NAMI Minnesota



NAMI Minnesota Legislative Update January 13, 2019The 2019 Legislative Session began on January 8thThe 2019 Session began this past Tuesday, January 8, with the swearing in of new members of the House of Representatives and 1 new State Senator. While some of these new members are returning, there are HYPERLINK "" \t "_blank" 36 legislators serving in the House of Representatives for the first time.It is always important for NAMI advocates to engage their state legislators on mental health issues, but it is crucial that you introduce yourself if your state legislator is serving for the first time.Here's what you can say:Hello, my name is _________ and I live in ________. Congratulations on being sworn in as a new member of the House of Representatives. I am a NAMI member and I am contacting you to remind you about how important mental health is to me and my family.(Share personal story about why you are a NAMI member)Our mental health system is still under construction, that's why I'm counting on you to support the expansion of mental health services in our community. Thank you for serving as a state legislator. I am excited to work with you this session to build our mental health systemNAMI Minnesota depends on its statewide grassroots network to create change at the state and national level.?There are many ways to stay up-to-date on public policies and to know when your voice is needed.We have a significant need for volunteer support sending out our big legislative mailing to NAMI members. We will be reaching thousands of NAMI members from across the state with information about their state representatives and senators, key issues for the 2019 session, and how to get involved. We won't be able to get this information out in a timely manner without volunteer support. Can we count on you to join us next week anytime between 9AM and 5 PM to help send this mailing out? Contact HYPERLINK "mailto:ssmith@" \t "_blank" Sam Smith if you are ready to step up and join our team that will be sending out our 2019 legislative mailing!Follow the links below to find out more about the many ways you can advocate for change: HYPERLINK "" \t "_blank" Get Legislative Updates HYPERLINK "" \t "_blank" Sign up for our e-newsletters HYPERLINK "" \t "_blank" Find Advocacy Volunteer Opportunities HYPERLINK "" \t "_blank" Lobby HYPERLINK "" \t "_blank" Engage Elected Officials and Candidates HYPERLINK "" \t "_blank" Read about NAMI in the NewsFind out who represents you HYPERLINK "" \t "_blank" Click hereNews from the State and Federal LevelVocational Rehabilitation ServicesThe Department of Employment and Economic Development (DEED) is making significant changes to the rules regarding Extended Employment Services for individuals on a Medical Assistance Waiver. The rule was originally submitted for public comment on November 20th and NAMI raised a number of significant concerns with the proposed changes.DEED chose to make some changes based on NAMI Minnesota's comments, including a change on page four from "behavior management" to "symptom management" in a discussion about reasonable accommodations that employers can make. DEED also opted to use a broader definition of qualified professional on pages 5 and 6 to refer to all mental health professionals. While these small changes are helpful, NAMI Minnesota continues to have major concerns with the overarching changes DEED has proposed:NAMI is strongly opposed to requirement that MA recipients will not be able to receive extended employment services. Unlike other Medical Assistance waivers, is rare for people with mental illnesses using the Community Access for Disability Inclusion (CADI) waiver to receive any employment services.NAMI is also strongly opposed to the definition of Community Employment and Competitive, Integrated Employment, particularly because the very successful AbilityOne program run by Tasks Unlimited would receive a lower rate.You can read NAMI's HYPERLINK "" \t "_blank" full public comments here and the new proposed rule from DEED HYPERLINK "" \t "_blank" here.Walz Administration Creates One Minnesota Council on Diversity, Inclusion, and EquityIn an early Executive Order, Governor Walz has created the One Minnesota Council on Diversity, Inclusion and Equity. This council will connect key members of the Walz Administration with members of the public to respond to "Disparities in Minnesota, including those based on race, geography, and economic status, [that] keep our state from reaching its full potential." NAMI Minnesota supports this important work and hopes that the needs and challenges of people with mental illnesses will be considered by the Council on Diversity, Inclusion, and Equity. You can read the full proclamation from Governor Walz HYPERLINK "" \t "_blank" here. December Bed Report from Direct Care and TreatmentEvery month, the Department of Human Services (DHS) must disclose the occupancy rates for all State-Operated Programs. Despite the high level of need for this level of care, many state-operated programs continue to operate fare below their licensed capacity. Here are the numbers:The Anoka Metro Regional Treatment Center (AMRTC) is at 76.36% of their budgeted beds and 48% of their licensed