Statement from Phillip C. Parrish, Candidate for Governor of Minnesota 2026
Addressing Inefficiencies and Improving Care in Minnesota’s Health Department
July 9, 2025
As a candidate for Governor of Minnesota in 2026, I am committed to ensuring our state government operates efficiently, prioritizes taxpayer dollars, and delivers high-quality care to our most vulnerable residents. Recently, I received a detailed account from a retired Registered Nurse with 43 years of experience, including service in Minnesota’s health department, who courageously shared concerns about systemic inefficiencies, wasteful spending, and inadequate oversight in the state’s regulation of assisted living and home care facilities. To protect her privacy and safety, I will keep her identity anonymous, but her insights demand urgent attention and action. As your future Governor, I pledge to address these issues head-on, restore accountability, and improve care for Minnesotans.
Concerns Raised by a Dedicated Nurse
The nurse’s account highlights several critical issues in the Minnesota Department of Health (MDH) and Department of Human Services (DHS), particularly in the oversight of assisted living and home care:
1. Wasteful Spending in the Maltreatment Department: The state’s unique maltreatment department, which investigates complaints in assisted living and home care, employs dozens of high-paid nurses to produce lengthy reports with no clear follow-up or impact. These reports, often delayed by months, duplicate efforts already handled by facilities, police, or legal systems, costing taxpayers millions with little value added.
2. Overstaffing in Survey Teams: Since the COVID-19 pandemic, survey teams inspecting assisted living and home care facilities have tripled in size, adding unnecessary costs without improving care quality. This overstaffing burdens facilities with excessive deficiencies, often for unclear or poorly communicated regulations.
3. Unsafe Resident Mix: Assisted living facilities, intended as home-like settings for the elderly, increasingly house individuals with mental illness and, in some cases, sexual offenders or drug traffickers. This mix creates unsafe environments and strains under-resourced facilities unable to provide specialized care.
4. Lack of Training and Regulation Clarity: Unlike federal nursing home oversight, the state provides ineffective training and unclear regulations for assisted living and home care providers, leading to confusion, deficiencies, and substandard care.
5. Evasion of Accountability: Some home care agencies and assisted living facilities have dropped their licenses to avoid penalties for poor care, facing only misdemeanor charges. This loophole allows bad actors to escape accountability, undermining resident safety.
6. Post-COVID Bureaucratic Bloat: The state has added entire departments, including legal teams to “fight” facilities over deficiencies, inflating costs while failing to address root causes of poor care.
These concerns paint a troubling picture of a health department that has lost focus, squandering resources while failing to protect Minnesotans in assisted living and home care.
Substantiating the Concerns
The nurse’s observations align with broader evidence of inefficiencies and challenges in Minnesota’s health and human services systems:
• Budgetary Pressures: The DHS, which oversees assisted living and home care, proposed a $23.8 billion budget for FY 2026, with $12.6 billion from federal funds, yet faces structural deficits and uncertainty due to potential federal Medicaid cuts. A December 2024 Legislative Auditor report found DHS failed to recover over $40 million in Medical Assistance overpayments, indicating lax oversight and financial mismanagement.
• Staffing Increases: While exact figures for the maltreatment department are unavailable, the nurse’s estimate of 40–50 nurses (up from 17 in 2016) is plausible given post-COVID hiring trends. The House Human Services Finance and Policy Committee noted a $300 million budget reduction target for 2026–27, suggesting overstaffing and inefficiencies are under scrutiny.
• Resident Safety Issues: Reports of mixed populations in assisted living, including individuals with mental illness or criminal backgrounds, are supported by industry concerns. The Minnesota Elder Justice Center has highlighted risks to elderly residents in facilities unprepared for complex behavioral needs, echoing the nurse’s call for specialized care settings.
• Training Gaps: The 2021 Assisted Living Licensure Act aimed to standardize regulations but has been criticized for inadequate provider education. A 2023 MDH report noted ongoing compliance challenges due to unclear state guidance, corroborating the nurse’s critique.
• Accountability Loopholes: Minnesota Statutes § 144A.44 (Home Care Bill of Rights) and § 144G (Assisted Living Licensure) impose only misdemeanor penalties for unlicensed operation, as the nurse noted, allowing providers to evade serious consequences. A 2022 Star Tribune investigation revealed cases of unlicensed facilities operating with impunity, endangering residents.
• Public and Legislative Concern: Fraud and inefficiency in state programs, including Medicaid, have drawn legislative attention. The House Fraud Prevention and State Agency Oversight Policy Committee (July 2025) emphasized stronger anti-fraud measures, reflecting broader distrust in DHS operations. Republican candidates like Scott Jensen have also criticized state spending, citing a $17.5 billion surplus spent in 2023, aligning with the nurse’s view of fiscal irresponsibility.
These findings validate the nurse’s concerns and underscore the need for reform to ensure taxpayer dollars deliver meaningful outcomes for Minnesotans.
