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By Tom Scheck
January 23, 2001
Part of MPR's online coverage of Gov. Ventura's budget proposal.
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The Commissioner of the Minnesota Health Department says Gov. Ventura's budget is the most comprehensive health agenda in years. Ventura has allocated $14 million for eliminating racial health disparities in the state and another $22 million to eliminate teenage pregnancies. But some health advocates are disappointed Ventura didn't go farther in long-term care and children's health insurance.
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GOV. VENTURA WANTS THE STATE TO CUT 5,000 nursing-home beds in the state and redirect that money towards assisted living and other home health-care services. Since more seniors would rather receive health services in their homes or apartments, Ventura says it's time to invest $82 million in those facilities.
Department of Human Services Commissioner Michael O'Keefe says his office will start asking different regions of the state to assess their future long-term care needs. Once that's finished, he says, the state will decide which nursing-home facilities should be closed and which parts of the state need money for community-based care. "This is a problem that's creeping at us, it's coming at us over a 20- or 30-year period of time so if we can make a substantial step this year around, we'll make other steps in two years and in four years from now," O'Keefe said.
But the long-term care industry may need major steps right now. A tri-partisan task force, which included O'Keefe, released a proposal last week that said home health-care workers needed a raise. Ventura's budget doesn't address that until 2003.
"His budget doesn't reflect a willingness to address the problem," said Sen. John Hottinger, DFL-Mankato. While he applauds Ventura's decision to start changing the long-term care system, Hottinger says the governor isn't fully funding the system he wants to change. In some rural areas, he says, some nursing homes are refusing patients because there aren't enough workers. He says Ventura needs to address that problem before doing anything else.
"When we're at the beginning of a crisis in the long-term care system because of a lack of personnel and funding, if we don't provide funding to meet those wage needs, we're going to have short-term pain in order to accomplish long-term care and I don't think many people want to do it that way," Hottinger said.
Hottinger says the legislative members of the Long-Term Care Task Force will propose a bill that spends $113 million on the issue.
The long-term care industry wants to go even further and is lobbying for $500 million to reform the industry.
Patti Cullen, the vice president of CareProviders of Minnesota, says many nursing homes are already on the brink of bankruptcy and many more could close if Ventura's proposal goes through without additional funding.
"We have to convince the public that their choice is pretty clear as well," she says. "If you want all of the money back, all of the surplus back in tax rebates or lower license-plate fees or whatever, then you have to recognize the tradeoff is decreased quality in the services for the elderly, decreased access to services and perhaps mom or grandma living at home with you."
Commissioner O'Keefe acknowledged the governor's budget doesn't go far enough to address the overall needs of long-term care, but he says it's a dramatic first step. He expects the Legislature and Ventura to re-examine these concerns and come up with a policy that stays within the governor's budget and still pleases lawmakers.
But lawmakers aren't taking issue only with Ventura's health-care plans for the elderly. They're focusing in on his treatment of the young too. When Gov. Ventura first ran for office in 1998, one of his top priorities was to provide health insurance for every Minnesota child before Ventura finished his term. Even though the governor is proposing to spend an extra $14 million to provide additional health insurance for children and wants to streamline services to allow greater access to health care, Ventura says the state still can't provide health insurance for every child. He says a 20-percent increase in health-care costs for state workers and other budget priorities forced him to change his plan.
"You have to make hard choices and you make them, you make them with the best knowledge you have available and the best information you have available and you prioritize it best you can," Ventura said.
But some say Gov. Ventura isn't prioritizing on a pledge he made during his campaign. The Children's Defense Fund's Jim Koppell says he's disappointed Ventura isn't doing enough to reach out to the 50,000 to 70,000 Minnesota children who lack health insurance.
"We had hoped that the governor would follow through with his pledge to cover every child before he left office, today he didn't come anywhere close to taking a major first step," Koppell said.
Koppell says he'll try to convince Ventura and the Legislature that children's health care should be a major issue this session.
Tom Scheck covers health issues for Minnesota Public Radio. Reach her via e-mail at tscheck@mpr.org.
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