beds.The Community Behavioral Health Hospitals (CBHHs) were at 83.33% for both budgeted and licensed beds.The Minnesota Security Hospital (MSH) was at 95.13% for budgeted beds adn 90.72% of licensed beds.These numbers, particularly for the AMRTC, are disappointing and demonstrate the need for changes in the Direct Care and Treatment programming at DHS. You can find the HYPERLINK "" \t "_blank" full report here.Key Federal Health Care Issues in 2019As the longest-ever partial government shutdown continues to dominate the headlines, there remains significant work to be done at the federal level related to mental health and substance use disorder treatment. Here are some of the key issues identified by the National Council:Government Shutdown: Partisan gridlock has lead to the longest partial government shutdown in U.S. history. However, 75% of the Government has already been funded including Social Security, Medicare, Medicaid, CHIP coverage, Veterans benefits, Substance Abuse and Mental Health Services Administration (SAMHSA) funding. However, important federal programs could run out of money such as food stamp support, rental assistance through Housing and Urban Development (HUD), and other key programs. It is imperative that Congress and President Trump reach an agreement and end the partial government shutdown.FY 2020 Budget: Without legislative action, Federal non-discretionary spending will face massive funding cuts through the process known as "sequestration." While these cuts will not impact funding for Medicaid, recent increases for mental health programs are at risk without action from Congress.ACA Legal Challenge: After the failure to repeal the Affordable Care Act (ACA) through congressional action, some conservatives have turned to legal action to dismantle the ACA. The most significant effort to do so is a recent decision from Judge Reed O'Connor that the ACA is unconstitutional following the repeal of the individual mandate. While most legal experts doubt that this ruling will ultimately be upheld, it remains an issue that NAMI Minnesota will be monitoring in 2019.MA Waivers: The Trump Administration continues to show interest in granting states additional control over Medicaid Waivers, including work-reporting requirements for nondisabled adults without children in order to be eligible for Medical Assistance. NAMI Minnesota has strongly opposed work-requirements for Medicaid because most people on Medical Assistance already work, people will lose health insurance due to paperwork challenges, and work requirements are not proven to increase employment rates. While work-requirements are unlikely to receive support from the new Democratic majority in the House, the Trump Administration is likely to continue expanding work-requirements through executive actions.Bill IntroductionsHouseHF 1 (Kotyza-Witthuhn, Pinto, Liebling, Davnie, Youakim, Olson, Bahner, Howard, Christensen, Lippert, Gomez, Schultz, Cantrell, Hornstein, Long, Persell, Halverson, Kunesh-Podein, Mariani, Freiberg, Sandell, Wazlawik, Noor, Hortman, Winkler, Pryor, Lee Wolgamott, Huot, Lislegard, Sundin, Lesch, Ecklund, Lillie) Great Start for All Minnesota Children act adds utilization of high-quality prenatal care to Minnesota goals for eliminating health disparities for children of color and American Indian children. Appropriates $5 million in Fiscal Years 2020 and 2021 to support this goal. Creates a new grant program to support evidence-based home visiting for pregnant women and families with young children. These grants are targeted to serve those who are high risk or have high needs including parents with a history of mental illnesses, domestic abuse, substance use disorder, first time mothers, or families who are eligible for public benefits such as medical assistance or food support. Appropriates $23 million in fiscal year 2020 and $41.6 million in fiscal year 2021 with a final base appropriation of $56.5 million a year. Also creates the “Great Start Fund” to support early learning scholarships. Lastly, the Great Start for All Minnesota Children Acts appropriates $10 million over the biennium for child care and requires all grant fundings to be evenly distributed to communities outside of the 7 county metro area. Referred to Ways and Means.HF 2 (Edelson, Christensen, Davnie, Youakim, Mariani, Lillie, Mann, Schutlz, Loeffler, Hornstein, Bahner, Cantrell, Howard, Long, Lippert, Gomez, Pinto, Persell, Liebling, Kunesh-Podein, Halverson, Becker-Finn, Freiberg, Sandell, Wazlawik, Noor, Hortman, Winkler, Lee, Wolgamott, Huot, Lislegard, SUndin, Ecklund). Defines who can provide school-linked mental health services to include community mental health centers, an Indian health service facility, a Children’s Therapeutic Services and Supports (CTSS) provider, or a mental health or substance use disorder agency with at least two full time mental health professionals or alcohol and drug counselors. Allowable grant expenses also include transportation expenses during summer months and the costs of establishing and operating a telemedicine program. Appropriates $5.12 million in fiscal years 2020 and 2021 from the Department of Education to the Department of Human Services for school-linked mental health