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Events, Speeches &
Floor Statements

Klobuchar pushes for legislation to support state medical services

February 14, 2008 | Watch

Mr. President, I rise to speak in strong support of amendment number 4023. And this is the amendment that my friend, Senator Mikulski, just spoke about.  It's a bipartisan amendment cosponsored by myself, Senator Mikulski, Senator Coleman, and many, many other senators from across this country.

This amendment would stop the administration from making drastic changes to its targeted case management system that would hurt those in our country who are most in need of assistance. Targeted case management benefits children in foster care, kids and adults, battles mental illness, and seniors and disabled people receiving institutional care.

It exists to help these individuals navigate the complicated web of available services, to help these men, women and children overcome bureaucratic barriers in order to achieve independence. These services include transporting people with disabilities to and from doctors appointments as well as managing pharmacy services for individuals with severe mental illness. These essential services are now threatened by a proposed rule change from the centers from Medicare and Medicaid services.

For eight years, Mr. President, I served as the chief prosecutor and top lawyer of Minnesota's largest county serving Minneapolis and 45 suburban communities with a population of over one million people. In that role, I worked closely with our county child protection and adult protection agencies, and with our hospital, which was the biggest emergency hospital in the state of Minnesota. And I saw firsthand what would happen if we didn't prevent people from getting in trouble, what would happen when they'd end up in the emergency room, what would happen when they would end up in the jail because they weren't getting the necessary mental health care that they needed.

I know first-hand the vulnerability of these individuals both young and old and the responsibility of government to help them achieve as much independence, well-being, and dignity as possible.

Mr. President, when Congress passed the Deficit-Reduction Act in 2005, it clarified exactly what services are eligible for payment under the Targeted Case Management program. And Senator Mikulski went through many of these important services. Unfortunately the centers for Medicare and Medicaid services have since come out with a rule that goes miles and miles beyond what congress intended. That rule is scheduled to be implemented next month. This impending rule with a have a devastating fiscal impact on states and local communities. It will endanger the well-being of vulnerable people who benefit the most from these crucial services.

Our states received over $2 billion in funding for targeted case management in 2005. If this rule is put into effect, funding will be slashed in 2008. I want to use one example, and it's from a county my State, Senator -- Dakota County. This is not a wild-eyed county.  It tends tor a conservative county in our state. But like any other county, they have need for state services for people that are mentally ill, seniors, young kids that need help. In this county -- this county made a practice of developing a system of services that relies heavily on case management. They did it to save money.

Medicaid funding has been key to developing service alternative in homes and in less expensive settings than institutional settings. This is the kind of innovative cost-effective approach that we want to encourage from government. Instead with the sudden rule change, they're being punished. And even worse, the vulnerable individuals themselves are being punished.

 I always believed, Senator, that this is a country where we wrap our arms around the people that need the help. That's what America's about. That's what patriotism is about. But with the slash and burn of these services, they're not wrapping their arms around these people. They're rejecting them. For Dakota County, the suburban county in Minnesota, and for states like Colorado, New Jersey, New York, North Dakota, pulling the plug on targeted case management will disrupt the lives of those served by these cost-effective efforts.

Furthermore, in the end it will just increase the total cost borne by state, local and federal government, which means all of us as taxpayers will pay more. It simply defies common sense. Our amendment will postpone the center for Medicare and Medicaid services rulemaking by one year. We need a year to examine exactly how badly this will hurt our state and local governments, and especially the children, the disabled, and the seniors who need these services most.

Mr. President, I occupy the senate seat once held by Hubert Humphrey. Some of my colleagues had the great privilege of serving in the senate with Hubert Humphrey. He was someone who, of course, was never at a loss for words.  Many of those words were memorable. There is one statement in particular that I believe is very appropriate for this topic.  Senator Humphrey once said that -- quote -- "the moral test of government is how that government treats those who are in the dawn of life: the children, those who are in the twilight of life, the elderly; and those who are in the shadows of life: the needy, the sick, and the disabled.”

I submit that this hasty, ill-considered action to cut essential services for the most vulnerable people fails that moral test of government.  I believe we can and we must do better.  That is why I strongly support our bipartisan amendment, an amendment focused on saving money in the long term by keeping people in settings that actually save taxpayers money, by not slashing funds to the most vulnerable in our society. That is why we support this amendment, and we ask our colleagues to vote with us.

Thank you very much, Mr. President. And I yield the floor.