Monthly Archives: February 2023

Minnesota House of Representatives

Human Services Finance Committee

Chair – Rep. Noor

February 21^st, 2023

        Re: HF 1626 Supporting, but with questions and concerns

Dear Mr. Chair and Members, many thanks for the opportunity to testify today. My name is Idil Abdull, I am a Somali Autism Mom and a pissed-off advocate who would like to retire soon.

HF 1626 is asking for a rate increase for EIDBI. This is for autism therapy providers. I want to let you know that autism is extremely high in children born in Minnesota to Somali parents according to research done by Gov Pawlenty’s health department in 2009 and UMN in 2013.

Additionally, I want the record to state that Early Intensive Developmental & Behavior Intervention passed the state legislature around midnight on Thursday, May 16, 2013. I know because I was the only person of color advocating for this bill at that time. It was Somali autism parents and the Somali community that solely advocated and fought tooth and nail to ensure Medicaid-covered autism therapy.

Fast forward to today, 2.21.23, there are more minority children particularly Somalis being served under EIDBI and more Somali EIDBI providers than any other ethnicity including non-minority providers who were initially against EIDBI.

Here are my concerns, given this dark and long-fought history in getting EIDBI to pass both in Minnesota and in CMS which was no day at the park, why are there not more Somali and other minority EIDBI providers at the table when this was being written?

Further, what is the cost and what does DHS shall develop a rate framework mean? Who is at the table for this development?

We know that DHS is notorious for excluding providers of color, and in general people of color from being at the table and prefers that we are on the menu. If this committee is serious about racial equity and person-centered then it needs to be action-oriented, not just using pretty hip words. Additionally, DHS’ commissioner refused to add fair rate adjustments for EIDBI providers even though the state has billions in surplus. What message do you think that gives? I hope someone asks DHS why they refused to support autism families and providers.

Finally, while I thank the author for bringing this bill forward, I wish our community was asked to be involved. It is not lost on me that the chair of this committee reflects our community. Racial disparity cannot survive and thrive when folks in power reflect minority communities. In Somalia, we call that “Lax Bacaad Lagu Lisay”.

Thanks for your time.

When EIDBI was approved by CMS.

Sincerely,

Idil Abdull – Somali Autism Mom

The above words do not reflect any candidate, agency, or committee.

Idil Abdull

Alright – so, Thursday, 2.16,23, the Health Finance and Policy Committee in MN Senate heard this bill. I have signed up to testify in favor and sent in my written testimony and was going to orally testify via zoom. If you have ever advocated for any law or policy then you know, it is the wild wild west. Things change at a moment’s notice. I saw that the Health insurance plans (or as I like to call them – the blood-sucking insurance companies) sent in one page where they added a Somali woman they helped with care coordination.

I had to change and address that. Our bill was the last to be heard and the committee members spoke with no end in sight about the bills before SF 404. I often wonder why there is no time limit to how long an elected official can speak in a committee. Anyway, we are glad it was heard. It was laid over for inclusion into the big omnibus bill. Below is my new testimony.

Dear Madam Chair and Member, thanks for the opportunity to testify supporting SF 404. 

First, I want to thank Dr. Nathan Chamilo for his iconic report on the state of US-born black Minnesotans. In that report, Dr. Chamilo stated the majority of black Minnesotans have MCO for health coverage. He also stated there is a dire racial health disparity. I totally understand the fatigue associated with racial disparities. So then let’s stop talking about it and start doing something about it. The first option to decrease and eliminate racial disparity is giving low-income Minnesotans the option and freedom to CHOOSE their health care.

This legislation is about having options; not restricting choices and freedom.

Everyone deserves the right to make their own decision about their healthcare.

The Somali woman who was going through domestic abuse, first my heart goes out to her, but if the MCO helped her coordinate services, then she can stay where she is at.

By the same token, patients who need services provided by fee for service, they too shall have the same option and ability to make decisions about their health care needs.

You know, what makes this country so great is having options and choices. We cannot in good conscience take this option from low-income Minnesotans. If we do, what does that say about us?

Madam chair – earlier you stated – Minnesotans getting quality health care was important. That is exactly what SF 404 is about; giving Minnesotans the opportunity to get the quality health care they choose for themselves and their family.

Thanks, and I hope you all support this bill.

