Commissioners travel to Cloquet to talk health care

Tony Lourey hasn't forgotten the rural areas he served as state senator.

On one of his first road trips as Minnesota Department of Human Services Commissioner, Lourey - along with agricultural commissioner Thom Petersen - called a "town hall" meeting in Cloquet last week to discuss proposals put forth by Governor Tim Walz to create broader access to health care coverage and mental health care.

Attended by mostly healthcare professionals along with media, the meeting covered the ONECare Minnesota proposal put forth by Gov. Walz and Lt. Gov. Flanagan in the governor's budget the day before.

"Every Minnesotan should be able to access care without worrying about going bankrupt," Lourey said. "Lack of comprehensive coverage, rising drug prices and limited access to dental care are forcing many Minnesotans to make impossible decisions between receiving care and paying the bills. ONECare Minnesota helps to address many of the immediate health care challenges facing Minnesotans across our state."

The ONECare package would create a statewide comprehensive health insurance option for Minnesotans with a broad provider network and benefit set similar to the MinnesotaCare program, including dental and vision benefits and behavioral health services. It also creates options in any region of the state where the individual market fails to provide coverage choices.

The proposal would also make prescription drug benefits the same for all state health coverage programs, to better leverage the state's purchasing power to lower drug costs. In turn, this would hypothetically help people access needed medications with more consistent choices and fewer disruptions and simplify the process for providers. Additionally, the ONECare Minnesota package creates a simpler and more equitable model for purchasing dental benefits to help dentists serve all patients in their community, improving dental access and experiences.

Dr. Vicki Anderson attended the town hall meeting, she said, to see what Lourey had to say about how the budget would impact health care in our area.

Afterward, Anderson said she liked the idea of using MinnesotaCare as a kind of model for extending the program to help small businesses and farmers.

"I think MinnesotaCare is wonderful," she said, praising the program as well-run and helpful to many. "As a physician, I've been happy to pay my 2 percent provider tax that supports it. It's helped a lot of my patients who couldn't afford insurance or who were otherwise not insurable - because companies wouldn't accept them because of pre-existing conditions."

A family practice doctor who retired from Raiter Clinic in 2014 after 38 years of practice in Cloquet, Anderson still practices part-time in the ER at Community Memorial Hospital, where she is also Medical Director of Quality.

The Walz-Flanagan budget also includes mental health initiatives for rural residents.

"Governor Walz's budget addresses two issues that are critical to the health and well-being of Minnesota farmers and rural communities – affordable health care and access to mental health resources," said Commissioner Petersen.

Lourey talked about getting rid of the stigma that sometimes surrounds mental health.

"Seeking help early, recognizing that is the right thing to do is a sign of strength, not a sign of weakness," he said.

Dave Lee, Carlton County Public Health and Human Services director, asked if the state would be encouraging rural clinics and hospitals to also build for mental health resources as they add on to their facilities, so patients could get complete and comprehensive care in one location.

"It's even difficult for folks going into a medical clinic, let alone a siloed separate mental health facility," Lee pointed out.

Lourey said "yes" and talked about six existing Certified Community Behavioral Health Clinics (CCBHC) across the state, and plans to add five more.

"We do need to be integrating behavioral health (mental health and chemical dependency) into the physical health space and make sure that it isn't just - 'oh, here's an appointment, you go try to find someone at a later date,'" he said, explaining that CCBHCs combine mental health, chemical dependency, physical health and social determinants of health all in a one-stop service center for patients.

"It's amazing," he said. "It really is transformational for clients, who will tell you they've been struggling for decades to be be seen as a whole person."

In response to questions from CMH CEO Rick Breuer, Lourey agreed that the solutions for overhauling provisions of health care toward maintaining wellness rather than waiting until someone is sick will be different for rural areas than for larger metro parts of the state.

But it might not be the rural areas that need to change the most, he said.

"Honestly, the type of care we're looking for is the type of care that rural is used to getting," Lourey said. "We know our providers, that's why when network design starts to exclude our providers, it's much more personal to us, and if we're looking for the care model that really serves the patient, we should really look to rural for some solutions."

He assured the several providers in the room that payment rates would be no less than Medicare payment rates. Once the program is set up and running, it will be paid for by the people using it, not through special subsidies. People will be able to use existing federal and state tax credits to help mitigate costs, he said.

"We want to work with our provider community to figure out how we make this product work, so people can actually come and achieve the better health that actually helps us reduce the cost of the health care system," Lourey said. "These solutions do exist."