services, $12.133 million for support our students grants in fiscal years 2020, $15 million for full service community schools in fiscal years 2020 and 2021, $ 4 million for home work starts at home to support homeless students in fiscal years 2020 and 2021, $6 million in fiscal years 2020 and 2021 for grants to support educators of color, and $8.5 million for the grow your own pathways to teacher licensure program. Referred to Ways and Means.NAMI supports increasing funding for school-linked mental health grants, but would like to see some additional language to ensure that existing grant dollars are used to sustain the school-linked services that are succeeding.HF 3 (Liebling, Moran, Schultz, Loeffler, Morrison, Sandell, Lillie, Christensen, Xiong J, Xiong T, Lippert, Gomez, Hornstein, Bahner, Becker-Finn, Sauke, Cantrell, Davnie, Howard, Long, Persell, Pinto, Kunesh-Podein, Mariani, Hansen, Freiberg, Noor, Hortman, Winkler, Lee, Wolgamott, Klevorn, Acomb, Huot, Lislegard) Authorizes Department of Human Services and Department of Human Services to develop a system for any Minnesotan to purchase health insurance coverage through MinnesotaCare. Human Services and Commerce must submit a plan to the Legislature by March 1st 2020 and must seek any necessary federal waivers to operate the MinnesotaCare buy-in. Referred to Health and Human Services Policy.NAMI Minnesota does not have a formal position on the MinnesotaCare Buy in.HF 4 (Lesch, Moran, Liebling, Cantrell, Persell, Wazlawik, Noor, Hortman, Winkler, Lee, Schultz, Wolgamott, Acomb, Klevorn, Huot, Lislegard, Sundin, Ecklund, Olson, Lillie, Hausman, Morrison, Stephenson, Carlson A, Gomez, Vang, Kunesh-Podein, Xiong T, Long, Howard, Her, Bahner, Claflin, Sauke) Prohibits a manufacturer or wholesale drug distributor from price gouging in the sale of essential or lifesaving off-patent or generic drugs, defining price gouging as an excessive increase in price that is not justified by the cost of producing the drug or expanding access to the drug. The Department of Human Services or a health plan can notify the attorney general of any price increase for an essential generic or off patent drug when the price increase is over 50%, a 30 day supply of drug exceeds $80, or a full course of treatment exceeds $80. Grants the attorney general the authority to request the drug manufacturer or wholesale distributor to produce the records or documents necessary to determine if they are violating the law. Referred to Health and Human Services Policy.HF 5 (Halverson, Richardson, Sauke, Olson, Moran, Persell, Lillie, Morrison, Elkins, Lippert, Gomez, Carlson A, VAng, Howard, Schultz, Noor, Her, Cantrell, Claflin, Hansen, Bahner, Wolgamott, Mann, Long, Wagenius, Hortman, Kunesh-Podein, Carlson L, Hornstein, Lee, Hassan, Pinto, Pryor, Winkler) Creates public program administered by DEED that allows for people to receive payment while on leave from their employment for pregnancy, caring for an ill family member, bonding with a new child, or receiving health care treatment. In one calendar year, this program will support up to 12 weeks of leave for a serious health issue or pregnancy and up to 12 weeks of leave for bonding with a new child, including people who are self-employed. This program is funded through premiums on wages for all taxpayers of unemployment insurance. Employers can receive a waiver from allowing employees to receive paid leave through this program if a majority of employees agree to not receive this benefit and the employer offers weekly payable benefits that are at least equal to the weekly benefit available through this bill. Referred to the Labor.This legislation would allow for family members to take family leave to care for a loved one with a mental illness.HF 8 (Pinto, Moller, Richardson, Lesch, Mariani, Loeffler, Hornstein, Edelson, Mann, Cantrell, Bahner, Schultz, Christensen, Davnie, Gomez, Howard, Long, Kunesh-Podein, Liebling, Becker-Finn, Lippert, Freiberg, Sandell, Wazlawik, Noor, Hortman, Winkler, Pryor, Lee, Wolgamott, Huot, Olson, Moran, Hausman, Fischer) Expands requirements for a firearm transfer permit and firearm transfer reporting from a pistol or semiautomatic military style assault weapon to any firearm and also requires the transferee to be at least 21 years or older. Requires a background check for private party firearm transfers such as a purchase at a gun show. Referred to Ways and Means.HF 9 (Richardson, Pinto, Lesch, Edelson, Mariani, Moller, Howard, Long, Xiong T, Davnie, Gomez, Liebling, Persell, Halverson, Becker-Finn, Lippert, Freiberg, Sandell, Noor, Cantrell, Hortman, Winkler, Pryor, Lee, Schultz, Wolgamott, Olson, Hausman, Moran, Fischer, Morrison, Stephenson, Her, Huot, Carlson A) Allows for a family member, household member, law enforcement, a city or county attorney, or a guardian to apply for an extreme risk protection order, which requires the individual under the order to transfer all of his or her firearms to a federally licensed firearm dealer or law enforcement. Under this order, the petitioner must demonstrate under oath and with evidence that the respondent poses a significant danger of bodily harm to self or others so long as they possess firearms. The court must order and