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Mental health care for children could suffer under Pawlenty plan
by Tom Scheck, Minnesota Public Radio
June 23, 2003

A portion of the health and human services bill passed by the Legislature changes the way the state provides grants to Minnesota counties. Instead of providing grants to counties for specific services, county officials will receive larger block grants. Supporters of the new provision say counties will be able to prioritize spending based on their unique needs. But several special interest groups say counties may deliver money to services that have the most political clout instead of services that need the help the most.

St. Paul, Minn. — Supporters of the block grant concept say state regulation gets in the way of efficient spending by counties. They say different counties have different needs. For example, several smaller rural counties in western Minnesota have an older population which could use more money for vulnerable seniors. Other counties may prefer to use the money for children's services.

Gov. Pawlenty says the block grants will allow counties to deliver services the way they think is best.

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"To have this whole overwhelming regulations and mandates and in order to do things, you've got to click your heels three times and spin around before you can issue a grant. That may not make sense for those kinds of counties. What we're trying to say is it's not necessarily one-size-fits-all, either from a regulatory standpoint or a socioeconomic standpoint," Pawlenty says.

The state will begin delivering two health and human services block grants to counties, one for welfare, the other for children and community services. The Children and Community Services block grant combines 18 grants that used to be given out individually. The bundling of grants worries Louise Brown with the Children's Mental Health Partnership.

She says Minnesota used to provide about $21 million a year to counties for children's mental health services. Brown says the Legislature passed the Children's Mental Health Act in 1989 to ensure that all counties provide a minimum amount of services for children with mental health needs. She says mental health groups will now have to compete for funding with senior groups, disability rights organizations and groups that represent abused children.

"What we've been working for is a statewide system so that wherever you live in the state you can at least get a minimal set of services and this will eliminate that significantly," she says.

Brown says counties will be expected to provide mental health services unless they run out of money. And Brown expects that to happen because the block grants provide 25 percent less than the total amount for all of the grants in the previous budget.

Others say they're concerned that mental health advocates don't have as much political clout as other groups. Tom Johnson, a client advocate for the Mental Health Association of Minnesota, says senior organizations and groups representing neglected children may be better at bending the ear of a county commissioner.

"People with mental illness don't always make good advocates," he says. "They can be but many people with mental illness aren't going to want to address the county commissioners or advocate at a hearing. It's going to be very difficult for them to do that."

Johnson says any cuts to mental health services will add to an already stressed system. Officials with the Department of Human Services say they'll lobby counties to continue to provide mental health treatment. James Huber, the director of Partnerships for Child Development at DHS, says they expect counties to continue to provide services but says counties will prioritize which services are most important.

"There's no hard and fast way to say that we're going to force a county to do one thing over another. Part of this legislation was drafted for counties to be less regulated than they have been. It takes a lot of money to regulate. It takes money away from services for people which we feel is the most important thing," Huber says.

County officials say they like the block grant concept because it allows them to focus time and money on direct services. But they say overall funding is inadequate.

Sue Zuidema, the acting director of the Department of Children, Family and Adults in Hennepin County, says the cuts will force them to make some tough decisions.

"Our first priority is to meet the Legislature's desire in the area of protection. I think some of the mental health concerns are that they look at this group too and see that they're down on the list but I don't know what we can do on the local level given that we're a sub unit of state government given what the list says," says Zuidema.

Zuidema says the Hennepin County Board of Commissioners will consider the budget in September.

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