Confusion over which services will be funded

Justice Kathleen Blatz
Former Supreme Court Chief Justice Kathleen Blatz talks to Joseph Cassioppi, an associate in Fredrikson & Byron's Litigation Group during the temporary funding hearing in the Minnesota Judicial Center, Friday, July 1, 2011 in St. Paul, Minn. Blatz is serving as the special master during the shutdown and will further rule on which programs are essential and should be funded.
AP, Photo/Jim Gehrz, Pool

It's the first day of the shutdown, and one area of Minnesota state government is attracting a large share of attention: the Department of Human Services.

The size and complexity of the department hampers efforts by judges and government officials to determine how it will be affected by the shutdown.

The department provides health insurance and welfare payments to tens of thousands of Minnesotans. It oversees programs that provide in-home care for people with disabilities and community support for people with mental illness. It's also the most costly department in the state, accounting for one-third of the state budget.

Two days before the shutdown, a judge decided which state services would continue if DFL Gov. Mark Dayton and Republican lawmakers failed to reach a budget deal. The ruling by Ramsey County District Court Judge Kathleen Gearin said many health and human services programs will continue operating as usual.

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Those programs include all services paid for by Medical Assistance - a long list that includes prescription drugs, doctor visits, hospitalizations, in-home care for people with disabilities, and a service that provides transportation to appointments.

Advocates for the poor say the ruling was a relief, but the message isn't reaching everyone. Some people who rely on the programs still believe they've lost all benefits. Nonprofit organizations have been planning for a shutdown for weeks, but some staff said they're still waiting to hear if certain programs will be funded. However, many groups acknowledge that the shutdown has not affected the basic services they provide.

Sharon Dixon prepared for the shutdown by cancelling her medical appointments. She's enrolled in Medical Assistance and sees a doctor regularly to monitor her recovery from gastric bypass surgery. Dixon, 53, also canceled an appointment to get her blood drawn because she thought she'd be stuck paying the bill.

"You cancel a lot of things because you don't know, and you know you can't afford it," she said. "And the last thing I need is to be turned over to a collections agency because I can't afford my bills."

Dixon, like all other benefits recipients, received a letter two weeks ago from the government notifying her that benefits could be suspended on July 1.

Dixon's benefits include Medical Assistance and $16 a month in food support, She said she's used to getting by without much money. She lives in Grygla, a small town in northern Minnesota, about an hour from Thief River Falls, where she goes fishing a few times a week to keep her grocery bills low.

She worries for other people who are uncertain about their benefits. "What about those cancer patients that can't afford the chemo and think nobody's paying for it?" she said.

Dixon hasn't yet received a letter telling her that her benefits have not been affected.

"I haven't heard anything from them for at least two weeks," she said. "They should let me know."

COMMUNITY-BASED PROVIDERS ASSESS THE IMPACT

In Minnesota, many basic services, like homeless prevention programs, mental health drop-in centers and chemical dependency treatment centers, are operated by nonprofit groups.

The groups receive funding from a variety of sources, including Medical Assistance, private insurance, state and county grants and private donations. In the weeks leading up to the shutdown, nonprofit leaders reviewed their budgets to make sure they could survive a temporary suspension of state funds.

Sue Abderholden, the executive director of NAMI Minnesota, a mental health advocacy group, said the mix of funding sources and reliance on community-based providers contributes to the confusion.

"I think what's so scary about all of this is that it isn't a very clean system in Minnesota in terms of human services," Abderholden said.

"Because we use so many community nonprofit providers in the state of Minnesota, we also don't know how long some of them can float without payment," she added.

Some nonprofit organizations plan to lay off workers if the shutdown lasts more than a few days, but many were relieved to learn they would continue receiving payments from Medical Assistance.

Ron Brand, the executive director of the Minnesota Association of Community Mental Health Programs, said he had a list of eight to 10 mental health programs he was worried about earlier in the week. The judge's ruling Wednesday included funding for most of those programs.

Now Brand said his list is down to two or three programs, and he's hopeful that Judge Kathleen Blatz, who is serving as the special master during the shutdown, will agree that those programs are essential and should be funded.

"It's so much better than I thought it would be three days ago," he said.

As of Friday afternoon,questions remained about funding for programs to aid the homeless. Advocates for the homeless petitioned the special master to fund emergency shelter grants and rental subsidy for low-income families. Other nonprofit organizations expressed concern that they would be unable to hire new staff, as the state will not provide background checks during the shutdown.

Blatz heard appeals from social service organizations on Friday. She said she'll begin making decisions about which programs should be funded as early as this weekend.