If you wanna watch this hearing, here is the link. Our bill is about 1.50 min into the hearing or so. Phew, I had to talk fast and stay within 2 minutes.

The above words do not reflect any candidate, agency, or committee.

Idil Abdull – Somali Autism Mom & Advocate

Alright – so, first, I cannot wait to retire. I went back to the capitol last week after being gone for years since the pandemic. I also have not been to the health care committees since – I think 2014 when I advocated for the autism portal. The minute I saw this building, I got a headache and had to take Tylenol. Then I took Advil when I left. Ugh. We all know the MCOs are horrible. They get public funds to provide health care to the poor in Minnesota. They are paid whether they provide the services or not which to me sounds insane. What the heck? why would the state of Minn do this? how can this possibly be cost-effective? Prepaid Medical Assistance is highway robbery. Payment should be provided to these blood-sucking insurance companies after services actually occur. At any rate, I and so many others have been trying relentlessly to change this stupid law and give patients the freedom to choose their publicly funded health care. Below is my testimony in the Senate supporting this.

Minnesota Senate

Health & Human Services

Chair: Sen. Wiklund

February 16, 2023

    Re: Supporting the Freedom to Choose and opt out of MCOs SF 404

Dear Madam Chair & Members, many thanks for the opportunity to testify today in support of SF 404.
My name is Idil Abdull. I am a Somali Autism Mom, an advocate who wants to retire, and a provider. I usually never advocate from a provider’s perspective, but I chose to do it today at least from a provider of color.
As you may have heard, autism is high in Somali children born in Minnesota. Please see the attached research and articles that should be in your folders. I also want to point to your attention the fact that Minnesota has one of the worst health racial disparities in the county. See attached articles about this as well.
My son was diagnosed with autism at age 3 and ½ years old which is considered early and good by most standards. I took him to an ABA therapy clinic. To make a long story that included lawsuits and becoming an advocate, I decided instead of always complaining about my son not getting the services that he needed; I would become an advocate and a provider.
So, at the age of 90, I went back to school and got a master’s degree in autism therapy, particularly applied behavior analysis (ABA) therapy. I partnered with my attorney and started a small ABA clinic. Our goal was and still is to serve autism families particularly Somali children as well as other black and brown autistic kids.
In parallel, as an advocate, I, and other Somali autism parents (Hodan & Istahil) and our community fought long and hard to ensure the state of Minnesota covered autism therapy for children with Medicaid. Please see attached articles, especially the Mpls Tribune one titled – double standard. With the help of Abeler, Gottwalt, Hann, Pogemiller, Berglin, Sheran, Liebling, Gov Dayton, and so many others we were able to pass what later became early intensive developmental and behavior intervention (EIDBI). This ensured MCOs covered the same services as Fee for Service. We thought our fight was over and we prevailed. We were mistaken.
There are dozens of autism therapy clinics including mine who are no longer able to serve MCO autistic children. Why you ask. When we serve a client with fee for service, DHS has straight and simple guidelines and policies to follow. They train us on how to do the treatment plans, get authorizations, do billing, and provide monthly clinical/policy hours for providers. We are able to bill every other Thursday up to 11:59pm and get reimbursed the following Tuesday for services we have provided. There is no drama and no confusion.
When we serve an MCO client who has Ucare or BCBS, there is no provider training, no billing training, and we have no idea when we are going to get reimbursed for the therapy we provided. It can take weeks to months and sometimes never. There is no support nor guidance from MCOs.
I even contacted Kathryn Kmit who directed me to connect with Mr. Andreson and Mr. Lucas Nesse whom I knew when he was the LA for Sen. Senjem. I am sorry to report neither of them cared about their members or their contracted providers. They refused to help. I then contacted CMS Chicago office and CMS Baltimore and told them what the MN Medicaid agency was doing with MCOs will only increase the racial disparity we have in Minnesota. CMS told me that they asked the state Medicaid agency to ensure the training for MCO contracted providers was the same as that of FFS. Sadly, it is not. I then contacted the person at DHS who does the MCO contracts PJ who informed me MCOs will now have one recorded training for providers. That simply is not enough. As a result, our clinic and many others have made the painful and heartbreaking decision of not being able to serve MCO autism children.
Think about that for a minute. This will now increase racial disparity. It will increase the support and resources these children will need later on in life because they are not getting early intervention.
In summary, madam chair and members, the ball is in your corner. Even though there is the saying insurance companies have more money than God. You have the power, the responsibility, and quite frankly the obligation to ensure low-income Medicaid patients have the freedom and the opportunity to choose their health care. I hope you do the right thing and vote for this bill. People’s lives and health care depend on you and your vote.

