Waiting for the bus at the intersection of Lyndale and Franklin avenues a few weeks ago, I happened to notice a middle-aged gentleman standing on the corner several feet away from me. His haggard face matched his thick green jacket, which was torn and covered in dirt. The man was unintelligibly rambling to no one in particular.

A resident of the streets, the man was largely ignored by passersby at the heavily trafficked intersection. He was just another component of urban scenery.

Unfortunately, the homeless and mentally ill are easily ignored âÄî especially by our elected officials.

They are not particularly well organized. They do not reliably turn out to the polls on Election Day. Nor do they have a high-powered group of lobbyists deployed at the state Capitol.

Perhaps it is because of this that Gov. Tim Pawlenty was so willing to pull the plug on General Assistance Medical Care, which pays for the health care of more than 30,000 childless, low-income adults who do not qualify for other state or federal assistance.

After a Supreme Court ruling and extensive negotiations with the Legislature, funding was ultimately restored to GAMC but with significant cuts. As of June 1, GAMC no longer covers services provided by community-based mental health providers.

These cuts have had a significant impact on nonprofit organizations like People Incorporated that provide crisis and residential mental health services that much of the GAMC population needs.

“WeâÄôre trying to deal with it … case by case, through individual fundraising … working with the counties … [and] the hospitals,” Dr. Tim Burkett, CEO of People Incorporated, said.

People Incorporated and several other organizations in Hennepin County received some good news last week when the Hennepin County Board approved $1.2 million to pay for mental health services that in the past would have been covered by GAMC. The money will come from a contingency fund that the county had set up to cushion expected losses for Hennepin County Medical Center.

As a result, People Incorporated and its subsidiary programs the Anchor House and the Nancy Page Crisis Residence could receive up to $520,000 for services they would otherwise provide at a loss. “Without that, I donâÄôt know what weâÄôd do,” Burkett said.

People Incorporated serves about 2,000 people annually in its residential treatment and homeless support services, 17 percent of which are on GAMC. Burkett projects that the organization will lose $1 million to $2 million in 2011 as a result of the GAMC cuts.

While the $1.2 million approved by Hennepin County is much appreciated by Burkett and the other eligible programs, it only amounts to 35 to 45 percent of the amount these providers would receive from GAMC. In other words, itâÄôs a life preserver, not arescue boat.

If not in treatment facilities like the Anchor House, the homeless and mentally ill often turn up in hospitals, costing the state, counties or cites significantly more, Burkett notes. “Taxpayers are going to be better off funding this community-based support for these people, because the hospitals cost four to five times as much, minimally, as any service we provide,” Burkett said.

This point is not lost on Hennepin CountyâÄôs Human Services and Public Health Department Chief Financial OfficerCurt Haats.

Haats said that the GAMC population is hospitalized at an “enormous rate” compared to the general public, and the county gets stuck with the tab.

For an average length commitment at Anoka-Regional Treatment Center, which is 75 days, he said Hennepin County would pay more than $10,500, with the state also chipping in a portion. Community-based programs serve as a cheaper and more efficient alternative to hospitalization,
Haats said.

While some view the swelling health and human services budget as a symbol of government expansion, itâÄôs important to remember the consequences of inaction. The most vulnerable Minnesotans are not going to disappear because government needs to trim spending. When they cannot access the community services they need, they will end up in hospitals and emergency rooms driving up insurance premiums and property taxes.

Haats said that by allocating $1.2 million to pay community-based mental health providers, the county hopes to fill the gap between now and 2014, when federal Medicaid reform takes effect and those currently on GAMC would be eligible for Medicaid. Of course, the state does have the ability to opt-in early, but Pawlenty has been unwilling to do so.

PawlentyâÄôs resistance to federal health care reform does not reduce the need for services; rather it shifts the burden of paying for them onto local government and taxpayers. Hopefully in a few months, we will have a governor who understands the virtue and fiscal value of compassion, because Minnesota cannot afford to continue passing the buck on health care.

Michael Rietmulder is a columnist. Please send comments to [email protected].