Funding Nursing Homes: Priority for our Community
Jul 25, 2007 News
I would like to respond to questions I am hearing about the funding of nursing homes in our communities. Nursing homes, especially in rural areas, are under-funded, and have been for a good portion of this decade. Our older relatives and friends have given so much to our community and I believe it is vital for us to commit the adequate funds to provide diversity in resources and comfortable living conditions. In addition, the skilled and unskilled care workers who care for them have seen little income improvement due to the reimbursement structure nursing homes must live with.
Improving this is a priority for our community, and while we have made positive strides, more work is needed to address the concerns of nursing homes in our area.
I was an advocate for the increased funding of nursing homes this past legislative session and voted yes for a Health and Human Services bill that would have increased funding to nursing homes by 6% over the next two years. This was a substantial increase centered on the needs of rural nursing homes, and aimed toward reversing a disconcerting funding trend. In fact, in 2004-05, the legislature provided a minuscule increase of one-half of 1 percent. In 2006-07, funding was not restored at all.
Additionally, I authored a bill that would have delivered more funds specifically to retirement homes in Northfield by including them in the Metro Reimbursement Pool. Unfortunately, Northfield Retirement Center and Three Links sit just outside of an arbitrary metro-line, which precluded them from receiving funds from the Metro Reimbursement Pool. This arbitrary boundary makes it harder for them to compete for the same pool of workers because they are unable to offer the same wages. This bill was regrettably taken out of the final bill in conference committee, but is an issue I will continue to champion.
Unfortunately many bills like this were put on the chopping block due to Governor Pawlenty's veto of the Health and Human Services bill. This veto erased the 6% increase in nursing home funding and forced us to make difficult choices with respect to our severely troubled health care system.
Along with increasing funds for nursing homes, it was critical to provide more health coverage to needy children, ensure better child care options for single parents and attend to much needed concerns for mental health programs. As a result, nursing home funding received a smaller increase than in the initial bill I voted for. I wish we could have included the 6% increase in nursing home funding, but I am proud, among other things, we were able to provide health care for 30,000 more uninsured kids.
Its important to balance priorities, and funding nursing home increases on the backs of uninsured children and single mothers is unacceptable. I am committed to adequately addressing both concerns.
While more comprehensive attention needs to follow, we did make positive strides for nursing homes this Session. Nursing home funding constituted the single largest increase of all new general funds spending at a level of 40%. Contrary to those who have alleged that welfare increases trumped nursing homes, the new spending increase for nursing homes doubled those for MFIP and TANF funds. And in terms of base budget, long term care spending is more than triple the amount spent on welfare.
The long-term care industry is changing and presenting more and more challenges. I am optimistic we have ventured down a path leading us toward ample long-term care for our seniors. What is most encouraging is the manner in which the three nursing homes in my district have responded, becoming leaders in the evolving industry. The Northfield Retirement Center and Three Links offer terrific care and diverse services with the resources they have been provided. We must match their ingenuity at the State Capitol next session to continue on the right path.
New Laws 2007
Jul 9, 2007 News
It is now possible to visit the Web and find overviews of the 150 new laws enacted during the 2007 legislative session. The overviews are put together by nonpartisan House Public Information Services staff, with help from the nonpartisan House Research and House Fiscal Analysis departments. You will find they are written in an easy-to-understand style, and provide links to the House or Senate version of the bill.
You will also find a selection of bills that were not enacted it into law, but could be considered when the Legislature convenes again on Feb. 12, 2008.
To access New Laws 2007, go to the NEWLAWS page or the House of Representatives
Web site at www.house.mn and click on New Laws under the information category located in the center of the main page.
Special Election may be about Education and Healthcare
Jul 9, 2007 News
As you might imagine there is lots of interest in the special election over in House Seat 28B, held for the last 30 years by Rep. Sviggum. Eleven candidates are vying for the seat. That’s five Republicans and six Democrats.
I was struck by the tone expressed by the two Leaders in the House.
The following quotes regarding the special election candidates appeared in the Rochester paper:
"They all seemed very focused on education and the well-being of their communities, and that seems to be a really good fit with the House DFL caucus right now," Anderson Kelliher said.
"If you elect a Democrat, you're just basically contributing to an already sloppy DFL majority that's slanted toward the inner city. It's another vote for Minneapolis leaders," Seifert said.
