2002 Legislative Summary
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The 2002 Legislature officially adjourned on May 20. There were many ups and downs during the session; however, in the end, some remarkably good things happened for public health.
In the fall of 2001, MDH and other state agencies were directed to prepare a budget reduction plan to be submitted to the Legislature. The plans were intended to help resolve the $1.95 billion dollar shortfall in the state budget, as predicted by the November forecast. This legislative summary includes MDH's proposal for budget reductions, the portion of that proposal acted on by the Legislature, the bonding proposal and health-related policy proposals.
MDH developed a set of principles to guide the development of its budget reduction proposal. The reduction proposal retained a commitment to public health priorities, but reshaped how things are done.
The plan was based on the following principles: 1) protect state and local core public health capacity; 2) continue to make prevention investments that save money downstream in public and private sector health care costs, human services, education, corrections, and economic productivity; and 3) make reductions where programs can be streamlined or eliminated if there is little statewide benefit, where programs have other sources of funding, and where the private sector can be challenged to play a larger role.
After making some changes, the Legislature approved Phase I of the budget reductions early in the session. This Phase I package was sent to the Governor and vetoed. The Legislature then overrode the veto. The Governor's main opposition to the package was that it was a one-time fix and did not take into consideration the upcoming budget cycles. In addition, it did not raise any revenue (taxes) to offset future shortfalls. Shortly after Phase I had been enacted, the Department of Finance announced that the state had an additional $439 million shortfall. This began the process of developing a Phase II budget plan, which was only agreed upon during the final days of the session.
Throughout most of the session, many legislators viewed the tobacco endowment as a funding source to help balance the budget. MDH successfully made a strong case for keeping the endowment intact so that we could continue to operate our youth tobacco prevention initiative.
In the end, legislators decided that the principal of both the medical endowment fund and the tobacco use prevention fund would be available for the state's cash-flow needs. They agreed, however, that any money borrowed from the funds would have to be paid back with interest. Few would have predicted that the endowments would have come through this session without major reductions. Unfortunately, since the Legislature did not to approve a cigarette tax increase or any other "revenue enhancers," the state will be faced with another budget shortfall next year. This may require MDH to again make the same arguments defending the endowment.
Family planning grants
The grant money MDH awards for family planning projects across the state was seen as another source to help fix the budget deficit. Legislators did not end up using this funding source, thereby preserving this valuable public health resource for families across the state.
State employee contracts
The House Republicans refused to ratify the state employee contracts negotiated last fall. Technically, that would mean the contracts are null and void. However, Employee Relations Commissioner Julien Carter has worked with union leaders, and they have re-signed the original contracts. This means the negotiated contracts will remain in effect, but will once again be subject to legislative debate next year.
The Legislature accepted the proposed reduction of $4,850,000 in FY02, FY03, FY04, and FY05, which accounted for the general fund contribution to MERC. MDH, in cooperation with the Academic Health Center, determined a way to allow the University of Minnesota to transfer that same amount of funding to MDH from their medical education endowment. This allows MDH to receive matching federal funds for those dollars, which would not have been available with the general fund cut. MDH will repay the money to the Academic Health Center.
Juvenile Assessment Center grants
The Legislature accepted the proposed reduction of $650,000 in FY02 and FY03. Juvenile Assessment Center grants were intended to develop a system of 24-hour centralized receiving, processing and intervention facilities for children who are accused of committing delinquent acts or status offenses or who are alleged to have been victims of abuse or neglect. The program has not demonstrated the outcomes that were anticipated. The program will be eliminated.
Fetal alcohol syndrome
The Legislature accepted the proposed reduction of $100,000 in FY03 and beyond. This eliminates the duty of MDH to develop curricula about fetal alcohol syndrome for the professional training of health care and social services providers, educators and other professionals. This program will be resized and reshaped to reflect its accomplishments.
Health Status Improvement grants
The Legislature accepted the proposed reduction of $120,000 in FY02 and $120,000 in FY03. This eliminates the funding for Health Status Improvement grants. The program had not yet been implemented.
