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Agencies pan omnibus health bill’s approach to elder abuse

Almost all seats in a State Office Building hearing room were filled April 18 while the House Health and Human Services Finance Committee walks through its potential omnibus bill. Photo by Andrew VonBank
Almost all seats in a State Office Building hearing room were filled April 18 while the House Health and Human Services Finance Committee walks through its potential omnibus bill. Photo by Andrew VonBank

Two top government officials said Wednesday the newly unveiled omnibus health and human services finance bill fails to sufficiently address the elder abuse crisis.

A delete-all amendment to HF3138 was heard publicly for the first time in the Health and Human Services Finance Committee, where testifiers got the chance to respond to the 241-page screed, released the night before. Rep. Matt Dean (R-Dellwood), the committee chair, is the sponsor.

The committee is scheduled to mark up the bill and take a vote Thursday.

To help with the protection and care for elder and vulnerable adults, the bill would set up several work groups to study issues surrounding elder care, including how to institute a licensure program for assisted living facilities and modify requirements in the Maltreatment of Vulnerable Adults Act.

Human Services Commissioner Chuck Johnson said he agrees with the balance of the provisions in the bill. However, he added the elder abuse provisions don’t go far enough, given the concerns expressed by families of elders facing abuse. He advocated for requiring licenses for assisted living facilities and continuing funds for the Minnesota Adult Abuse Reporting Center. Simply studying the possibility of requiring licenses is not enough, Johnson said.

“A workgroup isn’t an adequate response to the needs in that area,” he said.

WATCH Overview of the omnibus health and human services finance bill 

Health Commissioner Jan Malcom said she was very concerned that almost none of Gov. Mark Dayton’s proposed budget was included in the bill. On elder abuse, Dayton’s budget included action based on a consumer working group and a report by the Office of the Legislative Auditor, she said. The omnibus bill, not so much.

“We don’t believe it goes far enough, and we don’t believe that it recognizes the important fact that there is strong, bipartisan consensus for a more comprehensive and immediate response to this issue,” she said.

Malcom pointed out the bill lacks provisions allowing cameras in patient rooms so families can monitor care. Furthermore, she said the bill has no “real promise of action in law or regulation to stand up for elderly and vulnerable adults in assisted living settings or dementia care units.” It lacks necessary teeth to ensure Minnesota’s law on vulnerable adult abuse isn’t just words on a page, she added.

 

Financial changes

The House budget resolution allocates an additional $10 million in new General Fund spending for health and human services; however, the bill contains numerous other fiscal changes that result in nearly $19 million in additional Fiscal Year 2019 spending for the Human Services Department and just under $11.94 million for the Department of Health.

Spending includes:

  • $7.74 million to home and community-based waiver service providers projected to be negatively impacted due to a rate transition;
  • $2.9 million to the University of Minnesota for biomedicine and bioethics innovation grants;
  • $1.9 million in child and economic support grants;
  • $1 million for the health professional education loan forgiveness program;
  • $786,000 to provide training to county and tribal child welfare workers and supervisors and staff at agencies providing out-of-home placement services;
  • $640,000 to fund five additional regional ombudsmen in the Office of Ombudsman for Long-Term Care;
  • $613,000 to decrease racial and ethnic disparities in access to and utilization of high-quality prenatal care; and
  • $291,000 for tobacco cessation services.

View the spreadsheet.

The Department of Human Services would be required to track down and collect unpaid premiums for MinnesotaCare from 2014-17. Department officials oppose the measure.

The amount MNsure can collect on individual and small group health insurance plans would be lowered from 3.5 percent of premiums to 2 percent beginning in January 2019. The MNsure board would be prohibited from imposing additional certification requirements on health plans beyond those authorized in state or federal law.

 

Opioids and prescription drugs

Included in the additional spending is $2 million for opioid abuse prevention pilot projects and $1 million for the opioid overdose reduction pilot program.

The bill would provide grants to ambulance services for opioid overdose reduction activities conducted by community paramedic teams, establish a drug repository program for donated drugs and medical supplies, and prohibit restrictions on consumers paying the lowest cost for prescription drugs.

Additionally, the Human Services Department would be required to “develop and administer a program to award grants to secondary school students in grades 7 through 12 and undergraduate students attending a Minnesota postsecondary educational institution, and their community partner or partners, to conduct opioid awareness and opioid abuse prevention activities.”

Not included is HF1440 sponsored by Rep. Dave Baker (R-Willmar), which, in part would draw $16.5 million from the General Fund to combat the opioid crisis by providing grants to emergency medical services teams and others on the front lines, and another $3.5 million to the board of pharmacy to integrate its prescription monitoring program with health care records.

 

Nurses

The bill would allow Minnesota to join the interstate nurse licensure compact whereby out-of-state nurses could practice in the state without a specific Minnesota license, if they have a multi-state license under the compact. Malcom said Dayton opposes the move.  

 

No SNAP changes

Not in the bill are controversial aspects of HF3722 and HF3612. Sponsored by Rep. Kelly Fenton (R-Woodbury), they would institute a work requirement for Medicaid and review Supplemental Nutrition Assistance Program benefits for possible cuts, respectively.

Under the proposed legislation, able-bodied adults who are not the sole caretaker of a child would be required to work or be engaged in community or public service for at least 80 hours per month, be seeking employment, or enrolled in a job training program.

 

What’s in the bill?

The following is a selected list of bills that have been incorporated, in whole or in part, into the omnibus health and human services finance bill:


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