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Seven County Changes…
A number of changes and updates were shared at the July 14th Delegate Assembly meeting of the Seven County Senior Federation. Most all of the update information was directly related to the final report delivered by the VELA Strategy Group. The report was the end result of their work in helping to create a strategic plan for the future of the organization.
One of the first changes was in the monthly meeting format. A meeting was held with the county vice-presidents following the call to order. The vice-president’s meeting was put in place to give each county leader an overview of what was in store for the next 12 months (and longer) at Seven County. Special emphasis was given to highlighting what their roles would be, as county vice-presidents, including a heightened awareness in bringing current information to the board about events, programs and other items of interest from their county
A number of other committees met and selected a chairperson, and then formed their plans and goals for the year. The committees that didn’t have an opportunity to gather and organize their formal structure will meet and do so at the August Delegate Assembly meeting.
- Issues & Advocacy
- Office Nominations
- Retail Store Board
- County VPs
Another monthly meeting change will revolve around workshop presentations on Seven County programs and services. These presentations will highlight one or more programs and/or services each month in order to give members a clearer picture of what the organization is and does in fulfillment of its mission.
Executive Officer elections took place at the 2016 Convention. This year the offices of 1st Vice-President and Secretary were up for election. Shown above are: ( l to r) 1st Vice-President Jeff Strand of Princeton, Secretary Majal Johnson of Mora, and Jim Oxberry the Convention Chairperson administering the oaths of office. All Executive Board offices are for terms of two (2) years, with a maximum term limit of two 2-year terms served in the same office.
In 2017 the offices of President, 2nd Vice-President and Treasurer will be on the election ballot.
Convention Decides Issues
The 2016 Annual Convention of the Seven County Senior Federation concluded with voting for issue priorities for the coming year. Possible choices were narrowed down before the convention by members of the Delegate Assembly at their monthly meetings leading up to the Convention.
Delegates chose from 5 choices in each category (STATE issues and FEDERAL issues).
The choices and vote totals were:
State Road/Bridge Repair Dedicated Funding - 58
Tax Relief for Seniors - 55
Protection of Water Resources - 55
Adjust MN Tax Structure for Top Earners - 56
Healthcare Financing Transparency for HMOs - 53
Protect Medicare/Social Security Structure - 84
Health Maintenance Organization Transparency - 28
Fairer Taxation Policy for Seniors & Middle Class - 48
Allow Medicare to Negotiate Rx Prices - 72
Federal Highway Road & Bridge Repair Funding - 42
STATE Priority Issues (Decided at 2016 Convention)
#1 - Road/Bridge Repair Dedicated Funding
#2 - Adjust MN Tax Structure for Top Earners
FEDERAL Priority Issues (Decided at 2016 Convention)
#1 - Protect Medicare/Soc. Security funding
#2 - Allow Medicare to Negotiate Rx Prices
Active Healthcare Legislation in 2016
With about 30 days left until the end of the 2016 MN Legislative session, there are still a few healthcare bills that are worth following and supporting.
The one that has grabbed the most publicity this session, and rightly so, is the estate liens bill related to MNSure and MA (Medical Assistance).
There are two (2) bills aimed at solving the “estate liens” issue (see Heartfelt), one in the Senate, and a companion bill in the House. Sen. Tony Lourey of Kerrick is the Senate author (SF 2501), and Rep. Matt Dean of White Bear Lake is the chief author in the House (HF 3467). Both bills have similar aims and contain language targeted at lifting a number of the liens for healthcare costs imposed by current language in the law, other than those costs generated by long term care. Long term care costs have always been a part of potential healthcare estate liens that can accrue for people on MA and they will remain as they are.
Another piece of legislation that has been introduced, and is working through committee, is the Health Care Cost Study bill authored by Sen. John Marty of Roseville (SF 0831). The companion bill in the House (HF 1181) is authored by Rep. Carolyn Laine of Columbia Heights.
This bill had its impetus from the recently completed activities of the Health Care Financing Task Force created last session. One of the key summaries resulted in a recommendation to actually create a comprehensive evaluation to compare cost systems that deliver healthcare services.
A “state public option” bill for purchasing health insurance is also alive in the legislature. The much talked about public option provision was originally included in the ACA (Affordable Care Act), but insurance industry pressure forced it to be excluded from the final bill passed into law.
Sen. Kathy Sheran of Mankato is the lead author in the Senate of the public option bill, (SF 2859) and the companion bill (HF 3283) is sponsored by Rep. Clark Johnson, also of Mankato.
This bill establishes a “state public option,” for publicly administered health coverage and available for purchase by anyone. It would be in lieu of a private insurance company policy.
The public option could be one possible choice along with insurance policy offerings currently available. This could happen by allowing people who are above the program’s income limits for low income assistance to purchase MinnesotaCare coverage. Permission would be requested from the federal government to let people use, just for this program, the same subsidies in use with private insurance policies.
Be Wary of So-Called “Asset Recovery” Services
The Consumer Financial Protection Bureau recently issued a consumer advisory on a new scam targeting seniors that packs a double whammy. These so-called ”asset recovery” companies target individuals who have already been victims of fraud – typically in speculative investments or timeshare scams - and scam them again, falsely promising to get their money back.
The Minnesota Commerce Department warns Minnesotans to not fall victim again by sending money.
“Asset recovery scams are particularly egregious because they prey on seniors who have already been victimized,” said Commerce Commissioner Mike Rothman. “I urge seniors to continue to be vigilant and safeguard their personal information. If you suspect fraud or have been the victim of a scam, call the Commerce Department.”
Keep an eye out for “asset recovery” companies that will contact a consumer or investor who has been defrauded by a money-making scheme. They promise to get your money back. They charge an upfront fee and it’s unlikely they will ever deliver on their promise.
These companies claim they have expertise to recover the lost money or file a complaint. But most of the services they offer, such as contacting your credit card company or a government agency, can easily be done for free.
The Commerce Department offers tips for Minnesotans who have been a victim of a scam:
Dispute the charge
If you paid for a service with a credit card and realize it might be fraudulent, contact your credit card company right away and see if you can dispute the charge. There is a limited time period to report fraud to avoid liability for unauthorized charges.
File a complaint
If you have questions or concerns about possible fraud or identity theft, contact the Commerce Department’s Consumer Services Center by email at firstname.lastname@example.org or by phone at 651-539-1600 or 800-657-3602 (Greater Minnesota).
- End the call. Don’t be a “courtesy victim.” When it comes to protecting yourself, there is no such thing as being rude. If you are uncomfortable or confused, just hang up the phone and end the conversation. Trust your instincts.
- Ask a friend. Reach out to someone you trust, such as a friend, family member or even your doctor, if you have questions or feel you are in an uncomfortable situation involving your finances.
- Report the fraud. If you believe you may be a victim of fraud, contact the Minnesota Commerce Department. Report the fraud so others don’t fall victim to the same scam.
Commerce is here to help
If you have questions or concerns about a potential fraud or scam, contact the Commerce Department’s Consumer Services Center by email at email@example.com or by phone at 651-539-1600 or 800-857-3602 (Greater Minnesota).
Another huge "Thank you" post goes out to our friends at Knife Lake Township, located in Kanabec County, for their generous donation! Donations received allow us to offer support and resources to EVERYONE in our Seven County region.
THANK YOU to the following townships, located in Mille Lacs County, for their generous donations to help support the work we do: Borgholm, Isle Harbor, Lewis, Onamia, Page & South Harbor.
Another "Thank you" posting goes out to our friends in Cambridge & Oxford Townships, both located in Isanti County, for their generous donations! Donations received allow us to offer support and resources to EVERYONE in our Seven County region.
"The Senior Center was very helpful when I was ready to sign up for Social Security. They also helped with signing up for Medicare and choosing my Supplemental insurance. They are a great resource and staff is great!" - Lola M. Nelson
Lent Township in Chisago County gets the big "Thank-You" for their generous donation!!!
Thank You to the fine folks in Blackhoof Township - Carlton County - for their generous donation!
A huge "THANK-YOU" shout-out goes to Pliny Township in Aitkin County for their recent donation!
Fiddle Sisters in Wahkon
The Fiddle Sisters (Jane and Nancy Conger shown above) will provide the musical entertainment following lunch at the 2016 Convention to be held at the Wahkon Inn on Thursday, May 12th. The sisters have been performing their musical wonders for many years and are well known for their engaging, toe-tapping style of entertainment.
Wahkon to Host 2016 Convention
The Wahkon Inn (pictured) has been selected as the site to host the 2016 edition of the Seven County Senior Federation Convention. Thursday, May 12th is the date and the pieces are all coming together to make the event a successful meeting for members of Seven County. A full chicken dinner lunch will be served following officer elections, issue priority voting, by-law updates and budget finalization. A special guest speaker will kick off the day’s activities starting at 9:30am (morning coffee and snacks will be ready by 9:00am). There’s plenty of meeting space right now, but spots will fill up fast, so call and reserve your spot for the 2016 Convention today!
Health Care Estate Liens Addressed by Legislature
The recent news that some families who are enrolled in Medical Assistance (through MNsure) have had substantial liens placed against their property was a shock to many Minnesotans.
According to the little publicized provision in the MNsure enrollment in MA (Medical Assistance - Minnesota’s version of Medicaid), if you’re 55 or older and on MA, the state places an estate claim with which to recover its costs after you and your spouse have died.
Statewide attention was focused on at least two (2) families living in Pine County within the Seven County region. Both families recounted similar experiences in their enrollments into the MA program. When asked about the issue, Sen. Tony Lourey of Kerrick, said, "the process lacked transparency. It is there in the fine print, but not anywhere near to the level that I think is acceptable.” Lourey has taken action to alleviate the current problem by introducing a bill that addresses select provisions of the law.
It’s worth knowing that the estate claim provision has always been in place for people enrolled in MA. However, with the 2014 expansion of MA under the Affordable Care Act (ACA), MNsure has brought younger people into the system (people in the 55-64 age range and with more assets). It’s that group of individuals who are now are now most affected by the same MA lien provisions. If a proposed law from Sen. Lourey passes, nursing home and long-term care costs will still accrue liens against MA enrollees estates, but a number of the other expenses will be exempted from the lien process if the measure passes.
Sen. Lourey’s curative bill is SF#2501 - the first part of the legislative language summarizes the bill’s intent:
SF 2501 retroactively limits medical assistance estate recoveries for those individuals who receive medical assistance while not institutionalized.
Section 1 (256B.15, subdivision 1, paragraph e – Circumstances under which a claim must be filed) retroactively modifies the circumstances under which the Commissioner of Human Services is permitted to file a claim against the estate of an individual who received medical assistance while not residing in an institution.
For services rendered prior to January 1, 2014, a claim against an estate must be filed if a person received any medical assistance and the person was 55 years old or older at the time the service was rendered.
For services rendered after January 1, 2014, a claim against an estate must be filed, but only if the person was 55 years old or older at the time the service was rendered and the services provided were nursing home services, home and community-based services, or related hospital and prescription drug benefits.
- - - - -
It should be noted that the language to create liens for this expanded group (55-64 years of age) was left as an option in 2014 for states that were operating insurance exchanges under the ACA. Minnesota’s Dept. of Human Services decided to include that option, but did not do an adequate job of communicating that change to the MNsure Board which, in turn, created much of the confusion that exists.
As of this printing, there is now a MN House companion bill similar to the Senate bill (HF#3467); it’s authored by Rep. Matt Dean of White Bear Lake.
Final Ballot Issue Items for
2016 Annual Convention Meeting
* Healthcare Financing Task Force Recommendation on HMO Transparency
The push for transparency & accountability has continued for over 8 years and that position has been reinforced by the HCFTF (Health Care Financing Task Force) recommendations. GMHCC and 7 County have participated in this effort to finally find out how HMOs spend your tax dollars every year. State law now mandates that everyone doing business with the state of Minnesota provide a detailed accounting of expenses. HMOs have received a temporary exemption from this law (the Timberjay Law) that we feel is unjustified.
* Tax Relief For Seniors for Property Taxes
The vast majority of seniors are on a fixed income and struggle to make ends meet. Property taxes can present a large problem when they continually rise past the point of affordability for seniors. It would be preferable for seniors to either: 1.) have a cap on their property taxes that is tied to a fixed percentage of their income, or... 2.) freeze property taxes at a specific level and allow taxes to be deferred until the property is sold to another buyer of the property.
* Protection of Water Resources
Our water resources are a finite item - once we use up our supply of potable water all life on the planet will be in jeopardy. Technological changes related to oil production by means of fracking pose a risk to surface water, as well as to the aquifers below, as their byproducts are extremely toxic. Currently, the contents of these byproducts are not required to be disclosed to the public. Also massive amount of chemicals used in domestic crop production find their way into our groundwater, lakes and streams. Legislative steps need to be taken to protect our water resources.
* State Roads & Bridge Repair / Constitutional Funding Amendment for Dedicated Funding
Minnesota has the nation's fifth largest highway system and much of it is old and in need of repair and maintenance. Additionally, over 2,900 bridges in the state of Minnesota are described as “structurally deficient” and are in need of replacement. If nothing is done to repair or replace them, the number of bridges that are over 50 years old (the average life span), and likely also deficient, will be over 8,000 by the year 2030. Minnesota should adopt a dedicated road/bridge funding stream.
* Further Adjust MN Tax Structure for Top Earners
Low and middle-income households pay a disproportionate share of Minnesota state and local taxes relative to high income households. The level of taxes are commonly measured in terms of the “effective tax rate” (or ETR), which refers to combined state and local taxes as a percentage of income. In a regressive tax system, low- and middle-income households tend to have higher ETRs than high-income households. In a progressive system, high-income households tend to have higher ETRs. In a proportional tax system, the average ETRs of high- and low-income households are the same. The Tax Act of 2013 in Minnesota helped level the playing field a bit, but much more needs to be done to protect seniors and ensure that they aren’t literally taxed out of their homes.
* Protect Social Security & Medicare Structure
There has been renewed talk about completely revamping Social Security (perhaps Chained CPI, or means testing, or privatization). Privatization of Soc. Sec. is one of the dangers of program reform as it would leave the program at the mercy of the stock market, for the most part. Likewise, Medicare is being talked about as a program that needs to be put in the marketplace (privatized) in order to provide “better service and to lower costs.” These are the same talking points that were used to privatize all the MN State healthcare programs with the same promises; more access and lower costs… neither of which has come true. Both programs need reform, but the reforms talked about so far have not considered some common sense alternatives - like raising the cap on wages to $200,000 to bolster Social Security funding.
* Fairer Taxation Policy Middle Class & Seniors -
Closing corporate tax loopholes for businesses sheltering profits in offshore/overseas accounts in order to avoid paying taxes should be a priority. Offering incentives for businesses that expand operations in the United States should be strongly considered. The more those corporations are allowed to avoid paying taxes, the bigger the tax burden will be on individuals to make up for the shortfall. This burden falls heavily on the middle-class, and especially affects seniors on fixed incomes.
* (HMO) Transparency for Medicare and Medicaid
The push for HMO transparency & accountability has continued for over 8 years. 7 County and GMHCC have participated in this effort to finally find out how the HMOs spend your tax dollars every year. Medicaid and Medicare dollars flow into the state and our MN Dept. of Human Services has not been able to produce a breakdown of how $5.1 billion dollars per year are spent in administering the HMO-run state healthcare programs. Taxpayers deserve to know how their tax dollars are being spent on ALL levels… city, county state, and federal.
* Allow Medicare to Negotiate Rx Prices on behalf of Medicare Part D
Drug manufacturers have been allowed to manipulate the supply and demand of the system so that U.S. consumers pay the highest retail prices in the world for prescription drugs. The inability to negotiate prescription drug prices has really harmed senior citizens physically AND financially. The VA is allowed to negotiate drug prices, so it seems fair that the most vulnerable and needy group in this country (seniors) should receive the benefit of negotiated prescription drug prices under Medicare Part D.
* Federal Highway Road & Bridge Repair / Infrastructure Building & Maintenance
Minnesota has the nation's fifth largest highway system and much of it is old and in need of repair and maintenance. Additionally, over 2,900 bridges in the state of Minnesota, are “structurally deficient” and are in need of replacement. If nothing is done to repair or replace them, the number of bridges that are over 50 years old (the average life span), and likely also deficient, will number over 8,000 by the year 2030. Federal matching dollars are needed to help repair the rapidly aging U.S. interstate highway system in Minnesota.
Short Session Means Fewer Bills - Less Focus on Health Care
Expectations aren’t high for advancing substantial healthcare reforms during the upcoming legislative session in Minnesota. For one thing, this is a bonding year which translates into a very short session (March 8th thru May 23rd), and for another, it’s an election year. Combine those elements and you see that the focus will be narrow with only “essentials” being considered worthy of committee hearings by the legislative leaders in both chambers.
In 2015 the legislature concluded its work without passage of a transportation or tax bill despite a record budget surplus (almost $2 billion dollars). In addition to healthcare reform issues, a number of important priorities, for greater Minnesota in particular, went unaddressed. The only thing that seems like a “sure thing” and which has almost complete agreement on by legislators, is that a transportation bill is very high priority for this session.
As far as healthcare transparency goes, there is an indication from the OLA (Office of Legislative Auditor) that they will be asking for funding to conduct (contract for) an independent outside audit of HMO/DHS payment practices this year. The audit process was stalled in previous years for a number of reasons, not the least of which was a reported lack of funding.
Two (2) years ago Jim Nobles, the Legislative Auditor, also reported that, following an extensive search, his office was unable to find a qualified audit agency to conduct a mandated (by the legislature) HMO/DHS audit. His OLA office then performed a limited internal audit of HMO/DHS reports (Dept. of Human Services) The OLA looked at reported administrative costs, but did not examine any medical expenses in the audit. There may be legislative action introduced this session that could help push a complete audit forward very soon. In the meantime, health reform advocates state that an incomplete audit is the same as no audit.
The following letters were submitted to the MN Association Of Small Cities (MAOSC) which is comprised of nearly 300 small city members across the state of Minnesota. These legislative leaders were asked to give their outlook for the upcoming session. MAOSC has graciously shared the letters with us…
Senate Majority Leader - Senator Tom Bakk (D) Cook, MN
Outlook for 2016 session
This upcoming legislative session is a short one, but that doesn't mean the list of important priorities before the legislature is short. More and more we see that Minnesota's economy is linked with the national and global economies. Because of this DFL Senators will once again be thoughtful about the investments being made at the legislature this year. We will work hard for priorities shared by all Minnesotans: a comprehensive transportation funding package, LGA (Local Government Aid), and a thoughtful bonding bill are three that I expect are of major concern to small cities. As a rural legislator, I've heard from my local officials that these three issues are urgent to the safety and stability of our cities.
Modernizing the gas tax is one part of a comprehensive funding plan that dedicates needed revenue to maintain our existing roads and bridges and invests in priority projects to make our communities more livable for everyone. Our world-class transportation system is one of the reasons Minnesota has had a successful economy, but we need to maintain and improve our transportation network to stay competitive. Everyone benefits from a safe and robust transportation system - families, farmers, small businesses, and our state's largest employers. Minnesota has not kept up with needed investments in our transportation system for the last 25 years. It is past time to invest in our roads and bridges - not only to maintain them, but to ensure they can handle our future needs so our economy can grow and prosper.
