With the 2015 Legislature headed for an overtime session to settle unresolved disputes with Gov. Mark Dayton, much has been said about policy aspirations still unachieved. Permit a word about two stellar achievements already attained. Major improvements were engineered this year for both mental health and nursing home care in Minnesota. The particulars:
• A wide range of mental health services will see increases totaling $46 million in the next two years. That’s the largest investment of new funding in mental health in state history and will go a long way toward establishing something that’s been lacking — an integrated system of services that can respond appropriately to mental illness, whenever or wherever in Minnesota it appears.
With a lobbying theme “We know what works; let’s build on it,” advocates argued for a mix of proven strategies rather than one or two silver bullets. The new money will flow to early intervention and crisis management; to ongoing, community-based services; to suicide prevention, and to supportive housing. In addition, it will ease a shortage of beds at Anoka Metro Regional Treatment Center, which provides the most intensive care for those with mental illness.
• A new reimbursement formula will bring an additional $138 million over two years to nursing homes. The enacted change should halt a long funding slide in the wrong direction for the facilities that care for Minnesota’s frailest citizens. The former reimbursement scheme was not keeping pace with the actual cost of care. The new formula is designed to do just that, while also providing incentives for quality and efficiency.
Residents of nursing homes will be the ultimate beneficiaries. But so will nursing-home workers, whose wages have not kept pace with comparable jobs in other settings. Richer reimbursement will allow for wage increases, while an earmark of $1.3 million over two years will fund scholarships for nursing-home employees seeking to pursue careers in long-term care.
We were also glad to see funding increases for home health care workers, dental services for the poor, child-protection services, and help for victims of sexual trafficking and abuse.
Why the good outcome on these fronts when progress elsewhere was stymied? In each case, change was many years in coming. Coalitions of stakeholders were built and evidence was collected to make a solid case for new approaches. Requests were fashioned that were both realistic and future-oriented — and were not dependent on one party’s electoral fate. Allies were found in both parties and both the legislative and executive branches of government.
While we salute these changes, we’re concerned about the shaky fiscal foundation that underlies the entire human-services budget in coming years. Too many obligations have been transferred to the special fund that undergirds MinnesotaCare, the state’s subsidized-insurance program for the working poor. That fund is sustained by a tax on health care providers’ services that is slated for elimination in 2019. Minnesotans who value dependable state help for the poor, sick and disabled have reason to keep an eye on a new commission charged with finding a way to stabilize those services going forward.