2023 session provided transformational changes  

Minnesotans with disabilities had plenty to celebrate when the 2023 Minnesota Legislature gaveled to a close May 22. A wide […]

Person holding colorful sign "Show PCA some love! Raise the rates"

Minnesotans with disabilities had plenty to celebrate when the 2023 Minnesota Legislature gaveled to a close May 22. A wide range of priorities made it in bills covering health and human services, education, public safety, housing and other areas. 

Advocates hailed the session as one of the most productive in recent years, and one with long-lasting disability rights impacts. 2023 saw a record number of bills introduced, with hundreds focused on various disability issues. Disability groups have spent hours combing through bills to verify details, dates of startup and other issues. 

Several disability community leaders were in the crowd May 24 to watch Gov. Tim Walz sign the “One Minnesota” budget into law. Made up of a dozen different bills, the $72 billion budget will dictate state spending for the next two years. Walz said the budget will have a “generational impact” on Minnesotans. 

With a DFL governor and slim majorities in the House and Senate, DFLers pushed through a complex and ambitious list of bills. Walz said that when looking back at the session, “History will tell the story.” 

DFLers celebrated the session’s outcomes. Republicans were critical and questioned whether the state can sustain so many changes and their costs. 

The session began with all eyes on a $17.5 billion surplus. While that record sum brought plenty of opportunities, it also caused much debate as to how and if it all should be spent. 

The session’s start also brought forth a record number of proposals, including bills that disability service organizations tried to get passed for years. MNCCD, other consortiums and disability service organizations worked on dozens of bills, many of which did win approval. 

Julia Page of the Arc Minnesota and Trevor Turner of Minnesota Council on Disability are leaders on policy issues for the Minnesota Consortium for Citizens with Disabilities (MNCCD). Page said that while there was a lot of change for the better this session, the surplus didn’t make things easier.  

“It was a hard year,” said Page. With more money to go around, it seemed like that wouldn’t be the case. But there were many competing needs, not just in disability but from many other areas. 

Turner agreed with that assessment. But both leaders noted that with measures that didn’t pass, there is momentum for future work. 

“This was a session where we got a lot of great things done,” said Turner. “We’ll see a lot of transformational change.” 

Increased Medicaid rates, additions in affordable and accessible housing, expanded voting measures, various bonding asks, improvements to broadband statewide, higher education inclusion, and numerous gains in mental health were pushed through. Elimination of parental fees tied to the TEFRA program is also hailed. Paid family and medical leave was signed into law, although it won’t start until 2026. 

One measure passed is to require adult-sized changing tables in public restrooms,. That meant a change to state building codes, to provide accommodations for people who need them. All too often people have to lie on public restroom floors to be changed. 
Several preK-12 special education measures passed. One key gain is the end of seclusion used as a punishment for disabled children. Another is the “recess for all” measure, which prevents the withholding of recess as a form of punishment. 

Disability Waiver Rate System (DWRS) changes will bring an additional $87 million in the first biennium and an additional $225 million in the second biennium in new spending within DWRS. Inflationary changes and changes in data used for rate adjustments were also made. 

The Minnesota Council on Disability saw its funding increased, to meet rising service needs. The state will also step up its disability hiring, with more specific goals. 

The $6.2 billion two-year health and human services budget includes many changes including creation of a state department of a state department for children, youth and families. 

But this bill was controversial as Nurses at the Bedside Act provisions to provide more staffing and other protections were stripped down in deference to Mayo Clinic opposition. That opposition extended to measures including the creation of a Health Care Affordability Board. The last-minute changes angered members of the Minnesota Nurses Association, who staged a sit-in at the capitol. 

Frustration remains 

There is still some frustration. While there were changes to the personal care assistance (PCA) program and waiver programs, there are questions as to whether or not those are enough to address longstanding problems. One change lifts the 40-hour household cap for parents of minors and spouses on Consumer-Directed Community Supports (CDCS) and Community First Services and Supports (CFSS), which will replace the PCA program.

