NAMI Minnesota Legislative UpdateTop of Form
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May 22, 2016The 2016 Session is Over
The legislature adjourns at midnight tonight, Monday, May 23rd and is constitutionally unable to do any official business on the last day of the second year of a biennium. This means the deadline to get bills passed was actually last night, Sunday the 22nd by midnight.
The omnibus supplemental budget and thebonding bill conference committees met a number of times over the past week and then really got down to business on Saturday. NAMI staff were at the capitol by 8 am Saturday, left at nearly 3 am, returned at 7 am to watch the supplemental appropriations conference committee adopt the final provisions of the omnibus supplemental appropriations bill. It passed the legislature late last night. We are now waiting to hear if the Governor will sign it into law. There is a press conference at 2 pm today so we should know more then.As many of you know the bonding bill was not passed.
On Saturday the bonding conference committee took testimony on the bonding bill and Sue Abderholden, NAMI Minnesota's executive director, testified to the need to complete the St Peter proposal on time and to invest in affordable supportive housing. The final bill, which did not pass, had only $10 M for updating public housing and no money for supportive housing, which is very disappointing. They did include funding for a new Child and Adolescent Behavioral Health Hospital in Willmar, security upgrades at Anoka Metro Regional Treatment Center, phase 2 of the MN Security Hospital in St Peter but not funding for the transition services or the sex offender program. With the bonding bill not having passed and rumors that there might be a special session to take up a bill, NAMI members should watch their inbox for an action alert related to the bonding bill. This bill is unacceptable.
Conference Committees
Omnibus Supplemental Budget Bill
Here are the main spending provisions of the omnibus supplemental bill. A more complete and detailed report of what is in the bill will come out in about a week. All in all we did VERY WELL! At the end of the meeting when the health and human services article was adopted Representative Dean mentioned the "broken mental health system" and that while they hadn't provided as much investment as last year they tried to "address the warning lights on the dashboard." Senator Lourey, a long time strong advocate for mental health care, also spoke about the investments made to mental health this year and mentioned the large amount of funding to state operated programs (over $62M compared to $40 M last year for the community). Both of these elected officials have been supporters of increasing funding to mental health and deserve our thanks.
Human Services
NAMI had fought hard for increased funding for our mental health system. The key items that were funded include:
· Language needed for the Excellence in Mental Health Act and include funding for certified community behavioral health clinics (CCBHCs). $188,000 then $8.433 next biennium.
· Changes to the crisis housing fund so it can be used for people who have a serious mental illness, not just a serious and persistent mental illness.
Increased funding for School-Linked Mental Health grants, with $33,000 in fiscal year 2017 and $1.45 million per year in the next biennium
· Increased foster care rates by 15% in the next biennium
· Increased funding for the Homeless Youth Act and Safe Harbor for sexually exploited youth with each program getting $33,000 in FY 2017 and $1.45 million and $750,000 respectively each year of the next biennium (and more funding was made available in the health department budget)
· State Operated Program received an operating adjustment of $8 M this biennium and $13.5 M the next biennium and an additional one time funding of $28 M was made to State Operated Programs to restore the fund that DHS moved from mental health to make up a deficiency in the MSOCS program.
· Funds were increased to State Operated Programs to provide a competency restoration program at St Peter (12 beds), increase staffing at the Community Behavioral Health Hospitals so that all the beds are used, closing the St Peter CBHH, keeping the Child and Adolescent Behavioral Health Hospital open, increasing clinical oversight and fund a nursing pool at Anoka Metro Regional Treatment Center (AMRTC). A direct appropriation to increase staffing at the Security Hospital in St Peter (MSH) was not made, but language was added at the last possible moment to allow the commissioner may to move these appropriations to ensure a safe environment at the Minnesota Security Hospital and other hospitals in direct care and treatment state-operated services. Any reallocation of the appropriations under this subdivision must be reported in the new report that will be required.
· Requires a report to the legislature on AMRTC, MSH, and CBHH. The report shall contain information on the number of licensed beds, budgeted capacity, occupancy rate, number of Occupational Safety and Health Administration (OSHA) recordable injuries and the number of OSHA recordable injuries due to patient aggression or restraint, number of clinical positions budgeted, the percentage of those positions that are filled, the number of direct care positions budgeted, and the percentage of those positions that are filled.
· Funding for a hardship waiver for those impacted by the federal spousal assets test under the Medical Assistance waiver
· Funding to continue the Zumbro Valley Mental Health Center's integrated care project
· Some funding for critical access to dental care
· Made changes to the Medical Assistance estate recovery which impacts people over 55 on Medicaid expansion who aren't using long term care services
Education
· Increase funding to expand the number of schools using Positive Behavioral Interventions and Supports (PBIS).
· Provide funding for staff development grants for Intermediate School Districts and Cooperatives.
· Provide matching funds to schools to hire new school support personnel
Higher Education
· Requiring the ombudsman for mental health and developmental disabilities to monitor the treatment of individuals participating in drug trials at the psychiatry department at the University of Minnesota, receive complaints and investigate complaints, and make recommendations to the Board of Regents to take corrective actions if it is determined a violation has taken place.
· Funding an addictionmedicinegraduatefellowshipprogram at HCMC
· Funding for thedesignand implementation of the collegiate recoveryprogramat theUniversityof Minnesota Rochester campus.
Housing
· Funding for the landlord guarantee fund was included in the equity article to help landlords rent to people with poor rental histories.