Minority leader Seifert also mentioned the Republican interest in Healthcare reform, which I will grant him is one of the top issues I hear about. In light of the attention Michael Moore’s movie ‘Sicko’ is getting it is not hard to understand that this is an issue that voters are very concerned about. But the Republican solutions are very limited and don’t really get at bringing down costs or increasing access to healthcare.
Seems everyone is talking about the magnitude of the problem. Here is Amy Klobuchar quoted yesterday in the Bemidji Pioneer :
“I personally think that the focus should be on health care costs and how we can make sure we have quality health care but reduce some of the paper-pushing and all the administrative costs,” And that includes providing health coverage to all citizens, especially those in rural areas who also have problems accessing health care.
“It’s just getting harder and harder for people to get by,” she said, with health care premiums up 60 percent in six years.
Paul Krugman dedicated his column this morning to the major roadblocks to solving the problem:
Meanwhile, every available indicator says that in terms of quality, access to needed care and health outcomes, the U.S. health care system does worse, not better, than other advanced countries. …
All of which raises the question Mr. Moore asks at the beginning of “Sicko”: who are we?“We have always known that heedless self-interest was bad morals; we know now that it is bad economics.” So declared F.D.R. in 1937, in words that apply perfectly to health care today. This isn’t one of those cases where we face painful tradeoffs — here, doing the right thing is also cost-efficient. Universal health care would save thousands of American lives each year, while actually saving money.
So this is a test. The only things standing in the way of universal health care are the fear-mongering and influence-buying of interest groups. If we can’t overcome those forces here, there’s not much hope for America’s future.
I believe we will see in this next session the debate of a single-payer Bill, two have already been introduced though they have not been heard in committee. SF 460 and HF2522 are both described as Single payer bills but the y do have there differences and I am sure they will change again as time goes on.If you have thoughts about healthcare I would like to hear what’s on your mind please e-mail me with your ideas. (rep.david.bly@house.mn)Here is a summary of what was passed in the last session related to Health and Human Services:
HEALTH & HUMAN SERVICES
- Comprehensive statewide health care reform: Funding for several initiatives, such as payment reform, electronic medical records, and improved reporting of uncompensated care, which will help lower health care costs for the 93 percent of Minnesotans who currently have insurance.
- Expanded health care access: Reduced or eliminated barriers to coverage for children, which will result in approximately 37,000 children and 20,000 adults receiving health care.
- Nursing homes: A 2 percent rate increase for long-term care facilities in both fiscal years 2008 and 2009. Phased-in rebasing of rates. Rebasing is particularly important for nursing facilities located in rural areas currently experiencing financial hardship.
- Targeted case management: $33 million in one-time money to offset federal cuts to "Target Case Management" services.
- Homeless/runaway youth: $1 million for efforts to help homeless and runaway youth.
- Family homelessness prevention: $7.5 million in new funding for flexible grants to counties and nonprofit organizations to help families or youth who are homeless or at imminent risk of homelessness.
- Mental health: The MA, GAMC, and MinnesotaCare benefit set is expanded to include more comprehensive mental health services.
- Early Hearing Detection and Intervention Act: Established a universal newborn hearing screening program, which will help to promote health child development.
- Critical access dental care: Increased funding for critical access dental providers.
- Continuing care for older Minnesotans: The Senior Nutrition Program; Senior Companion Program; Retired Senior Volunteer Program (RSVP); and Foster Grandparent program provided increased resources to continue their vital missions. The Senior Nutrition Program (Senior Dining and Meals on Wheels) provides nutritionally balanced meals and social contact for more than 88,000 older adults.
- Emergency contraception: Hospitals required to provide victims of sexual assault medically and factually accurate information regarding emergency contraception, and the emergency contraception itself upon the victim's request.
- Freedom to Breath Act: Effective October 1, 2007 smoking is banned in indoor places of employment including bars, restaurants, and in public transportation.
- Body piercing: Parental consent required for minors to get a body piercing other than pierced ears.
- School employee health insurance pool: Created a statewide health insurance pool for all school district employees.
- MCHA: Lifetime benefit increased to $5,000,000 to help people with chronic debilitating health problems.
- Health care visitation: Upon admission to a health care facility, a patient must be given the opportunity to designate a person who is not related who will have the status of the patient's next of kin with respect to visitation and making health care decisions.
