The March forecast came out and we now have only a $5 Billion deficit not the previous $6.2 Billion. I suppose we could all jump up and down, but of course these are still only projections. Some of this difference is capital gains, which can change quickly as we have seen in the past.

What the Governor has done however, is once again use a mix of taxes and services to put the $1.2 Billion back in the budget. He eliminated his temporary tax increase and on the other side of the equation eliminated the rate reduction to in home and nursing home services.

The Governor’s use of both income tax and reduction in services continues his pledge to spread the pain. We hope the Legislature will continue to consider this method of budget balancing. We must continue to ask them to consider taxes.

The Legislative Leaders continue to say they will present their budget later in March.

We do know that Rep. Abeler, Chair of the House Health and Human Services Finance Committee is working on his budget as I am writing this. Stay tuned!

For full details, visit the 2011 session page on our website.

Discussion of the Governor’s budget continued this week, and we have seen increasing talk about efficacy of services at the capitol.  For the full update, please see our website here.

As this discussion moves forward, we think that’s it’s critical that every Minnesotan knows where their legislators stand.  We think it would be good for legislators to start identifying the total budget plans that they support.  We know there will be change and compromise, but we need to see the whole picture, especially from the majority leadership in the House and Senate.  Up until now, the GOP has pushed smaller bills that deal with a percent of the total shortfall.  Now’s the time for everyone put their priorities on record so we can start real negotiations.

A few questions you might ask:

• Which comprehensive plan to balance the budget do you support?
• What changes would that plan make to the Health and Human Services budget and mental health services?
• Will changes or reductions you support result in increased costs for counties or individuals?

Gov. Mark Dayton has released his proposed budget for the state.  It is, as promised, a mix of cuts and revenue increases.  He explains that he is “not willing to make barbaric cuts in the essential services that affect peoples lives.”  We are greatly encouraged to see recognition from the Governor that we are not talking about mere numbers, we are making choices about real people.  However, reaction from the Legislature has been swift and harsh. This is an opening move, not a final bill.

Despite putting forward several bills that would cut spending, there has not been an official GOP budget plan that closes the entire gap.  We agree with Dayton’s veto message on HF 130: piecemeal solutions will not work for a problem this big.  We must intentionally and deliberately solve this problem. not leave the dirty work for later.  We would hope that all legislators would propose or officially endorse a plan for balancing the entire budget so their priorities are made clear and the people can speak their mind.

Read the rest of our weekly update here, on our legislative page.

In previous weeks, we’ve let you know about attempts to balance the budget by taking away
the foundations of Minnesota’s mental health system.  The more we understand about these
proposals, the worse they look.  These are services that matter a great deal to the people who
receive them and are overall budget savers for the state.  Traditionally, every bill that will alter
spending has a fiscal note attached to it.  The policy change is proposed by a legislator, but
evaluated by experts in the state agencies who are best able to predict the overall financial
impact of the bill.  To our knowledge, the bills moving forward were not scored.  We believe
they oversell the savings by ignoring greater future costs.

So how expensive will these cuts be?  Unless we inform legislators and our fellow voters and
change their minds, they might be very costly.  As you’ll see below, Minnesota has had great
success with controlling costs in the past and we’re risking those gains with every local and
preventive service we eliminate.

It’s an old saying, but an ounce of preventive, community based mental health service is
worth a pound of emergency services and hospitalizations.

This week, we want to get this very simple message out to an even greater audience.

Please visit our 2011 session page to see more information and how you can help.

As promised and expected, Gov. Dayton signed an executive order to expand Medical Assistance (MA) eligibility for single adults under %75 of the poverty line.  Federal law will expand eligibility even more in the future, but these changes are not scheduled to take place until 2014.  In the mean time, states are being given options to begin the transition early.  Under Gov. Pawlenty, Minnesota had declined these funds, but signed a compromise that would let the next Governor to take action.

Dayton’s signature on this is a major step forward.  MA, unlike the weakened GAMC plan that emerged last session, is a comprehensive plan.  It allows eligible individuals to seek treatment at any number of hospitals and clinics, not just a handful of locations in the Twin Cities.  Unlike Minnesota Care, it offers real coverage for expensive inpatient hospitalization for those least able to afford it.  While we are still waiting on information about how long the transition will take place and individuals are enrolled, we are very heartened to have good news to share.  Particularly for individuals who have lost work or housing and are living with mental illnesses, Medical Assistance represents a better hope for good quality medical care.

This is going to be a difficult legislative session, as the Governor and Legislature wrestle with a 6.2 Billion deficit.  Further cuts are all but inevitable.  With expanded MA, more low income individuals will be able to access resources they need to keep themselves healthy and safe.  For Minnesotans with mental illnesses, this is a victory.

Please stay tuned for further updates and stay in contact with your state legislators.  You can find out who represents you here.  They need to hear from you early and often as they consider the steps necessary to balance the State’s budget.  Let them know why your services are important to you and your community.

The Hennepin County Board of Commissioners is seeking applicants from the community to fill positions on seven citizen advisory boards, including the Adult Mental Health Advisory Council. This 32 member council advises the County Board on adult mental health issues within Hennepin County and monitors, studies, and comments on mental health issues at the federal, state, and local levels. Members serve three-year terms and meet monthly on the third Thursday from 2:00 until 4:30 p.m. The council meets at the Hennepin County Hosmer Library in Minneapolis. located at 347 East 36th Street. Volunteers must be a resident of Hennepin County to be eligible to serve on the council.

For more information or to apply for this volunteer position, please visit the Hennepin County website.

Applications will be taken through Friday, January 7, 2011.

The Social Security Administration (SSA) is looking at making some very important changes to the mechanisms by which disability is determined for people with mental illness. The proposed changes would probably be expected to make it much more difficult to be found disabled by the SSA if the primary basis of disability is a mental illness.