hold a hearing within 14 days of receiving the petition. If the court finds that there is a preponderance of evidence to issue the extreme risk protection order, the court shall notify the respondent and issue a ban from firearm ownership for a fixed period not less than six months and not more than two years, with the possibility for extension. If the court finds there are reasonable grounds that the respondent poses an immediate and present danger of harming self or others, the court must issue an emergency order prohibiting the respondent from possessing firearms. Once the order has been issued, the respondent must transfer their firearms to a federally licensed firearm dealer or a law enforcement as soon as possible but no later than 24 hours. It is a misdemeanor to present fall information under an extreme risk protection order. Referred to Ways and Means.Death by suicide using a firearm is a major issue facing Minnesota. However, NAMI Minnesota does not support characterizing this as violence and connecting suicide with violence against others.HF 11 (Lesch, Olson, Winkler, Becker-Finn, Lillie, Schultz, Loeffler, Lippert, Hornstein, Cantrell, Bahner, Christensen, Gomez, Howard, Long, Persell, Richardson, Davnie, Liebling, Halverson, Kunesh-Podein, Mariani, Freiberg, Sandell, Noor, Hortman, Lee, Pinto, Wolgamott, Sundin, Ecklund, Moran, Fischer, Nelson) Allows all employees to accrue a minimum of one hour of earned sick and safe time for every 30 hours worked for a maximum of 48 hours a year. Sick and safe time can be used for an employee’s to seek diagnosis, care and treatment of a mental or physical illness. This policy change does not impact more generous sick and safe time policies and prohibits retaliation against an employee taking sick or safe time. Referred to Labor.We support the inclusion of mental illness under the protections in this bill, but NAMI does not have a formal position on this issue.HF 12 (Cantrell, Hortman, Winkler, Xiong J, Kunesh-Podein, Moran, Freiberg, Wolgamott, Hansen, Loeffler, Lee, Her, Masin, Hornstein, Dehn, Liebling, Lillie, Morrison, Edelson, Moller, Bahner, Wazlawik, Hassan, Tabke, Howard, Christensen, Brand, Richardson, Long, Pinto, Mann, Stephenson, Fishcer, Lippert). Prohibits mental health practitioners and professionals from engaging in conversion therapy with a client younger than age 18 or a vulnerable adult. Conversion therapy is the practice of trying to change an individuals sexual orientation or gender identify. Also prohibits any deceptive advertising or misleading statements that could reasonably be interpreted to represent homosexuality as a mental disease or make a guarantee to change an individual’s sexual orientation or gender identity. Referred to health and human services policy.NAMI supports HF 12 and has joined the coalition advocating for the passage of a conversion therapy ban.SenateSF 1 (Rosen, Anderson P, Lang): Clarifies that Department of health grant program to treat pre and post-partum mood and anxiety disorders with grants for mental health treatment. The bill also defines who can provide school-linked mental health services to include community mental health centers, an Indian health service facility, a Children’s Therapeutic Services and Supports (CTSS) provider, or a mental health or substance use disorder agency with at least two full time mental health professionals or alcohol and drug counselors. Allowable grant expenses also include transportation expenses during summer months and the costs of establishing and operating a telemedicine program. Will also make appropriations for mental health counselling for farm families, school-linked mental health, mental health services for veterans in the C.O.R.E. program, grants for pre and postpartum mental health treatment for mothers, and grants for mental health services for homeless and at risk youth. Referred to Human Services Reform Finance and Policy.NAMI supports increasing funding for school-linked mental health grants, but would like to see some additional language to ensure that existing grant dollars are used to sustain the school-linked services that are succeeding.SF 3 (Draheim, Benson, Johnson, Pratt) Creates shared savings incentive program that must be offered by health plan companies to eligible enrollees. This program is designed to incentivize health plan enrollees to seek less expensive health services including, but not limited to physical and occupational therapy, obstetrical and gynecological services, radiology and imaging services, laboratory services, infusion therapy services, inpatient and outpatient surgery, and nonsurgical diagnostic tests. Using a website developed by the Department of Health, enrollees will have the opportunity to compare average charges for a health service by a procedure or surgery code. If an enrollee finds and receives a service that is below the average allowed amount paid by the health plan for that service of more than $25, then the enrollee receives 50% of the cost savings into a shared savings incentive account. This account can be used to pay for their health care costs including co-payments, co-insurance, or deductibles. If the enrollee identifies and receives health services from an out-of-network