More than half a million Minnesotans could lose government-funded medical care, child care and food support as of July 1 if the impending state shutdown occurs.

The Department of Human Services started sending notices Tuesday to benefit recipients -- mostly poor and disabled Minnesotans -- about the potential loss of support. While many steps could prevent the wholesale suspension of state benefits -- from a budget agreement, to court intervention, to "lights on" legislation while talks continue -- a human services official said people deserve fair warning.

"By law, we are required to give clients a certain amount of notice" when the status of their benefits changes, said Deputy Human Services Commissioner Anne Barry. "We just hit that point in the monthly calendar when, if we didn't get these notices out on this cycle, we wouldn't have gotten them out before their status changed."

By week's end, the state will have notified 572,000 Minnesotans on cash welfare, food support and health care programs; 7,000 families receiving adoption assistance payments, and 26,000 families receiving child-care subsidies.

The notices are littered with ambiguity reflecting the uncertain situation. While the department expects doctors to continue treating patients enrolled in such state-funded programs as Medical Assistance and MinnesotaCare, it told recipients it couldn't guarantee that they would still receive care.

"If a provider won't see you and you need urgent care, go to an emergency room," one notice advised.

Doctors, hospitals and other providers are hoping for court intervention that would designate their services essential and require the state to pay for them. Such a ruling was granted in the summer of 2005, just before a nine-day state government shutdown; Minnesota Attorney General Lori Swanson filed a petition in Ramsey County on Monday with a similar goal in mind.

On Wednesday, Gov. Mark Dayton plans to file a petition in Ramsey County District Court to detail which state services he believes simply must stay operational even if government shuts down.

Lobbyist Tom Lehman, who represents a variety of health care organizations, has arranged a meeting at the Capitol on Thursday for providers to discuss shutdown survival. Some nonprofit providers, particularly mental health clinics and group homes, receive most of their funding from state programs and have only enough reserves to keep their doors open for a few weeks.

False alarm?

Lehman was faulted by some opponents of the governor, who believe his administration sent Tuesday's notices partly to spread fear and to pressure Republicans to cut a deal. He said that isn't his intent.

"Do we need to reduce our hours? Do we need to lay off staff?" he said. "There's a host of 'what-ifs'. But in the health care world, providers have to deal with the 'what-ifs.'" What if, for example, a state-funded patient is in the middle of chemotherapy when the shutdown occurs? What if a pregnant woman's due date is July 1?"

Fairview Health Services, one of the state's largest hospital and clinic networks, plans business as usual and encourages patients to go to the appropriate source of care -- and not to flood emergency rooms, said spokesman Ryan Davenport. The organization backs a petition seeking "essential" status for health care services.

Beyond health care, Human Services sent notices to people receiving food support, even though it's entirely funded by federal money. Barry said it is still the Legislature's responsibility to approve that program in Minnesota and direct federal funding for it.

Barry stressed that the notices are the agency's best attempt to warn Minnesotans of the potential loss of benefits. "Worse," she said, "would be a position where people's status changed, and they weren't notified."

Lehman said there is comfort in recent history -- the 2005 shutdown -- suggesting that people won't lose their benefits. However, he said, people can't count on that precedent; the state deficit is bigger now and the gulf between Dayton and legislators appears much deeper at this point in the calendar.

"It's all new players," he said, "so you can't just assume what happen[ed] in the past is automatically what will happen in the future."

Jeremy Olson • 612-673-7744