There’s also a measure to get more post-secondary students interested in PCA and direct support careers, and to provide incentives for doing so. 

There’s also provisions for workforce recruitment and retention bonuses, with $90 million in one-time dollars. Advocacy groups are still digging into what this will mean and how it will operate. 

 “Regardless of what has been changed it’s still not enough,” said Vicki Gerrits of Minnesota First Community Solutions. There are worries that more service providers could drop PCA Choice or close altogether. 

People with disabilities and their family members already have challenging times finding staffing or struggling to provide staffing themselves. Extension of a pandemic-related benefit to allow parents of children under age 18 and spouses to continue serving as PCA workers for their family members for another six months is welcomed by some. 

The federal government approved the extension until November 11, 2023, and the final human services budget bill approved by state lawmakers makes that provisions. But it came so late, said Gerrits, that many families sought other care options. 

There’s also disappointment that not all changes sought in the Medical Assistance for Employed People with Disabilities (MAEPD) program were adopted.

There is also unhappiness that elimination of subminimum wages was set aside in the final days of session. 

Policy and finance additions 

The state’s care crisis was an ongoing focus throughout the session, looming over human services financing and policy debates. The effort to address that is part of the financing and spending plan for the biennium. 

Human services finance and policy legislation appropriated $14.11 billion, with $1.35 billion in new spending, for DHS for fiscal year 2024-2025. 

“Our budget makes great strides to not only care for our most vulnerable Minnesotans, but also the workers who care for them in turn,” Sen. Mohamud Noor (DFL-Minneapolis) said in a statement. 

State nursing homes will receive the largest increase in state history. After automatic reimbursement rate adjustments, they expect $847 million to reach the facilities over the next four years. 

Lawmakers praised the budget for making “historic” investments in nursing homes, long-term care and in Minnesota’s care workforce. Proposed new nursing home spending includes $22.84 million for a 25 percent rate increase for home care nursing, $1.91 million for critical access nursing facilities, and $680,000 for a nursing facilities rate study. 

Additional new spending includes 

  • $122.09 million for elderly waiver increases and consumer-directed community supports parity; 
  • $90 million for long-term workforce incentive grants (including nursing); 
  • $86.66 million for modifying the inflation adjustments to the disability waiver system; 
  • $46.59 million for disability and elderly waiver homemaker rate alignment; 
  • $12.1 million for HIV/AIDS support services. 

Numerous rate increases are included. Effective Jan. 1, 2024, intermediate care facilities for persons with developmental disabilities would see a daily rate increase of $40, as well as minimum daily operating payment rates set at $275 for.

Other changes would limit rent increases for certain properties to prevent mental health stress for seniors and people with disability, require DHS to conduct a sober home survey; add a Dec. 31, 2024 sunset to the opioid prescribing improvement program; and clarify spending requirements related to elderly waiver rate increases. 

Mental health made gains 

Minnesota’s Mental Health Legislative Network made a number of gains. But there was disappointment when the final health and human services bill had less funding for mental health needs than Walz had proposed in his budget. The funding for mental health is about $98 million per biennium which is less than what the governor requested and what the Mental Health Legislative Network wanted. The governor asked for $122.777 million in FY24/25 and $141.864 million in FY26/27. 

National Alliance for the Mentally Ill (NAMI) Minnesota released a list of measures that did pass. Those include funding for 988, the suicide and crisis lifeline, with a telecom fee; increasing rates for mental health providers by 3 percent; increasing grant funds for first episode of psychosis, crisis teams, school-linked mental health, cultural and ethnic minority infrastructure; and increasing funds to address the workforce shortage; putting the certified behavioral health centers back in the demonstration project. 

In other bills mental health advocates were successful in changing the definition of network adequacy; requiring health plans to cover psychiatric residential treatment facilities and psychiatric collaborative care; establishing a mental health parity enforcement office; changing the life insurance suicide clause to one year instead of two years; providing free phone calls from jail to case managers, etc.; and increasing funding for the Bridges housing program and the IPS employment program.  