provider at or below the average amount paid by the health plan, then the health plan must allow for the enrollee receive care from the out-of-network provider at the out-of-network rate. Incurred expenses shall also apply towards the enrollee’s deductible and out-of-pocket maximums. This program would begin in January 1st of 2020 and the health plans must submit an annual report to the legislature that documents the use of the shared saving incentive program, cost savings, and the number of enrollees participating in the program. Referred to Commerce and Consumer Protection Finance and Policy.SF 6 (Utke, Abeler, Hoffman, Koran, Eken) Modifies the Disability Waiver Rate System including the addition of a competitive workforce factor. Makes changes to the applicable services that are authorized under a home and community-based service plan by removing behavioral programming and adding positive support services. Also requires providers enrolled to offer these services to submit labor market data to the commissioner of human services including the number of employed staff, wages, overtime hours, benefits, vacancies, and retention rates.The legislature and Governor Dayton failed to pass legislation on Disability Waiver Rate Services (DWRS). If the new Legislature and Governor Walz are unable to reach an agreement, then providers will face an automatic 7% cut. SF 7 (Nelson, Wiger, Housley, Anderson P, Gazelka) Allows school districts to purchase public announcement systems, emergency communication devices, and other equipment to prevent violence and increase the security of school buildings through bonds. Creates a safe schools revenue levy based on a per-pupil rate. Safe schools revenue can now be used to deliver school-linked mental health services by telemedicine and cyber security enhancements. This revenue can already be used to co-locate mental health professionals at the school. Referred to Committee on E-12 Finance and Policy.SF 60 (Dziedzic and Hayden) Requires owner of a residential rental property with ten or more units to notify the Housing Finance Agency and the tenants at least 150 days prior of a plan to list and sell the property. The owner must also submit the sale price and conditions to both the tenants and the housing finance agency within 120 days of sale. During this notice period, the majority of the tenants or a nonprofit organization representing the majority of tenants has the right of first refusal and may acquire the rental property for the same price so long as the property continues to be a rental property with affordable units. Referred to Agriculture Rural Development, and Housing Policy.SF 73 (Clausen, Abeler, Hoffman) Requires private health plans to cover mental health services provided by a clinical trainee if this is within the scope of the trainees practice and the private plan would cover this service if it were done by a mental health professional. Referred to Commerce and Consumer Protection Finance and Policy.NAMI Minnesota supports this legislation and advocated for an almost identical bill in the last biennium. Medical Assistance already allows for clinical trainees to bill for services if it is within their scope of practice.SF 82 (Dibble, Dziedzic) Creates new tenant protections regarding rent increases and not renewing a lease. Requires landlords to abide by the terms of a lease regarding timelines for rent-increases or not renewing a lease and ensures that tenants have the ability to leave their lease under the same timeline. Clarifies that a rental agreement cannot modify or alter time-periods for rent increases or a notice to quit. Referred to Judiciary and Public Safety Finance and Policy.SF 83 (Dibble, Hayden, Wiklund) Prohibits mental health practitioners and professionals from engaging in conversion therapy with a client younger than age 18 or a vulnerable adult. Conversion therapy is the practice of trying to change an individuals sexual orientation or gender identify. Also prohibits any deceptive advertising or misleading statements that could reasonably be interpreted to represent homosexuality as a mental disease or make a guarantee to change an individual’s sexual orientation or gender identity. Referred to health and human services policy. Referred to Health and Human Services Finance and Policy.NAMI supports SF 83 and has joined the coalition advocating for the passage of a conversion therapy ban.SF 89 (Nelson) Defines who can provide school-linked mental health services to include community mental health centers, an Indian health service facility, a Children’s Therapeutic Services and Supports (CTSS) provider, or a mental health or substance use disorder agency with at least two full time mental health professionals or alcohol and drug counselors. Allowable grant expenses also include transportation expenses during summer months and the costs of establishing and operating a telemedicine program. Appropriates $10.133 million in fiscal years 2020 and 2021 from the Department of Education to the Department of Human Services for school-linked mental health services. Referred to Human Services Reform Finance and Policy.Updates from NAMI Minnesota ................
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