DFL Senators understand how important Local Government Aid is for our communities. We have been and will continue to be advocates for this funding to return to 2002 levels, which will help our cities grow and prosper-as well as decrease reliance on property tax increases. Last session Republicans in the House were only willing to support LGA if they got to pick which cities would be awarded it-this not only weakens the broad base of support for LGA among legislators but also weakens the arguments for LGA in the future.
With regionally significant state assets throughout Minnesota, investing in our aging and diverse infrastructure is critical and beneficial to every corner of the state. The DFL Senators will prioritize necessary and targeted investments in communities throughout Minnesota so our infrastructure keeps up with the needs of the people it serves. With state having a stable financial footing and the availability of low interest rates, it is fiscally prudent to invest in the maintenance of our infrastructure to extend its lifecycle. Given the state's budget surplus, using cash to supplement the bonding bill would be wise financial planning for the state. The state will save money by using existing resources instead of bonds to fund infrastructure.
We will have our work cut out for us this session however it will not diminish our drive to accomplish these three priorities and other priorities shared by all Minnesotans. Feel free to contact me with your ideas or concerns: (651) 296-8881 or
Speaker of the House - Representative Kurt Daudt (R) Crown, MN
Outlook for 2016 session
More than 80 percent of all cities in Minnesota have a population of 5,000 or less -- I grew up in one and currently live in an unincorporated community called Crown. I understand how important small, rural cities are to our state as a whole. This biennium, House Republicans have made a concerted effort to address the concerns of communities across the state, not just those of Minneapolis and Saint Paul. We are proud of the progress we made in 2015 - increasing per-pupil dollars in the classroom by $396 for non-metro school districts, stabilizing funding for nursing homes, and investing in broadband infrastructure for underserved areas and workforce housing grants - and we will continue to make strides this year.
During the upcoming session our caucus will be focused on three key issues that are extremely important to rural economies and small cities in Greater Minnesota: transportation, tax relief, and infrastructure through Capital Investment.
Improving our road and bridge infrastructure statewide has been a top priority for House Republicans this biennium. Our plan, which passed the House with bipartisan support in 2015, would fix more than 15,500 lane miles of roads and 330 bridges statewide. It invests $7 billion over the next 10 years by using a small portion of the state's budget surplus, bonding, and existing taxes Minnesotans already pay on auto repairs, car parts, vehicle leases, and car rentals. I'm especially proud of a new program we established in 2015 giving small cities funds for roads and bridges for the first time. Our comprehensive transportation bill includes $25 million every year for this new program. For Corridors of Commerce, our plan would put about $800 million over the next seven years to fix or expand some of the most important highways, many in rural areas. I look forward to working with the Senate DFL Majority and the governor to pass a long-term transportation plan without raising the gas tax.
In our tax bill, House Republicans protect Local Government Aid (LGA) for all cities, including small cities while Minneapolis, Saint Paul and Duluth are fairly brought to the statewide average of per capita aid. With a nearly $2 billion surplus, we also aim to provide substantial tax relief. The most significant part of the tax relief package - a new Minnesota personal or dependent tax exemption - could save a middle-class family of four more than $500 over the next two years. In addition, 366,500 senior citizens who are living on fixed incomes would also benefit as our proposal would finally phase-out the tax on social security and 30,000 families could receive relief through the expansion of the education deduction to include pre-kindergarten expenses. The legislation would also help border communities by working toward restoring competitiveness with neighboring states through tax reductions for border city enterprises. If you are a college student, veteran, aging adult, farmer, job creator, or simply a hardworking taxpayer in a middle class family, you will be pleased with the tax relief provisions contained in this legislation.
Lastly, we will work to approve a reasonable Capital Investment (bonding) bill focused on areas of statewide or regional significance. Our Capital Investment Committee has traveled the state in the interim to get a hands-on look at projects and members will take the necessary time to properly vet all bonding requests during the upcoming legislative session.
As a farm kid from Isanti, I am grateful for the work your association does to keep our small cities in our rural communities a great place to live. Please do not hesitate to contact me with ideas or concerns at or 651-296-5364.
Volunteer Recognition for 2015
The Seven County Senior Federation held its annual Volunteer Christmas and Holiday party in December at Calvary Lutheran Church in downtown Mora. Along with the tasty lunch there was also great seasonal music supplied by the Braham Crackers trio. Following the luncheon volunteers were recognized for their dedication and service on behalf of Seven County. Shown above are the volunteers who also received special recognition for their contributions of time and talent in 2016. Left to right the honorees were: Cleo Neff, Barb Rische, Richard Brown, Shannon Jackson (Communications Coordinator), Donna Johnson and Carolyn Wicklund. Richard Brown donated over 1,600 hours of his time in support of Seven County through his work at the One More Time Store in Mora.
Health Care Task Force Releases Its Report
The 2015 legislature and governor created a task force on health care financing (Health Care Financing Task Force or HCFTF) to advise them on strategies to increase access and improve the quality of health care for Minnesotans. These strategies include options for sustainable health care financing, coverage, purchasing and delivery for all insurance affordability programs. The description of the task force is contained in this brief summary found in the final draft report:
Gov. Dayton named 11 members to the newly-created state Task Force on Health Care Financing, which was tasked with looking at the future of health care programs in Minnesota, including MNsure and MinnesotaCare. The Legislature authorized task force, which began meeting in August was to report its findings in January.
In addition to the members appointed by the governor, the group also included Commerce Commissioner Mike Rothman, Health Commissioner Dr. Edward Ehlinger and former Human Services Commissioner Lucinda Jesson (replaced in January by Emily Johnson Piper). Also on the task force are the current MNsure executive officer, Allison O'Toole, and legislative appointees.
Appointed task force members are:
- Lynn Blewett – St. Paul, Director, University of Minnesota State Health Access Data Assistance Center
- Elizabeth Doyle – Minneapolis, Associate Director/Policy Director, TakeAction Minnesota; Member from Broad-Based Nonprofit Consumer Advocacy Organization
- Monica Hurtado, – Minneapolis, Health Equity/Racial Justice Organizer, Voices for Racial Justice; Member from Organization Representing Consumers of Color
- Sheila Kiscaden – Rochester, Olmsted County Commissioner
- Sahra Noor – Roseville, CEO, People’s Center Health Services; Member from a Nonprofit Organization with Legal Expertise Representing Low-Income Consumers
- Dr. Marilyn Peitso – Sartell, Pediatrician, CentraCare Health
- Rosemarie Roach – St. Paul, Executive Director, Minnesota Nurses Association
- Jim Schowalter – Eagan, President and CEO, Minnesota Council of Health Plans
- Larry Schulz – Fergus Falls, CEO, Lake Region Healthcare
- Dr. Todd Stivland – Stillwater, CEO, Bluestone Physician Services
- Dr. Penny Wheeler – Minneapolis, President and CEO, Allina Health
Convened in August 2015, the Task Force was given a sweeping charge to consider alternatives to MNsure and options under a couple of healthcare waivers, including: (1) options for providing and financing seamless coverage for populations eligible for Insurance Affordability Programs; (2) options for transforming health care purchasing and delivery; and (3) options for alignment, consolidation, and governance of certain operational components of Minnesota’s coverage programs. The Task Force was directed to consider the impact of these options on the health care workforce and delivery system for hospitals, clinics, rural and safety net providers, rural safety net providers, clinics, and hospitals.
The Task Force was also tasked with evaluating various reform options in light of seven (7) distinct, but related, goals:
- Encouraging seamless consumer experience across all benefit programs
- Reducing barriers to accessibility and affordability of coverage
- Improving sustainable financing of health programs, including impact on the state budget
- Assessing the impact of options for innovation on their potential to reduce health disparities
- Expanding innovative health care purchasing and delivery systems strategies that reduce cost and improve health
- Promoting effective and efficient alignment of program resources and operations
- Increasing transparency and accountability of program operations
Synopsis of January 2016 Report:
An evaluation of the 66-page report’s findings were contained in a news release by the MNA (Minnesota Nurses Association), which indicated that the task force identified significant changes and enhancements that are needed for the sustainability of Minnesota’s healthcare system. Among the healthcare reform community, including GMHCC (Greater MN Health Care Coalition), there is broad agreement with the MNA position on the report.
The good parts include the added emphasis on transparency and accountability for $5.1 billion tax dollars allocated for healthcare in Minnesota, as well as the acknowledgement that simplified reporting should be better, as well as the concept that healthcare purchasing and delivery systems should be scrutinized for cost and effectiveness. This would and should give added emphasis to the County Based Purchasing system of healthcare delivery that has a proven track record of providing better access to more people while at the same time reducing costs and delivering better health outcomes. This report does inch the healthcare reform process forward and could create a path to substantial positive changes in healthcare delivery in the state. The key will be the commitment to change by the legislature and the administration.
One of the thirty (30) recommendations passed by the HCFTF holds particular promise for those who believe that a universal coverage, single payment system should be created. It is labeled as “Recommendation 23.”
Conduct a study that examines various long-term payment options for health care delivery. Study will do a comparative cost/benefit analysis of the health care system under the following approaches:
- Maintenance of current financing mechanism, without expansion of value-based purchasing beyond existing levels;
- Expansion of value-based purchasing within current system;
- Publicly-financed, privately-delivered universal health care system.
The study would additionally examine the stability and sustainability of health care system under the approach and identify any data or information needed to design and implement the system.
Justification: Although there was consensus among the Workgroup that Minnesota (and the United States, generally) must improve quality and reduce cost in order to get its health care system on sustainable footing, there is less consensus on how to achieve this. Some Workgroup members favored an expansion of value-based purchasing while maintaining the current patchwork of public and private programs; some Workgroup members favored further analysis to evaluate whether additional value-based purchasing would be necessary or effective to drive improved outcomes. Finally, some suggested that expanding value-based purchasing would be unable to improve the health care system, favoring wholesale shift to a publicly financed, privately delivered universal health care system. Given the widespread impact of each of these options, the Workgroup recommends further study of each of these three options.
Costs/Savings: Costs/savings were not estimated for this recommendation, however conducting a study examining various long-term health care delivery payment options would likely generate new State costs.
State/Federal Authority: This recommendation would require appropriations authority to implement.
GMHCC and its healthcare reform allies plan to meet in early February to formulate a strategy for the coming legislative session, as well as for the next 3-5 years.
Minnesota’s Foundation for Reform
The Health Care Financing Task Force is the most recent in a series of State task forces and commissions, including the Minnesota Health Reform Task Force established under Executive Order 11-30, the Health Care Access Commission of 2008, and the Health Care Transformation Task Force of 2007, demonstrating Minnesota’s longstanding commitment to transparent, regular examination of the direction of health and health care in Minnesota.
Additionally, the Task Force’s work is informed by and dovetails with Minnesota’s ongoing State Innovation Model initiative through which the State is using federal grant money to test new ways of delivering and paying for health care by promoting networks of accountable providers.
(from the HCFTF Final Draft Report - January 2016)
A look back at 2015…
2015 was a typically busy year for us at Seven County, as we conducted the business of the 1,500 plus members of the organization.
In May, we gathered in Hinckley for our annual convention (it was Pine County’s turn to host). Mike Hughes (convention chair) swore in the officers elected during the meeting. Shown top left are ( l to r): Mike Hughes, Joan McClay (Treasurer), Paul Venhuizen (President), and Arlene Morgan (2nd Vice-President).
In late August we supplied the people power to operate the food stand fundraiser booth at Chris’ Foods in Sandstone (raising over $900 for the 2 day event). Shown in the middle picture (l to r) are: Gail Nordin of Henriette (county delegate) and Cheryl Wickham of Markville (county delegate).
In mid-September we held our Annual Potluck at Hinckley’s Community Center. There was tasty food, lots of fun, great music - and pirates everywhere (that was the theme for the event)! Kathleen McLain-Gall (7C staff at center of pic in pirate hat) helped folks with their pirate hat construction.
We were busy in 2015… again!
221 people…enrolled in our 4 hour senior defensive driver training courses to save 10% on their auto insurance
29 people…were participants in our 8 hour senior defensive driver initial course (see above)
557 people…received direct assistance, in person, or by phone, with all of their Medicare of Social Security related issues
42 families in need…received free donations of household goods as needed from either of our One More Time thrift stores
96 people...were referred to us from social service agencies, local churches and/or area non-profits for free household goods and clothing
247 people...received free income tax and property tax preparation services from one of our friendly volunteers
Volunteers Needed For 2016 Tax Program
The new and improved 2016 tax preparation program is in need of more volunteers for the upcoming season.
Seven County will be teaming up with Lakes & Pines to offer free income tax preparation for basic tax returns in 2016. All of the Mora tax appointments will be handled at the Seven County offices located in downtown Mora. There will be no tax preparations performed at the Lakes & Pines location this year, but they will help schedule appointments. The tentative schedule will be Wednesdays from 9am until 6pm and Saturdays from 9am until 1pm.
Tax appointments will be taken starting in late January with the first appointments scheduled for February 10th or 3rd???
DHS Returns Part Of County Based Healthcare
The twelve counties that make up the South Country Health Alliance (SCHA) have breathed a measured sigh of relief. That comes on the heels of the decision
by a 3-person panel that reversed a MN Department of Human Services (DHS) ruling that excluded SCHA from receiving contracts for 2016 healthcare services
in their areas.
It was a measured sigh because it will not be business as usual for SCHA, one of the most successful county based healthcare operations in Minnesota. Starting in 2016 with the new contract year, all of the SCHA counties will be required to have at least a second source of administering services through a Health Maintenance Organization (HMO) doing business in the state. A couple of the counties will also have a third source/choice as well (Olmstead
received permission to add UCare and St. Louis and Wright counties are permitted to negotiate with Medica as a potential third source).
One of the major HMO provider sources in years past, UCare, was almost completely shut out of the state contracts altogether. Following the initial announcement of the contract awards, UCare filed a lawsuit against DHS claiming the process was unfair and also suggested that inside bid information had been shared illegally. A recent bidding disclosure released by DHS along with an explanation for the specifics of the evaluation process lead UCare to drop its suit against DHS.
The twelve (12) counties that comprise SCHA are: Brown, Dodge, Freeborn, Goodhue, Kanabec, Morrison, Sibley, Steele, Todd, Wabasha, Wadena, and Waseca .
Live Well At Home Projects Funded To Help Aging Minnesotans
News Release - MN Dept. of Human Services - 10/16/2015
$7 Million Going to Community Long-Term Services Statewide
Services that help older adults in Minnesota stay in their homes as they age are receiving more than $7 million in funds appropriated by the Minnesota Legislature and Gov. Mark Dayton, and awarded by the Minnesota Department of Human Services.
The 62 projects being funded through the department’s Live Well at Home grants, previously known as Community Service/Community Services Development grants, provide a variety of services and supports that allow older Minnesotans to remain in their homes rather than move to nursing homes or other more expensive settings.
“Minnesota is a national leader in long-term services and supports for older adults in part because we provide this seed money to community organizations and providers to be creative in helping people remain in their homes as they age,” said Human Services Commissioner Lucinda Jesson. “In addition to helping meet daily needs such as nutrition and housekeeping, these grants promote new technology and other innovations that benefit both older Minnesotans and their caregivers.”
Jesson announced the grants while visiting the Fergus Falls home of a PioneerCare client. PioneerCare is using the Live Well at Home grant to expand the use of technology by older adults and their families, empowering them to live more independently in their current homes. Through its PioneerLink project, the active 87-year-old Fergus Falls man is able to stay connected to help while at home, out on regular walks or while golfing with Mobile-Mate, a mobile safety device with fall detection.
Many grant recipients are non-profit community organizations that use a combination of paid staff and volunteers to provide core home and community-based services so that people throughout Minnesota regardless of income can remain in their own homes for as long as possible. These grant recipients are required to generate income by charging for services through the use of a sliding fee scale. More information about the grants is available on the DHS website:
Fare For All
We're involved in some BIG things around Mora - and its surrounding communities - and we'd love for you to be a part of it!
The look of surprise is often expressed by those receiving their food purchases for the first time.
The early stages of setup...deciding where to put all the pallets of food before we begin distribution.
We are here to make this a good experience for everybody that walks through the door.
Fare For All, a local food program created to make fresh fruits and vegetables more affordable for local families will be featuring their Holiday Packs for $30 at the TRIO Community Center on Wednesday November 4th from 3:30pm -5:30pm. Each Holiday Pack includes an 10-12 pound Jennie-O turkey, a Hormel pork tenderloin, boneless-skinless chicken breasts, pork sausage, two bags of green beans, and an apple pie.
Orders are being taken now at Emma’s Pizza (ask for Jackie), Lakes and Pines CAC Inc., and the Seven County Senior Federation (ask for Shannon) for regular and holiday packs. Distributions take place one Wednesday a month and orders must be received by the Friday before the distribution date. All orders must be picked up at the Trio Community Center at 111 Maple Ave E in Mora.
December Holiday packs featuring a 7-9lb spiral cut hickory smoked ham and other items will be available on Wednesday, December 2nd.
Fare For All, sells packages of fresh produce and frozen meat at 31 locations throughout Minnesota. With prices ranging from $10 to $30 per package, Fare For All offers savings that are much less than retail prices. The program has no income requirements and is open to everyone who is looking to save money. There are no forms to complete and cash or checks are accepted. EBT payments are also welcomed; however to use your EBT card call Fare For All weekday mornings at 800-582-4291, let them know what you are ordering to pick up at the Mora site.
Fare for All purchases fresh fruits, vegetables and frozen meats in bulk and passes on the savings to anyone who wants to stretch their food budget. Participants in the program save up to 40 percent on their food purchases. The end result is that households who utilize the program have access to and consume more nutritious staples.
“Many families have been forced to cut back on fresh produce and lean meats because of ever-shrinking food budgets. The program is designed to help make affordable, healthy foods available to those families—especially during the holiday season,” said Scott Weatherhead, the Program Manager for Fare For All.
Still have questions? Contact one of the following:
Shannon at Seven County Senior Federation 320.679-4700 - ext. 2403
Lakes & Pines Community Services Department 320.679.1800 - Option 4
stop in at Emma's Pizza.
Decision On Bidding Process Leaves Counties With Questions
An appeals process, undertaken by twenty-eight (28) counties in Minnesota, sought to undo or at least forestall a ruling by the MN Department of Human Services (DHS) regarding healthcare contracts. Their appeal had some success, but still left many questions unanswered as to the future and the budgeting process that will be needed to keep health programs functioning at a high level.
Prior to the DHS awarding of new contacts for 2016, counties who were part of a County-Based system of Purchasing (CBP) for healthcare were the sole contractor with healthcare providers in their region for Minnesota’s low-income programs (Medical Assistance and MinnesotaCare). DHS went through a new bidding process this past summer and they decided to award healthcare contracts to three private HMOs (Health Maintenance Organizations) and, at the same time, mostly eliminate contracts with CBP systems serving rural Minnesota.
A majority of the affected counties filed an appeal to DHS and their grievance was heard by a 3-person panel. After hearing and reading testimony from dozens of CBP supporters from throughout the state, fourteen (14) of the counties won modifications to the bidding results, with Olmsted County receiving permission to add UCare as a potential third insurer. St. Louis and Wright counties were permitted to negotiate with Medica as a potential third provider as well. The panel ruled that all of the CBP counties would be able to continue to receive and administrate their state healthcare contracts, but would not be the sole source as before. The counties will now share administration with another provider in their area. In Kanabec County, for instance, the secondary choice will be Medica for low-income healthcare administration.
