The session ends today. We apologize for the incorrect information on the Human Services Bill. We reviewed the wrong version of the bill. We try to provide as accurate information as possible, so are sorry for the error. The correct information is below. In addition the 844 page Health and Human Services bill was released this morning and we just finished reading it, so we have added information to that section as well.

Health and Human Services: This bill has not passed, and we saw the 800+ page bill this morning. Here is the additional information on the policy provisions in the bill:

The committee did release a spreadsheet on Friday night. The funding for mental health is about $98M per biennium which is less than what the Governor requested and what the Mental Health Legislative Network wanted. The Governor asked for $122.777M in FY24/25 and $141.864M in FY26/27.

Here are the mental health related issues in the spreadsheet:

Other funding items in the bill:

Concerns with the spreadsheet:

• It is not clear how the rate increase will be implemented,

• Funding was not included for voluntary engagement, where a person exhibiting symptoms of a mental illness can be engaged by a peer specialist early to agree to treatment voluntarily, thereby avoiding the ER or a police response. The ask was for this pilot project was just $250,000. If we want to address homelessness and ER visits, we must fund early intensive services. 

• Funding for the first episode mood disorder program was not included.

• Funding to add children to the Transitions to Community program, which would have dedicated resources to children boarding in the ER or “stuck” in inpatient or residential treatment, was not included.

• $13 million in the 24/25 biennium is for grants that DHS never spent in the current biennium (FY22/23) (despite the need for that funding). 

• The Housing with Supports for Adults with Serious Mental Illness Grant did not receive funding and it is an important program to help people with mental illnesses who are homeless or are trying to leave institutional settings obtain and retain housing. 

• With some grants, funding was reduced or zeroed out in the second biennium – such as school-linked and mobile crisis. This will cause major service disruption to people, especially children. 

Judiciary and Public Safety - Passed Chapter 52: Almost all of the Mental Health Legislative Network's (MHLN) proposal was included in the bill:

We were disappointed that our proposal to provide grants for reentry programs and jail social workers was not included in the final budget agreement, but we will keep advocating for this next year! Other highlights include:

Education - Passed HF2497: The education conference committee met yesterday and is expected to submit their report very soon. We know these MHLN priorities have been included:

Commerce - Passed SF2744: We have a lot to be proud of in this bill with many of the important provisions from the Mental Health Legislative Network included which will make a big impact in accessing care including:

Housing - Passed Chapter 37: $5.338 million each year through 2027 for the Bridges rental assistance program and that money can be used for landlord risk mitigation .

Employment: $2 million each year through 2027 for Individual Placement and Support (IPS) programs.

Veterans: $300,000 each year of the biennium for grants to make EMDR therapy available to veterans and veterans' spouses experiencing PTSD. The bill funds these grants ongoing at $200,000 beginning in FY26. The bill also includes funding for homelessness intervention and healthcare.

Last week, late in the conference committee process for the Human Services budget bill, new language was released changing a controversial law known as the 48-hour law. If a person is in jail and has been found incompetent to stand trial and then been civilly committed, the law requires DHS to admit the person to a state operated program within 48 hours. The law is well-intended so that people who need inpatient treatment do not languish in jail, but it has always been a narrow attempt to fix a much larger problem.

Recently there have been lawsuits against DHS for not admitting people within the 48-hour requirement. This is because there are not available beds, or insufficient staff to open beds at the state operated hospitals at Anoka Metro Regional Treatment Center or the Minnesota Security Hospital for people committed as mentally ill and dangerous (MI&D). The change that passed last week makes it so that the 48-hour clock does not begin until an appropriate bed is available.

On Monday, the Minnesota County Attorney's Association, Minnesota Sheriff's Association, Association of Minnesota Counties, and Minnesota Association of County Social Service Administrators sent a joint letter to the Human Services conference committee and held a press conference their stating opposition to the change. We understand the problem that these stakeholders face, but NAMI Minnesota sent a response to the letter providing what we consider important context to the conversation.

In summary, the issues that lead up to someone being in jail and being committed begin long before the 48-law goes into effect, and the solutions must be comprehensive. It is important to note that people are often sitting in jail for weeks and months before the 48-law goes into effect. What kind of care are they receiving in jail before they are committed? It is also important to examine how people end up in jail in the first place and who brings them? Building our crisis response system would have direct impacts on diverting people away from arrest. Additionally, one of the biggest reasons for the change in the human services bill, is that the 48-hour law does not allow for DHS to determine the medical necessity of people committed from jail. The change allows medical professionals to be able to prioritize people, both in the community and in jail, who have the highest needs.

