Editor's Column - February 2015

Tim BenjaminGovernor Dayton’s budget was released earlier this month. It included some positive signs. The governor is willing to increase funding for mental health and for children with autism. “We must continue to improve services and support for people with disabilities,” said Dayton, in issuing an order to continue the Olmstead Sub-Cabinet. He expressed his confidence in Mary Tingerthal, Commissioner of the Minnesota Housing Finance Agency, as he appointed her chair of the group. The Olmstead Plan must support the freedom of choice and opportunity to live, work and participate in the most inclusive setting for individuals with disabilities. But the budget funds only the planning. There are no identified dollars in this biennial budget to implement the eventual plan.

Don’t get me wrong, I like Governor Dayton and I like his sense of responsibility about keeping Minnesota financially stable. I also respect his strong desire to provide government support for our communities. But Dayton did not fund any of The 5% Campaign legislation, which increases reimbursement rates and improves services and support for people with disabilities and their personal care attendants (PCAs). He did not standardize the medical assistance income rates for adults without disabilities compared to income rates for people with disabilities. He left out changes in asset limitations and spousal disregard in some of the medical assistance alternative programs such as MA-EPD. He also did not fund important higher education initiatives. He left out funding for the Minnesota State College and University system, which is where our future health care workers and other middle-class workers for so many Minnesota-based industries are educated. Those same industries employee people with disabilities, so higher education funding creates a win-win for all of us. State government needs to consistently support all these needs.

Many of us are personally aware that reimbursement rates in the PCA program need re-evaluation. It’s become more and more difficult, especially in Minnesota’s revived employment market, to find qualified caregivers who are reliable, dependable and willing to work and dedicate themselves for low wages. For many, their income makes them eligible for some of the same medical assistance programs that their clients are using.

Browsing through the Department of Human Services website, I noticed that private-duty nurses are assigned different income levels depending on the quantity and kind of client needs. It made me wonder why the level of care and responsibility doesn’t affect reimbursement rates for PCAs. If the governor and the legislature are looking for ways to save money on care for senior citizens and adults with disabilities, why couldn’t there be multiple-level reimbursement rates for community support services? It seems possible that overall costs could be reduced by having lower reimbursement rates for people with lower levels of need for skilled care. The yearly needs assessment process to determine eligibility for PCA reimbursement hours could include an assessment about the level of care needed. There’s no question that there are many different levels of individual need within the PCA program; that’s currently measured in the number of hours allocated to each recipient. It seems it would be feasible to maintain quality care for lower and higher-level of care needed by some on the PCA program.

I hope everyone is surviving the Minnesota winter in good health. We haven’t had a lot of snow, but it does seem like it’s been plenty cold this winter. I hope the cold has not kept you away from the capitol to advocate for the needs of people with disabilities. Our presence is a constant reminder to legislators that we are very real and that funding to keep us independent and out of the hospital and nursing homes is a necessity. Not supporting independent living only costs the taxpayers more money in the long run. Keep reminding the legislators, as you run into them at the capitol, to support our medical needs.

Talk to you next month, or see you at the capitol. By the way, I’m on the road to good health again. No more of those pesky hospital stays for this guy—not any time soon, anyway