2009 Legislative Session

• 2009 Legislative Session – recap of highlights (and lowlights)

• Unallotment – what we know today

• 2010 electoral politics

2009 Legislative Session

Summarizing the Session

• “No one was celebrating”

• A lost opportunity

• Unfinished

• No deal

Older Adult Services a Top Priority

• Fared OK, relative to other interest groups

• Held onto rebasing for care centers

• Held the line on regulatory advances in senior housing

Legislative Session Take-Aways

• Older adult services

a top priority

• Jobs

• Rural Impact

• Endangered

“Nursing homes” broke through to top priorities list

2009 Legislative Session – Remember Where We Started?

• Massive budget deficits

• GOP recommitment to “no new taxes”

• Stronger (but not veto proof) DFL majorities

The State Budget Picture Initial Projected Deficit

(Nov ’08) = $4.847 BILLION

Unallotment Fall 2008= $426 million Budget reserve drained

$271.4 million in cuts

Revised Projected Deficit(Feb ’09) = $6.393 BILLION

Federal Stimulus $ to Minn. = $1.823 BILLION

2009 Budget Target = $4.570 BILLION

The Governor’s Budget Priorities

• K-12 Education

• Public Safety

• Veterans

• Control HHS Spending Growth

• No new taxes

Governor’s Budget Recommendations

• Care Center Funding Reductions:– Repeal rebasing– Change MA payments for single rooms– Reduce bed closure incentive– Freeze Operating Rates at 2008 Levels

• $13.16 million reduction for biennium

Governor’s Budget Recommendations

• Home and Community Based Provider Rate Reductions:– 3% rate cut– All HCBS providers including elderly waiver,

alternative care, ICF/MR, home health– $73.66 million reduction for biennium

House and Senate Budget Targets (major areas only)FY 10-11 Housereduction

FY 10-11 Senate reduction

FY 12-13 Housereduction

FY 12-13 Senate reduction

Early and K-12 Education

$0 (0%) $973 million (7%) $0 (0%) $1 billion (7%)

Higher Education $0 (0%) $221 million (7%) $122 million (3.9%)

$221 million (7%)

Health Care and Human Services

$400 million (5%)

$719 million (7%) $1.2 billion (9.6%)

$938 million (7%)

Tax Aids and Credits $250 million (7.3%)

$240 million (7%) $362 million (10.1%)

$252 million (7%)

Transportation $8 million (4%) $15 million (7%) $8 million (4%) $15 million (7%)

Public Safety and Judiciary

$66 million (3.5%)

$131 million (7%) $75 million (4%) $132 million (7%)

State Government $49 million (7.5%)

$44 million (7%) $49 million (7.5%)

$44 million (7%)

Total reductions $843 million $2.4 billion $2.1 billion $2.7 billion

HF 1362 Omnibus Health and Human Services Bill

• Reduced funding to HHS budget by $489 million in the next

• Governor cut an additional $381 million via line item veto of GAMC funding

• One time money increasing the federal match under Medicaid helped avoid even deeper cuts– Increased match will only last for the next two

years

The Final HHS Bill—Older Adult Services

Retains rebasing (small increases for some facilities, then 4-year freeze)

Reduces cut to EW from 3% to 2.58%

Adopts other HCBS cuts and “targeting” provisions

Adopts other care center cuts, e.g. private room payments, planned closure adjustments, “conversion of residents”

The Final HHS Bill

DOES NOT INCLUDE:

“Diversion” strategy for HWS

Mandatory reporting on rents, etc.

Cuts to high rate facilities

Change to rebasing methodology

Changes to equalization

Status of Key Bills: Long Term Care Imperative

• Long Term Care Financing Reform: No Hearing in 2009; expect discussion in 2010– HF247 (Thissen)/ SF 346 (Rest)– HF1085 (Thissen)

• Regulatory Reform: Passed

HF666 (Norton) / SF 652 (Lynch)• Moratorium Exception: Passed in part

HF 1890 (Hosch)/ SF 1535 (Prettner Solon)

Status of Key Bills:Other Legislation

• Communities for a Lifetime: Passed HF936 (Thissen)/ SF 839 (Sheran)• Vulnerable Adult Act Reform: Passed HF 818 (Hilstrom)/ SF 758 (Moua)• False Claims Act: Passed with preferred

amendments HF8 (Simon)/ SF 82 (Latz)• Property Tax Exemption: Passed HF 2180 (Doty)

Legislative Session Take-Aways

• Support for HWS will grow with time• Fueled by boomers’ own aging• Economic development/jobs message

as crucial as access and quality care• Dual grassroots strategies work• Sound PR strategy focused on earned

media

“Nursing homes” broke through to top priorities list

Legislative Session Take-Aways

Stakeholders Powerful Force When We Work Together

• Communities for A Lifetime

• Vulnerable Adult Justice Project

Consumers themselves will be an essential advocacy voice on matters of CHOICE and ACCESS

We have made progress in building a coalition of stakeholders that includes providers, consumers and organized labor

2009 Legislative Session

• No Special Session but cuts/shifts to come via unallotment - $2.7 billion

• Future Legislative Sessions Could Face Repeat Deficits:

– Underlying structural budget issues not fully addressed (cost shifts)

– Stimulus money blinks off in two years

– Rate of economic recovery unknown

It’s not exactly over . . .

Unallotment• Basically a delay or cut in spending

• Can’t be done before July 1, 2009 but no set timetable thereafter

• No programs are exempt, but can’t alter “policy”

• No limits on amount from any one program

• Commissioner of Management and Budget (Tom Hanson) acts; must consult with Legislative Advisory Commission before

• We will likely see “unallotment plan” before July 1, 2009, but process likely to unfold slowly

– Governor says he will follow outline of original budget

– Provide time for legislature to “fix” in 2011

Unallotment

“The Governor is going to try to protect

nursing homes in unallotment decisions.”

Representative Marty Seifert,House Minority Leader

TPT’s Almanac, Friday, May 15, 2009

2010 Electoral Politics

• Every legislative seat, constitutional office and currently-seated member of Minnesota’s congressional delegation up for grabs

• Governor Pawlenty NOT seeking a third term

Possible DFL Candidates for Governor• Sen. Tom Bakk• Rep. Paul Thissen• Sen. John Marty• Ramsey County Attorney Susan Gaertner• St. Paul Mayor Chris Coleman• Former House Minority Leader Matt Entenza• Former Senator Mark Dayton• Former State Senator Steve Kelly• Speaker of the House Margaret Anderson Kelliher• Minneapolis Mayor RT Rybak

Possible GOP Candidates• Rep. Marty Seifert• Rep. Laura Brod• Rep. Paul Kohls• Rep. Tom Emmer• GOP Activist Brian Sullivan• Commissioner Steve Sviggum• Sen. David Hann• Sen. Julie Rosen• Former State Auditor Pat Anderson

More Information Coming Soon…• Legislative Program set for June 29

• 2009 Legislative Report and value-added online resources being finalized now

• Monday Mailing and Action Alerts

• Technical assistance team standing by

• More details coming in the breakouts…