Legislature poised to enact landmark mental health bill

Dan Poss
Dan Poss gets treatment support, housing and employment through an agency called Tasks Unlimited.
MPR Photo/Marisa Helms

Columbia Heights resident Dan Poss, 41, was diagnosed with schizophrenia about 17 years ago.

"Panic attacks is like you're on judgment day, if you believe in judgment day, and you're condemned to hell. That's how much fear there is in panic attacks," he says.

Poss says without medication and supportive treatment, he has no inner strength to discipline his thoughts.

"In my case you're doing weird things to find out life's answers, you know. Like taking a cross in your mind, and touching, in your mind, the hand and the feet and the head of Christ, and stuff like that," Poss says. "When you are walking, pretending you're stepping on the cross, stuff like that. You know, it's kind of bizarre, but to you it's a way to find answers. And because you're so desperate for answers, you can't really hold a regular job."

Sue Abderholden is Executive Director of NAMI Minnesota.
MPR Photo/Marisa Helms

Poss is able to work 20 hours a week as a janitor. He's enrolled in a program called Tasks Unlimited, which provided him with housing and a job. Tasks is a nonprofit agency that helps hundreds of people like Poss who are disabled by their mental illness.

But programs like Tasks Unlimited can't help everyone. That's why Gov. Pawlenty and lawmakers want to spend about $45 million over the next two years, and $37 million per year after that, to try to assist people with mental illnesses -- to get them medical help, to find jobs, to stay out of prison and stay in school. The plan is aimed primarily at low-income people who are already on state assistance programs.

Sue Abderholden is executive director of the Minnesota chapter the National Alliance on Mental Illness. She and others have been working for years on the plan. She says children and adults with mental illness are not able to get the care they need, when they need it.

"Our system does not work for them," she says. "We don't provide early intervention. We don't try to make sure that people don't get sicker, we don't do any of that kind of thing. And so, we really felt like we needed to investigate the system and figure out how to do things better."

Rep. Mindy Greiling, DFL-Roseville, is the author of the House mental health bill. She's skeptical about the governor's Integrated Care Network proposal.
MPR Photo/Marisa Helms

The bill would spend $6 million to expand mental health services for low-income Minnesotans.

It also includes millions of dollars for school-based mental health screening and care for uninsured children, and programs to expand mental health care to racial and ethnic minorities.

Another part of the governor's plan would create a test program to coordinate physical health care with mental health care.

The Integrated Care Networks would require counties to cooperate with HMOs such as Medica, Blue Cross, and HealthPartners.

Many mental health advocates and some lawmakers say they're skeptical about that.

Rep. Mindy Greiling, DFL-Roseville, who's sponsoring the House version of the mental health bill, says the governor's plan would essentially "privatize" the mental health care system.

"County administrators don't earn the kind of salaries that even our Minnesota HMO people do," she says. "And I think our public dollars should not be for highly paid administrators, they should go into the frontline services for people with mental illness."

Wes Kooistra of the state's Department of Human Services says the governor's initiative will create a more holistic approach to mental health care.
MPR Photo/Marisa Helms

Wes Kooistra with the Department of Human Services says the current system isn't working well enough, and managed care might make it work better.

"The problem that we're facing politically with this is people equate managed care with limited care, and that's not the case anymore," says Kooistra. "But, I would also suggest that we have to be better purchasers of care. We're the ones that are putting money on the table, we're the ones issuing the contracts and signing the contracts, and we have to be clear as purchasers what we expect in terms of care delivery."

DFLers in the House and Senate also disagree with the governor over how to pay for the plan. Pawlenty wants to use money from the Health Care Access fund, which Democrats say should go to the MinnesotaCare program. The Democrats want to pay for the mental health initiative with general fund money.

Despite the differences, mental health advocates are confident a plan will pass this year to help the more than 100,000 mentally ill adults and 40,000 children. Many also hope they can expand mental health services in the future beyond low-income Minnesotans.