This decision is likely to create some new challenges at the county level for CBPs that had been doing all of the administration and budgeting for the system. It is not clear, and may not be for some time, how much of the business will flow through the county and how much will flow through private HMOs like Medica. The state’s PMAP (Prepaid Medical Assistance Program) enrollees could end up in the county’s private HMO choice with the local CBP ending up with half of their previous business or less.
UCare, which was one of four (4) HMOs serving the vast majority of low-income enrollees in the state, now has a uncertain fate, as they have been excluded from most all of the programs. Its business providing federal Medicare plans and smaller state programs for senior citizens will be unaffected. In early November, a judge is scheduled to consider the insurer’s arguments that the state bidding process was unfair and tipped competitors to financial information that allowed them to make superior bids.
Counties Appealing State’s Decision to Change HMOs
One of South Country Health Alliance (a county based healthcare organization in outstate Minnesota) and UCare’s last hopes for salvaging enrollment began September 16th, as a three person panel started to hear their case. Their appeal was based on a recent Dept. of Human Services (DHS) decision to drop UCare and South Country from administering the state’s public health insurance programs. The appeals come from counties that jointly administer the state’s Medical Assistance and MinnesotaCare programs.
The panel was scheduled to hear appeals from 30 counties, some of which question the decision to drop UCare, while others want to retain South Country Health Alliance.
According to an analysis of DHS enrollment data, there are about 135,000 UCare enrollees in the counties who have sought mediation,. Overall, the UCare HMO (Health Maintenance Organization) has about 363,000 enrollees in the families and children portion of the public programs, according to DHS. When you factor in the enrollees in South Country’s base there are over 450,000 people who will be impacted.
State officials announced preliminary results from competitive bidding in July, and the three-person panel will be asked to recommend whether Human Services Commissioner Lucinda Jesson should finalize changes.
“I really think they should take a fresh look at the scoring,” Jesson said. “If there are recommendations about how to do things differently, they’ll make those recommendations to me.” St. Louis County has appealed the decision, too, with officials saying UCare has provided good service. Patrick Boyle, a St. Louis County commissioner commented “I think we need to have some answers about why we’re doing this change… my hopes aren’t up, but I’m glad we’re having a little more transparency on the issue.”
However, the final decision rests with Jesson, who has said she will decide by October 1, making many county officials skeptical that the mediation process will result in any changes.
Minnesota hires HMOs like UCare, and county-based groups like South Country, to manage care for people enrolled in Medical Assistance and MinnesotaCare in the state. Medical Assistance is the state’s version of Medicaid, which covers people at or below the poverty line, and MinnesotaCare covering a slightly higher income group.
In July of this year, DHS announced the results of competitive bidding that purportedly would save state and federal taxpayers $450 million next year, but would drop UCare as an option. South Country was also dropped as an option in 10 of the 11 counties where it currently operates.
The state says bids from managed care organizations were scored with a greater emphasis on quality than cost. South Country sued to get access to DHS scoring documents, so the counties that created the managed care organization can better make their case during the mediation process. DHS and South Country reached an agreement in the dispute according to Tom Lehman, a lobbyist for South Country.
Earlier this month, a Ramsey County judge declined to issue a temporary injunction that UCare had requested in order to block the new contracts. A trial in that case is slated for November.
The stakes are high for both managed care organizations. During a legislative hearing in August, a South Country official said his group, with nearly 100 employees, might not be able to continue without the state contract. Likewise, the public programs accounted for roughly half of UCare’s $3 billion in revenue last year, so the HMO might need to eliminate about half of its 900-person workforce.
If the matter isn’t resolved in South Country Health Alliance’s favor, managed-care contracts will be awarded on a county-by-county basis, with at least two plan options in every county, and three plans in each county within the seven-county metro. That’s according to a statement released by Commissioner Jesson in July.
Pirates Sail The "Seven Counties"
Costume Contest Winners - Mary Stearns (left) & Evie Yates (right)
Seven County staff pirates Shannon Jackson (left) and Lisa Krahn (right) addressed the gathering of friendly deckhands at the Annual Potluck held in September in Hinckley.
“Captain” Gary Larson (of the MN Better Business Bureau) presented updated information about current scams that people need to be aware of. He offered tips on how to sort out fact from fiction regarding mail and phone solicitations.
Board members Gail Nordin (left) and Paul Venhuizen (right) had a good laugh while singing the “Pirate Song” - which was one of the fun activities at the Potluck.
One of this year’s fundraisers was the food stand at Chris’ Foods in Sandstone. This was the second year for Seven County to have the booth for a weekend fundraiser and we surpassed last year’s totals by earning well over $850 for the 2 day event. Funds raised are targeted towards a proposed senior chore service for the local region. Shown above working at the Chris’ food stand are Dolores Wickham, Cheryl Wickham and Paul Venhuizen.
Diane Knoben, who works at the Cromwell Food Shelf, was excited to receive a donation of non-food items collected and delivered by Seven County member Christine Bergmann. Seven County is serving as a collection point for people who would like to donate non-food items like toiletries, toothpaste, soap, facial tissues, etc., for those families in need. Items that are collected are distributed to a number of food shelves serving the region.
I don’t know how many of you are tuna eaters, but I wanted to share this article with you. If it doesn’t benefit you - maybe this would benefit others you know?
The following was taken from the August 31, 2015 Money Talks News.
You probably wouldn’t notice if your 5 ounce can of tuna was a few tenths of an ounce light on tuna and heavy on water (or oil). But Patrick Hendricks did, and it resulted in a class-action lawsuit against StarKist.
If you purchased a 5-ounce can of StarKist chunk light tuna or solid white tuna in water (or oil) between 2009 and 2014, you could be owed a refund, and you get to choose between $25 in cash or $50 in tuna.
Some StarKist tuna eaters will receive notices of the settlement. If you don’t receive a notice, you can file a claim yourself.
You don’t need a receipt to file a claim, but you do need to confirm “under the penalty of perjury” that you purchased StarKist Tuna during the five-year time frame covered by the lawsuit.
If you want to file a claim for cash or a tuna voucher, go to https://www.tunalawsuit.com/Landing.aspx
Claims need to be filed by Nov. 20, 2015.
Did You See Us?
We’ve been visibly on the go this spring and summer in a number of places, including most recently the Isle Days Parade in July. Shown riding the spectacular One More Time float in Isle are (l to r): Kathy Finlayson, Cleo Neff (OMT - Isle) and Lyle Finlayson. As is the tradition in the parade, our riders distributed lots of stuffed animals to the crowd as the parade moseyed down Main Street, much to the delight of the kids.
Shown below is Arlene Morgan (2nd Vice President) standing beside our parade entry for the Isanti Rodeo Days Parade (Lisa Krahn’s Honda disguised as a float). Other summer activities include an appearance at the Pine County Fair (we’ll have a booth there).
East Central Housing Organization (ECHO) Effort Will Focus on Seniors ... and more
The local East Central Housing Organization group (ECHO) continues to meet every month in conjunction with support from the Minnesota Housing Partnership project (MHP).
Groups of teams from across the state gather quarterly to compare notes and offer updates to the other teams on what their individual regional groups are working on. Seven County Senior Senior Federation is part of the local ECHO group along with Lakes & Pine, E.C. Regional Development, A Place For You, Mora HRA (Housing Redevelopment Authority), and the MN Housing Partnership.
Areas of the state represented included groups from the Cloquet/Carlton, Brainerd (Central region), St. Cloud is addition to the East Central (Mora) area.
The ECHO group has set one of its goals to assist in the development of affordable senior housing in the region, starting with Mora.
The other goal is to develop a comprehensive regional housing website for all aspects of housing, and services related to housing. Initial estimates for the cost of developing and launching a functioning website for the region are close to $20,000 dollars. Grants and donations will be sought to help cover the cost of this part of the project. Local and regional government entities, as well as businesses will be asked for design content ideas as well for financial support to help maintain the site once it’s up an running.
One of the biggest challenges for developing affordable senior housing is the lack of attention paid to the “affordable” side of the equation. In order to make housing affordable for seniors and attractive to potential developers requires some type of financial program support in the way of low-income tax credits.
As of now, there really isn’t a program or mechanism to acquire subsidies or low-income credits to create exclusively senior housing projects. That information was confirmed and shared by a panel of five (5) different developers who were on hand to give advice and answer questions at the July regional meeting.
The possibilities for moving the project forward include creating development that integrates some general occupancy low-income units as part of the senior housing project. Until funding guidelines change for low-income subsidies for seniors, this is the likeliest option currently available for project development.
EXTRA - EXTRA - READ ALL ABOUT IT...
We will have tax volunteers on site
Wednesday, August 5th
to prepare property tax refunds.
MUST have an appointment
Claims Data Will Now Be Part of DHS/HMO Audits Also… MinnesotaCare and MNsure rescued, but changed
As a result of some dogged determination on the part of Rep. Tina Liebling, stronger measures will be in place to assure more transparency by Health Maintenance Organizations (HMOs) who receive $4 billion dollars per year from the state of Minnesota. The funding dollars are there to administer the state’s low-income healthcare programs, which have been handled by HMOs since the early 1990s.
Some of the language that was inserted as part of amendments offered up by Liebling includes new restrictions on total administrative expense allowed by the HMOs. That number cannot exceed 6.6% of the total that DHS (Dept. of Human Services) pays to them. It’s likely that HMOs will resist by trying to re-classify more admin things as medical, but this amendment will put expenses, and expense requests, under heavy scrutiny.
Additionally, DHS will now be required to audit the paid claims data that it gets from the HMOs. Paid claims data is the breakdown of what treatments were done and how much HMOs pay doctors and hospitals to perform specific services. Individual patient information IS NOT part of paid claims data. Funding is appropriated to do this, and it’s projected that it will be adequate to do all that’s needed to perform the audits. The pressure will be on DHS to determine that the information supplied by the HMOs is accurate and not inflated, as has been suggested by a number of previous investigative audits.
The Liebling amendments will also restrict or exclude certain administrative expenses, especially details on various marketing items. There will also be greater clarity that the only charitable donations allowed will be ones that directly help services under the state programs. This provision could pose a problem for UCare, since most of its large charitable donations to the University of Minnesota are supposedly to help people who are NOT in state health care programs.
One interesting change is that HMO executives must personally certify that they are only including allowable medical and administrative expenses, and not including any they’re not supposed to. It isn’t clear what penalties are attached for violation of this provision.
On their face, these look like very significant improvements. A big thing to look for later this year will be the efforts by Legislative Auditor Jim Nobles to follow through on securing outside audit firms, now that the language is clear and funding is sufficient. Nobles OLA (Office of Legislative Auditor) office has been given new flexibility and funding to hire firms capable of conducting the needed audits. Given the changes put into law it appears that the OLA will be able to do an audit of 2014 expenses.
MNsure and MinnesotaCare
A new task force has been created to take up some of the biggest potential changes to the state’s MNsure exchange after lawmakers couldn’t reach agreement on several competing proposals.
The spending bill that was passed for health and human services does not include House plans to shift MinnesotaCare enrollees to the health exchange next year, nor does it include a House proposal to shut down MNsure in 2017.
The Senate, meanwhile, was unable to move plans forward for MNsure to become more of a traditional state government agency. The MNsure board of directors retains its authority, including choice of MNsure’s top executive.
The final bill health and human services bill included $500,000 for a task force to examine the future of MNsure, MinnesotaCare and the chance for federal waivers that could allow for a broad range of health care reforms. This 29-person task force will be required to provide a report to the Legislature by January 16, 2016. Members of the task force will be appointed by the House, the Senate, and Governor Dayton. It will include representatives from MNsure, health and human services, and the department of commerce.
Minnesota launched the MNsure exchange in 2013 as part of the federal Affordable Care Act. The government-run marketplace had a shaky website rollout which overwhelmed the call center during its first year of operation. Enrollment figures have continued to fall short of initial projections prompting calls for change from both DFLers and the GOP, but the substance of their reform proposals were quite different. They ranged from restructuring/fixing, all the way to complete abandonment of the program.
MNsure will be examined by the aforementioned task force, but broader questions about funding the state’s public health insurance programs will also be considered. The question of whether to combine MNsure and MinnesotaCare will be one of the top priorities. MinnesotaCare covers people with incomes slightly above the poverty level, a group that’s sometimes referred to as the “working poor.” This group is one of the prime beneficiaries of health insurance exchanges in other states, where people access tax credits to help pay for the cost of private insurance coverage. Historically, the reason state lawmakers have maintained MinnesotaCare is the program’s benefit level for enrollees, which provides better coverage than what’s provided for by most private policies.
It’s worth noting that there will be a $65 million dollar funding cut to MinnesotaCare in 2016-17, and a $96 million dollar cut in 2018-19. This will result in a tripling of the out-of-pocket costs for people in the program. This amounts to about $370 per adult per year for folks who are considered the “working poor.”
All of the aforementioned spending/budget proposals are subject to final approval by Governor Dayton, as this edition was in print before that event happened.
2015 Annual Convention Meeting
The 42nd Annual Convention Meeting of the Seven County Senior Federation conducted its festivities on May 7th in Hinckley. The Community Center was the host site in the downtown area of the city, directly across from the historic Hinckley Fire Museum. Nearly 135 people were on hand for the event and the day went by quickly, concluding with the giant raffle for 2015.
All by-law changes were approved as was the 2015 Budget plan. The morning business meeting wrapped up with presentation of issues for selection as the priorities for the next 12 months. Issue priorities were decided by way of delegate balloting. The results of priority balloting were as follows:
#1 State Tax Exemption for Social Security Income
#2 Property Tax Relief for Seniors
#1 Medicare & Social Security Program Protection
#2 Fairer Tax Policy for Seniors and Middle Class
New Officers Elected
Officer Elections were held during the 2015 Convention. Paul Venhuizen ran unopposed for President, as did current Treasurer Joan McClay. Arlene Morgan won her election for the position of 2nd Vice President.
Shown above being sworn in are: (l to r) Mike Hughes (Convention Chair), Joan McClay, Paul Venhuizen and Arlene Morgan. All terms run for 2 years and an officer may serve in 2 consecutive terms in the same elected office.
SCSF Paper Product Drive
Over 500,000 Minnesotans currently participate in the Supplemental Nutrition Assistance Program (SNAP). However, benefits cannot be used to purchase household and personal hygiene supplies or paper products. Because we know these items are necessary yet many will go without due to financial limitations, we are asking everyone to bring one (or more) of the suggested items listed below to the Annual Convention Meeting on May 7, 2015. We will make sure those in need receive them and … Thank you in advance for your generosity.
Paper towels - Toilet Paper - Body Soap
Feminine Products - Shampoo - Kleenex
Conditioner - Shaving razors - Shaving cream
Deodorant - Toothpaste - Lotion
Legislative Auditor’s Report…
The Minnesota legislature put into place a mandated independent audit of the expenses incurred by the state’s HMOs who administer nearly $4 billion dollars in state tax dollars. That’s the current price tag to channel money to healthcare providers for delivery of services to people enrolled in Minnesota’s low-income programs.
Questions and concerns have been raised over the years about the lack of transparency shown by the HMOs in charge of the service, including an ongoing Congressional investigation. A recent OP/ED by the Star Tribune editorial staff helped capsulize the situation and summarized the problem:
“... a report released this week by the respected Office of the Legislative Auditor (OLA) fell short of expectations. In 2012, lawmakers tasked Jim Nobles’ staff with doing a deep dive into the books of the state’s powerful, private nonprofit insurers — Blue Cross Blue Shield, Medica and HealthPartners (and UCare). The goal: to help lawmakers better understand how public dollars for these programs are spent and to address growing concerns that managed-care companies had long been overpaid by the state. A 2012 congressional hearing put a national spotlight on Minnesota managed-care costs, and a 2013 state report concluded that profits had often exceeded state-set targets.
OLA staff members delivered on part of their assignment. Their report provided greater insights into administrative expenses. But the auditors did not complete a critical part of their assignment: hiring an outside firm to scrutinize where most managed-care program funds are spent — on health care." <> 3/13/15
The OLA was tasked with finding an outside auditing firm to conduct the independent audit requested by the law. After a six month, nationwide search the report from Jim Nobles (Legislative Auditor) was that there wasn’t a qualified applicant for the task.
That curious lack of response from qualified applicants help spur requests to Nobles for copies of the Request For Proposals (RFP) he put together for the audit firm search. The OLA was given a budget of $1.9 million dollars to offer in the RFP for audit firms to do the job.
After unsuccessfully locating a firm to conduct the audit, Noble asked for and received permission to conduct the audit through his OLA office. Doing it that way saved taxpayers about a half million dollars, but it totally defeated the purpose of finally having an independent, outside investigation of the HMO expenditures, which is what the committee asked for in the first place.
At a Senate hearing on March 16th there were hard questions asked by the committee about the report’s findings. Many of those questions were not adequately answered. Despite the frustration shown by the Senate Committee, they offered no concrete next steps.
HMO Exemption Hearing… Not Scheduled Yet
An expense disclosure mandate was put into law in 2014 (the "Timberjay" bill). It required all businesses having contracts with the state of Minnesota to provide complete accounting for all expenses. HMOs in Minnesota receive nearly $4 billion dollars annually and, as yet, have not been required to provide the equivalent of an itemized invoice to the state for expenditures of those dollars.
On February 9th the MN Dept. of Human Services (DHS) released a report that was requested by the creation of a law last session. A joint House/Senate committee had asked for and expected the report in early December of 2014. It was due in order to evaluate the request for exemption from expense disclosure from the state’s HMOs.
It’s possible that the two month delay of the DHS report has given the legislature a plausible reason to not call for a discussion and review of the report during the 2015 session. The response from the chairs in both the House and Senate Human Services Committees has been “there’s just not enough time” to fit a hearing in this session. The only glimmer of hope for a hearing came from Sen. Kathy Sheran who expressed possible interest in an “information only” type of hearing (no action could be taken).
If no action is taken the original one-year exemption granted to the HMOs would expire and would require them to disclose their expenses.
Another possible option would be that the HMOs could convince a sympathetic legislator to insert nullifying language in an omnibus bill to allow HMOs a permanent expense disclosure exemption.
Issues Ballot Finalized for Convention Meeting
At the Delegate Assembly meeting held in February, the final issue resolution ballot was agreed upon. The ballot items will be presented at the Annual Convention Meeting on May 7th to determine the top issue priorities for the next 12 months for Seven County Senior Federation.
There will be five (5) issues in the state category and five (5) issue at the federal level. Here are the issues that will be presented at the Convention for discussion and final priority balloting:
The push for transparency & accountability has continued for over 7 years. GMHCC and 7 County have participated in this effort to finally find out how the HMOs spend your tax dollars every year. State law mandates that everyone doing business with the state of Minnesota provide a detailed accounting of expenses. HMO have requested a permanent exemption from this law.
Property Tax Relief For Seniors
The vast majority of seniors are on a fixed income and struggle to make ends meet. Property taxes can present a large problem when they continually climb past the point of affordability for seniors. It would be preferable for seniors to either: 1.) have a cap on their property taxes that is tied to a fixed percentage of their income, or... 2.) freeze property taxes at a specific level and allow taxes to be deferred until the property is sold to another buyer of the property.
MN Health Plan Cost Study
The MN Health Plan is going to be proposed as a healthcare option for Minnesota in 2017 under the terms of the Affordable Care Act. In order for this to be put into place there needs to be a cost study for the bill itself that would describe all of the costs, potential costs, and benefits derived from putting the MN Health Plan into place. The study will cost approximately $200,000 and is to be funded by the state of Minnesota through an appropriation.
