Legislative updates for the 2015 session will be archived on this page. Watch here or check your email for updates.
February 16, 2015
This past week the legislature primarily focused on reviewing the Governor's budget recommendations for the next biennium. The House and Senate HHS Finance committees heard from the public in two full committee days of testimony as well as from DHS staff. The 2015 legislative session has been relatively slow so far, but it is expected to pick up as we get closer to March and committee deadlines.
March 24, 2014
Omnibus Supplemental Budget Bills
HEALTH AND HUMAN SERVICES
House DFL Releases Spending Targets
House DFLers on Friday unveiled their supplemental budget for the 2014 session. The new spending targets reflect the majority caucus’s spending choices for the $1.23 billion budget surplus that was forecast in the February economic forecast. The proposed budget would give $75 million for health and human services which was the only are of the state budget that was reduced last session. The majority of the HHS budget in projected to go towards rate increases for home and community-based healthcare providers. The House Ways and Means Committee on Monday is scheduled to discuss the resolution.
HHS Policy Bill Passes Committee
HHS Policy Omnibus Bill (HF 2402) passed out of the House HHS Policy Committee on Friday evening. The bill includes a number of provisions ranging from the regulation of electronic cigarettes to modifications to the newborn screening program. HF 2402 does not include the Music Therapists licensure language MSHA has been working to defeat. Although Speech Language Pathology Assistant licensure was not included into to final omnibus bill, there is strong indication from the Chair of the committee that it will be addressed next year before prospective SLPAs graduate in 2015. The Senate HHS Policy Omnibus bill is expected to be introduced later this week.
Temporary Limited Licensure
February 19, 2014
The Minnesota Speech Language Hearing Association (MSHA) is proposing two pieces of legislation. The reasons for proposing the pieces of legislation are to meet our common goals of ensuring that students/clients in Minnesota receive speech therapy from trained professionals and addressing the shortage of Speech-Language Pathologists.
The first is dealing with the use of the Temporary Limited License (TLL) to fill vacancies in school districts when a licensed Speech-Language Pathologist (SLP) is not available. Currently, according to Minnesota Statute 8710.1250, an individual can apply for a TLL with a bachelors degree in speech-language pathology, speech and hearing sciences, communication disorders or in a a related field. As a result, individuals who have limited or no clinical training may be working with children with communication disorders. While the idea of that "we all use language we all should be able to teach language” is one viewpoint, the reality is that out there this approach may only work if the individual has a language system that is not in some way delayed or disordered. Individuals with communication disorders do not acquire language like those with typically developing language systems. The other areas of communication such as articulation, voice, fluency, dysphagia (swallowing), and social communication also require specialized training in order to positively affect the outcomes in individuals with communication disorders. Lack of proper training may lead to therapy approaches that produce more harm than good. MSHA is proposing this change in legislation in order to ensure that the students in Minnesota schools who meet the criteria for special education services in the area of speech language impairment receive services from the highest qualified professional.
In the area of identification and evaluation, most undergraduate programs do not thoroughly train their students on psychometric processes, the use of and the interpretation of evaluation results. This can result in the under- and over-identification of students with communication disorders if the individual completing the assessment does not understand these principles, which, in turn, affects caseloads.
MSHA is proposing that the state statute governing the granting of a TLL in speech-language pathology be changed to require that an individual must have at least 100 supervised clinical hours prior to receiving the license. This will assist in ensuring that the students are being properly served. Individuals who are enrolled in a master’s degree program and have obtained the requisite clinical hours would be eligible for a temporary limited license, which would allow them to fill a vacant SLP position while completing their master’s degree.
The second piece of legislation deals with licensing the Speech-Language Pathology Assistant. The primary reasons for seeking a license for the SLP Assistant has to do with ensuring the highest quality of services for those receiving speech-language pathology services from the emerging group of professionals who are serving as assistants to SLPs. This will also bring us in line with other professional groups offering licensure to assistants, including physical therapist assistants and certified occupational therapist assistants.
