minnesota hospital and health system priorities for the 2018 legislative session
View the 2018 legislative session priorities.
Continue to build mental health supports
The Legislature should be proud of significant investments in our mental health delivery system in recent years, but more capacity is needed to provide appropriate and effective care to the one in four Minnesotans who will experience a mental illness in his or her lifetime.
- Streamline the Department of Human Services’ Intensive Residential Treatment Services (IRTS) licensing process. There needs to be a quicker and simpler process for developing community-based mental health services with supportive housing. Legislation would help decrease the time needed to build new capacity.
- Provide additional funding for Mental Health Innovation Grants. Last year, the Legislature funded a total of $2.1 million for 2018 and 2019 grants. There are more good proposals for this grant funding than money available. The state received 40 proposals totaling more than $18.2 million from hospitals, counties, community mental health centers and tribal communities partnering to undertake new initiatives to improve mental health care.
- Support a capital investment bonding bill that includes supportive housing for people with persistent mental health needs and regional behavioral health crisis facilities to be operated by counties in partnership with mental health professionals. These new care models will provide individuals with access to mental health services more easily and add capacity to a stretched-too-thin system, without relying on less effective and higher cost services provided by hospital emergency departments and county jails.
Take bold action to address the opioid crisis
According to the Minnesota Department of Health’s (MDH) Opioid Dashboard, 395 Minnesotans died in 2016 because of opioid overdoses, an 18 percent increase in opioid-involved deaths from 2015. We cannot wait for federal money to trickle into Minnesota.
Huge pharmaceutical companies have made billions of dollars on the sale of opioids. By supporting the bipartisan Opioid Family Recovery Act introduced by Sen. Julie Rosen and Rep. Dave Baker (SF 730/HF 1440), a small portion of those destructive profits should be used to defray some of costs opioids have imposed on Minnesota’s health care system and county social services.
- Create an opioid stewardship fee with a goal of raising approximately $20 million per year from opioid manufacturers to help fight Minnesota’s opioid crisis. Opponents will claim this approach will increase health care costs. The truth is, opioid addiction is raising our health care costs. From 2010 to 2016, substance abuse emergency department visits increased 146 percent. A recent analysis of a White House Council of Economic Advisors’ report showed that opioid addiction cost Minnesota nearly $5.5 billion in 2016.
- Increase capacity and accessibility of addiction treatment services, including making it easier for providers to prescribe medication-assisted treatment, including Suboxone.
- Provide resources to improve the Prescription Monitoring Program (PMP) so it can be better integrated into electronic health record systems used by providers. The easier the PMP is to use, the more providers will use it to make better care decisions for patients.
Modernize Minnesota’s Health Records Act to improve coordination of patient care
Minnesota’s Health Records Act (MHRA) should align with federal laws and standards that govern health data privacy practices in 48 other states. Our current state law impedes more streamlined exchange of clinical information because its requirements go far beyond those of the federal Health Insurance Portability and Accountability Act (HIPAA). By updating state law, caregivers could access potentially life-saving information needed to deliver the best care possible. This would also lead to reduced health care costs by reducing duplicative procedures and tests.
This legislation is supported by a broad list of health care organizations, payers, business groups and consumers, including a rare consensus among the Minnesota Hospital Association, the Minnesota Medical Association, the Minnesota Council of Health Plans, the Minnesota Chamber of Commerce, the Minnesota Business Partnership, law enforcement and consumer health advocacy organizations.
Preserve meaningful health care coverage for low-income Minnesotans
Approximately 200,000 Minnesotans with yearly incomes of less than $15,792 have been able to receive health care coverage because of the Affordable Care Act (ACA). In addition to the health benefits of coverage for these low-income individuals, about $1.6 billion per year in federal money has been invested into our state’s Medical Assistance program, health care delivery and insurance systems and economy. Another 100,000 Minnesotans earning less than approximately $24,000 per year are enrolled in health coverage through MinnesotaCare.
MHA urges Minnesota legislators to preserve Medical Assistance and MinnesotaCare coverage for low-income Minnesotans; maintain the current eligibility standard for these programs and ensure that our state’s successful innovations and policies remain in place. When people have health care coverage, they are healthier, have greater access to preventive and primary care and are less likely to delay care or rely unnecessarily on hospitals’ emergency rooms.
Continue efforts to expand Minnesota’s Integrated Health Partnerships (IHPs)
MHA has supported the state’s Integrated Health Partnerships (IHP) demonstration projects ever since the original enabling legislation was signed by Gov. Pawlenty. The first four years of the IHP program have produced positive results; including $213 million in cost savings to the state, a 7 percent decrease in emergency room visits and a 14 percent decrease in hospital stays — all while improving the quality of care for 460,000 Minnesotans getting their health care services through an IHP.
MHA supports efforts by the Department of Human Services to develop the next generation of IHPs, including the possibility of some IHPs taking additional accountability for the care they provide and competing more directly with health plans. The IHP program succeeds, in part, because it is voluntary, flexible, incremental and supported with timely data for providers. Shared savings models need to be updated to maintain their success. Lawmakers will undoubtedly continue to look for cost savings in the Medical Assistance program and innovative ideas like this need to be supported.
Oppose a government-mandated nurse staffing quota
Minnesota hospitals and health systems have long opposed a perennial nurses’ union campaign to impose government-mandated quotas for nurse staffing. This issue has been studied and addressed several times by the Legislature. A significant compromise bill, the Nurse Staffing Disclosure Act, was passed in 2013 requiring all Minnesota hospitals to post their annual projected staffing plans, actual nurse staffing levels and patient census information by hospital unit, updated on a quarterly basis on MHA’s quality website, www.mnhospitalquality.org.
Decisions regarding care should be made by the patient and the entire care team, including physicians, nurses closest to the bedside and other health care professionals such as respiratory and physical therapists. Staffing should be based on the individual patient’s needs, the severity of the patient’s illness and the skill mix and experience of the entire care team caring for the patient. Legislators should not impose regulations that add costs to the health care system without demonstrated improved health care quality specifically attributed to nurse staffing ratios.