Food safety education
The Legislature accepted the proposed reduction of $200,000 in FY02. This eliminates the funding for a grant to the city of Minneapolis to establish a community-based health education and promotion program on food safety in certain communities. This program was appropriated money in 2001 and had not yet been implemented.
Occupational Respiratory Disease Information System
The Legislature accepted the proposed elimination of this program. This activity provides work-related respiratory disease surveillance for seven counties in northeastern Minnesota. The program is limited in scope and the probability of securing sufficient funding to establish a statewide program was very low. Funds for the project will be phased out by FY03. New strategies and resources will need to be identified to complete the study and develop an understanding and prevention of work-related respiratory disease.
One-time grant reductions in health disparities and suicide prevention
The Legislature accepted the proposed one-time savings in FY02 through grant programs that were established in the last legislative session and are just now being implemented. These grants will be a slightly slower start than originally anticipated; however, the grants will again be up to the fully appropriated amount after two years.
The legislature accepted a proposal to reduce administrative costs in the department by reducing administrative staff and other expenses and reassign related functions to remaining staff.
Additional Budget Reductions for MDH
The Legislature had additional budget reductions that affect MDH. These include a $347,000 reduction in Health Care Access Funding, and a portion of the cuts related to the statewide contractual funding reduction still to be determined.
Budget Reductions Proposed but not Adopted
Summer Health Care Internship Program
Proposed reduction of $200,000 in FY02 and FY03.
Dentists Loan Forgiveness Program
Reduction of $140,000 in FY04 and $280,000 in FY05.
Health and Long-Term Care Career Promotion grants
Reduction of $120,000 in FY02 and FY03.
TANF carry forward and one-time reduction in family home visiting
Proposed reduction of $6 million in FY02 and $2.5 million in FY03 in unexpended funds.
MDH/MDA lab and office facility
The Governor proposed a public/private partnership to build a new, modern laboratory facility, housing the separate laboratories for the departments of Health (MDH) and Agriculture (MDA). The final bonding bill included financing for a building to house new labs for MDH and the Department of Agriculture, and permission for the state to work with a third party developer for a building at the same site, to house MDH staff who work closely with the labs on a regular basis, and non-lab staff from MDA. This adjacent office facility would be leased by MDH, with an option (and intent) to own. This means MDH and MDA will soon be able to begin planning the new facilities. If all goes as planned, the Public Health Laboratory and much of the Health Protection Bureau will be moving into new state of the art facilities by the fall of 2004.
Minnesota Emergency Health Powers Act - CH. 402 HF3031/ SF2669
This was a major policy initiative put forward by MDH. MDH proposed legislation that would extend and expand the state's existing emergency response system to deal more effectively with public health emergencies.
Immediately after the attacks on 9/11 and the subsequent anthrax events, it became clear that the antiquated public health laws needed updating. With the help of the circulation of a Model Public Health Law, MDH began drafting updated language to previous laws. This legislation was developed with input from a specially-convened Task Force on Terrorism and Health, and MDH sought comment and advice from a variety of sources during the drafting process.
MDH considers this legislation a workable framework for protecting the public in the event of a health emergency - while also providing appropriate protections for individual civil liberties. Although the bill is significantly different than as introduced, MDH feels it is a start to a continuing process of updating public health emergency laws. Among other things, the bill clarifies that a public health emergency allows the governor to invoke the emergency management powers in current law. It specifies the powers and duties of the governor and the commissioner of health during public health emergencies. It establishes principles governing isolation and quarantine, and establishes due process procedures for persons under isolation or quarantine. It also directs the commissioner to study several issues and report to the legislature by January 15, 2003. Some issues to be studied include: immunity and liability for health care providers, emergency measures concerning dangerous facilities and materials, control of healthcare supplies and facilities, measures to detect and prevent the spread of disease, including isolation and quarantine and due process protections, ways to preserve effectiveness of antibiotics vital to protecting human health, and impact of all recommendations on constitutional and other rights of citizens.