By Eric Dick, MNAAP Lobbyist
The 2015 legislative session stumbled across the finish line on midnight of May 18, though legislators face another lap in the form of a special session. With legislative leaders unable to reach an agreement with Governor Dayton around policy and spending for early education and environmental protections, the Governor is expected to soon call legislators back to the Capitol for a short special session.
While legislators have not completed the entirety of their work, we do know that a number of key MNAAP priorities received significant attention and support at the Capitol this year.
Mental health
Legislators from both parties and both bodies made mental health a high priority throughout the legislative session, and the HHS spending package includes an increase of $46 million in supports for mental health.
Suicide prevention efforts found new funding and policy provisions, including better data gathering and text-based prevention tools. Mental health crisis supports received more than $8 million in state funding, and health plans will soon be required to support mental health crisis services.
DHS is also instructed to establish a 24-hour central phone number to provide 24-hour telephone consultation for mobile crisis teams. First episode of psychosis supports received more $250,000, and more than $800,000 was earmarked for respite care for families of children with mental illnesses. The bill also extends Medical Assistance coverage for inpatient pediatric psychiatric treatment, though the change is not effective until July 1, 2017.
The funding bill also included increased funding for chemical dependency prevention efforts, as well as new investments in safe alcohol and drug withdrawal management programs.
Funding for communities to focus on adverse childhood experiences (ACEs) was included, though the funds are not available until the next biennium. The bill also includes $500,000 for fetal alcohol syndrome prevention. DHS is awarded more than $5 million to establish behavioral health care homes to focus on mental health needs, though the program is not effective until July 1, 2016. New funding for school-based diversion for students with co-occurring disorders was also funded.
Child protection
Legislators also acted favorably on MNAAP-supported efforts to reform the state’s child protection system. The conversation around this work began with a damning series of article in the Star Tribune highlighting the many failures of the system to protect vulnerable children. The HHS funding bill earmarks more than $50 million in new funding intended to improve the system, much of which is to be used to fund child protection grants to address child welfare disparities. The grants are intended to address structural factors that contribute to inequities in outcomes, as well as identifying and implementing strategies to reduce racial disparities in treatment.
There are also changes included in how mandated reporters such as physicians are involved in child protection. Should a mandated reporter make a report, that individual will now receive a summary of the disposition of the case, including whether the case has been opened for child protection or other services, or if a referral has been made to a community organization, unless release would be detrimental to the best interests of the child. The bill also calls for closer coordination between social welfare organizations and law enforcement and county attorney offices.
The bill also requires DHS to establish review teams to study child fatalities and near fatalities due to child maltreatment and child fatalities and near fatalities that occur in licensed facilities. The review teams are instructed to assess the entire child protection services process from the point of a mandated reporter reporting the alleged maltreatment through the ongoing case management process, with the goal being process improvement.
Other issues
The session did, however, also contain some disappointments. Despite strong support from the MNAAP and other public health advocates, as well as terrific testimony by Dawn Martin, MD, the chair of the MNAAP’s immunization work group, the effort to narrow the way in which parents can forgo recommended vaccinations for their children for school enrollment did not advance in the House. Minnesota pharmacists were approved to give immunizations to teens ages 13 and older and required to check the MIIC prior to vaccine administration.
The MNAPP’s goal of expanding the Freedom to Breath Act to include a prohibition on the use of e-cigarettes indoors in most public spaces also failed to advance.
And the MNAAP-supported legislation to bring transparency and greater disclosure to the prior authorization process for medication did not move in the House. That effort, a partnership of over 40 physician groups and patient advocacy groups, is certain to continue in 2016.
An initiative to increase physician reimbursement for primary care services provided under state health programs was included in the Senate’s version of the HHS finance package, though it was not included in the final spending bill. MNAAP President Sue Berry, MD, testified in support of this provision when it was before the House HHS Finance Committee.
And finally, a Senate-only provision that would have barred MDH from the distribution of address information of new parents was not accepted in conference committee. Opponents of newborn screening have used that information to send new parents inflammatory, inaccurate information about the newborn screening program that may be leading some parents to destroy valuable medical records.
Early education and brain development
One of the MNAAP’s chief priorities – investments in early brain development – is the primary source of the disagreement that has led to the special session. In a happy change from previous debates on the subject, elected officials are not arguing about whether to invest in early childhood learning, but rather how much should be invested. Two distinct approaches have emerged, with Governor Dayton and many DFL legislators supporting funding for universal pre-K schooling, while most Republican members are supporting targeted scholarships to allow children from low income families to attend high quality preschool programs. This debate will be at the center of the special session.
While the ink has not yet dried on the bills passed this year, and a special session looms, we do know one thing for certain: the 2016 session is set to begin on March 8, 2016.
