Advocates for the disabled were surprised to find new policies for group homes included in the state budget bill passed last week — policies they said were never publicly discussed or debated by lawmakers, state officials, or the governor.
Particularly concerning, providers said, was one paragraph that was inserted into the health and human services bill in the final hours of the shutdown.
The provision highlights the problems caused by weeks of secret negotiations between Republican legislative leaders and the DFL governor, and was the main source of both concern and confusion in the six days since Gov. Mark Dayton signed the budget deal.
The bill cuts the number of licensed beds at privately-owned group homes for adults with disabilities across the state. Each home provides meals, support, and 24-hour supervision for up to four adults living with disabilities like severe cerebral palsy, traumatic brain injury and schizophrenia.
Providers and advocates assumed the new provision applied to all adult group homes, and some providers sent out letters to families over the weekend warning they may have to shut down.
Cindy Johnson received a letter from the Roseville group home where her 51-year-old sister lives. It said, in part, "It's clear that such a change would make the ongoing provision of services difficult to impossible and would likely lead to the closure of group homes like ours."
Johnson said she spent the weekend wondering if she would have to find a new home for her sister, Kim, who has constant seizures and relies on a feeding tube.
"To get a letter like that about my sister, it's just so alarming," Johnson said.
Advocates contacted lawmakers over the weekend to question the policy change. As they understood it, the provision indicated that as someone moves out of a group home for any reason, the group home would permanently lose the license for that bed. As more people moved out, the provider would not be able to admit new residents, nor would it be able to keep enough staff to care for people who still lived there.
"Without having other options for people, you're marching people into nowhere," said Bruce Nelson, who heads the Association of Residential Resources in Minnesota, a lobbying group for community-based providers.
Advocates got a quick response from Rep. Jim Abeler, R-Anoka, who chairs the House Health and Human Services Finance committee. Abeler told them he thought the provision was a mistake and said he would ask the Department of Human Services not to enforce it. He said department officials added the section during final negotiations on July 19.
"They were in quite a hurry to get done, and so were we," Abeler said. "And so it didn't receive the ordinary scrutiny. Upon further review, we decided that that was a lot of overkill, and I did not agree with that idea."
But on Monday, the Department of Human Services said the providers and advocates were mistaken. They said most group homes would not be affected. The provision only applies to about two percent of people who are approved to live in group homes due to a disability or a traumatic brain injury, they said. For those individuals, if their health improves and they are able to live independently, the group home would lose the license for the vacant bed. But for all other situations, the number of licensed beds would not change when someone moves in or out.
"There's some misinterpretation of the legislation," Loren Colman, assistant commissioner for continuing care, said. "We've begun talking with the providers and advocates in the disability community so they understand what this provision is intending to do."
The department does not have an estimate for how many group home beds would be lost, but Colman said, "It's not thousands. It's important to the two percent, but it's not a massive change to the system."
Johnson was relieved to learn that the bill won't affect the group home that provides care for her sister, but she had sharp words for the bill's authors.
"If they didn't intend it that way, then shame on them for scaring the crap out of everyone," Johnson said.
Advocates and providers said they're frustrated that the closed-door negotiations led to a budget bill that has sections that even the most experienced health care providers cannot understand.
"It's been kind of like peeling back an onion to find out exactly what was meant here," said Steve Larson, public policy director for the Arc of Minnesota, an advocacy group for people with disabilities.
Unlike many other sections of the health and human services budget bill, the group home licensing provision had not been included in previous versions of the bill, or even discussed by members, Larson said.
"Instead we're left in the situation we were last week, where we had to interpret language we never saw before," he said. "And as a result, thousands of Minnesotans are being unduly alerted and scared as to the future of their services." The Department of Human Services plans to talk with providers this week about the provision.