Disability advocates in Minnesota are organizing on many fronts to respond to Governor Ventura’s budget proposals for the 2002-2003 biennium.
In interviews conducted by this reporter, many advocates expressed shock and outrage at the number and severity of the funding cuts the Governor is recommending for a variety of programs that benefit people with disabilities. This article will provide only a quick overview of some of the major issues, since many details remain unclear (or remain to be uncovered) as this issue of Access Press goes to the printer, just two week after the Governor’s bombshell budget announcement. Next month’s issue will have further, and more detailed, analysis and comment.
The good news in the Governor’s budget is in the area of transportation. For the first time in at least 15 years, says long-time transit advocate Lolly Lijewski, the Governor’s budget proposal recommends full funding for Metro Mobility, the paratransit service that provides transportation for people with disabilities in the Twin Cities.
The Metropolitan Council requested an 11 percent increase for Metro Mobility, up to a total of $42.3 million. An additional $3 million was proposed to allow the agency to address the issue of trip denials, which is when a client calls to reserve a ride and the agency is unable to deliver it at the desired time. Lijewski comments that, advocates have put in years of “nitty-gritty, tough work to convince the Metropolitan Council that they need to advocate for increased funding for Metro Mobility.” Now, she says, “We’re getting some results.”
“Now,” says Lijewski, “it’s time for Metro Mobility riders to say Thank You! to the Governor, and to encourage legislators to do the right thing and support the Governor’s legislative request.”
Jeff Bangsberg, Government Relations Director at the Minnesota Home Care Association, points out that the most effective way to address the severe health- and home-care worker shortage in the state is to attract higher numbers of workers into the industry by offering higher wages.
Governor Ventura’s January 23rd budget proposal, in contrast, calls for a freeze on the wages for home care workers for the next biennium, followed by a small 2 per cent increase in the next. If inflation averages more than 1 per cent per year during that time – a virtual certainty – the Governor’s budget proposal would actually result in a reduction in pay for those workers in real terms.
A state task force which spent the summer examining the system for providing long-term care in Minnesota recommended that the state raise its health-care worker reimbursement rate by 2.5 per cent this year, followed by another 2.5 per cent increase in the following year. Bangsberg expressed surprise and dismay that the Governor “ignored the strong recommendation of the task force,” despite the fact that group was bipartisan and even included “three agency heads appointed by the Governor.”
Bangsberg points out that most consumers of home care services have those services paid for by state funds, which are channeled through the various agencies that employ home-care workers. The State, by setting the rates at which these agencies are reimbursed for the hours worked by their employees, in effect sets the prevailing wage for these workers throughout the state. There is wide agreement among advocates that those prevailing rates are too low, and the severe shortage of needed workers in the state appears to support that conclusion. Minnesota’s currently-tight labor market makes the problem worse.
Waiting List for Developmental Disability Community Services
For “over a decade,” according to advocate Anne Henry of the Disability Law Center, people with developmental disabilities have been lined up and waiting for a chance to receive urgently-needed services that would allow them to live in the community. A state law passed in 1999 set aside funds to eliminate this waiting list. These funds have had a positive effect, according to State Representative Fran Bradley, who co-chairs the House Health and Human Services Policy Committee. She points out that 1,822 new people have been authorized to receive services in the state since the law was passed.
The Governor’s budget proposes to take some $44 million in unspent program funds and credit it to the state’s budget “surplus.” Factoring in matching federal funds, the total loss to people with developmental disabilities still on the waiting list comes to $88 million.
The Governor’s decision “pulled the rug out from under the waiting list effort,” according to Representative Bradley. Henry stresses that the reduction in the budget does not reflect a reduction in the need for the services, but rather a series of other problems, including a severe shortage of the workers who provide the needed services. Such problems have resulted in the enrollment process proceeding at a slower pace than expected., and some families have had to make do with only a portion of the approved services for which they qualify.
Bob Brick, Executive Director of Arc Minnesota, notes that “there are still several hundred people who have been identified as having an urgent need,” adding that the state could, and should, simply redirect these unspent funds to meet those needs, in line with the intent of the 1999 legislation.
Consumer Support Grants
For several years, the State of Minnesota has had in place a “safety net” program that allows people with disabilities who are having difficulty in getting home care services to, in effect, “opt out” of the standard system. This program would allow them to “cash in” their allotted hours for hiring personal care assistants and use the state portion of those funds (under 50 per cent; the rest is federal money) to try their own unique approaches to try to meet their needs. Called the “Consumer Support Grants” program,” or CSG, the plan was intended to allow consumers to take matters into their own hands when facing a crisis caused by the inability to find appropriate home care, an all-too-common problem for people with disabilities at this time of severe workforce shortages in the field.
The Governor’s budget proposes that the size of the program be arbitrarily capped at a size not much greater than it is at present. Henry says that the Governor estimates that this “cap” will save the state $15 million in the next biennium, and $32 million in the next.
The idea of a cap is unfortunate, according to Henry, who says that it is only recently that families of children with severe disabilities have begun to use the program in significant numbers. This means that the program would be expected to grow quickly in the next biennium, unless the legislature accepts the Governor’s seemingly-arbitrary limit on the size of the program.
The Governor’s plan calls for needy families and individuals to be shifted to an as-yet-to-be-created federal demonstration project, which “would not have nearly the flexibility” of the state program, in the words of Bob Brick of Arc Minnesota. By de-funding a successful state safety net for people with disabilities in favor of an unproven and less-desirable federal program, the Governor is “slamming the door” on people who are trying to get some help to address the critical shortage of community services that are desperately needed by the state’s people with disabilities, according to Henry.
Health Care for Workers with Disabilities
For many years, a serious barrier to employment for people with disabilities entering the workforce has been the fact that income earned from work, while usually insufficient to pay for needed health care and other independent-living services, was almost always too high to allow people to remain eligible for the public programs that will pay for those needs. In an attempt to address this problem, Minnesota in 1999 created a program called the “Medical Assistance for Employed Persons with Disabilities” program, or MA-EPD, under which people who go to work may pay a small premium and retain their health benefits.
The commentary by Joel Ulland that appears nearby details the Governor’s proposal for major changes in the program. Briefly, Mr. Ventura’s plan says that individuals with disabilities who are in the workforce should pay significantly higher premiums than they do now in order to retain their health-care eligibility. The proposed increases could be as much as 800 per cent.
Since the first comprehensive study of MA-EPD has not yet gotten underway, it is not possible at this time to evaluate either the program’s effect on overall health-care costs or it’s effectiveness at reducing unemployment among the state’s population of people with disabilities. What does seem clear is that MA-EPD is quite popular among those who have participated in it, and the Governor’s plan would make participation in the program significantly more expensive for all of them.
The Governor’s budget contain no new funding proposals for special education. The only increases are due to formula changes passed during the last legislative session. The budget does contain funding for an additional staff person to investigate the maltreatment of minors in schools and to work on approving education programs in care and treatment facilities. There are several proposals to address the teacher shortage in certain targeted areas such as special education.