Legislature approves some fixes to health and human services

Many breathed a sigh of relief when the February forecast showed Minnesota had no new deficit in the current biennium. The positive fiscal news means there is no need for policymakers to consider yet another round of deep spending cuts to critical services. In fact, the House and Senate did not issue any official “targets” calling for finance committees to cut their budgets.

Instead, Governor Dayton and the Legislature have advanced budget proposals for health and human services recommending mostly small changes, primarily fixing some unintended consequences from budgets approved in previous years and reforming service delivery.

Earlier this session, Governor Dayton released a supplemental budget proposal that included $28 million in additional funding for health and human services in the current biennium, and $68 million in FY 2014-15. On Wednesday, the House and Senate approved a conference committee agreement on House File 2294 that increases net general fund spending for health and human services by nearly $11 million in the current biennium, and by less than $1 million in FY 2014-15. It seems likely that Governor Dayton will sign the bill when it reaches his desk.

Highlights of the conference committee agreement include:

  • Some Emergency Medical Assistance coverage restored. Last session, policymakers cut many services previously available through Emergency Medical Assistance, which provides health care coverage for qualifying non-citizens who face a medical emergency or suffer from a serious chronic health condition. The Governor’s supplemental budget would have restored coverage for kidney dialysis and cancer treatment. The conference committee agreement adopts the Governor’s position, but only restores coverage for services in FY 2012-13. In another twist on this issue, a recent legal settlement between the Minnesota Department of Human Services and immigration advocates requires the state to provide health care services in situations where failure to provide treatment would result in a medical emergency within 48 hours.
  • Personal care attendant cut delayed. Personal care attendants enable individuals who need assistance with the activities of daily life to remain in their communities and avoid institutional care. The Governor’s proposal repealed a 20 percent cut made last year in payments to people who work as personal care attendants (PCA) for family members with a disability. This cut raised the concern that relative caregivers, especially those in rural areas, would have to find different jobs to support themselves, leaving their relatives with no options for at-home care. The conference committee agreement delays the implementation of the 20 percent cut in payments until July 1, 2013.
  • Continuing care payment rate cut delayed. Continuing care services help Minnesotans live independently in the community and avoid institutionalized care. The conference committee agreement delays a 1.67 percent cut in payment rates for continuing care providers until FY 2014 (when it is anticipated that a federal waiver will make the cut unnecessary). However, the payments that are restored for FY 2013 will not actually be paid to providers until FY 2014, an accounting move that will push most of the $23 million cost into the next biennium. The Governor did not propose any changes to continuing care payment rates.
  • Employed persons with disabilities allowed to work longer, keep more assets. The Governor’s proposal allowed individuals in the Medical Assistance-Employed Persons with Disabilities program to work past the age of 65 and maintain more of their assets. The conference committee agreement adopts the Governor’s proposal.
  • Child care absent days increased for students. In 2011, lawmakers reduced the number of absent days that the state’s child care assistance program would reimburse providers from 25 to 10. The reduction makes it challenging for families to maintain child care if illness or emergency result in too many absences. The conference committee agreement increases the number of paid absent days back to 25, but only for families where at least one of the parents is under 21 and attending school. The Governor did not propose any changes to the absent day policy.
  • Funding for Family Assets for Independence in Minnesota (FAIM) grants reinstated. In 2011, policymakers eliminated state funds for FAIM, which matches savings by low-income participants who are seeking to obtain post-secondary education, purchase a home or start a new business. The conference committee agreement provides $250,000 in one-time funding for FAIM. The Governor did not propose any funding for FAIM.

Overall, the health and human services conference committee agreement focuses on addressing some of the most pressing challenges facing vulnerable Minnesotans. While the agreement does not offer a complete solution to all of these issues, it moves us in the right direction while respecting the state’s tight budget situation.

-Christina Wessel

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