Protection of All Water Resources
Our water resources are a finite item - once we use up our supply of potable water all life on the planet is in jeopardy. Technological changes related to oil production by means of fracking pose a risk to surface water, as well as to the aquifers below, as their byproducts are extremely toxic. Currently, the contents of these byproducts are not required to be disclosed to the public. Also massive amount of chemicals used in domestic crop production find their way into our groundwater, lakes and streams.
Further Adjust MN Tax Structure for Top Earners
Low- and middle-income households pay a disproportionate share of Minnesota state and local taxes relative to high income households. The level of taxes are commonly measured in terms of the “effective tax rate” (or ETR), which refers to combined state and local taxes as a percentage of income. In a regressive tax system, low- and middle-income households tend to have higher ETRs than high-income households. In a progressive system, high-income households tend to have higher ETRs. In a proportional tax system, the average ETRs of high- and low-income households are the same. The Tax Act of 2013 in Minnesota helped level the playing field a bit, but more needs to be done to insure that seniors aren’t literally taxed out of their homes.
Protect Medicare & Social Security Structure
There has been renewed talk about completely revamping Social Security (perhaps Chained CPI, or means testing, or privatization) Privatization of Soc. Sec. is one of the dangers of program reform as it would leave the program at the mercy of the stock market, for the most part. Likewise, Medicare is being talked about as a program that needs to be put in the marketplace (privatized) in order to provide “better service and to lower costs.” These are the same talking points that were used to privatize all the MN State healthcare programs with the same promises; more access and lower costs… neither of which has come true. Both programs need reform, but the reforms talked about so far have not considered some better alternatives - like raising the cap on wages to $200,000 to bolster Social Security funding.
Campaign Finance Reform
Since the passage of Citizens United the cost of elections has continued to skyrocket. Big money interests are pouring millions of dollars into campaigns nationwide in hopes of electing their candidate to office. The fact that here are virtually no limits to contributions (through PACS and Super PACS) is made worse by the fact that they are mostly anonymous - disclosure has been all but eliminated. People need to decide elections, not corporate money.
Fairer Taxation Policy For Middle Class and Seniors
Closing corporate tax loopholes for businesses sheltering profits in offshore/overseas accounts in order to avoid paying taxes and should be a priority. Offering incentives for businesses that expand operations in the United States should be strongly considered. The more that corporations are allowed to avoid paying taxes the bigger the tax burden will be on individuals to make up for the shortfall. This burden falls heavily on the rapidly shrinking middle-class, and especially affects seniors on fixed incomes.
HMO Transparency for Medicare and Medicaid
The push for transparency & accountability has continued for over 7 years. GMHCC and 7 County have participated in this effort to finally find out how the HMOs spend your tax dollars every year. Medicaid and Medicare dollars flow into the state and our MN Dept. of Human Services has not been able to produce a breakdown of how $4 billion dollars per year are spent in administering the HMO-run state healthcare programs. Taxpayers deserve to know how their tax dollars are being spent on ALL levels… city, county state, and federal.
Few people now deny that our climate is changing rapidly, but the debate on what the causes are continue unabated. A small, but very loud segment of the population insists that human activities are not the major factor in climate change. And in that small group a number of them argue that there is little impact that is attributable to human activities at all, despite overwhelming evidence to the contrary. We are not scientists, but we know many people who are and we should look to them for advice and guidance when setting policy for the future.
Listening Session with Rep. Erin Murphy
Rep. Erin Murphy, Deputy Minority Leader of the MN House of Representatives paid a visit to the area on February 13th. Her goal was to hear about the concerns and needs of seniors, as well as those of the local business community. Rep. Murphy received input from a number of people including Mora Mayor Jack L’Heureux, Jere Bartz (Bartz Accounting), Karen Amundsen (Exec. Director Mora Chamber of Commerce), Lila Skramstad (past president of Seven County), Joan McClay (treasurer of Seven County), and Shannon Jackson (Communications Coordinator at Seven County). Murphy will return to Mora to take a guided tour of local business operations in the near future.
Regional Housing Work Group
Representatives from local agencies have agreed to take part in a regional housing program. The organizing and funding agency is the MN Housing Partnership in conjunction with the Greater MN Housing Fund. Team ECHO (East Central Housing Opportunities) includes: (L to R) Tim Burkhardt (Exec. Director of Seven County), Rose Dunn (Mora HRA), Mary Kay Sloan (a Place For You founder), Cherre Palenius (MHP), Jennifer Russell (Econ. Dev. Director ECRDC), Deanna Hemmesch (Exec. Dir. Central MN Housing Partnership), and Lezlie Sauter (Agency Planner Lakes & Pines).
“Designing Our Destiny”
Aging Ain’t for Sissies… Challenges, Opportunities, and Affordability
Seniors and retirees are invited to attend the 39th Minnesota Gerontological Society’s Annual Conference entitled “Designing Our Destiny” coming up on April 24, 2015.
This day-long conference runs from 8:00AM - 4:00 PM (7 - 8AM registration and networking). It will be held at the Earle Brown Heritage Center, Brooklyn Center, MN. The cost is $45.00 which includes: coffee, lunch, a post conference reception, and prize drawings.
To register: Go to mngero.org or call (952) 829-5937
7C Issue Committee
The Seven County Issues Advocacy Committee met on January 21st to establish specific issue items for the 2015 Annual Convention Meeting coming up in May.
A broad ranging discussion culminated with the creation of a substantial list of possible priority issues for Seven County for the coming year. A total of eight (8) possible state issues (Minnesota) were agreed upon, as were a total of nine (9) Federal issues.
The next step in this process will be the presentation of theses possible priority issues at the February 12th Delegate Assembly meeting.
Delegates will discuss the issues at the February meeting and will vote for their preferences. They will select five issues that they feel belong on the final ballot to be established for the Convention Meeting on May 7th.
HMO Exemption Delay
The 2014 Legislature passed a reporting bill for all entities doing business and receiving funds from the state of Minnesota. This common sense, bipartisan business legislation was created to bring some much needed transparency to government contracting in the state. It was spurred in large part by action taken by the Ely Timberjay newspaper related to suspected “sweetheart” deals or no-bid contracts with the vendors to Minnesota schools.
In effect, the legislation said that all businesses with government contracts had to disclose how they spent those tax dollars.
There were no objections by any business entitles in the state except for one; the state’s non-profit insurance companies.
The HMOs (Health Maintenance Organizations) doing business asked for and received a temporary exemption from disclosing how they spend the $4 billion dollars they get annually from the state. HMOs contend that disclosing how they spend the contract dollars will jeopardize pricing by potentially raising rates for people covered under one of the plans they administer.
The argument that rates would go up with payment disclosure was addressed by an amendment that directed DHS (Department of Human Services) to investigate those HMO claims of rate hikes. DHS was to submit its finding to a Health Committee panel by December 21, 2014. That allowed over 6 months for DHS to complete their task.
The DHS representative who appeared at the December 21st meeting informed the committee that they had not completed the report. Rep. John Lesch, who chaired the Dec. 21st meeting, stated emphatically “This really stinks…” when informed that the DHS report would not be ready.
DHS has promised to have the finished report delivered by mid-February, where it’s expected to be delivered to the House Civil Law Committee and the Senate Judiciary Committee. All comments received by DHS from those for and against the exemption, including some from GMHCC, will be included.
At the Annual Volunteer Christmas luncheon in December a number of Seven County/One More Time Store volunteers were recognized for their hours of dedicated service.
Shown above (l to r): Bob Larson (1,313 volunteer hours), Fran Levings-Baker (SCSF President), Cleo Neff (1,170 hours), and Carolyn Wicklund (1,060 hours).
Many thanks to all of our hard working and friendly volunteers!
2014 Summary of Seven County Activities:
« Over 225 people received FREE tax preparation assistance
« 312 people took one of our 55+ Senior Defensive Driver courses
« 261 people received FREE Medicare and/or insurance counseling
« Hosted over 140 people at our annual potluck fundraiser in Hinckley in September
« Over 100 people took part in our 2014 Annual Meeting in May
« Made appearances in 24 community celebrations, parades, and health/business expos
« 42 Families in need received FREE household goods from our One More Time Stores as referred by churches, social service agencies or other non-profits.
« 132 individuals in need received FREE household goods from our One More Time Stores
« Over 1,600 people renewed their membership in Seven County Senior Federation
« 140+ Volunteers donated almost 25,000 hours to Seven County in 2014
“What we do… by the numbers”
Thanksgiving Prize Winners
The 2014 winner of the Thanksgiving drawing at our Isle One More Time store was Kathy Perkins of Wahkon (left photo). Also shown is Karen Ladwig (right photo) of Brook Park who was the lucky winner in our Annual Turkey Giveaway promotion at our One More Time store in Mora. Congratulations to both winners and thanks to all of our loyal shoppers and supporters.
As directed by the legislature in 2014, a committee charged with examining an exemption request from the state’s HMOs met recently in St. Paul to take testimony from all parties.
The issue of information disclosure was part of a bill passed in 2014 now known as the Timberjay Bill. That bill restored the right of the public and media to obtain details of public contracts and projects associated with them and requires disclosure of detailed expenses. It was intieated through the effrots and support of the Ely Timberjay and the MN Newspaper Association. They contended that government expenditures of tax dollars needed to be transparent for any entity having a contract with the state of Minnesota.
The state’s HMOs are pushing for an exemption to that law. They publicly stated that it would “adversely affect insurance premiums” if they (the HMOs) were required to disclose how they were spending the $3 billion tax dollars received each year from the state of Minnesota.
A recent court case in Michigan was brought by Hi-Lex Corporation seeking similar transparency from Blue Cross Blue Shield. Hi-Lex was awarded damages against that insurance company (Blue Cross) for violations related to their fiduciary responsibility regarding transparency and disclosure.
For an audio link to the hearing: http://bit.ly/1tIyfay
Senior Defensive Driving Classes
2014 was another busy year for Seven County as we sponsored our Senior Defensive Driving classes and helped over 300 people earn discounts on their auto insurance in the process. The Senior Federation has helped put on these classes for well over 20 years and their popularity continues to grow each year. To qualify for the refresher class people must first take the initial eight(8) hour instruction. Seven County plans to offer the 8-hour initial class on an as needed basis, as the minimum class size has to be at least 12 people. For information about the programs call the Seven County office.
And don’t forget…
We offer a 4-hour refresher course every month (except December) for Defensive Driving for Seniors. The classes are held at the Mora Public Library. The cost is $15 for members, $20 for non-members.
AND… Income Tax Preparation services for seniors and low income families will get started on Wednesday Feb. 25th and will run every Wednesday thereafter until April 15th.
FOR MORE DETAILS… about either of these service programs call or stop by our office in Mora.
(320) 679-4700 or (866) 679-4700
More Tax Volunteers Needed For 2015 Season
Seven County Senior Federation, in cooperation with AARP, will bring free income tax preparation services to the region. Starting on February 25, 2015 from 9 a.m. - 3 p.m. (by appointment ONLY), tax preparation services will again be offered to seniors and low-income families at our downtown Mora office. This service has been offered for nearly 25 years by the Senior Federation. This year, as in years past, there are a number of volunteer positions that will need to be filled in order to provide this free service to as many people as possible during the upcoming tax season.
There are five positions that people may apply for if they’re interested. They include: The Client Facilitator position, District Coordinator, Local Coordinator, Counselor, and Technology Coordinator. These positions are mostly self-described in their titles and are all critical elements to maintaining a strong tax program for this region. Training for all of these positions is provided courtesy of AARP. Lunch is also provided for tax volunteers at the Mora site throughout the tax season. According to an AARP spokesman, the greatest need is for more Counselors (tax preparers), as it’s good to have at least six or seven just to meet the growing need. There are also needs for Counselors in other tax preparation sites, such as in Cambridge, Sandstone and North Branch.
(Page 3 of Echoes has details on all 2015 Tax Volunteer opportunities along with complete descriptions of the open positions and how to apply).
GMHCC Meets With DHS Commissioner
Greater Minnesota Health Care Coalition members (GMHCC) traveled to St. Paul in August to meet with Lucinda Jesson, Dept. of Human Services Commissioner for the state of Minnesota.
The meeting was designed to continue a dialogue that started over 2 years ago when Jesson was named to the post and GMHCC was one of the first groups to secure an audience with her. Subject matters discussed were very similar to those that started 2 years ago, but with updated information and experience added by GMHCC and Commissioner Jesson. It’s safe to say that there has been lots of healthcare activity since the last time a meeting took place, both nationally and locally in Minnesota.
The Affordable Care Act launched nationally last Fall, and MNSure debuted at the same time in Minnesota. Both programs had shaky rollouts but seem to have stabilized in the interim. Both topics were discussed briefly but were not the centerpiece of discussions.
As most of you know, GMHCC and its allies have been working for over 6 years to finally bring transparency and accountability to the subject of healthcare costs in Minnesota related to state sponsored programs run by HMOs (over $3 billion tax dollars per year). An independent report by the Segal Corporation following an internal examination of the facts confirmed that there are significant deficiencies in the accounting practices being used by DHS and the HMOs they work with.
The legislature passed a law in 2010 that mandated that DHS collect encounter data from the HMOs. DHS was then supposed to use that data in their annual rate setting process to adjust payments to the HMOs. According to all external indications, this has not taken place in any meaningful way… yet.
~ Commissioner Jesson stated that changes are being made in this regard (encounter data used for rate setting). She went on to defend the actions taken by DHS under her leadership, including the issue of rehiring the Milliman (of Milwakee) accounting firm in the fall of 2013. The change was made following Jesson's statement in early 2013 that DHS had fired Milliman (of Minneapolis) as the state's accounting/auditing firm. The commissioner reiterated that a number of changes will likely be evident within the next 12 months as the tracking systems catch up with the changes.
DHS Commissioner Lucinda Jesson
Health Reform Allies to Meet in September
A large contingent of healthcare reform allies from across the state will be meeting in downtown St. Paul in early September. The meeting is being coordinated by HCAMn (Health Care for All Minnesota) and is hosted by the MNA (MN Nurses Association).
Among an impressive list of other invitees are: Growth and Justice, SEIU Healthcare MN, Minnesota Nurses Association, Minnesota AIDS Project, MN Federation of Teacher Local 59, Physicians for a National Health Plan (PNHP), TakeActionMN, Catholic Charities, Metro Independent Business Association, Children’s Defense Fund as well as HCAMn. These groups have confirmed their attendance and over a dozen more are invited.
It was approximately one year ago when a similar group met in St. Paul and heard (via Skype) from Dr. Deborah Richter of Montpelier, VT. Dr. Richter has specialized in healthcare systems creation and has spoken to countless groups within communities and medical groups about the need for universal access to healthcare.
The upcoming September meeting will focus on the events and activity of the past year in health reform, not the least of which is the implementation of the ACA (Affordable Care Act) and its impact on reform. There are a number of pluses that came with the ACA (extension of children’s coverage until age 26, no denial of services due to pre-existing conditions, and more), but the rocky rollout of the program cast a bit of a shadow on the entire program.
One of the stated goals of the meeting of allies is to discuss the different policy options and strategies which use the ACA State Innovation Waiver in order to progress toward a universal, single-payer type health care system.
The realistic possibility of progress on health reform is made possible because the ACA’s State Innovation Waiver allows states to pursue their own innovative strategies to ensure their residents have access to high quality, affordable health care. As the ACA didn’t go nearly far enough, in the opinion of health reform allies (and over 60% of the general public), the need for more significant changes in healthcare delivery and payment are still much needed.
For instance, even though the uninsured rate in Minnesota dropped by 41% as a result of the ACA, private health insurance companies are still refusing to pay for some medical care that should be covered. This forces many patients to pick up a larger share of the bill because benefits were designed to make the sickest patients pay more for services and prescriptions. It also limited access to doctors and hospitals. The ACA did well to expand private health insurance coverage, but for many individuals and businesses that insurance will still be costly, have high deductibles and co-pays and leave some Minnesotans out altogether.
The coalition of health reform allies will be working to address most all of the shortcomings of the ACA, as progress is made towards a universal, single payer health system.
Information and Messaging Specialist
Seven County Senior Federation has a current opening for a full time Information and Messaging Specialist. The ideal candidate will be skilled in writing, marketing, communication and be capable of effectively educating the general public about our organization and services through a variety of mediums (print, web, video, radio, etc.). This paid position is being offered through AmeriCorps VISTA (Volunteers In Service To America) and offers a choice of education award or end of service stipend, training, childcare assistance if eligible, relocation allowance, health coverage, and a living allowance.
Interested candidates can review a more detailed job description and VISTA guidelines at my.americorps.gov and search for Seven County Senior Federation, or by contacting: Shannon Jackson at 320.679.4700 or toll-free 866.679.4700.
Members will Win Prizes
for Recruiting New Members
Is your copy of the ECHOES always read cover-to-cover? Would you like a friend or neighbor to enjoy our ECHOES newspaper as much as you do? Recruit them as a NEW Member and YOU can earn a valuable prize, now through August! Anyone age 50 or better is a candidate!
- Bring in one of our first 50 NEW Members and we’ll reward you with a $5 gift certificate to spend at the One More Time Stores. That’s $5 for each one!
- Every member who recruits a NEW Member by Aug 31st will be entered to win a $200 travel voucher courtesy of FirstWorld Travel (toward a flight, a day trip or a cruise!?)
It’s our Member Drive (we’re overdue; our last one took place during the Reagan administration)! Just for you, we’ve designed a form on page 6 of ECHOES to make it easy for you to tell us about the NEW Member you have found.
We love our current members and want to reward their efforts to find the next generation of members. So please, only members who find a NEW member (not a renewal) will count for the summer prizes of $5 gift certificates and the travel voucher drawing.
Why all this effort? To keep the Seven County Senior Federation vital and relevant, it is time to attract more potential members (yes, older adults across our seven county region and beyond). To build momentum, the Membership Committee aims to increase the NEW Members in our worthy organization as we start out our 41st year.
“We are asking that each Member do their part, too, by recruiting a neighbor, friend, or relative to become a NEW Member of this worthwhile organization… no better time than this summer!” says Christine Bergman, chair of the Membership Committee. “Our budget suggests 84 NEW Members as a goal. We need NEW members with new insights & ideas on solving the problems & needs of older adults.”
Watch our progress here in the ECHOES as we aim for 84 NEW Members this summer! Good luck!
The NEW member you have recruited will get our ECHOES mailed to their doorstep; know how easy it is to have ready access to real people with real answers; earn extra discounts every last Saturday at our One More Time Stores in Mora and Isle; earn tuition discounts on our Defensive Driving 55+ courses; connect with like-minded neighbors at our spring Annual Meeting & our autumn giant Potluck. As an excellent introduction to our services and programs, it’s a great gift!
Delegates Authorize Small Raise
In Membership Fees For 2014
As part of the Annual Meeting’s business on May 1st, the gathered voters approved a slight increase in membership fees starting June 1, 2014.
On that date membership fee structures will change as follows:
* Single $15 year
* Household of two $25 year
* Auxiliary $10 year
The old rates had been in effect since 2002 and were a discussion item for review and/or change when the 2014 budget was put together in December 2013.
For folks whose membership are due to expire later this year, you can still take advantage of the old rates if you want to renew before the June 1st deadline. Anyone who does renew early can just extend their membership from their existing membership expiration date.