Information regarding the proper role, duties, and restrictions for a the SLP Assistant can be found below and is based on Minnesota Statute 148.5192, which mirrors the recommendations from the American Speech Language Hearing Association (ASHA).
SLP Assistants Can:
MSHA is grateful for your support of the TLL and SLP Assistant legislation. These proposed laws strengthen our common goal to protect students and clients with communication needs, as well as the professionals who serve them. Please contact MSHA with any questions at 651-290-6292.
Jeremy D. Braun Sarah Angerman Marilyn Fairchild
Online Resources Related to SLP Assistants
Scope of Practice: The link below provides information regarding ASHA’s guidelines for SLP Assistant scope of practice. This information was used to inform the language within MN Statute 148.5192.
Frequently Asked Questions: ASHA provides answers to a variety of questions pertaining to SLP Assistants. Questions include how to define SLP Assistant roles, how to supervise, credential, and train SLP Assistants, how to provide fieldwork experience for SLP Assistants, and how to get reimbursement (when possible) for services provided by SLP Assistants.http://www.asha.org/associates/SLPA-FAQs/
ASHA Associates: SLP Assistants are currently not regulated, licensed, or certified by ASHA. Regulations regarding the hiring of SLP Assistants vary from state-to-state. However, ASHA has developed an Associates level of membership. This page gives information regarding this program and provides links to other resources regarding the hiring of SLP Assistants.http://www.asha.org/associates/
SLP Assistant Overview: ASHA provides information regarding key issues, resources, and references re: SLP Assistants.
Specific State-by-State information re: SLP Assistants: This document examines current licensure, registration, and minimum qualifications for SLP Assistants across the 50 states.
Licensure Information: The following links provide licensure information state-to-state; this information is not necessarily specific to SLP Assistants (i.e.: covers SLP licensure as well)
Reimbursement for SLP Assistant services: The use of assistants can improve access to and reduce costs of quality services. It is appropriate to bill for the service provided; however, Medicaid reimbursement of SLP Assistants varies from state to state; in MN, Medicaid does not currently recognize SLP Assistants as service providers. Medicare policy currently does not recognize SLP Assistants, regardless of the level of supervision and does not reimburse for SLP Assistant services. Private insurers may cover licensed or registered SLP Assistants. One must query each payer to verify coverage. Private insurers may or may not provide a different rate of reimbursement for services provided by an SLP as opposed to an SLP Assistant.
April 24, 2013
Education Finance Bills Move Forward
The respective education finance bills moved through the Legislature this week. Included in both bills are provisions of interest to MSHA:
The full House and Senate are expected to take up their Education Finance bills some time mid-week of next week. After that, a conference committee will meet to resolved differences between the House and Senate bills.
With a budget target that would spend $150 million less than the current biennium, the House and Senate Health & Human Services Finance Committees have passed differing omnibus finance bills. The House proposal, HF1233, offsets the $150 million by increasing surcharges on hospitals (amounting to $100 million) and by capping HMO reserves (saving the state $50 million). Home care and nursing home providers would receive a 2% increase as well as the repeal of last biennium’s 1.67% rate decrease. The proposed rate increases are funded by redirecting funds that would otherwise be proposed increases to community service grant programs, which provide capital improvements for long-term health care programs. A number of mental health proposals are also included in HF1233.
In the Senate, the omnibus language in SF1034 was introduced on April 15 and was quickly voted out of committee the following evening. That plan calls for a surcharge on HMOs of $80 million and to align Managed Care Organization (MCO) rates which reflect recent experiences, saving the state $54 million. The bill also includes a plan for a $16 million surcharge on nursing facilities, a sharp departure from the House proposal. The Senate plan calls for the same 2% increase and 1.67% rate decrease repeal that is in the House language. Child care providers will also see a 2% rate increase if the Senate plan becomes law. The bill emphasizes a priority on mental health, through funding for mental health peer specialists and higher MA reimbursement for psychological consultation.
