As we’ve reported for the past few months, there are several studies that indicate that Minnesota spends more than other states on disability services. Those, studies, however, are classic examples of apples-to-oranges studies. Nonetheless several legislators don’t understand that and have been talking about making Minnesota spending more in line with other states. They are working from very dangerous misinformation.
ARRM and advocates met Monday with the DFL Disability Caucus, chaired by Rep. Patti Fritz (DFL-Faribault) to discuss what is and what isn’t behind those numbers. Steve Larson from The ARC of Minnesota presented more contextual data that DHS has prepared. ARRM provided bullet points of weaknesses in the analyses making their way into legislators’ hands.
The meeting ended with agreement that better data and analyses of disability spending are needed and an agreement to work with us before and during session.
Other legislators at the meeting were Rep. Julie Bunn (DFL-Lake Elmo), Rep. Diane Loeffler (DFL-Mpls.), and Rep. Tina Liebling (DFL-Rochester). All are active in House health and human services committees.
This Friday ARRM and other stakeholders will address this issue head on at the “Expert Panel” meeting with DHS, which has been very supportive in setting the record straight.
Here’s what ARRM prepared for Monday’s meeting. Feel free to use these talking points with legislators if and when the topic of disability spending comes up:
Disability Spending Needs Comprehensive Analysis
Prepared by ARRM for House DFL Disability Caucus – December 14, 2009
Background:
Some recent studies have indicated that Minnesota spends more per capita on long term care services for people with disabilities than other states. Most analyses, however, are classic examples of apples-to-oranges comparisons. When looked at from a holistic economic perspective, Minnesota programs are extraordinarily cost effective – while providing high quality services.
Twenty years ago Minnesota decided to deinstitutionalize people with disabilities and that decision has proven successful fiscally and programmatically.
A comprehensive analysis must consider:
Managed care: Data for Minnesota include expenditures through managed care. Data from other states don’t. Wisconsin, for example, also utilizes managed care – but those data are not reflected in Wisconsin’s data.
Local contributions: Minnesota programs are almost entirely funded by state and federal funds, with a small amount of charitable donations. Wisconsin and some other states, for example, also rely heavily on local government to pay for their services.
Mental health offset: Minnesota and two other states made the wise decision to provide supports for many people with mental illness through waivers (the CADI waiver in Minnesota). That spending offsets some of Minnesota’s need for more costly clinical and acute care.
Counting mental health dollars: Minnesota long term care data include mental health support services and other states’ data don’t. This apples-to-oranges comparison skews spending for Minnesota’s long term care spending compared to other states.
Historical savings: The per person cost of proving services in institutions (like Regional Treatment Centers) is greater than similar or same services in home and community based settings. Because Minnesota is deinstitionalized, we have realized a net per person savings over the past 20 years.
Forecast savings: Spending for disability support services is under forecast. Without that economy of services, the forecasted deficit would have been worse.
Next steps:
As Minnesota moves ahead with reforms adopted by the 2009 legislature to make our system more cost effective, it is critical to develop comprehensive expenditure analyses.