Seven County Senior Federation
Executive Board for 2014-15
Officer elections held during the Annual Membership Meeting on May 1st selected two candidates to fill offices whose terms had expired. Re-elected for a 2nd term to the office of 1st Vice President was Bob Skogman of Isle. Elected for a 1st term as Secretary of the Seven County Senior Federation was Majal Johnson of Mora. Both terms run for a period of two (2) years each. The complete Executive Board:
Fran Levings-Baker Bob Skogman
President 1st Vice President
Markville, MN Isle, MN
Patrice Winfield Majal Johnson
2nd Vice President Secretary
Cloverton, MN Mora, MN
2014 Issue Priorities (as endorsed May 1st)
for Seven County Senior Federation
Property Tax Relief For Seniors
Minnesota Health Plan Support
Fairer Taxation Policy
Social Security & Medicare Reform
The East Central Business & Commerce Expo was held at the Mora Civic Center on April 11-12, 2014. Congratulations to the randomly chosen winners at the Seven County Senior Federation booth:
Winners of $5.00 gift certificate to One More Time Thrift Stores
- Vivian Barker, Mora
- Earl Molin, Mora
- Sheldon Sandberg, Mora
- Bart Swanson, Ogilvie
- Dianne Larson, Mora
- James Rogers, Mora
- Jaclyn Heyen, Mora
- Aaron Lang, St. Cloud
- Bonnie Ordner, Rush City
- Judy Bergstadt, Mora
Winners of a year’s membership in the Seven County Senior Federation
- Christie Koran, Ogilvie
- Annette Lindstrom, Pine City
- Rich Campbell, Brook Park
- Lenny Weber, Hinckley
- Pat Hokanson, Mora
- Joan Erickson, Mora
- Donna Youngquist, Mora*
*Member whose current status will be extended.
MN Health Department Report Shows Where Your Healthcare Tax Dollars Go
The Minnesota Dept. of Health (MDH) has released a report which was instigated, in no small part, because of continuing efforts by the Greater MN Health Care Coalition (GMHCC). Entitled “Study of Capital Reserve Limits in Minnesota,” the 210 page MDH study examined the amount and origin of capital (money) accumulated by HMOs and insurance companies running the state’s healthcare programs.
A number of interesting and revealing facts were contained in the report, not the least of which was the upward trend of capital accumulation by theses insurers. Since 2003, reserves have risen 112% for HMOs and insurance companies who administer health programs in the state. GMHCC has tracked this information for a number of years and has constantly pushed for an examination of practices used by the aforementioned insurance entities. The new MDH report pulls back the curtain just a bit on the capital accumulation designated as “reserves.”
Presently, there is no upper limit on HMO’s reserve accumulation due to the removal of an upper limit by the legislature in 2003. GMHCC is pushing to have the cap on reserves reinstated, as a number of HMOs have accumulated 3 to 4 times the amount recommended by the Nat’l Assoc. of Insurance Commissioners (NAIC).
The report contains many items of concern, but one alarming note that caught the eye of many healthcare advocates is a statement in the report that says “It is difficult to estimate the portion of reserves that is due to earnings from Minnesota’s public health care programs.” It’s alarming because dollars generated by insurance company sales to the general public are not to be co-mingled with funds (tax dollars) received from the state to run state healthcare programs.
A link to the 4-page MDH summary report can be found at: http://bit.ly/NoJR4K
Legislative Auditor Releases Update on HMO Accounting Mandates
In 2012 the Office of Legislative Auditor (OLA) was directed to fulfill a mandate to find an outside accounting firm to examine the payment practices of HMOs and insurance companies. These are the same entities who administer state healthcare programs which total over $3 billion dollars per year in taxpayer funds.
Two years after the legislation was passed, the OLA (headed up by Legislative Auditor Jim Nobles) has indicated that they have been unable to find a qualified accounting firm to conduct the outside audit of those programs, despite a nationwide search.
In a letter to the chairs of the Senate and House Human Services Committees, Sen. Tony Lourey and Rep. Tom Huntley, respectively, Auditor Jim Nobles wrote:
“I am writing to inform you that after many months of efforts, the Office of the Legislative Auditor (OLA) was unable to secure the services of a qualified accounting firm that was, in our opinion, adequately independent to conduct the audit.”
Members of the Greater MN Health Care Coalition (GMHCC) met in March and discussed the action taken by Nobles in response to the 2012 legislative outside accounting mandate. The consensus was that this response from the OLA was grossly insufficient and didn’t come close to meeting the intent of the original legislation, vis-a-vis the need for outside auditing.
Nobles response also contained a request for the wording of the legislation to be changed in order to allow the OLA to be in compliance, albeit retroactively. In response to language that the audit be conducted independently, Nobles stated his request thusly:
“To avoid any misunderstanding concerning how OLA is fulfilling the legislative mandate, I would appreciate a change in the language that was adopted in 2012 to reflect that the audit will be conducted by the Office of the Legislative Auditor, not an outside audit firm.”
His suggestion that language be weakened considerably was also part of his request to the House and Senate Legislative Committees that oversee healthcare in Minnesota. These changes have the effect of rendering almost the entire 2012 audit legislation meaningless when it comes to transparency and oversight.
GMHCC sent a comment/response letter to the House and Senate Committees who will make the decision on how to respond.
2014 Annual Membership Meeting
Thursday, May 1, 2014
Fish Lake Resort of Mora
Coffee at 9:00 a.m. Meeting at 9:30 a.m.
Formerly known as the Annual Convention, the 2014 Annual Membership Meeting will: conduct Officer Elections, debate and decide 2014-15 Issue Priorities, review and approve the 2014 Budget, feature a FAQ session where members can ask questions on any Seven County topic, and... the meeting will also highlight an encore presentation by special guest David Feinwachs on the topic of HMO Transparency and Accountability.
We will be serving coffee and snacks before the
meeting starts and lunch will be served at 12 noon.
Pre-payment required, reserve your spot today!
2014 Legislative focus will be narrow and brief in MN
The 2014 legislative session in Minnesota is likely to be an interesting foray into the world of efficiency, clarity, and brevity; words that don’t often appear in the same sentence with the legislative process at any level.
The brevity part already has its parameters laid out on the calendar with a February 25th start date and a May 19th end date. That’s less than 90 days to accomplish the state’s work. With recent budget forecasts showing a state surplus in the range of around $1 billion dollars, there will be plenty of impassioned suggestions as to what to do with those (tax) dollars.
One train of thought says that there are pressing and neglected needs in the state that must be addressed, like those of transportation, road/bridge repair, and education. The logic that’s used to support those causes revolves around those issues being shortchanged and ignored in previous bienniums and their related bonding proposals. Supporters see this as an opportunity to invest in the future of the state.
Another train of thought is that the current surplus has been created by overtaxing the people of Minnesota. This perspective opines that those surplus dollars should go back to the people of Minnesota. Supporters of this point of view see this as a responsible, common sense, and fiscally sound approach to managing the state’s revenues.
The clarity part of this session will be to see how effective each side is at selling their message to their fellow legislators and the constituents in their home districts. It will be important to compose a clear, simple message. Whichever side creates the best message to the masses will likely have more of their ideas prevail. The goal of getting to a resolution and some helpful legislation at the end of the session should drive the discussion.
If one side is able to be more efficient in getting their message out broadly and consistently, they may just change the tipping point of where tax dollars are, or are not, spent.
This brings us back to the starting point of brevity. In addition to being a bonding year this is also an election year in the MN House. As a result, it’s likely that the discussions of minimum wage, Sunday liquor sales and medical marijuana (and more) will be used as both a shield and a lance, depending on which side of the issue you sit on.
Seven County applies to 2014 VISTA program
Seven County Senior Federation has submitted an initial application to be considered as a host site for a VISTA volunteer for the 2014-15 project year.
The focus of the proposed Seven County VISTA project will be the coordination of program promotion and expansion within the service area. Programs like the Senior Defensive Driving courses, FREE income tax prep services, Senior Partners Care, Medicare/Insurance counseling, and program referral services, would be the focus of the new coordinated program promotion efforts.
Application for the VISTA program in this region is handled by CMIF (Central Minnesota Initiative Foundation) as the sponsoring organization.
As an AmeriCorps VISTA sponsoring organization, CMIF oversees the recruiting, placement, training and supervision of 20 VISTA members across Central Minnesota. Host sites interview and select their own VISTAs from a pool of local and national candidates.
Interested applicants follow this link - https://my.americorps.gov/mp/listing/viewListing.do?id=54088&fromSearch=true
Executive Board News
Joan McClay of the Mora area has been named to fill the balance of the Treasurer’s term left vacant by former Treasurer, Kathy Kawalek. Kathy has moved out of the area to the Twin Cities and resigned her post in December.
At the January Delegate Assembly meeting of the Seven County Senior Federation, Joan McClay agreed to have her name submitted for nomination to fill the vacancy.
The January assembly, by a unanimous vote, approved her for the unexpired term of office. The current term of the Treasurer’s position runs through spring of 2015.
There will be two Executive Board spots up for election this year at the Seven County Annual Membership meeting (formerly called the Annual Convention). Officer terms are for two (2) years with a maximum of 2 consecutive terms served in the same office.
This year’s meeting will take place on Thursday, May 1st and will be held in Kanabec County at a site to be determined.
Members interested in running for one of the open offices this year should call Shannon at Seven County: (320) 679-4700.
As per the By-Laws, the 2014 open offices are:
1st Vice-President - The First Vice-President shall represent the President in all areas where the President is unable to be present. The First Vice-President shall preside over the Issues Standing Committee. The First Vice-President shall monitor delegate representation and shall keep the Seven County Senior Federation abreast of any changes in representation that occur.
Secretary - The Recording Secretary shall record the minutes of the Delegate Assembly, Steering Committee meetings, and Annual Convention (now Annual Membership Meeting).
From the President's Desk ...
By Fran Levings-Baker
When I retired in 1996, I immediately joined a Book Club. My membership lasted about three months before I decided it wasn't working for me. To begin with, many of the club members did not read the selected books. Secondly, the conversation always drifted to a gab-fest and lastly, I realized that I was hogging all of the discussion. Loving to talk about books, I hardly gave anyone else a chance to speak.
My husband, Dave Baker, and I now refer to ourselves as a Book Club. It is very common for us to continually ask each other what we are reading now and thus beginning a discussion. With this annual Echoes article of reporting on my favorite reads for the past year, I am going to include some of his most memorable books also.
His brow being much higher than mine (he reads some pretty intellectual stuff); Dave especially enjoyed INVADING TIBET and TIME TRAVELER. The latter deals with paleontology. His favorite fiction book in 2013 was BLEEDING EDGE by Thomas Pynchon. Mr. Pynchon has been short-listed for the Nobel Prize for several years now.
LET THE GREAT WORLD SPIN by Colum McCann was my favorite novel for 2013. The chapters are interspersed by other chapters detailing the 1974 walk on a tightrope stretching between the Twin Towers in NYC. I kept wondering what the author had in mind when he put these chapters into the plot. I think now he was trying to say that we are all walking a tightrope-that's what life is.
A second favorite from last year for me was by the same author- TRANSLANTIC. Spanning three generations and moving back & forward in time, we follow the stories of some incredibly believable people. BEAUTIFUL RUINS by Jess Walter has a theme of love and ruin in the lives of some people we come to care about. Not only did I enjoy this book, but Communications Coordinator Shannon Jackson also liked it. An absolutely heart-wrenching story was THE UNNAMED by Joshua Ferris. It is the story of a man with a medical condition-unnamed and untreatable-which causes him to walk nonstop.
Seven-County member Don Smith, Duquette, recommended THE UNLIKELY PILGRIMAGE OF HAROLD FRY by Rachel Joyce. What a story! Thanks, Don.
Taking Action On Priority Issues
By Patrice Winfield, 2nd Vice-President
Every year at our Seven County Senior Federation Convention/Annual Membership Meeting we vote on the issues we want our organization to work on through the coming year. We choose two Federal issues and two State issues that we, as members, consider to be the most important to improve our lives and the lives of those we care about. Unfortunately for many, if not most of us, that’s where our interest in the issue ends. We all have busy lives and we figure it’s up to the board or the “organization” to implement the policies we have chosen. To some extent we are right, but in a democracy, citizenship requires more than just voting and I would like to share with you an easy and even fun way to get more involved in the State level issues.
I know not every Seven County member is computer savvy, but for those of you who are, I would like to introduce you to a very helpful website. If you go to www.leg.state.mn.us you will be able to access everything you would ever want to know about what the Minnesota State Legislature is doing. You can easily find a particular topic, committee, bill or legislator. At our last Convention, the two State Issues that received the most votes were “The Minnesota Health Plan” and “Property Tax Relief”. I’ll use “property tax” for my example. Once you’re on the main page under “Bill Search & Status” you can choose, for example, “House Bills by: Author, Topic, Committee or Action”. If you click on “Topic” you get a list of all bill topics. Scroll down to “Taxation-Property”, highlight it, click on “go” and you’ll have a list of bills that deal with property tax. By reading the short description, you should be able to find a pertinent bill. This is just one small example of how to find what you’re looking for.
There is so much more you can do with this website, I couldn’t possibly give you examples for everything, so just play around with it for a while. I think you’ll soon find it very easy to navigate. I found that one of the best features on this site is the “My Bills” option, under “Bill Search & Status”. There, you can set up an account to track certain bills and you will automatically get an e-mail whenever any action is taken on the Bills you choose to follow. Another helpful feature is the “How Do I...” section.
If you don’t know who your representatives are or how to reach them, you can get that information by clicking on “Who Represents Me?”. Once you get the names, of both State and Federal Senators and Representatives, click on a name and you’ll be taken to their website which will have all their contact information.
If you want to make a difference, get involved. See what’s going on in your government. Contact the people who represent you and tell them what you want them to do. How are they going to know how you feel about particular subject if you don’t tell them? This website makes it easy, so check it out. The next Minnesota Legislative Session starts February 25, 2014. www.leg.state.mn.us
Some great memories from years gone by...
Kawalek Retires From Board
~Interim Treasurer Being Sought~
Current Seven County Treasurer Kathy Kawalek announced her plan to resign as Treasurer effective the end of 2013. Kathy has sold her home in Kanabec County and will be moving to the Twin City area to be closer to family. Her oversight of financial matters as part of the Treasurer position, as well as her input on many topics, has had a very positive impact on the organization. Seven County is very appreciative of her time, efforts and expertise.
In the interim, Seven County is looking to fill the Treasurer position, at least on an interim basis, until our Annual Convention, or perhaps to complete the rest of the existing term (2015). Nominations, volunteers or officer suggestions are welcome. For more information or to ask questions about the position, please contact Shannon Jackson who provides staff support for the nominations committee. (320) 679-4700
Gift Certificates to One More Time Stores are the ideal
gift for that special person in your life… and they help support the Seven County Senior Federation.
You can purchase them at our One More Time Stores (located in Mora or Isle), or stop by our Mora office!
Tax Preparation Program Returns to Seven County
A 20 year tradition service offering, that was interrupted last year, will be returning to Seven County in 2014. The free income tax preparation service targeted at seniors and low-income families will be part of the organization’s 2014 service program offerings for the coming tax season.
Volunteers have been recruited and specialized training is continuing in advance of the target start date in early February of 2014. As in years past, there is no charge for this service that provides simple tax preparation to those individuals who are qualified, but donations are welcome and encouraged to help offset the costs associated with training and hosting of this program.
The program, which began over 20 years ago in Seven County, allows senior citizens with simple tax returns (non-itemized filers) to get their returns prepared for free. Also, low income families (200% of federal poverty guidelines) may also get their tax returns prepared under this program.
All appointments will be made for Wednesdays during the tax season and the first date for the service will be on Wednesday, Feb. 12th. Hours set for appointments will run from a 9 a.m. until 3 p.m. start times.
Registration for appointments will begin in mid-January and can be made by calling the Seven County office in Mora @ 320-679-4700 ot toll-free 866-679-4700.
Charitable Donations to Seven County are Tax Deductible
In general, an individual who itemizes deductions may deduct contributions to most charitable organizations up to 50% of his or her adjusted gross income computed without regard to net operating loss carrybacks. Individuals generally may deduct charitable contributions to other organizations up to 30% of their adjusted gross income (computed without regard to net operating loss carrybacks).
There are a number of ways individuals can donate to the charity or non-profit of their choice, with the simplest being a monetary contribution. It’s wise to make sure that the charity you are considering making a donation to is truly a registered non-profit in good standing and therefore eligible to receive tax deductible donations. Two important places to look are the MN Attorney General website and also the IRS Charity/Non-profit website. Seven County is registered and in good standing with both entities. They can be found at: http://1.usa.gov/19eOFhE (IRS report) and at: http://bit.ly/18XY0Ou (Attorney General report).
Charitable donations can also be made in the form of a bequest noted in a person’s will or in a qualified charitable distribution (QCD). A QCD is an otherwise taxable distribution from an IRA (other than an ongoing SEP or SIMPLE IRA) owned by an individual who is age 70½ or over that is paid directly from the IRA to a qualified charity. An IRA owner can exclude from gross income up to $100,000 of a QCD made for a year, and a QCD can be used to satisfy any IRA required minimum distributions (RMDs) for the year. Also, the amount of a QCD excluded from gross income is not taken into account in determining any deduction for charitable contributions. The American Taxpayer Relief Act of 2012 (ATRA) extended the qualified charitable distribution (QCD) provisions for 2012 and 2013. For additional information you can go to the IRS website: http://1.usa.gov/1bGb25r. For updated information on this possibility it’s good to consult with your tax preparer or financial planner.
55+ Defensive Driving Program To Change Slightly in 2014
The extremely popular and cost-saving 55+ Defensive Driving© classes, sponsored by the Minnesota Safety Council and hosted by Seven County, will undergo a couple of program changes in 2014.
The first change will be in the way the program payments are handled. For those enrolling in either the 4-hour refresher class, or the 8-hour Defensive Driving initial class, pre-payment will be required.
The second change will be in the cost of the two programs. The new rate will be the same for either the 4-hour or 8-hour classes; $15 for Seven County members and $20 for non-members (a substantial discount) .
In addition to sharpening your driving awareness skills and learning some updated rules of the road, there is an additional benefit. People who complete the certified 55+ Defensive Driving© class will be eligible for a noticeable discount in their automobile insurance rates, somewhere in the neighborhood of 10%.
As in year’s past, Seven County Senior Federation will be offering the 4-hour refresher classes every month except December. The 8-hour initial classes will be offered at least twice per year. They will be publicized well in advance of their scheduled date, both in monthly ECHOES editions, as well as local radio stations and newspapers.
To register for a class you can either stop by the office in downtown Mora (47 N Park Street) or call ahead (320-679-4700 or toll-free 866-679-4700) to save your spot.
Pre-registration and prepayment are required in order to have the proper amount of course materials and certificates on hand the day of the class.
How Will 2013 Budget Affect Seniors?
by: Tim Burkhardt
The federal government shutdown has ended and a bipartisan Budget Committee has been selected by both houses of Congress. So what happens next and what will those talks do for seniors?
The recent legislation that was passed gives the President authority to raise the debt limit until Feb. 7, 2014. During this period, Congress would have to vote to actively prevent an increase.
After February 7th, the Administration would retain its current flexibility to take “extraordinary measures” to delay hitting the debt ceiling, and it’s unclear whether a new limit would be reached in a matter of weeks or months. At that point, it would be up to Congress to raise the limit again.