NAMI Minnesota has an extensive list legislative issues that passed on its website, at www.namimn.org 

Cannabis is legal 

Minnesota adults will be able to legally use cannabis for recreation, as that measure was signed into law. “The day has finally arrived. Today is the day that we are going to vote here in the House for the last time to legalize cannabis and bring the change that many Minnesotans have wanted for a very long time,” said Rep. Zack Stephenson (DFL-Coon Rapids), the bill sponsor. 

The change starts August 1. 

Some people with disabilities have long used cannabis as a means of finding pain relief. It’s been legal here for medicinal purposes for several years, with new diseases and conditions added in an annual review and approval process. 

There will be several legal limits on marijuana use, and civil penalties for violations. Adults could possess up to two pounds of cannabis in their homes or no more than two ounces in public, They cannot not operate a motor vehicle while under the influence of cannabis; give cannabis to a person under age 21; or smoke or vape cannabis in a multifamily housing building, on the grounds of a child care facility or family or group family day care program. 

There will also be an Office of Cannabis Management, licenses created for growers and sellers, and other regulations out in place. Opponents contend there isn’t enough time for the state’s law enforcement officers to get ready for the change. 

Transportation rolls on 

Walz’s first-ever veto as governor came down May 25, when he nixed a bill that would have set minimum pay rates for Uber and Lyft drivers and provided them greater protection against being fired. 

Uber said it would stop offering service in Greater Minnesota and only provide “premium service” in the Twin Cities if the bill became law. Walz instead will convene a working group to make recommendations for 2024. 

“Rideshare drivers deserve fair wages and safe working conditions. I am committed to finding solutions that balance the interests of all parties, including drivers and riders,” Walz said in a statement. “This is not the right bill to achieve these goals. I have spent my career fighting for workers, and I will continue to work with drivers, riders, and rideshare companies to address the concerns that this bill sought to address.” 

The rest of the almost $9 billion transportation bill was signed into law. Not every measure in the bill is for people who drive. Metropolitan Council will get $230.3 million to build out and operate the Twin Cities’ transit system over the next two years, with funds going to Metro Mobility, which serves seniors and people with disabilities. 

Starting in July and for the next 18 months, the Met Council must use sales tax proceeds to allow everyone authorized to ride Metro Mobility to ride any regular transit route for free, and to make two routes fare-free for a time. Those results will be reported to state lawmakers in February 2025. 

And tucked into drivers’ license changes is a measure that allows 15-year-olds who must care for a disabled family members to be able to get a driver’s licenses. There’s also a change for veterans who are considered 100 percent disabled to be exempted from vehicle registration and delivery fees. A new delivery fee for some goods and services will have a surcharge added. Food, medicine and clothing are exempt from the charge. 

Individuals had their day. 

In many cases, change happens because one person brings an issue forward. But sometimes those changes can take years. 

One of those persistent advocates is Joy Rindels-Hayden, an 87-year-old from Minneapolis. Rindels-Hayden never thought of herself as an activist. But after a fall and injuries while trying to board a bus in 2017, Rindels-Hayden devoted much of her time to seeking changes. She developed a partnership with the Minnesota Brain Injury Alliance. They debated ways to approach the issue and try to prevent more injuries. 

The result of their work is four sentences in the transportation bill. Metro Transit drivers must receive mandatory training to help people with disabilities get onto and off of buses. Training would include situations where access is limited, such as the snow and ice conditions that caused Rindels-Hayden’s injuries. 

“I didn’t know if I would live long enough to get this changed,” she said. The measure is known as “Joy’s bill.” 

A veteran activist celebrating a win is Jeff Bangsberg, who finally saw a measure passed on PCA driving. It’s long been a problem that the PCA program doesn’t allow people with disabilities to have their caregivers drive them around.  

The argument for the change is that having transportation is key to independent living, and that time spent driving should be considered as an “instrumental activity of daily living.” 

“For Pete’s sake, it finally got in there,” Bangsberg said. 

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