Lawmakers get to work on crafting compromise HHS budget bill

The omnibus health and human services conference committee got underway Wednesday beginning work on crafting a multibillion-dollar bill that will address everything from continued COVID-19 response efforts to addressing child care and housing stability. 

Conferees started with an overview of the fiscal provisions, input from leaders of Gov. Tim Walz’s administration, and a side-by-side bill comparison by nonpartisan research and fiscal staff. The committee will continue its walkthrough Thursday.

Rep. Tina Liebling (DFL-Rochester) and Sen. Michelle Benson (R-Ham Lake), who sponsor HF2128*/SF2360 and co-chair the conference committee, said they anticipate utilizing every meeting opportunity at their disposal to manage the tremendous amount of work needed to create a compromised agreement.

“We have very little time available to do a huge amount of work,” Liebling said. “So, I think we’re going to have to put the pedal to the metal here and use every available minute.”

Relying on state versus federal funding

Comprised of a complex array of funding sources, the bills are currently separated by millions of dollars and a variety of policy proposals. The House version would increase General Fund spending by $348 million during the 2022-23 biennium for a total budget of $16.7 billion.

Liebling said new investments would be funded with some of the state’s estimated $1.6 billion surplus, projected during the February forecast by Minnesota Management and Budget.

“One of the things the pandemic really has done is shown a spotlight on the importance of having a robust public health system and on the systemic inequities that exist in our state,” she said. “Fortunately, we do have a budget surplus and the House is using a large part of that to meet the needs of Minnesotans now and prepare for a healthier future.”

The Senate bill takes a different approach. It doesn’t include any new state funding during the upcoming biennium. Instead, it would rely on federal funding streams, maintaining the $16.25 billion forecasted 2022-23 health and human services budget.

“We took full use of the federal money, which I’m going to encourage us to do as we move forward,” said Sen. Jim Abeler (R-Anoka). “I think the General Fund is going to be very precious.”

Liebling said the House would be open to spending additional federal dollars as guidance becomes available on how incoming coronavirus relief funds can be used. 

Areas of overlap, and notable differences  

Health Commissioner Jan Malcolm and Human Services Commissioner Jodi Harpstead weighed in on the proposed plans.

Harpstead said she is pleased to see many areas of agreement, including increased investment in personal care assistant services, expanding telehealth services, improving infant and maternal health outcomes, the need to address inequities between foster care and adoption systems, and controlling the rapidly rising costs of prescription drugs.

Both also highlighted areas of concern, particularly within the Senate bill, which they say doesn’t align with the governor’s recommendations.

“The Senate took a very straightforward approach to the budget,” Benson said. “These two agencies have been through a lot in the past year and so we’re going to take the lessons learned from COVID and the lessons learned from the civil unrest, fund stability in the departments, but look at reforms going forward.”

House bill General Fund appropriations and policy provisions absent from the Senate bill include:

• $25 million for homeless grants and projects;
• $6 million for residential treatment and children’s mental health;
• $5.2 million for a Minnesota Family Investment Program cost of living adjustment;
• $3.1 million for housing support bed moratorium modifications;
• requiring a notice and hearing before closure of a hospital or a hospital campus, relocation of services, or cessation of offering certain services;
• requiring medical practices to make public a list of current standard charges for items and services they provide; and
• creating a COVID-19 equitable vaccine distribution program.

Senate bill General Fund appropriations and policy provisions absent from the House bill include:

• $61 million for Home and Community Based Services retainer payments;
• $9.7 million for a rate increase for home care providers;
• $5.2 million for the Vivian Act, newborn screening;
• $4.5 million for home health services rate modification;
• permitting a hospital, upon request, to destroy medical records of a patient who is a minor when the patient reaches the age of majority or after seven years;
• requiring marriage license applications to be modified to remove a space to indicate the applicant’s race, and removing race from the list of marriage certificate data required to be reported to the state registrar; and
• requiring pharmacies and other entities that dispense drugs to medical assistants be located within Minnesota.