Minneapolis Star Tribune, April 29
State action needed to boost immunization rates
To those who dismiss the risk of measles, consider these numbers: In 2015, this childhood disease caused more than 134,200 deaths globally, according to the World Health Organization. In Minnesota, as of Friday, there were 32 children, at least 11 of whom required hospitalization, infected with this potentially fatal but entirely preventable illness.
It is heartbreaking to watch case numbers rise in what has become one of the state’s biggest outbreaks of measles in years. So far, all those who have become ill range in age from 11 months to 5, an age group among the most susceptible to measles’ serious complications such as pneumonia or encephalitis.
Twenty-eight of the children are Somali-Americans. All have this in common: They are either unvaccinated or not fully vaccinated against this highly communicable disease. It is this last point about vaccination participation - a growing problem in many Minnesota communities, not just Somali-Americans - that should prompt legislative action.
Dishonest information spread by anti-vaccination activists about measles, mumps and rubella (MMR) vaccine risks is at the root of this alarming outbreak, causing parents to forgo or delay these vital shots. It is time for Minnesota to follow the lead of states such as California and tighten laws that allow parents wide latitude to exempt their children from school immunization requirements. However, legislation introduced in St. Paul this session went nowhere.
Minnesota’s Somali-American families should know that the state stands with their community during this outbreak. It is important to note the exemplary response from Somali-American faith leaders, medical providers, youth workers and communicators. A meeting held Wednesday in the Cedar-Riverside neighborhood in Minneapolis illustrated the community’s concern and eagerness to work with health officials.
The main fear in the community is that the MMR triggers autism - a link that continues to be disproved by large, reputable medical studies. Moreover, research suggests that brain changes linked to autism start before the MMR is given. But fears about the developmental disorder are deeply rooted here, in part due to a study showing that autism prevalence is about the same in Somali-Americans as it is in whites, but that the developmental disorder may be more severe.
That anti-vaccine advocates have recognized this fear and “targeted” Minnesota’s Somali-Americans is an outrage. Social-media posts by local activists, for example, recently discussed strategies to urge Somali-Americans to resist the vaccination even in the midst of this outbreak.
Fortunately, local leaders like Sharif Abdirahman Mohamed, an imam at Dar al Hijrah mosque, are working closely with public health officials to urge parents to get the shots. Abdirahman, also a Fairview Health Services chaplain, cautions against heeding anti-vaccine “false prophets.” Instead, he said, “Listen and take advice from people who are experts.”
The imam, a father of six, also emphasizes that he vaccinated his six children. His example and his words offer wise guidance for all Minnesotans. Still, lawmakers need to act. California’s vaccination rates are rising after a 2014 measles outbreak at Disneyland prompted the state to end “personal belief” exemptions for school shots and require written medical waivers from doctors.
Minnesota’s lax personal belief exemptions leave kids at unconscionable risk. Legislative remedy is urgent.
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The Free Press of Mankato, April 28
Health care: Question of rights comes into focus on budget
Americans under 65 years old who qualify for government paid health care may not vote much. And they certainly can’t afford to hire a lobbying firm. But they are the ones likely to be most affected by changes to how health care is paid for and delivered at the state and national level.
It’s an unsettling idea - denying someone health care because they cannot afford it - but one that will come more and more to the forefront in state and federal budget battles.
At the federal level, the Republican Congress and President Donald Trump are negotiating ways to “repeal” and “replace” Obamacare with a plan that inevitably must reduce spending and coverage for those on government-paid health care for the poor.
Millions of people who were given health care just a few years ago under Medicaid expansion will likely lose some of it or be forced to pay more for it. At best, states will be allowed to reduce coverage for things like mental health and other mandated services in the government programs.
Trump also has threatened to withhold federal funding for the Medicaid programs as a way to get minority party Democrats in Congress to help pass a repeal and replace bill. So far, the Democrats have ignored the threat.
The federal actions will trickle down to the states, as much of the cost of state Medicaid expansion comes from the federal government. If the federal government stops funding Medicaid to the states, Minnesota’s budget surplus of about $1.6 billion would be wiped out in one year.
Few may realize that under federal law, a person cannot be turned away from an emergency room or necessary medical care just because they have no insurance. But studies have shown that most of these folks don’t go to the doctor if they don’t have insurance, and their condition worsens and gets more costly.
The thought was that if we provide them preventive care, we ultimately save in the long run. Studies have borne that out.
But if we really want to move forward with these strategies to reduce health care spending, we should be ready to own up to the idea that we’re telling our people that health care is only a right to those who can afford it.
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Post-Bulletin, April 28
State preservation office belongs in executive branch
For nearly 50 years, the State Historic Preservation Office has quietly done its work as part of the Minnesota Historical Society.
The National Historic Preservation Act in 1966 directed the establishment of an office in every state to help identify and preserve our architectural and cultural heritage at a time when urban renewal, the Interstate highway system and the go-go economy of the 1960s was mowing down landmarks nationwide.
In Minnesota, the historical society has been the champion of recording and protecting the history of this area since 1849, nine years before statehood. It made sense at that time to have the society - a nonprofit organization that receives major funding from the state - be the point-of-contact for preservation issues.
The office’s job is to “identify, evaluate, register and protect Minnesota’s historic and archaeological properties; encourage the development of local history organizations and activities; and assist government agencies in carrying out their historic preservation responsibilities.”
It’s that last task that has changed most substantially over time, with more agencies, programs and financial issues involved. According to the National Conference of State Historic Preservation Officers, the office and its top executive typically manage state rehabilitation tax credit programs, maintain state grant programs, hold and enforce historic preservation easements, and other administrative functions.
According to the historical society, the preservation office, which has about 20 employees, reviewed more than 3,000 development projects last year to assure that historic properties were identified and cared for. As the CEO of the historical society has said, it performs a regulatory function.
So - isn’t a regulatory function, especially one that connects with government at all levels, typically handled by a government agency? That’s the way it’s handled in 48 other states. Only Ohio and Minnesota have outsourced the work.
Gov. Mark Dayton proposes to change that, to improve efficiency and accountability. Under bills in the House and Senate, the historic preservation office would move to the Department of Administration, as an executive branch function.
Rep. Rob Ecklund, of International Falls, the House bill’s sponsor, told the Star Tribune this week that “frustration” with the pace of reviews at the preservation office “has been building for a while.” The governor’s chief of staff has acknowledged that some of that frustration involved delays in the review of the PolyMet mining project near Hoyt Lakes.
Dayton’s critics have said the change is simply payback for the historical society’s objections to his redecorating plan for the Governor’s Reception Room last year, and fans of the historical society are treating it like a modern-day Northfield Raid.
This may seem like a dispute that only a bureaucrat could love. The office apparently has worked well enough at the historical society for 48 years, and there’s something to be said for it being somewhat independent of government.
But as an office that performs regulatory and administrative functions, it seems appropriate that it operate within the executive branch of state government, with direct accountability, not down the street at a nonprofit organization.
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