When it comes to services for people with disabilities, how well do you think current public policies and practices in Minnesota meet your needs? What’s working for you? What isn’t? These are all questions the Minnesota Olmstead Committee would like to ask.

By October 2012, this committee must develop goals, recommendations, and a timeline that will become Minnesota’s Olmstead Plan. This Plan will be submitted to the State of Minnesota through the Minnesota Department of Human Services. The Minnesota Department of Human Services will begin to implement recommended changes in 2013.

You can help shape this plan by going to the Minnesota Olmstead Planning Committee’s website. The committee wants to hear from individuals living with disabilities, their families, service providers, and concerned community members.

The site is still being developed, but check back often for more information about the Olmstead Decision and ways that you can be a part of the conversation.

by Kim Lutes, MHAM volunteer

The Hennepin County Mental Health Advisory Council will meet on Thursday, March 15, 2012, at the Hosmer Library on 36th and 3rd avenue. This Thursday’s meeting is a special one because it is the first meeting of our 2012-2013 session. The council will welcome newly appointed members.  The formal meeting begins at 2:00, but members are encouraged to arrive at 1:30 for a brief gathering in honor of the new members. Since Thursday’s meeting marks the beginning of the 2012-2013 session, much of our time will focus on orienting our new members to the council– sort of like “Advisory Council 101”.  We hope this will also be a helpful review for returning council members.  In addition, Commissioner Jan Callison is scheduled to address the council. I look forward to a full meeting and a productive year.  Stay tuned for monthly updates on this blog.

In more ways that one, the recent budget settlement is about going back to work.  The state government ordered employees to report as normal this morning, and will be bringing back functions and services as able.  For the politicians, they now go to the task of explaining, spinning, selling their actions to their constituents.  For us?  It means trying to fully understand where the impacts of this budget will be felt, and setting the stage for next year.

Because Minnesota borrowed money to patch the budget, it is very unlikely that we have hit bottom in terms of service cuts and reductions.  State grants to counties have been cut, something that we tried very hard to avert.  Much like in the years leading up to the successful reforms of 2007, we find ourselves with a mental health system with less and less capacity to foster recovery and support people in the community.  What will it take to get another victory, and start investing in mental health again?

But there are bright spots, as well as concerns.  Counties will still have spending requirements for mental health services (known as maintenance of effort).  This has been a major point of contention, and we are very relieved to see this.  The efforts to repeal the expansion of Medical Assistance were turned back.  And some of the crisis grants that help get people to treatment instead of taxing the 911 system were preserved.

This is a very mixed verdict, and one that will be difficult for many of us.  MHAM is more determined than ever to make the case at the capitol for community mental health.  We are so grateful for everyone who called, wrote, and pushed their legislators to consider the impacts.  We hope you will stick with us over the break (we will update as needed, but less often than in session) as we get ready for another chance to make things better.

For more details, please read our update on the website.

More heat is on the way for Minnesota.  Please take care of yourself, and check in with folks who may be sensitive to heat.  For more information, please check out our entry from earlier this summer.  Keep drinking water, maybe check out a library or other public build that has AC, and stay safe.

In other news, we may have a budget and an end to the shutdown in sight.  You can find our more on our legislative update page.

Are you feeling the impact of the state government shutdown yet?  If you care about accessible mental health service, the chances are you have.  Not not everyone is equally affected.

As the shutdown drags on, however, the number of people impacted is going to expand greatly. Construction projects are stalled, some restaurants can’t restock because their liquor license has expired.  Racetracks and state parks are closed.  Resorts are losing business, because fishing permits are on hold.  Lottery tickets can’t be purchased in MN.

While the ability to enjoy many of these recreational opportunities will not be “critical” as defined by Judge Gearin’s rulings, they are the kinds of things lots of folks notice.  We hope that people will take their frustration about these things and join the chorus: find a budget compromise, as free as possible from divisive policy issues, and get the state back to work.

We all play a role in creating the voice of the people.  Not everyone uses every service the state provides.  You might notice a different impact of the shutdown than what others do.  So speak out, and make sure your priorities are heard.  We need to make sure that we are reminding our elected officials that we expect the state to continue to fund programs and services that help make recovery a possibility for all Minnesotans with mental illnesses.

For more detail, please see our weekly update.

It strongly appears that we are no closer to an approved budget, despite getting one week closer to the final deadline before a government shutdown. This week’s update has more details on what some of the court filings have been and the issues that remain.

We are encouraging anyone who can to join us on Tuesday evening for a candlelit vigil on the steps of the State Capitol Building.  We’ll be there with other groups in the Mental Health Legislative Network, reminding policymakers of the impact of both the cuts that are proposed as well as the interruption of a shutdown.  For more information, you can check out the event here.

This morning, Judge Kathleen Gearin made initial rulings on some of the petitions before the courts.  She dismissed arguments from both sides, refusing to appoint a mediator as Dayton had asked, but also declining to order a special session of the legislature.  She pointedly reminded both sides of their ability to solve these issues and spoke of her concern of the potential impact of a shutdown.

Right now, we do not know if there will be a shutdown.  We don’t know how long it would last if it happens.  We don’t know for sure what services will be “essential” and what will stop.

We do know that it will be a bad outcome for so many.   Interruption of services, financial strain on  community health providers, loss of health insurance…

Please check out our update this week on what we’re seeing, and how you can help get a budget that is fair to Minnesotans with mental illnesses.

This week’s update really puts a focus on how cuts in the last few years have effectively rolled back the bipartisan 2007 reforms.  $34 million of new grant money was going to really change the way that mental health services are delivered in the state, by putting more focus on the community providers and what we can do to keep people from needing in-patient care.