Proposed Solutions
As Governor, I will implement bold, practical solutions to address these issues, prioritizing efficiency, accountability, and resident safety:
1. Restructure the Maltreatment Department:
• Conduct an independent audit of the maltreatment department’s budget, staffing, and outcomes to assess its value. If reports lack actionable follow-up, I will redirect resources to facility-level complaint resolution, aligning with federal nursing home models.
• Expected Impact: Save millions annually while empowering facilities to resolve issues promptly, reducing state bureaucracy.
2. Streamline Survey Teams:
• Reduce survey staff to pre-COVID levels, focusing on high-risk facilities. Implement performance metrics to ensure inspections improve care rather than generate excessive deficiencies.
• Expected Impact: Cut costs by at least 30% in survey operations while maintaining oversight quality.
3. Segregate Resident Populations:
• Propose legislation to restrict assisted living facilities to elderly residents, directing those with severe mental illness or criminal histories to specialized facilities. Explore reopening state-operated psychiatric facilities for cost-effective, high-quality care.
• Expected Impact: Enhance safety and reduce facility strain, with potential savings from centralized care models.
4. Enhance Training and Regulation Clarity:
• Mandate MDH to provide free, accessible training for assisted living and home care providers, modeled on federal nursing home standards. Publish all regulations and clarifications online in a user-friendly format.
• Expected Impact: Reduce deficiencies by 20% within two years, improving compliance and care quality.
5. Close Accountability Loopholes:
• Advocate for legislation to increase penalties for unlicensed operation to felony status for repeat offenders or cases involving harm. Strengthen MDH’s authority to pursue civil penalties and ban bad actors from re-entering the industry.
• Expected Impact: Deter license-dropping and protect residents from negligent providers.
6. Combat Bureaucratic Bloat:
• Freeze hiring in non-essential DHS and MDH departments and conduct a zero-based budgeting review to eliminate redundant programs, such as legal teams fighting facilities over deficiencies.
• Expected Impact: Save $100–200 million in the 2026–27 biennium, redirecting funds to direct care services.
Legal Precedents and Authorities for Immediate Actions
While some solutions require legislative approval, several immediate actions are within the Governor’s authority, supported by legal precedents and existing statutes:
1. Executive Order for Department Audit:
• Authority: Minnesota Statutes § 4.035 grants the Governor authority to issue executive orders for efficient administration. Governor Tim Walz used this in 2020 (Executive Order 20-01) to reorganize COVID-19 response efforts.
• Action: Issue an executive order mandating an independent audit of the maltreatment department and survey teams by the Office of the Legislative Auditor within 90 days, focusing on cost-effectiveness and outcomes.
• Precedent: Governor Mark Dayton’s 2011 Executive Order 11-05 ordered performance reviews of state agencies to identify efficiencies, leading to streamlined operations in several departments.
2. Reallocate Budget Resources:
• Authority: Minnesota Statutes § 16A.152 allows the Governor to propose budget adjustments during fiscal emergencies or deficits. With a projected $6 billion shortfall by FY 2028–29, this authority is relevant.
• Action: Direct DHS to reallocate funds from overstaffed survey teams to training programs for assisted living providers, effective FY 2026.
• Precedent: Governor Walz’s 2025 revised budget reduced general fund spending by $808 million, including DHS cuts, demonstrating executive budget reprioritization.
3. Strengthen MDH Oversight:
• Authority: Minnesota Statutes § 144.05 vests the Commissioner of Health (appointed by the Governor) with broad powers to regulate health facilities and enforce compliance.
• Action: Instruct the Commissioner to issue emergency guidance clarifying assisted living regulations and mandating training within six months, using existing MDH funds.
• Precedent: In 2021, MDH issued emergency rules under the Assisted Living Licensure Act to address compliance gaps, proving the Commissioner’s ability to act swiftly.
4. Task Force on Resident Safety:
• Authority: Minnesota Statutes § 15.014 allows the Governor to establish advisory task forces for policy development.
• Action: Create a Governor’s Task Force on Assisted Living Safety to recommend policies on resident segregation and psychiatric care within 120 days, involving stakeholders like the Minnesota Elder Justice Center.
• Precedent: Governor Walz’s 2019 Task Force on Aging addressed elder care gaps, leading to policy recommendations for assisted living.
These actions can begin immediately upon taking office, leveraging executive powers to address urgent concerns while building momentum for legislative reforms.
A Call to Action
The concerns raised by this dedicated nurse are a wake-up call. Minnesota’s health department must serve its residents, not burden them with waste and inefficiency. As Governor, I will fight for a system that prioritizes quality care, fiscal responsibility, and accountability. I invite Minnesotans to join me in this mission—contact my campaign to share your experiences or support our vision for a better Minnesota.
Together, we can rebuild a health system that works for all, ensuring our elderly and vulnerable receive the care they deserve while respecting the hard-earned dollars of taxpayers. Let’s get to work.
Phillip C. Parrish
Candidate for Governor of Minnesota 2026
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