Buying time for mental health

  • Article by: WARREN WOLFE and JOSEPHINE MARCOTTY , Star Tribune staff writers
  • Updated: April 13, 2010 - 9:14 AM

Legislators seek to block Pawlenty plan, shift funding, and keep state mental-health and dental clinics open for now.

A bipartisan group of legislators said Monday they intend to block the Pawlenty administration from overhauling state mental health services in a plan that would cut $17 million and streamline service delivery.

In what is becoming a familiar exchange, the lawmakers say Gov. Tim Pawlenty is balancing the state budget on the backs of the poor and the sick -- in this case, about 15,000 people, many getting court-ordered mental health care.

The group, led by Senate DFLers, said they intend to block the plan, announced last month by the Department of Human Services, and replace it with their own.

"What we are doing, essentially, is buying some transition time so the department can do the planning and consulting with stakeholders in order to get it right," said Sen. Linda Berglin, DFL-Minneapolis. "Right now, it's a plan that will fail."

Berglin added, however, that she agrees on the need to restructure mental health services and accepted the administration's "overall vision.''

Human Services Commissioner Cal Ludeman said Monday he'll need to see the Senate's full budget for health and human services to know "whether her proposal is really workable. It comes down to the money."

The Senate plan would cost about $7 million to $8 million in new state spending this biennium -- at a time when legislators are trying to erase a nearly $1 billion deficit -- but bring in an additional $20 million next biennium in new federal Medicaid money.

It would temporarily keep open six 16-bed community mental health hospitals scheduled to close by June 30, and save the jobs of 200 state employees. It also would keep open all six state-operated dental clinics for people with developmental disabilities, which Pawlenty intends to close.

Ludeman said his department will proceed with its plan "unless the budget changes or we get orders to stop," he said, adding that the changes will improve access to better and more cost-efficient care.

Ludeman also noted that it may be difficult to increase Medicaid spending in Minnesota. "We're still getting direction" from the federal government after recent health care legislation expanded health coverage under Medicaid, "and if we guess wrong, we might have to come back to the Legislature for tens and tens of millions of dollars," Ludeman said.

Replay?

A similar showdown between lawmakers and Pawlenty led the Legislature in February to pass bipartisan legislation for a new way to finance General Assistance medical care for about 35,000 poor, sick residents after the governor cut funding last year. Pawlenty vetoed that bill but last month agreed to a stripped-down compromise that generally is viewed as a stop-gap program.

The state's mental health system underwent a major reorganization three years ago in an effort to get better care spread around the state through community behavioral health hospitals, which have never been filled.

Last year, the Legislature asked the Department of Human Services to figure out how to get more federal funding for mental health facilities in Cambridge and Anoka and shift treatment from those centers into metro area community settings.

"They didn't do it," Berglin said, "so I've done it for them."

State officials said that once they began to examine a few mental health programs, they saw they needed to broaden their reorganization. In addition to closing most of those community centers, the plan that emerged also envisions adding several types of psychiatric residential care in every region of the state; starting a 24-hour psychiatric consultation service to advise families, law enforcement officials and others; and spinning off some services now provided by the state to private mental health practitioners.

Some legislators and advocates say the state didn't consult stakeholders outside the Human Services Department until late fall, and that the recommendations to the Legislature came as a surprise.

Sue Abderholden, executive director of the Minnesota branch of the National Alliance on Mental Illness, said she's also concerned that the plan remains vague and may not provide the services needed by people with serious mental illness.

Several Republicans, including Sen. Paul Koering, R-Fort Ripley, appear ready to join DFL critics of the plan.

Meanwhile, House members said last week they intend to require the Human Services Department to stop the changes until it gets legislative approval.

"Sometimes the [Human Services] department forgets that we're their board of directors," said Rep. Jim Abeler, R-Anoka.

Josephine Marcotty • 612-673-7394 Warren Wolfe • 612-673-7253

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