Funding for disabled and long-term care? It's personal

The state human services budget involves more than numbers and politics. Even for some legislators, it's personal. Take state Sen. Kent Eken, DFL-Twin Valley, the sponsor of this year's bill to boost wages for home health care workers for the disabled 5 percent in each of the next two years.

One might say that concern about state funding for the disabled runs in the Eken family. The senator's father, the late Rep. Willis Eken, likely never would have run for the House in 1970 if he had not seen the need for more state help for his intellectually disabled son Kyle, Kent's older brother. The young farmer became an advocate for more funding for special education in the mid-1960s as he and his wife, Betty, resolved to raise Kyle at home, not in an institution 100 miles away.

Willis Eken, whose 14 years in the House included four years as majority leader, fired Kent's interest in politics and inspired him to launch his own legislative career in 2002. Remembering Kyle, who died at age 12, and watching Willis struggle with dementia and Parkinson's disease drew Kent to human-services budgeting. It gives him "a real sense of purpose," he said.

Willis died in 2010 after spending six years in a nursing home, during which, sad to say, the affable storyteller whom I knew as majority leader lost his ability to speak. Those who cared for him in his final illness were "like family," his son said.

That's why Kent Eken's heart is in his bill to increase funding for the services to the disabled — and why he's concerned about recent human services budget news from the governor and the state House.

On March 17, DFL Gov. Mark Dayton issued revised recommendations for the next two state fiscal years that included $25 million more for higher pay in nursing homes. But it offered no increase for the home care and group homes that keep disabled people out of those comparatively more costly institutions.

Then last week, the House GOP majority rolled out budget targets that include a 7 percent cut in human services spending from forecast levels for 2016-17. House Ways and Means chair Jim Knoblach took pains to say that the House's plan includes $160 million more for nursing homes, compared with their 2014-15 appropriation. He made no similar promise about home care services. For reasons having more to do with legislative history than logic, these two forms of long-term care are separate state budget accounts.

But a lot — or maybe too much — was said about home care services on the House floor on March 19. The House version of Eken's bill was the subject of the House DFL minority's game of Political Gotcha. In this depressingly familiar game, House minorities tempt majorities to abandon orderly budgeting and pass a popular bill immediately. The majority doesn't take the bait but, in sticking with the committee process, posts a batch of bad votes with which opponents can portray them as cruel, heartless and/or dimwitted in the coming election.

Republicans pulled this very stunt with, as memory serves, this very sort of bill when they were in the minority. A pay increase for caregivers was likely chosen because it tugs at heartstrings but is too expensive to be responsibly considered apart from the rest of the budget. No official cost estimate has been attached to 5 percent wage increases for home care providers in each of the coming state fiscal years, but a one-year increase of 5 percent enacted last year cost taxpayers $80 million.

Advocates for the 90,000 disabled Minnesotans who rely on home- and community-based services winced when their bill became the cudgel with which one party sought to bludgeon the other. Those advocates know they are going to need friends of both political stripes to alter a funding pattern that they say is unsustainable for an aging population.

Between 2006 and 2015, the state-determined provider rates that pay caregivers' wages increased 10.4 percent while inflation rose 23.3 percent, said Bruce Nelson, CEO of ARRM, a group home advocacy network. Wages for caregivers are typically $11 to $12 per hour, Nelson said. As the economy has recovered and wages in other industries have climbed, the caregiving workforce has become increasingly difficult to retain.

That's especially true in Eken's district, the senator said, where better-paying jobs for caregivers are right across the North Dakota line. "Stability is so important for the people who receive this care," he said.

Eken's aim this session is to avoid leaving disabled people and their caregivers behind. He also has a longer-term goal: getting long-term care off the state general fund roller-coaster. He wants to ask Minnesota voters to create a new state tax constitutionally dedicated to long-term care in any setting — nursing homes, group homes, private homes and any other home that may come along in the future.

The tax he has in mind is a Minnesota piggyback on the federal Social Security payroll tax. The feds apply that tax to incomes up to a cutoff that's pegged to inflation, and sits at $118,500 this year. Eken's idea is to apply a Minnesota long-term-care tax at the same rate as the Social Security tax to the portion of personal income above the federal cutoff.

Such a tax would raise a hefty $600 million per year from upper-income Minnesotans — the very folks who howled two years ago when DFLers socked them with $1 billion per year in higher state income taxes. The tax-averse House GOP majority is sure to recoil from Eken's idea. He introduced it this session but isn't planning to push it — yet.

But because his heart is in this part of the state budget, I expect Eken to push his constitutional-amendment idea to the fore eventually. And because so many other Minnesotans have a heart for their family and friends who are frail, disabled or both — and don't like how they fare in funding battles at the Capitol — I expect Eken's amendment to meet with a lot of interest.

Nelson, at ARRM, calls caring humanely for a fast-growing elderly and disabled population "the challenge of our times." Minnesota stands a better chance to meet that challenge well if its legislators can combine policy creativity with personal passion — as Eken does.

Lori Sturdevant is a Star Tribune editorial writer and columnist. She is at lsturdevant@startribune.com.