Referencing articles and research:

Mpls Tribune – Double Standard

Autism Rates higher in U.S Born Somali Children in Mpls

UofMN study funded by CDC, NIH and Autism Speaks confirms – autism IS higher in Somali kids born in Minnesota

Minnesota Racial Health Disparities

Sincerely,
Idil Abdull – Somali Autism Mom & Advocate

The above words do not represent any candidate, agency, or committee.

Idil Abdull

Minnesota House of Representatives

Health Finance & Policy

Chair – Rep. Liebling

February 9, 2023

Re: Supporting HF 816 one step closer to ending racial health disparities

Dear Madam Chair and Members, my name is Idil Abdull; I am a Somali Autism Mom and pissed-off advocate.

Many thanks for the opportunity to testify in support of HF 816. As you all know, Minnesota has horrible and shameful racial health disparities. This was shared with you by DHS’ medical director, Dr. Nathan Chomilo who testified in this committee. This report stated 80% of people enrolled in public health programs are served by managed care organizations (MCOs). Take a listen to what Dr. Nathan said about Minnesota’s racial health disparities on MPR.

I want to share with you a quote from this report: “There has never been any period in American history where the health of blacks was equal to that of whites…Disparity is built into the system.”-Evelynn Hammonds, historian of science at Harvard University.

You often hear the system is racist; there is institutional racism; the infrastructure is racist. Let’s dissect this. This so-called system is made up of policies created, enhanced, and maintained by people. This bill moves one step closer to dismantling Minnesota’s systemic racism. It will allow low-income people who are forced into MCOs the freedom, opportunity, and right to choose their health care. Isn’t that what makes this country – America. Freedom is embedded into the American soul and fabric.

It is a must that low-income Minnesotans enjoy the same freedom to choose their health care as high-income Minnesotans do.

Data from DHS tells us in 2020 368 children with autism enrolled in MCOs are getting services vs 991 children with autism enrolled in fee for service (FFS). In 2021, 1773 children with FFS are getting autism therapy vs 696. You see madam chair and members; this is what systemic racism is. Michael Smith with FFS Medicaid gets services and therapy while Michael Smith with MCO Medicaid does not. How can anyone think this is right.

The opponents of this bill will tell you MCOs save the state money. That is unequivocally false. For example, MCOs are paid at the beginning of the contract year the full amount for the number of patients enrolled. In other words, they are paid for services not rendered, and most likely will never be rendered. On the other hand, FFS is reimbursed after services have been rendered.

In summary, I hope you all support and vote for this incredibly important legislation for two main reasons.

1. It will decrease racial health disparities in Minnesota.
2. It will save the state money because services that actually occurred will be paid for.

Finally, I want to thank the author Rep. Hicks for having the courage to carry this and Rep. Liebling who has always been a champion for autism families.

If you wanna watch the hearing, here is the link. Our bill is heard first.

Sincerely, Idil Abdull

The above words do not reflect any candidate, agency, or committee.

Idil

Alright – so, if you have a child with autism, you have probably been in front of a judge. It may have been something with school and went to an administrative judge. Maybe it was about the county and had to go to a DHS judge. Or maybe your kid was discriminated against and went to a district or a federal court judge as I have done.

For me, I have been in front of almost every kind of a judge. I am yet to see a judge that looks like me. Why? how does one become a judge? Is it a job they apply for? no. Is it a job they are appointed to? yes. By whom? the state governor for state courts. Is it a job you campaign for? Yes. In Minnesota, a judge runs for an election after his/her term is done if they have been appointed by the governor. Federal bench judges are appointed by the president.

There are 87 county attorneys in Minnesota. One is a minority; the one in Ramsey county. Think about that. No minority even runs for these positions. Why? because we are sleeping and are only good at useless marches. Oh please, stop being so sensitive. Remember, Henn County district attorney – Freeman? how many times did black people protest and demonstrate against some wrong decision he made. Imagine, if one black or brown attorney challenged him in an election. No one ever did. He retired last year and there is now a white woman district attorney. A black lawyer also ran for this, but she lost.