Both proposals also return dollars to the Statewide Health Improvement Program (SHIP), a Department of Health initiative that would encourage families and individuals to live healthier lifestyles. Medical Education and Research Costs (MERC) funding was also restored in the two bills, though the House appropriates considerably more. MERC provides support for certain medical education activities in Minnesota that have historically been supported in significant part by patient care revenues. Funding to both of these programs was dramatically reduced during the previous biennium.
April 8, 2013
As the legislation moves closer to committee deadline for finance bills, the next couple of weeks will bring a flurry of activity to St. Paul. Some major budget items, including Education and Health and Human Services will highlight this week’s committee work.
Education Finance committees to begin work on appropriations bills
Prior to the break, both the House and Senate released their budget targets. These are the amounts of new spending (or cuts) that each body’s leadership has assigned to their respective committees.
The House E-12 target provides for a $550 million increase for education over the biennium. Key elements of their plan will include fully paying back the education shifts, funded by a temporary income tax surcharge on high earners. The details of the House education finance bill are expected to be released on Tuesday evening. The committee is expected to wrap up the bill on Friday, April 12.
The Senate E-12 budget target calls for a $486 million funding increase that includes money to buy down local levies by $150 million and funding for all-day kindergarten. The details of the Senate education finance bill is expected to be released on Tuesday morning. The committee is expected to wrap up their bill that same day.
Big Week for Health and Human Services Funding
With both the House and Senate Health and Human Services Committee expecting to introduce their budget plans this week, healthcare providers are eagerly anticipating how the budgets will impact their organizations and businesses.
Leadership in both the House and Senate has proposed reducing the health and human services budget by $150 million over the next two years. This is contrasted with Governor Dayton’s proposal to increase HHS funding by $170 million over the biennium. The House HHS Finance Committee is expected to introduce their budget on Tuesday April 9 with a presentation of what is included. Public testimony to the bill will begin on Wednesday and Thursday followed by amendment proposals on Friday. Expect the Senate to introduce their version of the HHS Omnibus Finance bill later in the week.
This week will also focus on results of a recent HMO audit with a joint House and Senate HHS Finance hearing on Wednesday. With the report showing that the state has overpaid health plans over $200 million, look for legislators to propose taking those extra dollars to assist in balancing the state’s budget.
February 25, 2013
The state legislature has taken their Easter/Passover break. Beginning March 25 through April 1, no committee work or session will take place. The break also has coincided with the second committee deadline, meaning if a policy bill has not been voted out of a policy committee in both the House and Senate, the bill cannot continue on its own this session. Look to find that some bills not passed out of committee by this second deadline included into a future omnibus bill.
As mentioned earlier, House and Senate leaders announced committee budget targets earlier this week. We will not know the specifics until the committees assemble their omnibus bills but this gives us a first look of their legislative priorities.
House DFL leaders unveiled their plan stating that education, early education through higher education, will be their priority for the 2013 legislative. Key elements of their plan include fully paying back the education shifts, funded by a temporary income tax surcharge on high earners, and a $550 million increase for education over the biennium.
The Senate DFL plan prioritizes education funding and property tax relief. However, they disagree with the House DFL on paying the shift back and plan to have it paid back according to current law. Their proposed education budget target calls for a $486 million funding increase that includes money to buy down local levies by $150 million.
Special Education Bills Moving Forward
The House and Senate Education Committees recently heard several bills of interest to MSHA. The first bill was HF1383/SF1169, which proposes to establish a special education caseloads task force. The MN Department of Education testified to the need to address caseloads and paperwork issues. They believe a task force is the best way to bring stakeholders to the table. This legislation is a priority of the Governor as well.
The second bill heard was HF356/SF262, which proposes to increase the safe school levy and to increase funds for Positive Behavioral Intervention and Supports (PBIS).
The next bill, HF771/SF1083 , updates the law on the use of seclusion and restraints in the schools. This bill further clarifies the definition of emergency, expands the role of the local review committee, strengthens state oversight, clarifies when IEP teams meet and extends the use of prone restraints in emergencies for two more years.