For now, sufficient resources are available to continue paying Social Security and Medicare benefits, as well as other government obligations.
Under the agreement, Congress provided short-term funding for federal government programs through a continuing resolution (CR) through Jan. 15, 2014. That funding level is the same as fiscal year 2013, a post-sequester amount totaling $986.3 billion.
On Jan. 15th, an “enforcement sequester” will automatically kick in, triggering another round of across-the-board cuts if appropriations aren’t reduced to fit under the 2014 cap of $967 billion, or the sequester isn't eliminated or pushed back.
States and local areas soon will be able to draw down Older Americans Act (OAA) dollars, but some programs that had to shut down or scale back services may not be up and running at full capacity immediately.
As for Social Security, those offices should be able to offer the full gamut of services, and Congress provided another $470.6 million for administration.
The agreement provides for the long-delayed conference committee negotiations to craft a compromise FY14 budget resolution between the House and Senate versions passed earlier this year. The House and Senate proposals remain far apart. For example, the Senate included $1.85 trillion in deficit reduction, split evenly between spending cuts and revenues, while the House included $4.6 trillion in spending cuts alone.
The committee has a deadline of Dec. 13 to come up with an agreement on the total level of spending for the upcoming year and potentially also craft measures to replace all or part of the sequester and address larger debt and deficit issues.
House committee member include: Reps. Ryan (R-WI), Cole (R-OK), Price (R-GA), Black (R-TN), Clyburn (D-SC), Van Hollen (D-MD), and Lowey (D-NY).
Senate members are: Sens. Murray (D-WA), Wyden (D-OR), Nelson (D-FL), Stabenow (D-MI), Sanders (I-VT), Whitehouse (D-RI), Warner (D-VA), Merkley (D-OR), Coons (D-DE), Baldwin (D-WI), Kaine (D-VA), King (I-ME), Sessions (R-AL), Grassley (R-IA), Enzi (R-WY), Crapo (R-ID), Graham (R-SC), Portman (R-OH), Toomey (R-PA), Johnson (R-WI), Ayotte (R-NH), and Wicker (R-MS).
It remains unclear what progress will be made as Democrats and some Republicans will want to eliminate or push back the sequester.
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Some of the information in this article was found on the NCOA website. www.ncoa.org
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MNsure Launches Insurance Exchange
by: Tim Burkhardt
MNsure, Minnesota’s Health Insurance Exchange marketplace, was launched on October 1st and has received heavy traffic and usage during the first thirty (30) days of operation. The Affordable Care Act called for the creation of health insurance exchanges in each stae and MNsure is the result of that provision. Although there have been a few bumps in the system, the MNsure system is proving to be much easier to access than those exchanges that were not set up exclusively by states themselves.
Those states who chose not to set up their own health insurance exchanges are either partnering with the federal government to set up their sites, or are choosing to allow a system designed by the federal government to provide the service in their state.
People can access the MNsure system online or by the use of a network of navigators or counselors for the program. So far, the vast majority of the MNsure navigators are current insurance agents or brokers. Non-profit agencies and others were allowed and encouraged to also fill the role of navigators to the system. To this point, the numbers of navigators other than insurance agents/brokers is relatively small, but that could change soon.
The training and certification process for becoming MNsure navigator/counselors was not overly burdensome and could be done online as well. Although a large number of agencies have applied for navigator/counselor status, few have been able to get up and running to offer the service as of October 1st, the date for the program to “go live.”
There doesn’t seem to be any single reason for why this delay may be happening. According to a MNsure spokesperson, outreach efforts have been slow to start due to delays in training, background checks, and finalizing MNsure's contracts with organizations that provide one-on-one help.
Nationally, the rollout of the Affordable Care Act has been burdened with trying to do too much, too soon. It appears that the projected startup date was not in sync with preparations needed to get the www.healthcare.gov website up and functioning. Now that projections have met with reality, there has been a concerted effort to bring more expertise on board to get the national site up and running smoothly by the end of November.
Beginning October 1, 2013 residents of Minnesota will be able to obtain health insurance through MNsure, the health insurance exchange marketplace created under the Affordable Care Act (ACA).
Initially, individuals who are not currently covered under an employer’s plan and small businesses with up to 50 employees can use MNsure. Large employers will be allowed to participate in 2017.
Individuals and families may qualify for a low-cost or free plan. Tax credits (called advanced premium tax credits) are available to individuals making $45,960 or less and a family of four making $94,200 or less. The amount of assistance is based on a sliding scale, so the higher your income, the lower the amount of assistance.
MNsure will offer:
- An easy-to-use website where you can search and compare plans
- A hotline you can call to talk with someone about your options
- Places where you can sign up in your community
- A one-stop place to shop for health insurance plans
- Lay out plan options side-by-side for easy comparison
MNsure will also:
- Ensure that plans meet certain baseline benefit standards
- Let you know if you qualify for tax credits or financial assistance
- Let you know if you qualify for a low-cost or free plan
- Allow you to apply and enroll online in health benefit plans
- Show you up front what your potential cost will be for insurance
- Give you examples of average costs for common health services
- Show you quality ratings for hospitals and clinics in your community
Medicare Recipients Are NOT Affected By MNsure Signup
Those people who are enrolled in Medicare are not required to take any action regarding the new Health Insurance Exchange or MNsure.
Questions have been coming into the Seven County office, as well as other senior advocacy organizations, regarding the requirement for individuals to sign-up and purchase healthcare insurance. The required insurance sign-up is part of the ACA (Affordable Care Act) signed into law in 2010, which aims to reduce the number of uninsured in the country. It also is designed to reduce the overall cost of insurance for individuals by including as many people as possible into much larger pools.
Even though there is no action required by Medicare enrollees, that doesn’t mean the ACA will not affect them, indeed it already has. For one thing, the infamous “doughnut hole” that is a part of Medicare Part D (Prescription Drug Plan) has begun to shrink due to additional funding made available by the ACA.
Also, because successful reforms in the Affordable Care Act are making Medicare more efficient and reducing costs, the Medicare Part B premium for 2012 was $99.90, $6.70 lower than the amount projected, and only a few dollars more than the premium that most beneficiaries had been paying. In addition, the Part B annual deductible decreased by $22 to $140, the first time in Medicare's history when the deductible was lower than the previous year. The 2013 Part B monthly premium – $104.90 – is also lower than previously projected by the Medicare trustees.
For more information, stop by or call the Seven County office and ask about the “How the ACA Helps Seniors” report.
DHS Fires Auditor, Rehires Same Firm
In a move that surprised many, including the members of the Greater MN Health Care Coalition (GMHCC), the audit firm that was to be fired for doing questionable work for the state previously, was rehired in late September.
Minnesota’s Commissioner for the Department of Human Services (DHS), Lucinda Jesson, announced on September 22nd that the firm of Milliman of Milwaukee had been hired to replace the accounting firm of Milliman of Minneapolis.
Questions had been raised by many advocate groups about the reasoning behind using Milliman to do the audit work for DHS for reports submitted by the state’s HMOs. Milliman of Minneapolis is the firm that has, for many years, prepared the HMO’s reports that are then sent to the state for review and subsequent audit. To have that same firm then review and comment on their own reports (Milliman reviewing and approving Milliman work) seems to be inappropriate at the least, if not outright suspicious.
When asked to comment assistant DHS Commissioner Scott Leitz stated: "We selected easily the best qualified vendor for this project… we're extremely confident that even though this is a branch of Milliman, they are independent from all aspects of the Milliman of Minneapolis office."
Milliman's work for the state from 2004 to 2011 was conducted by its office in Minneapolis, said Leitz, the DHS official. By contrast, Milliman's office in Milwaukee worked with the state to set rates for 2013, he said, adding that those rates were lower than those paid to health plans in 2010.
"The two offices are independent from each other both financially and in terms of personnel," Lucinda Jesson, human services commissioner, wrote in a letter sent to all MN legislators.
The awarding of the audit contract, which carries a value of nearly $700,000 per year, is the latest chapter in an ongoing saga at the state Capitol. The issue at hand is about payments to HMOs hired to administer health benefits to people covered through the Medicaid and MinnesotaCare health insurance programs. The rate-setting, or the amount the state pays the HMOs to handle these programs, is heavily dependent on the audits conducted each year. In this instance, the audits give the distinct impression that there is no independent look at the HMO’s costs, with the same firm doing audits for the HMOs and DHS. This leaves open the possibility that this is a closed rate-setting process without outside review. This seems to thwart all attempts at $4 billion in healthcare accountability.
For more information on the healthcare accountability subject, try searching online for these key words: Lucinda Jesson, Scott Leitz, Milliman, Sen. Sean Nienow, DHS-MN, David Mosely, GMHCC, MN Segal audit, Rep. Jim Abeler.
2013 Potluck FUNDRAISER
Over 100 friends, supporters and members of Seven County took part in this year’s Potluck Fundraiser held at the spacious Hinckley Community Center. In addition to great music by Mike Turner (AKA - Mr. Banjo Man), there were fun games like “Identify the Red Cooking Ingredients” (see photo below). Red was key as we celebrated our 40th Anniversary as an organization, which is represented by the Ruby gemstone. Thank you to all who attended!
Healthcare Allies Gather to Compare Notes on ACA
Close to fifty people representing nearly two dozen groups in Minnesota gathered to hear updates on healthcare changes in the state. With the impending launch of the ACA (Affordable Care Act), which was signed into law in 2011, there are a number of changes that people and organizations will need to be aware of.
The meeting was convened by HCAM (Health Care for All Minnesota) and was held in the conference room at the MNA (MN Nurse Association) building in downtown St. Paul. Erin Anderson, Executive Director of HCAM, led a presentation showing the need for a broader statewide coalition of interest groups who will work on adding significant improvements to the elements contained in the Affordable Care Act.
There was near consensus by the group that there were some really strong elements included in the ACA that have improved healthcare for all. These include:
Ending Insurance Company Abuses: Thanks to the Affordable Care Act, insurers can no longer put a lifetime cap on how much care they will pay for if you get sick or cancel your coverage when you make a mistake on your paperwork. Starting in 2014, health insurers will be prohibited from charging you more because you are a woman.
More Affordable Care: Today, we have the new 80/20 rule: insurance companies must spend at least 80 cents of your premium dollar on your health care or improvements to care. And insurance companies must publicly justify their actions if they want to raise premiums by 10 percent or more. And States have more power to block them.
Coverage for Young Adults: Under the Affordable Care Act, young adults under age 26 can stay on their parent’s health insurance plan until age 26 – a change that has already allowed 3.1 million young adults to get health coverage and given their families peace of mind.
Coverage for Pre-Existing Conditions: The Pre-Existing Condition Insurance Plan in every State offers an option to people who have been locked out of the insurance market because of a pre-existing condition like cancer or heart disease. And under the new law, insurers can no longer deny coverage to children under age 19 because of a pre-existing condition like asthma and diabetes. Starting in 2014, health insurers will be prohibited from discriminating against anyone due to pre-existing conditions.
Preventive Benefits: All new health plans must now cover preventive services ranging from mammograms to FDA-approved birth control to vaccinations for your child, without making you pay a copay or deductible.
GMHCC representatives support the MN Health Plan as a better solution than the current ACA, as do these other noteworthy groups who were on hand, including: MN Nurses Association, Catholic Charities, MN League of Women Voters, Land Stewardship Project, American Cancer Society of Minnesota, Metro Independent Business Association, Children’s Defense Fund of MN, Growth & Justice Foundation, International Brotherhood of Electrical Workers (IBEW), MN Federation of Teachers and Take Action MN.
A follow up meeting is set for mid-October.
Nearly fifty advocates and supporters of healthcare reform gathered at the Minnesota Nurses Association offices in St. Paul to receive updates on changes in Minnesota. The group had a chance to interact via a video link with Dr. Deborah Richter of Vermont, who showed an Affordable Care Act comparison to Green Mountain Care. Dr. Richter has been actively involved in creating Green Mountain Care in Vermont, a comprehensive statewide plan that provides cover age for all citizens.
Dr. Deborah Richter MD
Dr. Richter practices in Montpelier, Vermont. She is a former President of PNHP (Physicians for a National Health Plan).She has spoken extensively to both community and medical groups, is a frequent spokesperson in the print, TV, and radio media, and is active in coalition building on the need for universal access to health care.
PNHP Fast Facts
* A nationwide survey of physicians in 2011 showed that 62% support a national health plan
* Over 1,000 physicians in Minnesota belong to PNHP
* Over 18,000 physicians nationwide belong to PNHP
We're seeing RED because it's our Ruby (40th) Anniversary.
Please join us on Thursday, September 12, 2013 at the Hinckley Community Center for our annual potluck starting at 9:30 a.m. Bring a dish to share and visit with friends (old and new), while enjoying a day of fellowship and entertainment.
Featured Entertainer * Mike Turner
Folk music has never lost its appeal or value and is experiencing a revival among young and old alike referred to now as music Americana, roots, and soul.
Mike has been performing for over 25 years nationally and internationally on TV, Radio, and Concerts and has recorded over 20 albums of his music in Nashville TN.
Mike Turner is a singer/songwriter - musician - humorist and entertainer extraordinary and is a virtuoso on the acoustic guitar and 5 - string banjo.
8 Hour Defensive Driving Class Coming in October - Sign up NOW!
Seven County Senior Federation and the FirstLight Health System are proud to announce the Minnesota Safety Council “mature driver” training (8 hour class) for drivers age 55+. Upon successful completion of the two-day Defensive Driving class, drivers are eligible for a discount of at least ten percent on auto insurance.
Fri. October 4, 2013 ~ 5:30 pm to 9:30 pm (part 1)
Sat. October 5, 2013 ~ 8:30 am to 12:30 pm (part 2)
First Light Health Systems
301 Highway 65 S., Mora
Reserve your spot in the next class (deadline: Friday, September 27) by calling the Seven County Senior Federation at 679-4700 or 1-866-679-4700.
The cost for the 8 hour class is $20 ($15 for members of the Seven County Senior Federation). The Seven County Senior Federation offers the 4 hour refresher class on a monthly basis at the library in downtown Mora. The current cost for the 4 hour refresher class is $12 ($9 for Seven County Senior Federation members).
*Prepayment is required for the 8 hour class!
40th Annual Convention Highlights
Center City played host to the 40th Annual Convention of the Seven County Senior Federation on May 9th, a date that was later than previous conventions. A dangerous winter storm hit the region on April 9th (the original convention date) so the event was postponed for a month. All of the scheduled events went off as planned, with only a couple of minor timing changes taking place the day of the convention.
An official welcome was offered to the convention crowd by Center City mayor Jill Behnke, and American Legion Post #272 was on hand to present the colors and lead the crowd in the pledge of allegiance.
Seven County President Fran Levings-Baker then gave a “state of Seven County” address and confirmed that the organization remains “in good health.” Fran urged members to continue to be involved and engaged with as many facets of the organization as possible, from volunteering, to serving as a delegate, to letter writing, or to active involvement on one of the many issues facing seniors.
Former state demographer Tom Gillaspy served as the keynote guest speaker. Tom offered up an insightful, detailed look at how future trends would likely affect folks in Minnesota and beyond.
Following the budget report the convention delegates got to the business of reviewing and voting on the Seven County priority issues for the coming year (shown below). The top two issues in each category will be the priorities for 2013 meaning the majority of advocacy resources will be devoted to those causes. Position papers will be drafted for approval for all of the ballot issues which will reflect Seven County’s position on those issues.
Pressure Mounting on HMOs and DHS
The questions and conversations about the way that $4 billion dollars in taxpayer dollars are spent every year continue to be part of day-to-day life at the MN Department of Human Services (DHS).
Those same questions are also being asked of the four (4) Minnesota HMOs who receive those dollars annually to provide coverage for people enrolled in GAMC (General Assistance Medical Care), MinnesotaCare, and Medical Assistance.
Due to the doggedness of GMHCC (Greater Minnesota Health Care Coalition), the issue of transparency and lack of accountability by the HMOs and DHS has drawn state and federal attention.
The Minnesota Department of Commerce, which oversees MN insurance company activities, released a report in December of 2012 which indicated serious problems in the HMO-DHS payment system. The report indicated that it had found “significant examples of incorrect calculations, questionable expenses, and some expenses that directly violate federal law.”
The consultant who submitted the report makes clear that their discoveries and reports do not by themselves trigger any corrective actions; therefore it is up to State regulators or legislators to decide whether or not to do anything about them.
For a complete summary of the report plus audit information from the Segal Company, plus GMHCC commentary on the process, go to the GMHCC website:
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40th Annual Convention has been rescheduled
Due to the weather, we have rescheduled our 40th Annual Convention to Thursday, May 9, 2013. Location and all other information regarding the event will remain the same.
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GMHCC Commentary on
HMO Independent Audit
Greater Minnesota Health Care Coalition ~ March, 2013
Comments on the Dec., 2012 reviews issued by the Dept. of Commerce; and the March, 2013 preliminary report by the Segal Company
Part A. Analysis of Dept. of Commerce reviews of Blue Plus, HealthPartners,
Medica, and UCare for 2011
To fulfill part of an Executive Order issued by Gov. Mark Dayton in March of 2011, the MN Dept. of Commerce (DOC) contracted with the Risk & Regulatory Consulting company to conduct limited reviews of the 2011 finances of the four HMOs that the State contracts with for the public low income health care programs. These HMOs are: Blue Plus (owned by Blue Cross/Blue Shield of MN), Medica, HealthPartners, and UCare. The reports included some auditing of administrative expenses.
The set of four reports, issued Dec. 3, 2012, found significant examples of incorrect calculations, questionable expenses, and some expenses that directly violate federal law. The consultant makes clear that their discoveries and reports do not by themselves trigger any corrective actions, and therefore it is up to State regulators or legislators to decide whether or not to do anything about them.
Here are summaries of key points raised in each of the four reports:
A.1. Blue Plus
$5.1 million and $1.3 million errors
The most glaring finding was that in calculating how much money it would need to keep to cover claims yet to be paid, known as a Premium Deficiency Reserve, Blue Plus was off by $5.14 million too much. This might have a bearing on how much profit the company is supposed to return to the state. Another error was uncovered, which was $1.372 million charged to Medical Assistance (MA) and MinnesotaCare (MnCare), for something called: “Additional Allocation for 2012 Strategic Spending.”
The report also noted “unusual fluctuations” in what Blue Plus reported year to year for reserves, expected next-year losses in the public programs, donations, and distribution of capital gains. Plus, at times the official reporting instructions of the Nat’l Assoc. of Insurance Commissioners were not followed, as are required.
$3.6 million in questionable expenses
The report identified 13 expense categories in which amounts charged to MA and MnCare have questions as to being proper. The grand total of these is $3.648 million dollars Items in this total include $1.2 million for marketing and corporate communications; $100,000 in TV?ads; and $13,000 for a Twins ballpark sponsorship.
Prohibited costs: $99 K
Very noteworthy is that the report identified certain costs that are absolutely prohibited, by federal law, to be paid by the Medicaid program. These are $88,000 in lobbying expenses, and $10,000 to help pay for an audit of Medicare expenses. While not huge, there are clear-cut unallowable items.
$10 million donation
One more striking expense is a $10 million donation to the Blue Cross/ Blue Shield of MN Foundation.This is not allocated on Blue Plus’ books to the public low income programs, and so Blue Plus was apparently not trying to pay for this donation out of the State program revenue.