The Bazelon Center for Mental Health Law has studied and provided a recap of the proposed rule changes Major concerns revolve about the proposed implementation of standardized tests and eligibility determinations hinging on the number of standard deviations from the mean on the new standardized tests. Bazelon projects that only one to two percent of the nation’s population will qualify as disabled as a result of a mental illness under the rule change if adopted. This is far below the most conservative of the estimates of the people with mental illness that are thought to be unable to work.

There are no standardized tests that have a body of evidence that suggest the tests will be able to predict an individuals ability to work Adoption of the proposed rules can be expected to result in many people being turned down by Social Security, but who will not, due to their mental illness, be able to work.

You may express your concerns and/or objections to the proposed rule changes to the Social Security Administration, but you must do so by November 17, 2010. Address your comments to the SSA by one of the following methods:

Go to the http://www.regulations.gov/search/Regs/home.html#home website and search for docket number SSA-2007-0101 and follow directions.

or Fax the SSA at 410-966-2830

or mail the Office of Regulations, Social Security Administration, 137 Altmeyer Bldg., 6401 Security Boulevard, Baltimore, MD 21235-6401

In just under a week, Minnesotans will go to the polls to choose their Governor, legislators, and many other offices.  This represents a major chance for people to have their say on both federal, state, and local issues.  We strongly encourage people to research the candidates and to vote this Nov. 2nd.

For more information about voting and to see sample ballots for your precinct, visit the MN Secretary of State’s website.  You can find out more about voting if you are under guardianship or living in a group home.  Did you know that people living in a residential facility can get help with getting their ballot delivered to them?  Or that doctors, family members and guardians cannot decide if a person can vote without approval by a court?  Minnesota has a strong tradition of civic engagement and voter participation: please be a part of that this November.

We also encourage people to think about mental health care when they are speaking with candidates and considering their choices.  As a non-profit, we do not support or oppose candidates.  We’re willing to talk to and work with any elected official, but our priorities will always be clear: access to quality and timely mental health services for more Minnesotans.  A few questions to consider:

• How will Minnesota work with former GAMC patients to reduce reliance on emergency rooms as primary care?
• How can State Operated Services be redesigned to help fill the gaps in mental health services in the state?
• Will we continue to see cuts to lower intensity services like PCA, or will we renew our commitment to serving people in their communities?
• What happens to county based services as we try to balance the state budget in the years to come?

These are tough questions with no easy answers.  The future of mental health services in Minnesota is up for debate here, and we all need to do our part to create and protect the kinds of services that matter most for Minnesotans with mental illnesses.

Whatever your views, please take the time to consider your vote and participate in the election.

Federal Health Care Reform was signed into law this spring.  But how that law will be enacted remains a hotly contested issue.  Many of the provisions do not go into full effect until 2014.  In the mean time, states are being offered a variety of grants to study, plan, and implement these changes.

Last week, Gov. Pawlenty ordered state agencies to halt applications for these grants unless given specific permission by his office.  There is some question concerning his authority to do so, because the Legislature had specifically directed that some of these grants be sought in a bill that Pawlenty signed into law.

Sadly, this appears to be a case in which potential avenues of compromise have been shut off.  The idea of insurance exchanges is not new.  Versions of the concept have been promoted by members of the House Republican Caucus as a potential solution to health care access.  Pawlenty, in fact, supported a similar concept a few years ago.

A wide range of groups has called on Pawlenty to reconsider this decision, including the Minnesota Budget Project (an initiative of the Minnesota Council of Non-Profits), the Minnesota Council of Health Plans, the Minnesota Hospital Association and the Minnesota Medical Association, as well as the Minnesota Chamber of Commerce.

We know that many Minnesota counties are doing what they can to help those without health insurance, trying to move as many people as possible on to other programs if they are eligible.  Some counties have paid premiums so that former GAMC patients can participate in Minnesota Care.  But these are stopgap measures.  Eventually, we will need to expand the MA system to cover more low-income single adults.  Eventually, we will need to set up an insurance exchange for individuals and small businesses buying their own coverage.

The question is: how much control will we take over the shape of things to come?  One of these grants in particular would have given the state greater control over how our insurance exchange would operate.  Delaying these programs hurts Minnesotans who lack health care coverage, and we know that many of those individuals have significant mental health concerns.

Meanwhile, the “compromise” GAMC program is straining to meet the needs of the metro area, and has let down individuals across the state that cannot travel to seek medical care.

As Minnesotans decide how to address these issue, we will continue to call for long-term solutions that provide equitable access to care.  Right now, there are two great opportunities for shaping that future.  You can contact Gov. Pawlenty’s office to let him know why health care access is important to you.  You can also participate in the Federal rulemaking process that helps determine how specific parts of the new law will take effect.  You can submit your comments at www.regulations.gov, by searching for “health care” and looking for rules that might impact you.

We think that it is vital for people with mental illnesses to be a part of creating new systems of care.  We know what services are missing from our communities, where the barriers have been, and what we need to do.  Please make it a priority to speak out and be heard.

Minnesota will hold primary elections on August 10th.

MHAM and our partners in the Mental Health Legislative Network sent out some questions to candidates who are running for Governor.  We don’t support or oppose any candidate, and we don’t grade their answers.  But we’ve presented their replies here for your information.

Gubernatorial Candidate Questionnaire Responses

Several candidates responded and shared their views on some of the key issues that are important for mental health.  If you don’t see your preferred candidate represented here, or simply want more information on where candidates stand: please contact their campaigns to ask your questions.  We strongly encourage everyone to get involved.

You can go to The Secretary of State’s Office or call 1-877-600-VOTE (8683) to get more information on finding your polling place, registration and eligibility and more.