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.