Law Commons^™

Transforming Minnesota's Early Care And Education Infrastructure, Nicole Frethem

Student Scholarship

In 2021, the Minnesota legislature authorized the Great Start for All task force to present recommendations for how the state can provide “access to affordable, high-quality early care and education that enriches, nurtures, and supports children and their families,” to “all families” in Minnesota.

The early care and education landscape in Minnesota has experienced dramatic changes in programming and investments over the last twenty years. In the early 2000s, the state’s primary child care subsidy program, the Child Care Assistance Program (CCAP), was moved from the Department of Children, Families and Learning to the Department of Human Services in an …

Covid-19 And The Caregiving Crisis: The Rights Of Our Nation's Social Safety Net And A Doorway To Reform, Leanne Fuith, Susan Trombley

Faculty Scholarship

In March 2020, the United States declared a pandemic due to the global Covid-19 virus. Across the nation and within a matter of days, workplaces, schools, childcare, and eldercare facilities shuttered. People retreated to their homes to shelter-in-place and slow the spread of the virus for what would become a much longer time than most initially anticipated. Now, more than a year into the pandemic, many professional and personal lives have been upended and become inextricably intertwined. Work is now home, and home is now work. Work is completed at all times of day and well into the night. Children …

What To Expect When You’Re Expecting…Tanf-Style Medicaid Waivers, Laura D. Hermer

Faculty Scholarship

Many health policy scholars believe that Medicaid, the federal-state coverage program for lower-income Americans, should remain free from welfare reform trappings such as work requirements that are extraneous to the program. It would seem such requirements would be both inappropriate and counterproductive to the goals of Medicaid. Given the high probability that such requirements will, at least at some level, go into effect during the Trump administration, it bears considering what to expect. What evidence, if any, suggests that imposing welfare reform-style requirements on certain Medicaid beneficiaries will yield harmful results to those beneficiaries, or harmful to Medicaid’s programmatic goal …

Independence Is The New Health, Laura D. Hermer

Faculty Scholarship

Medicaid plays key roles in supporting our nation’s health. Under the Affordable Care Act, Medicaid took an even more central position in public health endeavors by extending coverage in all interested states to millions of adults who typically fell through the health care cracks. Nevertheless, the Trump administration is now undoing these gains by actively encouraging states to curtail access to Medicaid in key respects while using the rhetoric of health.

This article examines Trump administration efforts in two contexts: (1) state § 1115 waiver applications seeking to better align their Medicaid programs with cash welfare and food stamp programs, …

On The Expansion Of “Health” And “Welfare” Under Medicaid, Laura Hermer

Faculty Scholarship

Medicaid was intended from its inception to provide financial access to health care for certain categories of impoverished Americans. While rooted in historical welfare programs, it was meant to afford the "deserving" poor access to the same sort of health care that other, wealthier Americans received. Yet despite this seemingly innocuous and laudable purpose, it has become a front in the political and social battles waged over the last several decades on the issues of welfare and the safety net. The latest battleground pits competing visions of Medicaid. One vision seeks to transform Medicaid from a health care program into …

The Future Of Medicaid Supplemental Payments: Can They Promote Patient-Centered Care?, Laura Hermer, Merle Lenihan

Faculty Scholarship

Supplemental Medicaid payments such as DSH and UPL are the exception to the financing of specific services to specific patients. Medicaid DSH funds currently finance over 30 percent of hospital care to the uninsured. As a result of the Affordable Care Act (ACA), DSH funds will be substantially reduced. At the same time, their importance will be heightened, especially in states that refuse to take up the ACA’s Medicaid expansion. DSH payments to hospitals have been plagued by a lack of accountability and transparency and an inability to assess whether patients benefit from such payments. Flexibility in the DSH program …

On The Uneasy Relationship Between Medicaid And Charity Care, Laura D. Hermer, Merle Lenihan

Faculty Scholarship

Medicaid and charity care have a lengthy relationship fraught with complications. These complications will remain and in some respects become even more acute following the implementation of the Patient Protection and Affordable Care Act.

This article focuses on the uneasy relationship between Medicaid and charity care, one that becomes particularly acute in the context of Medicaid reimbursement. It traces the lineage of Medicaid in charity, and uses Medicaid reimbursement and supplemental payments as lenses through which to examine the relationship between Medicaid and charity care. The tension that we uncover will need to be resolved if Medicaid is to come …

Rationalizing Home And Community-Based Services Under Medicaid, Laura Hermer

Faculty Scholarship

This article examines efforts states are making to expand access to community-based services for elderly and disabled Medicaid beneficiaries and suggests several options that might improve such access nationally. Like much of Medicaid, Medicaid long term services and supports (LTSS) have developed through a complex process of accretion. Policymakers appear only rarely to have considered an overarching view of such services and the needs of those who require them. Rationalizing Medicaid LTSS will accordingly require not only additions but also substantial pruning, and may even warrant a reconsideration of who should have ultimate authority to develop and direct such services. …

Standards For Health Care Decision-Making: Legal And Practical Considerations, A. Kimberley Dayton

Faculty Scholarship

This Article explores the guardian’s role in making, or assisting the ward to make, health care decisions, and provides an overview of existing standards and tools that offer guidance in this area. Part II outlines briefly the legal decisions and statutory developments assuring patient autonomy in medical treatment, and shows how these legal texts apply to and structure the guardian’s role as health care decision-maker. Part III examines the range of legal and practical approaches to such matters as decision-making standards, determining the ward’s likely treatment preferences, and resolving conflicts between guardians and health care agents appointed by the ward. …

