House lawmakers consider extending changes made to human services programs in response to COVID-19

Some changes made to keep people safe during the COVID-19 pandemic — like the expansion of telemedicine services — might make for long-term improvements to Minnesota’s human services programs.

SSHF105, sponsored by Rep. Tina Liebling (DFL-Rochester), would extend waivers and modifications to human service programs after the end of the state’s COVID-19 peacetime emergency.

The House Health and Human Services Finance Division approved the bill, as amended, Monday, referring it to the House Ways and Means Committee.

A companion, SSSF99, sponsored by Sen. Jim Abeler (R-Anoka), was introduced in the Senate Monday and tabled. Liebling said it is aligned with the current version of SSHF105.

While some of these extensions will allow policies to be considered for permanent adoption, others are needed to either remain in federal compliance, or provide a “ramp-up” period for the return to services.

This is especially vital for counties, tribes, and community partners, said Human Services Commissioner Jodi Harpstead.

The first category —which would extend modifications and waivers until June 30, 2021 — includes an expansion of what modes can be used for delivering services under the Medicaid program.

Previously, “strong restrictions” limited patients’ ability to use phone calls, FaceTime, or other video meeting platforms like Zoom — which the division used to hold its remote hearing. But they might not have access to the “more robust equipment” needed for qualified telemedicine servicess, said Matt Burdick, the department’s director of state government relations.

Other modifications and waivers that would be extended until June 30, 2021 include measures that would:

• expand and provide flexibility to telemedicine services, including those used to bring mental health services into schools;
• allow flexibility for the oversight of personal care assistance services, and housing licensing requirements;
• partially waive county costs when COVID-19 diagnoses delay discharges from Department of Human Services-operated psychiatric hospitals;
• expand remote home and community-based services waiver services;
• authorize the use of telemedicine for patient assessments and consultations in the medical cannabis program; and
• modify certain requirements for early intensive developmental and behavioral intervention services.

The bill was amended to include a $1.14 million appropriation allowing the extension of a provision that increases the length of time people can be away from their homes while remaining eligible for state-funded housing support.

This would accommodate COVID-19-related hospital stays, and ensure people have a safe place to be discharged to, Liebling said.

It would be financed by a federal coronavirus relief bill, though that means the funding would only available until Dec. 30, 2020, making it “not a great solution,” Liebling said.

“But it’s kind of the best we can do at the moment,” she said. “Even if it could really only go to the end of this year… it’s better than not extending it at all.”

Stakeholders said additional waivers and extensions and provisions should be included in the bill.

“I like to think of this as counties asking for more tools in our tool belt, to be able to appropriately and safely serve the individuals we work with on a daily basis,” said Angela Youngerberg, human services director of business operations for Blue Earth County.

Extensions in the bill required for the state to remain compliant with federal law and eligible for full federal funding include:

• measures intended to preserve health care coverage for people on Medical Assistance and Minnesota Care;
• changes to the Supplemental Nutrition Assistance Program;
• elimination of cost-sharing for COVID-19 diagnosis and treatment; and
• changes to the eligibility period for the Refugee Cash Assistance Program and Refugee Social Services Program, which are federally funded.

Other human services modifications and waivers made in response to the COVID-19 peacetime emergency would be allowed to remain in effect for up to 60 days after the end of the peacetime emergency in order to transition the affected programs into operating normally.

Matthew Bergeron, representing the Minnesota First Provider Alliance, and Sara Grafstrom, director of state and federal policy for the Association of Residential Resources in Minnesota, both spoke in support of these measures, but said that service providers could use even more time to meet fingerprinting requirements.

Sites are limited and can be difficult for people to access — especially in Greater Minnesota — and a backlog could exacerbate the state’s workforce shortage, Grafstrom said.