What was not funded that we had advocated for:
· Increased rates for outpatient mental health services by 5%
· Make it difficult for health plans to use prior authorization, including step therapy, so that people can access the best medication to treat their mental illness.
· Requiring police to have four hours of training on mental health crises and de-escalation
· Funding the development of curricula for police to meet the four hour training requirement
· Hire experts to reduce the use of seclusion and restraints in schools. $500,000
· Fund additional treatment beds for chemical dependency and mental illnesses in Minnesota prisons.
Press Conference - Affordable Housing Bonding Proposals
NAMI and Homes for All
On Thursday, the Homes for All Coalition held a house press conference to urge legislators to add funding into the bonding bill for more affordable and supportive housing. The bonding bill presented at the house Capital Investment Committee on Wednesday proposed $800 million in projects, but absolutely no funding for housing. During the committee hearing, Rep. Hausman spoke in opposition to the bill stating her concerns with the zero funding for housing projects. Governor Dayton's capital budget recommendations included a total of $90 million in housing infrastructure and public housing rehabilitation bonds. Sue Abderholden, NAMI Minnesota executive director cited a wilder study reporting that 60% of adults and 57% of youth who are experiencing homelessness live with a mental illness and that percentage is growing. "When we talk about how to build our mental health system, people often say we need more beds in hospitals, but truly what we need are more beds in affordable homes," stated Abderholden.
OLA Review of UMN Department of Psychiatry
The Senate Higher Education and Workforce Development held an informational hearing on Thursday to hear theOLA review of restructuring currently underway at the University of Minnesota related to human subject research in clinical drug studies.
Legislative auditor Jim Nobles andElizabeth Stawicki, OLA director of legal research presented on the report, a follow-up to a preliminary assessment of the University's reform efforts. Click here for the full report.
AuditorNobles reported the University is in the process of implementing a wide ranging reform plan, resulting from strong and consistent criticisms of their current practices. He described the plan as "ambitious and far reaching," but have the potential tomake significant differences in strengthening protections for human research subjects at the University of Minnesota's department of psychiatry.
Elizabeth Stawicki reviewed the six areas of assessment:
1. Recruiting vulnerable people into psych drug trials. The University now prohibits recruiting those on 72-hour holds, and 12 hours following the expiration of the 72 hour hold. There is stillmuch work to do including supplying research participants with an advocate to weigh pros and cons and revising outdated informed consent forms.
2. Conflicts of interest. In the case of Dan Markingson, his treating physician also recruited him for the study. Currently there is a ban on this practice and other conflicts of interest such as financial (see page 8 of the OLA report).
3. Communications with families. Slawicki referred to reports of the treatment of Markingson's mother, and explained there are improvements that are still in process. Development of a card with vital info about the study to provide to participants and their families is still being finalized.
4. Researchers delegating tasks to unqualified staff. Reform plan does not require specific training, but better oversight for all people who work within the department of psychiatry on clinical drug trials.Dr. Brooks Jackson, Dean of the University's medical school stated in his testimony "we need more well trained professionals in this difficult field."
5. The Institutional Review Board (IRB) inadequate system for investigations. The University is investing $5M in a new system to make the entire process electronic and will continue to implement changes in order to strengthen the oversight capacity of the IRB. IRBs will be expanded to include a variety of experts.
6. Inadequate documentation of an adverse event. Stawicki reported there is not enough documentation of adverse events such as medical problems or hospitalizations that occur during a clinical drug trial.
Both Auditor Nobles and Stawicki stated the OLA was unable to verify the consultant's allegations,documentation was inadequate and it wasunclear how much the consultant did follow-up to support evidence of the allegations. AuditorNobles said that despite the allegations, he was encouraged after interviewing 24 University staff who reported they are dedicated to high ethical standards and that the department will soon be under new leadership.
Sen. Bonoff asked why this card to keep family informed has not been put into practice.
Stawicki and Nobles cited "a language issue" and simply the process to develop a uniform card as to why it has not been put into practice. Dr. Brian Herman, VP of research at the University reported the information card would be available the end of June.
SenSheran asked for clarification regarding recruiting vulnerable people and having access to a research advocate at all times, asking "who is the advocate?" Stawicki reported it would besomeone independent of the University and stated "this has not been very clear, we have not seen anything even in policy about who the advocate would be, that's a good question for the University."
Jan Dugas, the consultant referred to in the OLA report, was hired to provide an independent assessment of the University's department of psychiatry's human subject research program. It was in part Dugas' allegations that spurred the legislature to request that the OLA complete an investigation. Dugas stated that she felt "threatened and intimidated" and that her concerns were minimized by the University.
Sen. Bonoff offered language that she asked be considered by members regarding legislative oversight and further reporting by the commissioner of higher education to the legislature. Click here for video of the full hearing.
Read more on the hearing from: the StarTribune, Pioneer Press, MPRNews,
Governor Dayton Signs Bills
Governor Dayton signed HF2803 requiring a facility releasing an individual before a 72-hour holding period is up, to notify the agency that employs the peace officer who transported the person to the facility. Several more have been signed into law including sentencing reform, the human services and health departments' policy bills, legislative task force on child protection, juvenile justice task force, use of IDDT screenings, and more. Click here for the Governor's bill tracker. Again, all of these will be included in our more complete legislative summary next week.
Senate Floor Sessions
On Monday, the senate heard SF3481 (Latz) having to do with sentencing guidelinechanges for controlled substance crimes. A number of members raised concerns that reducing sentences for low level drug offenses will make the state look soft on crime. Members who supported some or all of the provisions in the bill talked about focusing on the larger issue - chemical health and treatment.