Lastly, HF1371/SF1364, would exempt speech pathologists from the teaching requirements for the Special Education Director license. MSHA supports this legislation and submitted a letter stating their support to the House and Senate Education Committees.
Health and Human Services
While many areas of the budget are looking at slight increases, the health and human services world was not among them. After languishing through a biennium with a roughly billion dollars reduced from the HHS budget, both House and Senate leaders have proposed decreased HHS targets of $150,000 this biennium. Many providers and other non-profits who have seen their rates reduced over the last few years are potentially facing yet some more pain.
It will now be up to the chairs of both the House and Senate Health and Human Services Finance Committees to come up with a budget that will once again be looking at reductions.
The State Health Exchange bill, HF 5/SF 1 has been signed into law by Governor Dayton this past week. The state, having to have passed the legislation by March 31, now has an official name, MNsure. By April 30, the governor will appoint six MNsure board members to serve with DHS Commissioner Jesson. Insurance providers will begin placing plans on the exchange website beginning in October, with purchasing set to begin in 2014. Up to 1.3 million residents are expected to purchase their insurance through MNsure.
The Music Therapy Licensure bill, HF 849/SF 404 was not heard in either a House or Senate policy committee, therefore it cannot continue. Although the bill cannot officially move forward this session, there are opportunities for legislators to amend this language to another bill.
February 25, 2013
This week, the Governor’s education funding recommendations were introduced. HF630/SF453 includes the Governor’s recommendations to increase special education funding by 13% ($140 million) and replace the current special education-regular and excess cost formulas with a new formula under one appropriation beginning in FY15. The Governor also put forward recommendations to reduce special education paperwork but that language is not included in the budget bill. MDE expects to get a policy bill introduced in the next week and hopefully details will be found there. We will keep you posted.
Health and Human Services
This week, HF849/SF404 was introduced in both houses which creates music therapy licensure. The bill would create a music therapy advisory council along with licensure application requirements, and defines the practice of music therapy. This legislation may be of importance to MSHA due to what the scope of practice may include. As of now, the bill includes language that a music therapist will be able to assess each client and create an individualized plan that identifies goals, objectives, and potential strategies. The bill was referred to the Health and Human Services Policy committees in both the House and Senate. We will keep you updated on any movement with this legislation.
January 30, 2013
Governor Dayton released his budget recommendations for the 2013 legislative session. The following recommendations affect speech-language pathologists and audiologists in health care and educational settings:
MA Rate Increase for Targeted Service Categories:
There is a provision is his Department of Human Services budget that may pertain to MSHA. The Governor recommends increasing MA rates for specific categories of service to maintain provider access for public program participants. Specifically, this increase applies to inpatient hospital, outpatient, mental health, basic care, and physician and professional services in MA fee for service. The physician and professional services include primary care, podiatry, chiropractic, audiology, vision, radiology, and mental health. This increase is effective beginning in 2014. There are no specifics at this time.
The Governor recommends increasing special education funding by 13% and replacing the current special education-regular and excess cost formulas with a new formula under one appropriation beginning in FY15. The new special education formula will include a pupil-driven formula that accounts for the incidence and cost related to disabilities as well as poverty concentration and an excess cost formula to make funding more predictable and ensure that funding is targeted to districts with the greatest need.
Beginning in FY15, all special education costs will be included in excess cost aid calculations, consistent with current practice for tuition billing (e.g., fringe benefits will be added), and aid will be calculated using prior year data.
For open-enrolled students, the new formula will require the serving district to pay for 10% of the unreimbursed cost of providing special education and services, which will encourage cost-containment. However, districts with high concentrations of special needs students (those in which more than 70% of students have Individualized Education Programs) are exempt from this requirement.
Special Education Paperwork Reduction:
The Governor recommends that the Department of Education develop model Individuals with Disabilities Education Act (IDEA) paperwork that would be available free of charge to schools. This model would be provided through an online system created and maintained by the MDE. It is estimated that by streamlining and simplifying paperwork requirements will provide cost-savings for local districts of approximately $1.5 million.
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2018 MSHA Convention