Forced reform for people with disabilities is ‘right thing to do’

Rather than living in shackles and handcuffs in institutions, former Minnesota Extended Treatment Options residents spoke loud and clear in a 2009 federal class-action lawsuit that they expect to live as independently as possible and make choices that affect their own lives.  

Rather than go to trial, the Department of Human Services agreed to a court-monitored settlement agreement. An action plan was developed to comply with the terms of the settlement known as the Minnesota Olmstead Plan, which the House Health and Human Services Finance Committee reviewed Thursday. No action was taken by the committee, which is charged with divvying up health and human services appropriations among the state’s programs and services.

The cost of making the necessary policy changes are daunting but the cost of non-compliance looms large over the committee.

“It’s also the right thing to do to protect the state against further loss,” said Roberta Opheim, a mental health and developmental disabilities ombudsman who helped launch the 2009 lawsuit.

The courts directed the department to move people with developmental disabilities from segregated living into more integrated settings. Since the settlement, DHS has discontinued the METO program and closed its Cambridge facility. In its place is Minnesota Life Bridge, a community-based residential treatment program consisting of two homes. Another two homes are in the works, one in northeast Minnesota and another in the Twin Cities metropolitan area.

Rep. Diane Loeffler (DFL-Mpls) said expanding the geographic footprint for housing “needs to be a priority,” because living close to loved ones or a support network is a “civil right.”

Rule 40, which directed the use of punishment procedures in licensed facilities, is being modified to encourage more positive-based care. It applies to home and community-based services licensed in Minnesota. Public comment on the revised procedures may begin next month, with final rules released during the summer, according to Deputy Commissioner Anne Barry.

In January 2013, the Olmstead Subcabinet was formed and about eight state agencies were identified to help develop and implement the plan, which requires policy changes in education, transportation, housing, staff training and other services for persons with disabilities.

Rep. Nick Zerwas (R-Elk River) said he is working on proposed legislation to reform the Medical Assistance assets limit for people with disabilities, which has not changed since the 1980s. The current system prevents them from developing any kind of safety net for financial or medical emergencies.

“That’s something that is such a complex issue … understanding what a burden for the sickest and poorest among us to then say that if you make a dollar over the federal poverty guideline, then we’re going to ask you to spend down to 75 percent ($730/month) for your income. We’re keeping them at the brink of poverty,” Zerwas said.

In addition to working across state agencies, counties, which carry out many of the disability services under the state’s supervision, are looking for state leadership on the changes.

“Any outcomes of this session need to consider the Olmstead Plan,” said Chisago County Human Services Director Nancy Dahlin.