- Physical therapy: No modifications to existing law governing direct access to physical therapists.
- Radon control: The Department of Labor and Industry directed to adopt rules for radon control as part of the State Building Code for all new residential buildings. Exposure to elevated levels of radon can cause health problems in humans.
Posting again
Jul 2, 2007 News
I have been back in Northfield a little more than a week and have been attempting to catch up on all those loose ends left hanging. It has been a busy week and a half and looks to continue in that vein but I will try not to avoid this communication tool if I can.
First let me report that I went to New York to help look after my brother Richard who recently discovered he has a brain tumor. In addition to tending to him in the hospital and helping settle some affairs I worked diligently to try to get his apartment more amenable to his return. The hospital kept saying they needed to send him home, as they were not doing anything for him. The truth is after the initial tests their ability to bill for his stay had ended.
We were waiting for the results of the brain biopsy to see what were dealing with. But my brother suffered a set back from the biopsy – paralysis on his left side and it was clear he could not go home to his five story walk up in that condition. The hospital was in a double bind as my brother could not go home and the rehab unit could not accept him with a diagnosis. The insurance company would not allow it. Eventually a deal was worked out so that he could be transferred even though the diagnosis would take several more days.
We now know that my brother has brain cancer, that it is treatable and we hope for the best. My mother and sister are looking after him, which allowed me to return home.
Land and People with Wendell Berry
Last Friday night I attended 25th anniversary celebration of the Landstewardship Project 
“Keeping the Land and People Together”. I saw several Northfielders in the audience and many old friends from western Minnesota. We all enjoyed conversation, music, readings, and local foods.Minnesota poets Joe Paddock and Mary Rose O’Reilley read from their works celebrating the land and rural life and Kentucky poet and essayist 
Wendell Berry read from some of his new works, “A new poem about hope and a funny story about Burley Coulter.” Joe was one of the co-editors of “Soil and Survival” a great publication about the preservation of land and rural life. Mary Rose is an award winning poet.Those unfamiliar with Berry () would do well to study his essays in the numerous books he has published from The Unsettling of America, The Hidden Wound, to Home Economics, to What Are People For?.
A recurring theme in his work is the importance of people to a landscape and how our current trend in the last 100 years has been to force people away from a landscape that as a result we are destroying, with chemicals and machinery. The following morning I had the pleasure of joining a group of folks for sightseeing and birdwatching with Berry on the Dave and Florence Minar’s Cedar Summit farm , just north of New Prague. As we walked through the pasture where the Minard herd are fed on chemical free grass, Wendell asked why would we let agriculture be dictated by the machinery on the farm and not the people and the land itself. It was clear he felt very much at home in that pasture.
Healthcare reform with Kip Sullivan
Later that same day I drove to MNPact in Burnsville for a forum with Kip Sullivan who you may remember from previous posts is an advocate of single payer universal healthcare system. Kip is a wealth of knowledge and a very articulate proponent of what could prove to be the fix for our ailing system.
Healthcare is one the issues I hear about continually and is written about daily. As an example here is a link to an article I received this morning while writing this blog.
"Why isn't the richest country in the world also the healthiest?"
by Weldon Berger | Jul 1 2007
Americans die younger and spend more years disabled than our counterparts in Canada and Europe. Our infant mortality rate is higher, too. And yet, even though the most common objections to nationalized health care from its opponents in the U.S. are that it's too expensive, too restrictive and too inefficient, we spend way more money on health care than they do. Why, if our health care is the best in the world and we spend more money on it than anyone else and the free market is a marvel of efficiency, aren't our results the best in the world? (To read more click here)
Kip spoke for about an hour and a half on the history of health insurance in the U. S. and how got in to the mess we are in. He then talked briefly about the wrong headed solutions currently in vogue like report cards and disease management both likely to cost more and reduce quality.
Afterwards, I was joined by six other area legislators to talk about our views and answer questions. There was agreement on the fact that the issue is one or two on everyone’s list and we have been talking about it for years. All six legislators were newly elected democrats who want to be a part of positive change at the legislature, which for me was the most hopeful part of our presentation. It remains to be seen what we will do but we have been working on bills that will move us closer to a better solution to the healthcare mess.
Several folks had seen Michael Moore’s “Sicko” and made reference to it. They urged others to see it as well.
