The State of Minnesota operates dozens of programs (nursing homes, group homes, activity centers, crisis programs, clinics and other services) to help maintain the health and well being of thousands of Minnesota residents. Ten or twenty years ago, many of these people would have lived in state hospitals. Today they live in more normal community settings, and in care facilities closer to their families.

Minnesota's commitment to community care took years to develop and is still a work in progress. The state employees who have helped carry out the transition from institutional to community care are largely unsung. Their contributions to assisting the aged and disabled lead normal lives go on every day. Like direct care workers elsewhere, state employees say Governor Jesse Ventura's proposed two-year budget is inadequate and that people with disabilities and the elderly will be the ones to suffer.

Situation difficult for veterans
Sam Bettie is president of Local 744 of the American Federation of State, County and Municipal Employees (AFSCME) at the Minneapolis Veterans Home. His 250 union members experience first hand what other nursing home employees in Minnesota are facing.

'Turnover is too high, nurses are leaving, and we just don't have the time for all the personal care we should be providing,' Bettie says. Some nursing homes experience over 60 percent employee turnover a year. While things are not as bad where Bettie works, he struggles to care for the 50 aged veterans on his unit. As few as five other care workers help out.

Bettie's hourly wage is so low that he must supplements his income with a second nursing home job. He sees a worsening situation for the veterans. 'It's tough recruiting people to work in nursing homes today. I like my job, but it's stressful and too few staff short changes residents,' Bettie says.

High turnover in group homes
Jo Ann Holton say the state-operated group home in Brooklyn Park was the greatest thing to have happened for the four disabled men she works with. All are former residents of Faribault Regional Center. The men are hearing impaired as well as severely disabled. Group home staff must build trust levels with the men using hand signs and other non-verbal communication to help them adapt to their new community. 'During the day time the men go to activity centers or help city work crews,' Holton states, 'activities they didn't have before.'

Holton has over 18 years experience working in care settings and is emphatic that her current job is the best yet. 'Our jobs are to make their lives as normal as possible. The men now have choices and are part of a real community," she adds. Holton recently helped initiate contact with neighbor families who in turn now regularly visit the home.

As changes have taken place in state programs for the disabled, the work of people like Holton has become more specialized and responsible. Her job now includes budgeting for the home and administering resident medications. She finds the job rewarding but also wonders about maintaining quality in the community program. She says the state's practice of hiring part-time workers leads to turnover, something especially damaging to relationships with her clients. 'People are looking for full time work,' Holton says. 'And our clients need full time care.'

Aiding those with mental illness
Craig Fladeboe's first client appointment may be in Hutchinson or Glencoe. Fladeboe works with Tri-Star, an 18-county program in southwest Minnesota that provides community-based care for persons with mental illness. A former employee of Willmar Regional Center, Fladeboe was one of the first state employees in the area to transfer to community work.

'The community environment makes a big difference. Our job is to help keep people in the community so they won't need re-hospitalization,' Fladeboe says. His entire work routine is different. The 19-year state employee used to work in one building at the Willmar hospital. Now he drives over 250 miles a week from his office in Cosmos, checking on clients in communities scattered throughout a large area.

Fladeboe describes a typically busy day. 'I might have to go over household schedules with a man in Glencoe and then pick up a woman to do grocery shopping in another town. Next, I'll meet with three clients for lunch to socialize some so they don't become isolated. I might then visit a man in town to go over his medication schedule or review his bills.'

Fladeboe's community support job is challenging and requires initiative, energy, and creativity. He works as a member of a team with eight other state and county employees. The partnership of different employees has worked well since the program began five years ago. Started to keep people with mental illness free of hospitalization, the program has been replicated in other parts of Minnesota. The program operates six days a week with on-call staff on Sundays to handle emergencies.

'We lose people to hospitals, but we follow them and help them return to the community,' Fladaboe says. 'Average hospital stays have dropped and that means some cost savings as well,' he adds.

Concern about budget
In the past two decades, state employees have been instrumental in helping to make a profound changeover in the type and quality of care received by some of Minnesota's most vulnerable people. They are concerned that progress made can be destroyed by neglect in St. Paul.

Echoing other care workers throughout the state, Sam Bettie claims 'the care we provide is being jeopardized by the Governor's budget proposals.' The state employees who do Minnesota's work are watching and waiting to see whether or not state officials will invest to maintain the great strides made in recent years.