Shifting the Focus

As the SOS redesign continues, we have had many opportunities to speak about what is important to mental health consumers in Minnesota. Our refrain has been: long term care and housing with supports. We believe that supportive environments, aimed at long-term stability is what consumers need from the system. This puts the focus on the client and their independence, while hopefully reducing the need for acute services. In particular, we are hoping to reverse direction, and restore funding for CADI Waivers, and other options that put Minnesotans with mental illnesses back into their communities, and provide them with the support to stay there successfully. As Executive Director Ed Eide stated in a recent Star Tribune article, the alternative has been to warehouse patients indefinitely in restrictive settings.

We strongly believe that this kind of focus is what needs to be at the heart of the redesign process. Preserving jobs and programs are important but the provision of quality services at an appropriate level is paramount. We are calling for many of the cuts to be reversed, but we’re also showing the need to get better results with that funding. We can only really talk about appropriate staffing once we know what services we need.

We have continued our conversations with policy makers in St. Paul as well as consumers and providers around the state, seeking to build consensus around what are the best options for positively transforming SOS. As the legislative process to decide what to do with SOS continues, we will continue to provide ideas and feedback.

Another recent development has been around the revised GAMC system. As you may remember, patients are being shifted towards hospital-based care organizations that would try to move care out of the Emergency Rooms and towards clinics and less intensive settings. However, recent roadblocks have come up. The House Heath Care and Human Services Finance Division heard testimony last Thursday that many rural hospitals would refuse to participate because they did not think they could set up services quickly enough or have enough of their costs covered. Now, HCMC has signaled that it will also decline to participate. As one of the largest providers of GAMC services in the state, HCMC has played a critical role in this program. It is hard to imagine a successful care plan for low income Minnesotans that does not involve them.

Under Federal Health Care Reform, the state has the option of covering single adults with up to 133% of poverty level income under Medical Assistance (Medicaid). There are some issues with this plan, namely timely implementation and fully understanding the costs until 2014 when that expansion will be required. However, as more hospitals refuse the GAMC compromise, this option may require a second look.