Federal/State Tensions In Fulfilling Medicaid’S Purpose, Laura Hermer

Faculty Scholarship

Medicaid has been subject to reconsiderations of the proper role of government in providing for the health and welfare of populations over recent decades. Over the last decade in particular, a number of states have transferred many functions that they once performed to private entities, including, in a number of cases, express policymaking functions. The Patient Protection and Affordable Care Act (ACA) takes some crucial steps towards readjusting the equilibrium of Medicaid. Rather than further prioritizing the market in its reforms, it gives the federal government stronger charge of Medicaid policy, refocusing the program more directly on expanding eligibility and …

Medicaid, Low Income Pools, And The Goals Of Privatization, Laura Hermer

Faculty Scholarship

This article examines the Bush Administration's attempts to transform certain supplemental payments, most notably Medicaid’s Disproportionate Share Hospital (DSH) program, into a means of subsidizing private health coverage for Medicaid expansion populations. Greater private market involvement in the state disbursement of supplemental payments such as DSH makes it more difficult to fulfill Medicaid’s original goals. It reduces the overall funds available specifically for care, provides beneficiaries with leaner benefit plans than those offered by the public system, and hinders beneficiaries from obtaining and retaining care. As such, it increases waste and inefficiency, rather than reducing them. At the same time, …

Foreword: Poverty Law Issue, Ann Juergens

Faculty Scholarship

This Poverty Law Issue provides testimony as to why and how the legal profession, the government, and society can better provide justice for people of small means. Overall, this Poverty Law Issue contributes to understanding how we may ensure that the difficulty of poverty borne by our fellow citizens does not become compounded by injustice. For when justice is compromised for one group, its integrity as a whole may rightly be questioned.

A Truly Good Work: Turning To Restorative Justice For Answers To The Welfare-To-Work Dilemma, Marie Failinger

Faculty Scholarship

U.S. welfare programs have traditionally come with strings attached: recipients must work for their benefits. I argue that there is a more practical and less morally repugnant way to marry work and welfare if proponents of work as well as their opponents would be willing to give up the unrealistic expectations they have placed on state-run public assistance programs, and define a clear and limited relationship between work and need for economically vulnerable people. Just as it has offered an alternative to both the pure retributivist and rehabilitation models in the area of criminal corrections, the principles and practices of …

A Home Of Its Own: The Role Of Poverty Law In Furthering Law Schools' Mission, Marie Failinger

Faculty Scholarship

This author argues that poverty advocates who are willing to carefully attend to their law school’s mission and vision, and to give careful thought to how poverty law may play an important role in achieving that vision, may win a more lasting place for poverty law in the curriculum than it has heretofore managed to achieve in most law schools. This article will argue that poverty law can be a key piece in the curriculum of law schools who define their mission, at least in part, as educating lawyers according to one of five paradigms: 1) lawyers as public citizens …

Lena Olive Smith: A Minnesota Civil Rights Pioneer, Ann Juergens

Faculty Scholarship

Lena Olive Smith and the National Association for the Advancement of Colored People (NAACP) created a spirited partnership in the public interest during the 1920s and 1930s. Throughout their long collaboration, this woman lawyer, her clients, and the Minneapolis branch of a national grassroots organization faced similar challenges: to stay solvent, to end segregation and increase equality, and to live with dignity. This article is divided into four sections. The first three roughly correspond with stages in Smith’s life and work. Part II briefly chronicles Smith’s first thirty six years, 1885 to 1921, as a single African-American woman in the …

Long Overdue: The Single Guaranteed Minimum Income Program, David Allen Larson

Faculty Scholarship

This article provides an overview of income support programs in the United States. The article first examines proposals for a guaranteed income. This initial examination consists of four separate sections. It begins with a summary of negative income tax plans. Second, it discusses legislation introduced in the United States Congress. Third, current guaranteed income proposals are examined. Finally, it concludes with a brief examination of social experiments conducted in several communities. Because no proposal for a comprehensive guaranteed income program has been adopted, this article next discusses the income maintenance programs including a short description and selected statistical information.

An Offer She Can’T Refuse: When Fundamental Rights And Conditions On Government Benefits Collide, Marie Failinger

Faculty Scholarship

This article criticizes the Maher/Harris conditions doctrine on two levels. At the first level, it suggests that the Maher/Harris doctrine cannot justify the Court’s decisions to uphold government withdrawals of funding from rights-exercises. At the second level, after exposing and contrasting the definitional presuppositions of the Court in Maher and Harris with previous cases, the article suggests that the Maher/Harris doctrine is a failure because it uses utterly inadequate rights theory to resolve emerging issues of conflicting human need and conscience, issues which are mediated by government action. The author creates a space for a discussion of a new framework …

The Minnesota Commitment Act Of 1982 Summary And Analysis, Eric S. Janus, Richard M. Wolfson

Faculty Scholarship

Minnesota law governing commitments has been substantially

revised and recodified in the Minnesota Commitment Act of 1982.

The prior law is repealed and the new law is substituted for it effective

August 1, 1982.

This article has three purposes. First, the significant changes in

the civil commitment law are identified and their implications explored.

Second, where appropriate, the legal background underlying

the changes is explored in order to place the changes in context.

Third, the article identifies ambiguities and inconsistencies in the

Act, posits resolutions, and suggests areas for legislative attention.