Health care reform one of many focuses for MN-CCD

A whole new landscape awaits self-advocates and disability service organizations at the capitol. The House and Senate both have Republican majorities for the first time in many years, and the governor’s race was still in a recount as of Access Press deadline. Co-Chairman Steve Larson and Chris Burns said the sweeping changes in leadership and committee structure will means changes in strategy.
   
Leaders of disability organizations talked at length Nov. 12 about what the changes mean and how to address them. Much of the early stage of the session will be an education process, most people agreed. Many new legislators may need and appreciate information on disability-related topics. Efforts to reach out across the state will be vitally important.
   
In November issue Access Press gave an overview of PCA issues and children’s issues. This month housing, quality assurance/self direction, healthcare and long-term services will be highlighted.
   
Issues of quality and access to health care and long-term care services are the focus for one work group.  One key recommendation is to support efforts to tie into federal health care reform, which state officials have resisted over the past several months.  This work group will monitor the Health-care Access Commission discussions which serve as an opportunity for legislators to discuss state and federal healthcare issues in a public setting.
   
Another need is to continue monitoring current DHS initiatives, including the 2009 county redesign of current county social services delivery system, the work of a caregiver/respite coalition and a report on recommendations improvements to the current case management system.
   
MN-CCD is opposing further increases in parental fees and further erosion to the MN Medicaid benefit set and is working to educate state lawmakers on what potential cuts to such benefits would mean.  
   
In the area of transportation, the position paper notes that while there has been progress, “overall access to transportation for Minnesotans with disabilities still remains inadequate.” Lacking public transportation can keep people from fully participating in their communities.   

Among the many priorities is a need to monitor the work of the newly formed Transportation Access Council and its impact, and see what can be done about the lack of coordination between services.  During the 2010 session the Interagency Committee on Transportation Coordination (ICTC) was replaced with the new council.  One focus is to amend the legislation to include appointment of stakeholders from the disability and elderly community.
   
Progress on 2008 transportation legislation will also be studied, including the requirement that the Commissioner of Transportation develop a transit service needs implementation plan that contains a goal of meeting at least 80 percent of unmet transit service needs in greater Minnesota by July 1, 2015, and meeting at least 90 percent of unmet transit service needs in greater Minnesota by July 1, 2025.
   
Other priorities include protection of Metro Mobility funding and supporting the Office of the Legislative Auditor Audit on nonemergency medical transportation services. The auditor is currently conducting an evaluation of services, of which many Minnesotans with disabilities rely upon to get to and from medical appointments. The report will likely explore many issues that disability advocates around the state are concerned with.
   
Employment also will be a focus at the capitol.  For many Minnesotans with disabilities, access to employment is a critical component of their quality of life. One overarching message with legislation on employment is that when Minnesotans with disabilities find jobs, they increase state revenues and decrease government expenditures on safety net services.
   
The Minnesota Work Incentives Connection has calculated some of the financial impact when Minnesotans with disabilities work. The Con-nection’s most recent data found statistically significant decreases in the following government benefit amounts received at 12-month follow up with Minnesotans with disabilities who had found employment.
   
Several recommendations are being made to lower the current disability community employment rate from 22 percent to the 70 percent rate for Minnesotans without disabilities. Providing better transition services from special education to work and preservation of vocational rehabilitation services funding are other goals.
   
Members of the employment work group will also focus on ensuring that the goal of increased employment of Min-nesotan’s with disabilities is supported and reflected in the various initiatives currently taking place in state government that will impact employment of Minnesotans with disabilities.

Another MN-CCD work group brought forward proposals on quality assurance and self-direction. This group noted that there a federal mandate to provide options for community based long-term care. Self-direction can be a cost- efficient way to manage a finite budget while respecting individual preferences. “Minnesota has been a national leader in self-direction for the past 12 years but our efforts to expand self direction have stalled,” the group’s position paper stated.
   
The recommendations include evaluating federal waiver options that will expand the availability of self-directed options, choosing what will work best for Minnesotans, passing authorizing legislation if necessary, and implementing effective November 1, 2011.
   
Steps are also being recommended to expand community directed consumer supports statewide. Even though these are mandated services many counties still don’t offer them. Some counties that do offer of support these don’t have the resources to expand and promote the supports to the extent necessary. A number of technical changes are recommended so that the Department of Human Services can help more services get started or expanded.
   
In the area of quality improvement, MN-CCD’s work group wants to see more done to build upon efforts that began in 2007. That’s when state lawmakers established a quality management system for Minnesotans receiving disability services. The purpose of that system is to improve the quality of series provided to individuals and to meet federal waiver requirements. DHS is taking a number of steps to implement and continue that management system, including surveys of service recipients and working to improve the critical incident reporting, investigation and analysis systems. But more is needed according to the MN-CCD work group on this issue. The work group wants to see the 2007 quality assurance report recommendations full implemented, among other needs.
   
Providing more opportunities for accessible housing is a focus for the MN-CCD housing work group.  Working with state officials to encourage more use of Housing and Urban Development (HUD) vouchers for housing is one need, as very few local housing agencies apply for these vouchers. Enforcement of fair housing regulations is another need.
   
The work group is also waiting for the DHS Housing Options Initiatives report, which is due this month. The report, which state lawmakers OK’d in 2009, requires DHS to study, pilot and expand available, affordable, accessible, independent housing options for people with disabilities of all ages that use home and community based services. Specific recommendations will be made after the report is released.
               
The complete agenda, position papers and upcoming meetings are at www.mnccd.org