Allocation of $10.3 million of realized capital gains
Blue Plus received income of $10.3 million from realized capital gains (sale of some assets). What is odd is that all of this income was assigned to a category of businesses services for Blue Cross programs, and not just in Minnesota, but in six other states as well. None of the money was assigned to either the public programs or the commercial insurance policies. This raises the question as to whether a portion of these capital gains proceeds should have been listed as income for the public programs. In contrast, for example, Medica allocated some of its 2011 realized capital gains to its public programs. MORE...
Audit Raises Concerns Over DHS-HMO Payments
$162 million discrepancy identified in preliminary report...
The four HMOs that run the state's Medicaid program were overpaid according to a preliminary state audit, paid for by the Minnesota Department of Human Services.
The audit, conducted by the Georgia-based Segal Co., says Blue Cross and Blue Shield of Minnesota, Medica, HealthPartners and U-Care, collectively, were overpaid at least $162-million dollars over the past eight years. That overpayment was funded by Minnesota taxpayers. The audit also says the overpayment was invested and gave the four insurance companies an additional $150-million dollars. The audit concludes that's a $312-million dollar benefit the HMOs should not have received.
State Senator Sean Nienow of Cambridge, who sits on the Health and Human Services Committee, told reporters that he thinks the HMOs should pay back the entire $312-million dollars. He says the preliminary audit focuses on just a fraction of the Medicaid costs and that the overpayments and investments paid to the four HMOs could exceed $500-million dollars. The final audit was due out at the end of March.
Senator Nienow says he is not happy to see the audit point to poor management and oversight as part of the reason for the overpayment. The relationship between the HMOs and DHS has created serious doubt about the legitimacy of the payments made for the state’s low income healthcare programs.
The four HMOs and the Minnesota Department of Human Services and the state's Medicaid program are currently being audited by the Office of Inspector General (OIG) out of Washington, D.C. The OIG arrived here in early January and they have auditors, inspectors and investigators working here going over the Medicaid books at DHS and at the four HMOs. There are also two Congressional investigations into Minnesota's Medicaid program, and the Minnesota Legislative Auditor will begin a state audit late this spring.
The Mpls. Star-Tribune has weighed in on the audit’s findings in a lengthy editorial shortly after the preliminary audit was released. In it they contend that “...the state of Minnesota has overpaid some of its biggest vendors — the private, nonprofit managed-care firms who are paid nearly $4 billion a year to run taxpayer-funded medical assistance programs for the poor.” They sum up their position by saying: “The (Segal) review raised further questions about whether the higher margins on programs funded jointly by the state and federal governments may have improperly subsidized a perennially money-losing state-run health program. The Segal authors’ incredulity is also apparent over the state’s lack of concern about annual rate hikes and its timidity in pushing health plans for better data. The state is now collecting that information.”
GMHCC (Greater MN Health Care Coalition) has pushed for over seven-years for independent, outside audits of the state’s system of funding for these taxpayer funded and HMO managed programs.
Health Insurance Exchange Bill Passed Into Law
The long-awaited and much talked about Minnesota Insurance Marketplace (Exchange) has become law. Gov. Dayton signed the legislation into law on March 21st following a sometimes frenetic journey through the MN House and Senate chambers.
Dozens of states across the country are doing the same thing, setting up insurance exchanges, as part of the ACA (Affordable Care Act) which was enacted in 2010.
Promoters of the new system (to be called MNsure) say it will improve access by making it more affordable for people to acquire health insurance coverage for themselves and/or their families. The ACA is designed to allow people to shop for their healthcare insurance and provides subsidies for lower income families and individuals who cannot afford the costs. ACA supporters contend that making insurance companies compete for business on a large scale should lower the cost to the consumer.
Individuals and small businesses can start shopping for coverage on the new marketplace beginning in October of this year.
Seven County will host 8 Hour Defensive Driving class.
FirstLight Health System and the Seven County Senior Federation are proud to announce Minnesota Safety Council “mature driver” training (8 hour class) for drivers age 55+. Upon successful completion of the two-day Defensive Driving class, drivers are eligible for a discount of at least ten percent on auto insurance. The discount can be maintained by completing a 4 hour refresher class every three years thereafter.
Friday April 12, 2013 ~ 5:30 PM to 9:30 PM (1st half)
Saturday April 13, 2013 ~ 8:30AM to 12:30PM (2nd half)
First Light Health Systems
301 Highway 65 S., Mora
Reserve your spot in the next class (deadline: Friday, April 5) by calling the Seven County Senior Federation at 679-4700 or 1-866-679-4700. The cost for the 8 hour class is $20 ($15 for members of the Seven County Senior Federation).
Prepayment is required.
The Seven County Senior Federation ALSO offers a 4-hour refresher class on a monthly basis at the library in downtown Mora. The cost for the 4-hour refresher class is $12 ($9 for Seven County Senior Federation members).
7C Legislative committee assignments:
Sen. Tony Lourey ~ CHAIR --- Senate Health/HumanServices Finance Cmte.
Sen. David Brown Senate Health/Human Services Finance Cmte. member:
Sen. Tony Lourey Health & Human Services Housing Cmte. member:
Sen. Michelle Benson Health & Human Services Housing Cmte. member:
Sen. Sean Nienow Health & Human Services Housing Cmte. member:
Rep. Tim Faust ~ Vice-Chair of Ag Policy Cmte. ~ Education Policy ~ Property & Local Tax Division
Rep. Kurt Daudt ~ Rules and Legislative Administration ~ Elections
Rep. Joe Radinovich ~ Early Childhood and Youth Dev. Policy ~ Education Finance ~ Housing Finance and Policy
Rep. Sondra Erickson ~ Education Policy ~ Education Finance ~ Property and Local Tax Division
Rep. Brian Johnson ~ Civil Law ~ Elections ~ Judiciary Finance & Policy ~ Public Safety Finance & Policy
Rep. Bob Barrett ~ Early Childhood & Youth Development Policy ~ Education Policy ~ Taxes
Sen. Carrie Ruud ~ Finance E-12 Division ~ Finance-Environment Econ. Dev.& Ag. Division ~ Jobs, Ag. & Rural Dev.
House Minority leader: Rep. Kurt Daudt (Isanti)
Voting Law Changes Would Harm Seniors
The 2012 elections might just be a turning point for seniors, not just in Minnesota, but across the country. A number of states are attempting to implement legislation and or laws that would restrict, and certainly hinder, the ability of many seniors to vote.
In Minnesota there will be a proposed Constitutional Amendment on the ballot this fall. If passed, the law would require all voters to produce a current photo ID in order to cast a ballot. It seems simple enough until you begin to look behind the numbers and the history of voting in the state. The incidence of voter fraud (someone attempting to impersonate someone else in order to vote) is a problem that has no history.
Analysis of *2,068 alleged election-fraud cases nationwide since 2000 shows that while fraud has occurred, the rate is infinitesimal, and in-person voter imperson-ation on Election Day, which is pointed to as the driving force causing thirty-seven (37) state legislatures to enact or consider tough voter ID laws, is virtually non-existent.
An extensive public records search was conducted in which thousands of requests were sent to elections officers in all 50 states. They were asked for every case of fraudulent activity, including registration fraud, absentee ballot fraud, vote buying, false election counts, campaign fraud, casting an ineligible vote, voting twice, voter impersonation fraud and intimidation.
Analysis of the resulting comprehensive information turned up 10 cases of voter impersonation. With 146 million registered voters in the United States during that time, those 10 cases represent one out of about every 15 million prospective voters.
In Minnesota, there have been 10 total cases of reported fraud and no cases of voter impersonation reported since 2000.
“Voter fraud at the polls is an insignificant aspect of American elections,” said elections expert David Schultz, professor of public policy at Hamline University School of Business in St. Paul.
“There is absolutely no evidence that (voter impersonation fraud) has affected the outcome of any election in the United States, at least any recent election in the United States,” Schultz said.
A number of states, including Minnesota, have initiatives moving forward or are already moving ahead with strict Voter ID laws. The trend alarms voting advocates like Lawrence Norden, acting director of the Brennan Center for Justice In Democracy Program, who said photo ID laws hit older people, the poor, African Americans and students the hardest. "This is the first time in decades that we have seen a reversal in what has been a steady expansion of voting rights in the United States," Norden said. "There's no question that citizens over 65 will be particularly impacted. The older you get, the more likely you won't have an ID."
**Nearly one in five citizens over 65 (about 8 million) lacks a current, government-issued photo ID, a 2006 Brennan Center study found. Most people prove their eligibility to vote with a driver's license, but people over 65 often give up their license and don't replace it with the state-issued ID that some states offer non-driving residents. People over 65 also are more likely to lack birth certificates because they were born before recording births was standard procedure.
Strict new photo ID laws could make voting this year more difficult for millions of voters, if the new laws stand, according to the Brennan Center.
Details of the investigation data can be found at:
*MinnPost & News21 http://bit.ly/OC0l3Q
**Brennan Center http://bit.ly/PzCdRF
Rep. Sondra Erickson of Princeton (c) faces off with challenger Joe Walsh (r) of Milaca in the race for MN House seat #15A. The candidates debated the issues at a forum co-sponsored by Seven County, Lakes & Pines and the Ogilvie School District and held in Ogilvie on September 13th. About one hundred people attended the event which was moderated by Scott McKinney (l) of KBEK radio.
GMHCC held a press conference on Thursday, August 23rd starting at 12:00 noon in Room #125 of the State Capitol building. The focus was the release of our 20 page Healthcare Accountability/Transparency report. It covers and documents of almost 20 years of HMO mismanagement of a $4 billion dollar per year income that is funded by your tax dollars.
Buddy Robinson explains the elements of the GMHCC Accountability Report on HMO Healthcare in MN
GMHCC Accountability Report Released to Public
The Greater Minnesota Health Care Coalition (GMHCC) held a press conference at the state capitol on to announce the release of a 20 page Accountability Report on the state’s healthcare system. Entitled “Who Was Minding The Store?”
The report details over 15 years of investigative analysis of the system and the relationship between Minnesota’s Department of Human Services and Minnesota’s HMOs. There are four HMOs in the state that are given the bulk of taxpayer dollars ($4 billion per year) to administrate and pay healthcare providers for health services delivered. MnCare, Medical Assistance (MA), and General Assistance Medical Care (GAMC) and Minnesota Senior Health Options (MSHO) are the state programs managed by UCare, Blue Cross/Blue Shield, Health Partners and Medica.
These four HMOs have administered these programs for nearly 20 years in what was supposed to be a “demonstration project.” There has never been an independent, external audit of these programs and the tax dollars they have been given since the state turned them over. The state has never evaluated whether or not they are saving money (as promised) or if the population served was receiving better care/access (as promised).
According to the GMHCC report, together these four HMOs carry more than $3 billion dollars in cash reserves (tax dollars), which represents nearly four (4) times the amount recommended by the National Association of Insurance Commiss-ioners which is the insurance industry oversight group .
A copy of the complete GMHCC Accountability report can by read or downloaded from either the Seven County or GMHCC websites
The press conference summary report from KSTP-TV can be found here:
AND you can...
CLICK HERE to view, print or download PDF report-
Who was minding the store?
A report on Minnesota’s problem with contracting out the state public health care programs to HMOs
Accountability Provisions Weakened in Final Omnibus Bill
It appears that the intended goal of installing or creating some accountability and transparency measures for state healthcare tax dollars will be met… sort of. A significantly amended version of the original accountability bills, brought forward by Rep. Steve Gottwalt and Rep. Carolyn Laine, was included in the final House Omnibus Bill.
The independent third-party audits required under the bill’s language would be effective for the 2013 calendar year. This means that audits would begin in 2014. This is a change from the original bill as far as the effective “first audit” date goes. In its original form, as introduced by Rep. Carolyn Laine, the effective date would have been 2011 so that auditing would begin in 2012 (now).
Also, there seems to be an interpretive difference of opinion when it comes to the definition of an “independent” 3rd party audit. That language has been weakened quite a bit since the bill’s introduction.
So... after many hours of debate and legislative wrangling over the provisions of what has become generically known as the Health & Human Services (HHS) Accountability Bill, the final version’s elements can now be revealed.
(This information comes courtesy of a private researcher and ally of GMHCC and Seven County.)
Audit language contained in HHS omnibus legislation
First introduced in various stand-alone bills, managed care audit requirements were folded into the 2012 Health and Human Services Omnibus bill, which emerged from conference committee on April 23rd.
The audit provisions alter Minnesota Statutes section 256B.69, by adding another subdivision, labeled (9d.). This subdivision allows that:
• The legislative auditor will contract with an outside audit firm to conduct a bi-annual, “independent, third-party financial audit” of managed care financial data.
• Audits will focus on data that HMOs and county-based purchasers already submit to DHS – including information on administrative expenses, revenues, reserves, reinsurance, and more.
• Audits will be conducted “in accordance with generally accepted government auditing standards issued by the United States Government Accountability Office.”
• The audits will determine if managed care programs are compliant with state and federal laws, as well as with the federal Medicaid rate certification process.
• Firms retained for the audit cannot have provided services to managed care or county-based purchasers during the time period for which the audit is being conducted.
• Future managed care contracts must include provisions that allow auditors access to relevant information, and stipulate cooperation with such auditors. Contracted firms will have the same powers as those of the legislative auditor, for the purposes of completing managed care audits.
• Managed care organizations must provide DHS with bi-weekly “encounter” and “claims” data on public health care programs.
• Audit results will be circulated to the Commissioner of DHS, the state auditor, the attorney general, and various members of the legislative leadership.
The end result of these changes is one long-sought by transparency advocates. The bill adds an additional layer of oversight to the state’s managed care programs, by inserting an external auditor who is empowered by (and answerable) to Minnesota’s legislative auditor.
Previously, the oversight of managed care programs fell to DHS, and to a lesser extent, to MDH and the Department of Commerce. The underlying premise of the audit legislation clearly appears to be that an outside observer can find new perspectives on the efficacy of public health care plans, even though they will be using the same underlying data set as state agencies.
The legislation omits a key provision sought by Senator John Marty, in that audits will only extend to contracts beginning in 2014, and will not be retroactive to prior years. Senator Marty has contended that understanding what occurred in the past will be critical to managing public programs going forward – as well as discovering the scope and scale of any past improprieties.
2012 Convention Report…
President Fran Levings-Baker called the 2012 Convention to order at 9:37 a.m. and gaveled it to a close at 2:04 p.m. on April 19th.In between those times the Seven County Senior Federation conducted a wealth of annual business.
Financial reports from 2011 were delivered by Seven County Treasurer Kathy Kawalek, who highlighted the point made by Levings-Baker that the state of Seven County was “excellent.” Kathy also submitted the 2012 Budget for final review and approval, which she received.
The recommended issue resolutions from the subcommittee assigned that task, both State and Federal, were then presented to the convention crowd for consideration. Following a fairly thorough vetting of the ten resolutions (5 State and 5 Federal) they were all approved for the final ballot. Priority voting followed, results of which are posted on this page.
Elections to fill two Board seats also took place during the morning business session. Bob Skogman of Aitkin County was elected to serve as 1st Vice-President for a two-year term. The Secretary position was also on the ballot and Janet Johnson ran unopposed. She will serve for another two years.
The keynote address delivered at the beginning of the convention, by attorney David Feinwachs, had the entire crowd buzzing. His factual recounting of what happened to him personally as the 30-year general counsel to the MN Hospital association was riveting. The steps that led up to his firing in November of 2010 were the stuff of spy novels, including back room deals, secret e-mails, and unseen hands guiding the entire process. There were audible gasps in the room and lots of head shaking as Feinwachs recounted, in detail, how billions of our healthcare tax dollars have never been accounted for. “HMOs continue to dictate how they will report their expenditures” he said.
Feinwachs Honored At Convention
As part of the activities at the 39th Annual Seven County Convention there was a special awards presentation. Special guest speaker David Feinwachs was honored by Seven County and GMHCC (Greater Minnesota Health Care Coalition) for his work in promoting healthcare reform through his focus on the issue of HMO transparency . Seven County President Fran Levings-Baker (at left) and GMHCC president Lila Skramstad (at right) honored Feinwachs (center) as their “Health Reform Advocate of the Year.” Over one hundred twenty delegates attended this year’s convention which was held on April 19th at Braham Evangelical Lutheran Church in Braham. Next year’s convention (the 40th Annual) is due to be held in Chisago County.
Skogman Elected 1st Vice President
The new 1st Vice-President for Seven County is Bob Skogman of Aitkin County, who narrowly edged out Majal Johnson for the slot that was up for election this year. Bob has been a member since 2008 and has served as Aitkin County Vice President since that time. His goal is to increase the visibility and membership in Aitkin County as well as the entire Seven County area.
Issue Priority Voting at 2012 Convention
Convention delegates had the opportunity to vote for their organizational legislative priorities for the coming year at the Federal and State level. The results of the 2012 voting is as follows:
- *Fairer Taxation Policy 67 votes
- *Campaign Finance Reform 50 votes
- Medicare Part D Reform 47 votes
- Social Security Reform 46 votes
- Arms/Defense Spending Reductions 21 votes
- *Restoration of Homestead Credit 76 votes
- *Passage of the MN Health Act 65 votes
- Restore Funding Home Health Aides 48 votes
- Voter ID Legislation Opposition 35 votes
- County Based Purchasing Expansion 9 votes
(117 total votes recorded)
*The top two issues at the State and Federal level will be the focus of our Seven County resources for the next year as voted on by our 2012 convention delegates.
A piece of strong, bipartisan Minnesota *legislation, designed to increase the HMO’s transparency and accountability for state health programs, has been sidelined.
Questions were raised last session over the $3 billion per biennium handed over to the non-profit insurance companies that run the states healthcare programs. As a result of the discussions both bodies of the Minnesota legislature crafted legislation which aimed to remedy that situation. Lack of HMO accountability seemed to be a high priority issue in 2012 as the Health and Human Services committees in the House and Senate held hearings on various bills.
A hearing held on February 14th in the House was the centerpiece of the early discussions.
Presenters at that meeting included Human Services Commissioner Lucinda Jesson and Deputy Commissioner Scott Leitz. The hearing also featured a presentation by former MN Hospital Association general counsel David Feinwachs which shed light on the current system. It prompted some tough questioning from the Human Services Committee members during the 3 1/2 hour hearing.
Representatives from the MN Council on Health Plans, who represent the HMOs, also were on hand. They were grilled about issues relating to the transparency, or lack thereof, in the state tax-funded and HMO administered health services in Minnesota. The Health Plan’s speakers argued, not very successfully, that their auditing and accounting procedures were “very thorough” and needed no added scrutiny. Despite the Health Plan’s reps assurances that transparency was at a high level, the committee members expressed serious doubts.
Adding fuel to the questioning and discussion was the revelation earlier in the day that the Federal Government had launched an investigation of the Minnesota Medicaid program. Medicaid has oversight provided by the MN Department of Human Services, and is run by the state’s non-profit HMOs.
The ranking member of the U.S. Senate Judiciary Committee sent a letter to Gov. Mark Dayton asking why UCare, a Minnesota health plan company, repaid $30 million in Medicaid funds to the state as a gift,rather than as a refund or reimbursement.
In the letter, Sen. Chuck Grassley, R-Iowa, said he's concerned that the way the funds were returned was meant to avoid reimbursing money to the federal government.
Grassley’s reference was to emails sent by Minnesota Department of Human Services Commissioner Lucinda Jesson in March 2011, in which she described how UCare should draft its press release about returning the Medicaid funds to the state.
