongoing.
  • The MinnesotaCare program is preserved as is with current eligibility, in line with MHA’s recommendation.
  • $4.8 million in FY 2017 and $28 million in FY 2018-19 to allow a spouse to preserve their family’s assets when their partner needs home- or community-based services provided through Medical Assistance;
  • $2.8 million in FY 2017 and $3.8 million in FY 2018-19 to tribal governments to support their efforts to provide culturally-responsive human services;
  • $2.5 million in FY 2016 and $4.8 million in FY 2018-19 to prevent liens from being placed on older Minnesotans’ estates when they enroll in Medical Assistance;
  • $20 million in FY 2018-19 for a 15 percent increase in payment rates to foster parents;
  • $188,000 in FY 2017 and $8.4 million in FY 2018-19 to be invested in certified community behavioral health clinics, a proposal that may be matched with an additional $15 million in federal dollars; and
  • $8.8 million in FY 2018-19 to support vulnerable youth through the Homeless Youth Act, school-linked mental health services and Safe Harbor for Sexually Exploited Youth.

Items Not Included: The bill did not include any of the proposals to seek approval from the federal government to change the way Minnesota manages our state’s options for affordable public health insurance.

Negative proposals left out would have:

  • Re-instituted asset testing for MinnesotaCare, placing an unnecessary, inefficient bureaucratic wall between more than 100,000 Minnesotans and affordable health insurance.
  • Provided working Minnesotans eligible for MinnesotaCare with options for health plans that come with higher premiums and cost-sharing than MinnesotaCare.
  • Constructive waiver proposals would have:
  • Re-established eligibility for Minnesotans earning 200 to 275 percent of the federal poverty guidelines, or $24,000 to $33,000 for a single adult. Minnesotans in this income range are nearly three times more likely to lack health insurance as Minnesotans with higher earnings. The cost of providing MinnesotaCare to these Minnesotans would likely be covered considerably or entirely by federal funding.
  • Allowed access to MinnesotaCare for people earning more than 275 percent of federal poverty guidelines.
  • Simplified health insurance enrollment processes for families with children eligible for Medical Assistance.

Compassionate Care Act

Legislation known as “The Compassionate Care Act” which would legalize Assisted Suicide was introduced in both the Senate and the House.  It did receive a hearing in the Senate, where the Bill Author, Chris Eaton presented her bill.  Ultimately, the legislation did not pass out of the committee, but it was a preview for the coming years as the discussion over assisted suicide will hit Minnesota.