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Reform measures draw support

Published (8/11/2011)
By Lee Ann Schutz
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One of the largest pieces of the state budget is health and human services, and for the 2012-2013 biennium, the law comes in at $11.3 billion, about 8 percent below the forecast base. However, according to the law’s sponsor, Rep. Jim Abeler (R-Anoka), the reform proposed puts health and human services on the road to sustainability.

Referring to the 2011 session omnibus bill vetoed by the governor, Abeler said, “If you contrast the choices, this (law) is superior in many ways. Who knew you can do reform with no money and save money.” The law reduces spending about $1.04 billion in the biennium and creates a growth rate of 4.8 percent in the out years, he said.

Sen. David Hann (R-Eden Prairie) is the Senate sponsor.

Rep. Steve Gottwalt (R-St. Cloud) said the law reduces growth in state spending from 22 percent to 11 percent in the first biennium.

However, Rep. Thomas Huntley (DFL-Duluth) said it “basically stinks.” He pointed to the cuts to hospitals and nursing home funding, saying this will force some out of business. He acknowledged some of the reform measures, particularly Medicaid early enrollment, but added that this was part of the federal Patient Protection and Affordable Care Act.

Provider tax not provided

The law provides the Department of Human Services with a General Fund appropriation of $11.4 billion over the 2012-2013 biennium and the Department of Health $143.2 million over the same period.

According to a nonpartisan House Research Department report, Minnesota imposes a series of taxes on various types of providers of health care goods and services. Revenues collected under these taxes are used to pay for the MinnesotaCare program, which provides state-subsidized health care coverage for low-income individuals. Under the new law, a phase out of the so-called provider tax will begin with complete elimination by 2020.

Some small rural nursing homes and rural pharmacies benefit from the law with a 15 percent and 4 percent rate increase, respectively.

The law also recognizes the increasing number of Alzheimer’s disease patients and those suffering from dementia. Beginning July 1, 2012, the commissioner of health is to develop measures for improving assessment and care related to these diagnoses.

Human services spending

The law saves more than $3.3 billion over the biennium by reducing or eliminating grants, including $826 million in child care development grants and child care facility grants, and $410 million by eliminating the University Special Kids Intensive Care Management grant.

The state’s managed elderly waiver program is cut by $20.4 million over the biennium, and there is a reduction to certain congregate living rates.

Reforms include changes for those using the EBT (electronic benefits card) program for cash and food assistance. The law spells out more clearly what the card can or cannot be used for, such as no alcohol or tobacco. It also requires liquor stores, tobacco stores, gambling establishments and tattoo parlors to negotiate with their third-party processors to block EBT cash transactions at their places of business and withdrawals of cash at ATMs located in their places of business.

Child care assistance provisions are tightened. The new law reduces the maximum rate of assistance that can be paid for the at-home infant child care program from 90 percent to 68 percent of the rate that is paid for licensed family child care assistance. Additionally, the law prohibits, under most circumstances, child care assistance funds from being used for services provided by a person who employs either the parent of the child or a person who resides with the child.

There are several eligibility changes to General Assistance and Minnesota Family Investment Program (MFIP):

• limiting recipients to one emergency General Assistance grant in any 12-month period. It establishes a floor of $1,000 per fiscal year for county emergency General Assistance;

• prohibits counties from negotiating supplementary services rates with providers that do not enforce a policy of sobriety;

• reducing the MFIP vehicle asset limit from $15,000 to $10,000; and

• excluding activities done for political purposes as work activities.

Counties administer most of the state’s health and human service programs. The new law begins the road toward giving counties more flexibility and fewer mandates.

The law creates three task forces related to:

• reducing prematurity and improving premature infant health care in the state;

• improving awareness, early diagnosis and care of those with an autism spectrum disorder; and

• eliminating the purchase of tobacco and alcoholic beverages by recipients of the cash and food assistance programs.

2011 Special Session: HF25*/ SF10/CH9

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