The good news is that it worked.  Hospital bed days were down, crisis services were started, and people got the help they needed, where they were. (Link goes to PDF)

The bad news is that last year’s cuts totaled 15 million.  The proposed HHS budget that Gov. Dayton vetoed for being too drastic would have cut even more than that.  In 2007, members from both parties and Governor Pawlenty proudly said that $34 million would change the system.

So what would these cuts do?

The 2010 Legislative session was an extremely active and difficult session.  While the primary goal was to pass a bonding bill for long-term projects, spending on health and human services came into sharp debate.  Looking back at everything that happened, what will be the impact on mental health services?

We see four areas of major importance.  GAMC was the big concern early and late in the session, and we expect more news to come soon.  For more detailed history on what happened, you can read our previous entries here.  Right now, letters are going out informing people that GAMC is changing and that they must select a hospital home for clinic care.  Otherwise, they will be restricted to emergency only treatment.  What we don’t know is how the proposed patient limits will affect this process, or how many previously eligible individuals will complete their paperwork.  We suspect that this will be a major barrier.  What we do know is that this is bad news for people living in outstate Minnesota.  The four hospitals that agreed to this plan are all in the Metro area.  People can still go to the ER, but only for emergency treatment.  We are working to find other resources for people who need assistance with obtaining medication or other non-emergency care, but the outlook is not great.

Guardianship law was one of the few “wins” we had this session.  You can read our summary here.  This change introduces a basic level of accountability for guardians and protects the rights of individuals to make long-term choices about their health care.  We believe that it is an important piece of working towards models of care that better involve and respect the person’s wishes.  In addition, it showed that we can still make important policy changes, as long as they do not require funding.

MA expansion was brought up several times in the session, and has an uncertain future, even though it is strongly favored by providers.  We view it as the best long-term solution to the GAMC issue and it is required to happen in 2014.  At the end of session, the final compromise budget did not include early expansion of MA, but authorizes the Governor to trigger entry at a later time.  Gov. Pawlenty has staked out a public position against federal health care reform and is unlikely to do so.  However, the next Governor may not be opposed or simply not have any choice to refuse so much federal money.  You can read about the candidates’ stances on MA expansion here.

Funding for basic mental health services came into jeopardy this session.  When the state invested an additional $34 M in spending in the mental health system in 2007, it was seen as a major move forward.  Yet, we are now seeing major cuts that will quickly dwarf that investment.  It’s hard to interpret this as anything but a step backwards.  Some of these cuts are set to expire in 2011, but we know that it will take a lot of political will in order to resist sustaining those cuts as the budget crisis deepens.  State Operated Services will be redesigned and face cuts, despite delaying the inevitable by refusing to follow legislative and community input.  MHAM is pleased to be included with other advocates and stakeholders in helping outline what SOS truly needs to deliver.  While the cuts will be significant here, we are hopeful that an intelligent redesign process will limit the impact on consumers.

As these conversations continue through the election season and into the next session, we think that the State needs to face facts about budget cuts.  We believe that many of these shifts and cuts do not really last.  Property taxes are up sharply as counties try to recover from reduced aid from the state, and cuts to low-income health care typically raise the rates for those with insurance.  Supportive housing, PCA services, drop-in centers, and other long term/lower intensity services have all been on the chopping block.  But hospitalization, crisis response, and police involvement are far more expensive.  When these services are cut, the trade-offs have both human and financial costs, and we will work hard to push back against the band-aid approach to budgeting in the state.

Working towards the next legislative session, a few things are going to be different.

• There will be many new faces.  We will have a new Governor, but we will also have many new legislators as well.  Many retirements were announced as the end of session, and many elections will be hotly contested.  We see this as an opportunity to educate and inform new lawmakers about why mental health services are important and can reduce long-term costs.
• The deficit will be larger.  The funding “shifts” for K-12 education will come due, one-time funding has been used up, and tax revenues are still lower than in previous years.  The new Governor and the Legislature will have difficult decisions to make about how to balance the budget.
• Lastly, we hope that more of you will join us in calling, writing, and staying involved.  We know that contact from constituents made a big difference in outcomes this session.  We will continue our outreach across the state to LAC groups and other communities, and we would love to hear from you about getting involved.

Once again, the future of mental health services are back in the hands of Gov. Tim Pawlenty. The House and Senate Conference Committee finally finished their negotiation of the final bill that would go to the Governor.  You can see the full details here.  These discussions have been long and tense, and many of the most important programs for our community were up for cuts.

The final bill is better than the Governor’s original proposal, and it is much better than the House proposal too.  But it still reflects the political and economic environment we’re in, and it will be a challenge to deal with in the coming year.  Please contact the Governor’s office and let him know what you think.  The compromise bill proposes:

• Restored funding for the Adult Mental Health grants supports community programs such as CSPs, drop in centers, and case management.  These grants were cut earlier in the session to pay for the GAMC compromise bill.
• Restored funding for ACT teams in rural areas.
• Cuts to housing with support for adults with serious mental illnesses.  However, these cuts are for 2010 and are not projected to continue at this point. All the major proposals have cut this amount.

We are particularly concerned for out-state Minnesotans at this time.  The Governor has taken it upon himself to modify the conditions of the GAMC deal struck with legislators earlier in the session.  When no hospitals would agree to participate, he  managed to convince 4 metro hospitals to accept a limited number GAMC patients.  There are two serious problems with this.  Patient limits were not part of the legislated solution, and may cut individuals off from needed care.  Secondly, four metro hospitals do not replace a state-wide safety net.  This is an unacceptable plan to people who do not live near the Twin Cities.

We would like to thank the members of the conference committee for hearing the needs of Minnesotans with mental illnesses.  We urge the Governor to do the same,