Over the last ten years since the law was enacted, the number of people that the 48-hour law applies to has risen substantially from 111 people in 2014 to 323 in 2021. This is why NAMI led the effort in 2019 to create the Community Competency Restoration Task Force and continued to drive the process to pass a comprehensive bill last year to address competency attainment in Minnesota. Both the interim and final reports of the task force provide in-depth analysis and recommendations to build the mental health system and partner with the legal system to address this issue. Some of those recommendations have been made into law, many which will take several years to see come to fruition like Travis' Law, improving mental health care in jails through the Hardel Sherrell Act, and the competency law itself. Many problems have been ongoing and exacerbated by the pandemic like workforce shortages and low reimbursement rates for mental health services.

The human services bill also creates a task force to look at the 48-hour law co-chaired by the Attorney General and the Commissioner of Human Services which includes NAMI among many other stakeholders. We are happy to continue this conversation in the task force, but we hope that the group is prepared to look broadly across the needs of our entire mental health system to solve the issue.

Last week, the House and Senate passed HF100 to legalize cannabis after a conference committee agreement. The House passed the bill on a 73-57 vote with GOP Representatives Garofalo, Hudella, Mueller, Skraba, and West voting in favor and DFL Representative Pelowski voting against. The Senate passed the bill on a party-line vote. The bill contains some provisions that NAMI advocated for including:

We will have a more in depth summary in our full legislative summary coming in June. Certain products can be legally in a person's possession and used starting August 1. The retail industry is set to go into effect early in 2025. We will be watching the implementation with our partners from the Mental Health Legislative Network.

The MN Office of Broadband Development (OBD) is preparing a statewide Digital Equity Plan to strategize improvements to internet affordability, access to internet-enabled devices, and access to digital skills training.

“Digital inclusion” refers to a condition in which all people can adopt and use technology – including internet access – in ways that enhance their daily lives. This plan is important because it will determine how the state invests future funding in digital inclusion activities.

They are asking for people to participate in a survey to help OBD understand Minnesota's real digital inclusion needs and goals. Any information from this survey will be anonymous.

It would be helpful to have responses by June 5, 2023.

Survey link: https://rb.gy/ran90

U.S. Senators Amy Klobuchar (D-MN) and Lisa Murkowski (R-AK) introduced the COPS Reauthorization Act to extend critical support for state and local law enforcement agencies across the country. This bipartisan legislation reauthorizes the Community Oriented Policing Services (COPS) program through FY 2029. The COPS program awards grants to state and local law enforcement agencies so they can hire new officers and provide training, technology, and equipment. It also enables the Justice Department to provide technical assistance to community leaders and law enforcement agencies at all levels.

On Wednesday, May 17, the Senate Health, Education, Labor, and Pensions (HELP) Subcommittee on Primary Health and Retirement Security held a hearing titled, “A Crisis in Mental Health and Substance Use Disorder Care: Closing Gaps in Access by Bringing Care and Prevention to Communities.” Senators and witnesses discussed the need to promote integrated care within various health care settings in an effort to address the mental health and substance use disorder crises. In particular, there was wide ranging bipartisan support for bolstering and expanding Certified Community Behavioral Health Clinics (CCBHC), mobile crisis services, and Community Health Centers (CHC).

From the National Council

One of the issues of concern as Congress and the President work to resolve this issue is that the Republicans want a work requirement for public programs, including Medicaid. NAMI Minnesota strongly opposes work requirements for SNAP and Medicaid. Food and health care are essentials. Work requirements have shown to be largely unworkable because counties don't have the infrastructure to actually follow and process all the paperwork, and large percentages of people on these programs are employed, but are very poor.

From the Kaiser Family Foundation:

Experience in Arkansas and earlier estimates of implementing work requirements nationally suggest that many could lose coverage due primarily with barriers in meeting work reporting requirements. An analysis from the Congressional Budget Office (CBO) found that a national Medicaid work requirement would result in 2.2 million adults losing Medicaid coverage per year (and subsequently experiencing increases in medical expenses), and lead to only a very small increase in employment. CBO estimates that this policy would decrease federal spending by $15 billion annually due to the reduction in enrollment. New attention on work and reporting requirements come as millions are at risk of losing coverage due to administrative barriers as states resume routine renewals and disenrollments with the unwinding of the Medicaid continuous enrollment provision that was included in the Families First Coronavirus Response Act (FFCRA) enacted at the start of the COVID-19 pandemic.

Read more here and here

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