The point is instead of our usual – we shall march and always be at the mercy of someone else’s decision and thumb, why can’t we simply run to be judges. I think every black and brown attorney should run to be a state court judge. Then there is the Minn Supreme court and the appeals court.  As you can see there is one black judge in the MN supreme court who was appointed by Gov Dayton. She ran when her first term was up and won. No one challenged her. The other is a black man on the MN Court of Appeals; he was appointed by previous Republican Governor Pawlenty. It is worth mentioning pretty boy Thiesen who was the previous speaker of the MN House of Reps and voted against what is now known as EIDBI is now a judge in the state’s supreme court.  This is the law that requires Medicaid to cover autism therapy for low-income autism families. He was appointed by Gov Dayton and sadly won the election after his term was up. No one ran against him. You see this is how disparity stays alive in the justice system. They just shuffle their cousins around to ensure we are always at the bottom of the pit.

So, how does one become a judge there? Usually, the governor appoints them; then after serving a few years, they run in an election year. They are usually listed on the second page of the ballot. In the last election (2022) in my precinct, there were 36 judges up for reelection. Guess how many had competition. One – Charles Weber. Every other judge ran unopposed. Imagine that?

They decide so many things that we depend on and we are never at the table; usually on the table like chopped meat. So frustrating why can’t we make the connection of bargaining with our votes. For example, telling the current One Minnesota Hoax governor if we vote for him and he wins, he will appoint 2 or 3 black/brown judges if/when the opening arises including a Somali. There has never been a Somali judge anywhere in Minnesota. Ugh. soooo frustrating and depressing. Where are all of the Somali state legislators? Sleeping and kissing ass.

I will write more about judges and how Walz, Dayton, and the last few presidents faired in appointing judges of color to the benches. The data/facts of this will surprise you. I will also write my experiences with both federal judges and state judges. By the way, DHS judges are DHS employees; they are not appointed nor run for elections. DHS hears and decides on thousands of cases for Minnesota’s most vulnerable population. I don’t know the racial makeup of this yet and will share once I get that data.

The above words do not reflect any candidate, agency, or committee.

Idil – Somali Autism Mom & Advocate

Alright – so, as I have said before and let me say it again, the job of an advocate is to rock the status quo. It is not to befriend or care about the selfish folks’ feelings who are benefiting from the status quo.

Further, as a black, Somali, Muslim, woman and most importantly autism mom, it is a thousand times harder to advocate for law and policy changes. Why? Because when a white woman advocates, she is a compassionate person who is passionate about the issue. When a black, Muslim, Somali woman does it, well then….wait for it….. drum roll please…..it is original….not really; she is an angry black woman. I have decided to wear this title with honor. I am a woman, I am Muslim, I am Somali and I am a pissed autism mom. I am not here to appease you or to make you feel comfortable. Why should I? your racist policies have made me and those who look like me incredibly uncomfortable.

You see, Commissioner Harpstead, you can surround yourself with Yes Ma’am Driving Miss Daisy black women/men gatekeepers at DHS to make you feel good. Facts are facts and data are data. Your administration has fired and screwed with black and brown folks more than the last three commissioners combined. Do you ever take responsibility. Heck no. Do you ever acknowledge the concerns and change. That would be too easy. No. you shut those that disagree with you down. You ignore it as though that makes the problem go away. It does not.

You are by far, the worst commissioner I had the displeasure of advocating in my almost 15 years of doing this. I am trying to retire at the end of this legislative session, but your ignorance and arrogance regarding the plethora of issues facing our communities may just make me stay on longer.

I was watching your horrifying reappointment in the Health and Human Services Committee in the senate where you gave yourself more credit than a boxing promotor, and all white legislators praised and showered you with candy and empty sugar. Well, except for the Brazilian doctor who became a legislator; she was simply quiet and mute. There is nothing more unattractive than a minority person in a position of power and influence who kisses ass instead of kicking ass.

I recently read this book and thought of how entitled and privileged you seem to me. I also thought of how One Minnesota Hoax Governor allows you with impunity to neglect and dismiss the very vulnerable communities that you are supposed to serve and support.

The above words do not reflect any candidate, agency, or committee.

Idil – Somali Autism Mom & Advocate