In order to have a good chance of keeping all of this money, it must be characterized as a donation. If a refund, feds clearly get half, Jesson wrote in an email.
The contents of that email exchange prompted some extended questioning of DHS Commissioner Jesson and her Deputy Scott Leitz. They stated that the dollars returned to the state from UCare ($30 million) was always termed as a donation, not as a refund.
A more in-depth question then arose about the nature of the relationship between DHS and the HMOs who receive $3 billion plus in state tax dollars per biennium to run healthcare programs.
According to David Feinwachs examination and interpretations, the unlimited reserves that HMOs accumulate in state tax dollars should be closely scrutinized. These reserves are created to fend off their “risk” of large claims. “The HMOs are never at risk…” Feinwachs stated when referring to massive reserves held by the HMOs. He explained that the way the system is set up now, if an HMO running one of the state health program experiences a shortfall one year, the rates are adjusted by DHS the next year to make up for the HMOs previous year’s “loss.”
Sen. Grassley also sent letters to all of the Minnesota, non-profit HMOs in charge of the state healthcare program and recipients of state tax dollars. In these letters he focuses on a number of key points, including some designed to examine potential “overpayments” received by the HMOs from Minnesota’s DHS.
Sen. Grassley’s letters and questions get at the heart of the accountability matter and, for those of you who are concerned taxpayers, they can be found at:
* (HF 2412 and SF 1824)
Feinwachs To Offer Convention Keynote
Attorney David Feinwachs will offer the keynote address at the 2012 Convention to be held in Braham on Thursday, April 19th.
Feinwachs has been a champion of healthcare transparency and accountability since his forced departure from the Minnesota Hospital Association (MHA) in late 2010. David was the general counsel for the MHA for nearly 30 years. A revealing video produced by Feinwachs helped illustrate the lack of transparency in healthcare plans funded by the state and administered by private insurance companies.
At issue in the video is the double-standard and lack of accountability that is now the rule for the non-profit HMOs in Minnesota (by law, all Minnesota HMOs are required to be organized as non-profit entities). Feinwachs describes the accountability problem as a “black box.” State “tax dollars go into the black box” of HMO accounting in the form of $3.8 billion dollars in tax money every biennium, and they are “never accounted for” in any meaningful way, according to Feinwachs.
The actions taken by Feinwachs created a flurry of legislative activity by members of both parties. Their efforts were an attempt to address the ongoing lack of oversight for tax dollars spent blindly on healthcare by private insurance companies. To date, the only apparent change has been an Executive Order from Gov. Dayton to require some enhanced reporting of expenditures by the HMOs. No meaningful legislation on transparency was produced in 2011. Legislation for 2012 remains up in the air as politics begins to trump policy. ~
Accountability Bill now "Toothless?"
March 30, 2012
It appears that the "teeth" have been taken out of proposed pieces of HMO Accountability legislation. Amendments newly added to a once-strong bill now restore ambiguity and murkiness to a bill originally designed to give clarity about how $3.8 billion healthcare tax dollars are spent by Minnesota's HMOs. Cut and paste this link for more... http://bit.ly/H8Eld8
HMO Accountability Now in Back Seat
March 26, 2012
A piece of strong, bipartisan Minnesota *legislation, designed to increase the HMO’s transparency and accountability for state health programs, has been temporarily sidelined.
Questions were raised last session over the $3.8 billion per biennium handed over to the non-profit insurance companies that run the state’s healthcare programs. As a result of the discussions both bodies of the Minnesota legislature crafted legislation which aimed to remedy that situation. Lack of HMO accountability seemed to be a high priority issue in 2012 as the Health and Human Services committees in the House and Senate held hearings on various bills.
A hearing held on February 14th in the House was the centerpiece of the early discussions.
Presenters at that meeting included Human Services Commissioner Lucinda Jesson and Deputy Commissioner Scott Leitz. The hearing also featured a presentation by former MN Hospital Association general counsel David Feinwachs, which helped shed light on the current system. It prompted tough questioning from the Human Services Committee members during the 3 1/2 hour hearing.
Representatives from the MN Council on Health Plans, who represent the HMOs, also were on hand. They were grilled about issues relating to the transparency, or lack thereof, in the state tax-funded and HMO administered health services in Minnesota. The Health Plan’s speakers argued, not very successfully, that their auditing and accounting procedures were “very thorough” and needed no added scrutiny. Despite the Health Plan’s reps assurances that transparency was at a high level, the committee members expressed serious doubts.
At the speaker’s table left to right were: Medica’s Geoff Bartsch, David Feinwachs (former general counsel to the MN Hospital Association), DHS Commissioner Lucinda Jesson and DHS Deputy Commissioner Scott Leitz. They all fielded some probing questions during a joint Health & Human Services Committee meeting convened February 14th by Reps. Jim Abeler (Anoka) and Steve Gottwalt (St. Cloud), chairs of the Reform and Finance, committees of the MN House, in that order.
Adding fuel to the questioning and discussion was the revelation earlier in the day that the Federal Government had launched an investigation of the Minnesota Medicaid program. Medicaid has oversight provided by the MN Department of Human Services, and is run by the state’s non-profit HMOs.
The ranking member of the U.S. Senate Judiciary Committee sent a letter to Gov. Mark Dayton asking why UCare, a Minnesota health plan company, repaid $30 million in Medicaid funds to the state as a "gift," rather than as a refund or reimbursement.
In the letter, Sen. Chuck Grassley (IA), said he's “...concerned that the way the funds were returned was meant to avoid reimbursing money to the federal government.”
Grassley’s reference was to e-mails sent by Minnesota Department of Human Services Commissioner Lucinda Jesson in March 2011, in which she described how UCare should draft its press release about returning the Medicaid funds to the state.
"In order to have a good chance of keeping all of this money, it must be characterized as a donation. If a refund, feds clearly get half," Jesson wrote in an e-mail.
The contents of that e-mail exchange prompted some extended questioning of DHS Commissioner Jesson and her Deputy, Scott Leitz. They stated that the dollars returned to the state from UCare ($30 million) was always termed as a donation, not as a refund.
A more in-depth question then arose about the nature of the relationship between DHS and the HMOs who receive $3.8 billion plus in state tax dollars per biennium to run healthcare programs.
According to David Feinwachs examination and interpretations, the unlimited reserves that HMOs accumulate in state tax dollars should be closely scrutinized. These reserves are created to fend off their “risk” of large claims. “The HMOs are never at risk…” Feinwachs stated when referring to massive reserves held by the HMOs. He explained that the way the system is set up now, if an HMO running one of the state health programs experiences a shortfall one year, the rates are adjusted by DHS the next year to make up for the HMOs previous year’s “loss.”
Sen. Grassley also sent letters to all of the Minnesota’s non-profit HMOs in charge of the state healthcare programs and recipients of state tax dollars. In these letters he focuses on a number of key points, including some designed to examine potential “overpayments” received by the HMOs from Minnesota’s DHS.
Sen. Grassley’s letters and questions get at the heart of the accountability matter and, for those of you who are concerned taxpayers, they can be found at:
*(HF 2412 and SF 1824)
HMO Accountability Now A Priority in Minnesota
February 28, 2012
A tireless effort by members of Greater Minnesota Health Care Coalition (GMHCC) is finally starting to yield a return in terms of legislative action.
Since early 2007, the GMHCC members have trumpeted the lack of legislative oversight for billions of tax dollars spent on healthcare in Minnesota. Those funds have been earmarked for the various state-funded programs like General Assistance Medical Care (GAMC), MnCare and Medical Assistance (MA).
Tax dollars assigned for those programs flow through to a number of HMOs who are designated as program administrators in almost all cases. The price tag is nearly $4 billion dollars per biennium.
A quick history shows that this system of flowing tax dollars through HMOs to do “managed care” of people enrolled in the aforementioned programs began in the early to mid 80’s in Minnesota.
Originally created as a “pilot project” to measure whether HMOs could deliver some healthcare services more cost effectively, it subsequently turned into a “permanent” program.
Numerous efforts by advocates and members of the MN Legislature to measure the HMO’s administrative effectiveness have been thwarted over the years.
Most recently, a push that was spearheaded by GMHCC in 2007 resulted in an OLA (Office of Legislative Auditor) report in 2008. The OLA report gave a partial glimpse into the lack of transparency and accountability in the program’s administration by the HMOs.
The issue of accountability was front and center as the subject of a joint Health & Human Services hearing, which combined both the Reform and Finance committees in a joint informational session.
Rep. Jim Abeler and Rep. Steve Gottwalt chairs of the HHS Reform and Finance committees respectively, recently convened a joint informational hearing. The impetus for the hearing was the information about the lack of HMO accountability brought forth by David Feinwachs. Feinwachs was general counsel to the MN Hospital Association for over 30 years. He was terminated for promoting information showing the lack of accountability by HMOs.
Legislation to help address the issue of HMO accountability has been offered up by Rep. Carolyn Laine and Rep. Steve Gottwalt in the MN House. The House bill is a companion to a similar measure authored by Senator Sean Nienow of Cambridge. At the heart of both bills is a call for independent and comprehensive audits of the HMOs accounting records for the state-funded healthcare programs.
Occupy Movement Comes To Minnesota
The number of protests now known as the “Occupy” movement grows a little more each day around the country and, at last count, listed over 100 sites nationwide.
In Minnesota the OccupyMN protest has developed in downtown Minneapolis near the Hennepin County Government Center.
A variety of interests/concerns are represented at the site including spots for campaign finance reform, environmental protection, bank regulation and oversight, and, of course, healthcare reform.
100+ people were on hand (in the rain) for an October 25th
Healthcare Reform Rally at Occupy MN.
A healthcare reform rally was called for the evening of October 25th at the plaza and representatives from at least a half dozen groups turned out to take part in the action. Physicians for a National Health Plan (PNHP-MN), MN Universal Health Care Coalition (MUHCC), Greater Minnesota Health Care Coalition (GMHCC), Universal Health Care Action Network (UHCAN-MN), Minnesota Nurses Association (MNA), Service Employees International Union (SEIU), and the Minnesota Green Party made up the bulk of the rally contingent.
After a 20-25 minute gathering rally the group took to the street and marched three blocks away to the front of the U.S. Court of Appeals plaza (also known as Bankruptcy Court). The gathering spot was chosen because of the preponderance of bank foreclosures attributable every year to overwhelming personal medical expenses.
According to PNHP-MN spokesperson Dr. Elizabeth Frost, over 60% of all bankruptcies filed in the United States are medical expense related and, of those, almost 70% had health insurance. “This is obscene (foreclosures due to medical costs) and it’s wrong…” Frost said, “we really need to change our broken system to something that works for everyone, not just the very wealthy.”
Cravaack Attempts To Answer Medicare Questions
Congressman Chip Cravaack (CD8) has convened a handful of town hall forums in the district recently to give people the opportunity to hear from their elected representative.
His most recent forum was in downtown Mora at Freddie’s Restaurant on South Highway 65. A packed room greeted the Congressman as he spent the better part of an hour giving updates on a couple of topics, with heavy emphasis on the “overwhelming debt load” that the United States faces.
Cravaack’s presentation of charts and graphic illustrations lasted almost 40 minutes. He then opened the floor up to questions from a very polite and unusually supportive audience. The questions were mostly covered by the substance of his video presentation but he politely referred back to his charts or graphs for additional support.
One of the last questions had to do with Medicare and the proposed revamping of the entire structure. The questioner (from Seven County) asked why the proposed changes leaned heavily towards Medicare privatization through the use of a “voucher system.” To support the validity of the question an illustration was given by the questioner of the “disaster that was Part D.” He cited the small number of people that received substantial-to-moderate help and the disproportionate cost of the Medicare Part D Drug program, relative to that assistance.
Representative Cravaack stated that the Medicare changes that are being proposed under the Rep. Paul Ryan Budget plan will actually save Medicare almost “38% in overall costs.” He went on to say that the changes were “originally proposed during the Clinton administration by Alice Rivlin.” Cravaack went on to correct the terminology being used to describe the Medicare revamping, preferring to call the changes “premium support/subsidies” and not “vouchers.”
According to reports and an interview in the Washington Post* earlier this year, the referenced Alice Rivlin Medicare proposals (1993) were substantially different than the Ryan Medicare proposals (2011).
The biggest difference had to do with adjusting the amount of the support/voucher annually to the cost of inflation. If the cost of healthcare went up substantially, as has been the case for the past decade, the value of the support/voucher would drop dramatically. That shortfall would mean that the Medicare recipients would then be liable for more and more out-of-pocket expense.
At earlier town halls in Mountain Iron and at the Duluth Airport a number of questions regarding the reported savings of Medicare Part D went unanswered. Cravaack’s aides promised to “do research and get back” to the questioners shortly. As of November 14th there has been no follow-up from Rep. Cravaack's office for answers/responses to those requests.
HMO's Reporting Requirements Under Scrutiny -
Will They Change?
A group of healthcare reform advocates, accompanied by some current legislators, received confirmation that Minnesota’s privately run system is lacking normal oversight and likely is wasting significant amounts of tax dollars.
A representative from a national accounting firm that specializes in the auditing of Managed Care Organizations (MCO) was asked to examine the practices used in monitoring the state-funded and privately administered healthcare programs in Minnesota. In his words, he was “shocked” by what he found. He called the lack of accountability “simply amazing” and indicated that the fact that this has been allowed to go on for so long “even more amazing.”
The visit and the subsequent look at the state’s healthcare practices were prompted in large part by the efforts of David Feinwachs. A video (created by Feinwachs) which pointed out the secretive nature of tax dollars handled by HMOs and insurance companies created quite a stir in the Minnesota legislature this past session. For his efforts Feinwachs was “released” from his duties as MHA (MN Hospital Association) General Counsel.
The attention to Feinwachs’ video and his accompanying report brought bipartisan support from the legislature. Republican Senator Sean Nienow (Cambridge) authored a number of bills aimed at improving transparency and increasing accountability. Likewise, Democratic Senator John Marty (Roseville) put forth similar bills with the same intent.
With the state facing a $5 billion budget shortfall, sharp scrutiny of the HMOs, which receive $3 billion bi-annually to provide health care for more than 500,000 individuals – looked inevitable early in the session. Reports that the HMOs’ financial reserves have ballooned to $2.5 billion only increased the calls for reform.
For some reason, none of the proposed bills for accountability ever got a hearing. “Bipartisan interest and no hearings – when’s the last time you saw that?” asked Feinwachs, a persistent critic of the state’s nonprofit health plans before, during and after his 30 year tenure as MHA General Counsel.
It is difficult to determine exactly why the impetus for overhauling the state’s rules for regulating HMOs, principally Blue Cross & Blue Shield, HealthPartners, Medica and UCare, dissipated and then disappeared. Capitol observers believe that a full-court press lobbying effort by the health plans effectively sidelined the issue. Together those four health plans have 27 registered lobbyists on the books.
An Executive Order issued by Gov. Mark Dayton in March may have had something to do with stalling the accountability efforts. One of the items in Dayton’s order was to cap HMO profits at 1%.
Under the directive, excess revenue would be returned to the state’s general fund. Critics of HMO accountability were unimpressed by the 1 percent cap on profits. That’s because there are no limits or definitions of what health plans can charge off as administrative overhead; the arrangement provides for no independent, outside audits of their books; and the cap is only in place for one year.
Nienow argued that the health plans can simply finesse their books to shield any profits. “The 1 percent cap is absolutely meaningless…” he said, “on paper it looks good… it’s something that makes everybody feel good, but doesn’t really do anything.”
Vermont Edges Closer to Single-Payer
Vermont has moved ahead of Minnesota and become the first state to lay the groundwork for single-payer health care when its governor signed an ambitious bill aimed at establishing universal insurance coverage for all residents.
"This law recognizes an economic and fiscal imperative," Vermont Governor Peter Shumlin said as he signed the bill into law. “We must control the growth in health care costs that are putting families at economic risk and making it harder for small employers to do business."
Legislators say the plan, approved by the Democratic controlled House and Senate this spring, aims to extend coverage to all 620,000 residents while containing soaring health care costs.
The chief architect of the Vermont bill is Dr. William Hsiao, Harvard Professor of Economics and healthcare expert. Dr. Hsiao leads a new program in health systems studies at Harvard University. He received his Ph.D. in Economics from Harvard and is also a fully qualified actuary with extensive experience in private and social insurance. His work was the foundation for the successful single-payer healthcare system operating in Taiwan since 1995.
In Vermont a key component of that legislation establishes a state health benefits exchange, as mandated by the new federal health care law. That exchange will then offer coverage from private insurers, state-sponsored and multi-state plans. It also will include tax credits to make premiums affordable for uninsured Vermonters.
Green Mountain Care (name given to the program in Vermont) will be managed by a five-member board; will set reimbursement rates for health care providers and streamline administration into a single, unified system.
Residents and small employers will be able to compare rates from the various plans and enroll for coverage of their choosing.
As designed, the goal is an eventual state-funded and operated single-payer system.
But its sponsors say that outcome is far from certain. The plan will be phased in over several years, with an evolving financial structure that mandates a number of conditions.
Among criteria are adoption of a financing plan by 2014; ensuring the new system costs less than the current fee-for-service one; and obtaining federal permission via a waiver to allow Vermont to proceed with the single-payer option, in around 2017.
Advocates of change say the current fee-for-service care in Vermont has a financial incentive to deliver more care, such as tests, with little attention to quality or better outcomes.
Vermont’s health care spending runs about $5 billion annually, with costs rising between 6.5 percent and 8.5 percent in recent years.
Some experts say a revised system would save an estimated $580 million annually and $1.9 billion by 2019, while creating several thousand jobs.
Reuters and Burlington Free Press
Healthcare Education Session with Dr. William Hsiao
Seven County and GMHCC were well represented for a presentation by Dr. William Hsiao, well known healthcare expert and Professor of Economics at Harvard University. He spoke to a crowd of about 175 people on Sunday September 25th in St. Paul. Shown above are (l to r): Char Fisher (Central Senior Federation), Dr. William Hsiao, Tim Burkhardt (Executive Director 7 County, GMHCC Co-coordinator), Lila Skramstad (President – GMHCC), Mary Mayer (Treasurer - GMHCC, Central Senior Federation), and Jerry Challman (Vice President—GMHCC, N.E. Citizens Federation).
T.R. Reid ~ MUHCC Fundraiser
Seven County Attends Healthcare Fundraiser
Renowned Journalist and author T.R. Reid was the featured guest speaker at the Annual Summer Fundraiser sponsored by the Minnesota Universal Health Care Coalition (MUHCC) and the Physicians for a National Health Program (PNHP MN) Minnesota chapter. Seven County and its GMHCC partners are working closely with these groups, and more, to promote meaningful healthcare change.
Hundreds of people gathered at Macalester College in St. Paul in June to help support the cause of advancing the Minnesota Health Plan closer to passage into law in this state. Seven County had the privilege of attending this outstanding event and were represented by staff members Tim Burkhardt (Executive Director), Lisa Krahn (Outreach Coordinator), and Shannon Jackson (Communications Coordinator).
Reid spoke about the need to realistically assess reforms that have been proposed in order to find a ‘uniquely Minnesotan’ healthcare solution and he spoke glowingly about the concerted efforts underway in Minnesota to improve the delivery of healthcare for all citizens.
Shown above: Lisa Krahn (7 County), T.R. Reid and Shannon Jackson (7 County).
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