Feb. 12, 2020

Featured

Gov. Tim Walz: One Minnesota Requires an Age-Friendly Lens

On February 12, 2020 by Jodi Boyne

Governor Tim Walz joined the LeadingAge Minnesota Institute & Expo last week to present the Caregiver of the Year Award, express his appreciation for professional caregivers and share his vision for an Age-Friendly Minnesota.  

“I often talk about One Minnesota. It doesn’t mean we all agree on everything, but it means there is a place for everybody,” said Governor Tim Walz. “If we are truly going to be One Minnesota, an Age-Friendly State, a decision focused through that lens is going to matter. One of the biggest things we can do is to lift up this industry (aging services) and, more importantly, lift up the individuals to make this happen.”

Governor Walz shared his remarks at the opening session of the 2020 Institute & Expo, which was attended by more than 4,500 people. He presented the Caregiver of the Year Award to Amanda Gruber, Household Coordinator  at Three Links in Northfield and shared his appreciation for caregiving, our work on safety, respect and  dignity in our settings   and the reality that lies before Minnesota as it prepares for the aging boom that’s to come.

In his remarks, Governor Walz shared that his mom, Darlene, was a caregiver in a long-term care setting and he knows and values the compassion she showed every day in her work.

“Caregiving is an absolutely essential and noble profession. Your capacity to show kindness and to allow our family members to age with dignity is something to be incredibly proud of,” said Governor Walz.

Governor Walz also recognized that Minnesota has crossed a major milestone: for the first time in our state’s history we now have more people age 65 and older than under the age of 18.

“We all know the reality of aging. We need to understand how it impacts everything we do, from how our cities and transportation systems work to how we think and do things to make sure our communities remain accessible and welcoming for seniors,” Governor Walz said.

Governor Walz also recognized the collaborative work that took place to pass the 2019 Assisted Living and Older Adult Protection Act and credited aging services providers for their role in that achievement.

“It was the industry that brought this forward and it was the industry that said ‘we want to make sure that everyone in our facilities is cared for with dignity’,” Governor Walz said. “You helped bring together advocates, legislators and others to pass legislation that will ensure the work that you do and that the public understands how much you care. I am grateful for that.”

Legislators Kick-Off the 2020 Legislative Session; We’re Ready to Advocate for You

On February 12, 2020 by Libbie Chapuran

Yesterday marked the first day of Minnesota’s 2020 legislative session and we are ready to advocate for you, maximizing our time at the State Capitol advocating for several public policy solutions this session that will benefit the seniors you serve and their caregivers.  

The second year of every biennium is typically focused on bonding and this year is no different; a top priority for legislators is a capital investment bill focused on our state’s infrastructure. There are some policy issues leftover from last session, both large and small, that will see renewed activity this year and we should be prepared for a vigorous debate over how to spend the budget surplus. Budget discussions are expected to heat up after the February budget forecast is released at the end of the month.

KEY DATES: Legislators will have just one month until the first bill deadline – March 13 – when bills have to be moved out of all policy committees in at least one body to remain alive; and then an additional week until the second deadline – March 20 – when the other body must act on those bills.

Priorities for the session will come into focus after March 20 as the field of bills still available for passage is greatly narrowed. The final bill deadline, for finance bills, is April 3, which is also the last working day before the legislature’s Spring Break begins on April 4. Legislators will return to Saint Paul on April 14, giving them about five weeks to finish their work before the constitutionally required adjournment date of May 18.

OUR PRIORITIES: LeadingAge Minnesota and the Long-Term Care Imperative are proud to bring forward focused legislative priorities developed and vetted by provider members. You have shared your concerns and challenges and we are advocating for several public policy solutions this session that will benefit the seniors you serve and their caregivers. See a complete list of our 2020 legislative priorities.

SAVE THE DATE: We invite you to save the date for our Day at the Capitol that will be held on March 19. More information will be sent out later this week.

GET WEEKLY UPDATES: If you would like to receive detailed weekly updates from the Capitol, please sign up for our Capitol Conversations email that is delivered to your inbox every Friday.

Amanda Gruber, Household Coordinator at Three Links, Named Caregiver of the Year

On February 12, 2020 by Jodi Boyne

Amanda Gruber, a Household Coordinator at Three Links Northfield, has been named the Caregiver of the Year by LeadingAge Minnesota. The award was presented to Amanda during last week’s Institute & Expo by Governor Tim Walz. 

“Amanda Gruber not only cares for her residents and their families, but also her co-workers. She is the heart and soul of the Pathway Dementia Neighborhood at Three Links in Northfield. It is my privilege to present Amanda with the Caregiver of the Year award,” said Governor Tim Walz. 

Watch the Caregiver of the Year award ceremony.

The Caregiver of the Year award honors an individual who demonstrates exceptional commitment to seniors and enhances and enriches the quality of life of those they serve. 

“Every day I am amazed at how caregivers put others needs before their own. I realized this award is to bring recognition to every caregiver and I am humbled by this opportunity to represent such an amazing group. I have been blessed to know some of the greatest mentors and role models in the world,” said Amanda Gruber.

LeadingAge Minnesota President & CEO Gayle Kvenvold said Amanda’s excellence as a caregiver, devotion to her co-workers, and commitment to the residents and families she serves is unparalleled among her peers in the field of aging services.

“Amanda is an exceptional caregiver who embraces the joys and challenges of caregiving. Her heart is evident in her work and her creativity in life enrichment activities for residents in memory care is the epitome of person-centered care, ensuring respect, purpose and dignity for each individual,” said Gayle Kvenvold.

Amanda’s achievement also received a letter of commendation for U.S. Senator Tina Smith who wrote: “After learning about your dedication to serving seniors in Minnesota, I can’t imagine a more fitting recipient of the Caregiver of the Year Award. Your commitment as a caregiver warrants the highest honor awarded to Minnesota caregivers who dedicated their lives and careers to serving older adults. Thank you for making a difference for individuals, families and the health of Minnesota”

Amanda first joined Three Links as a nursing assistant in 2007 and now serves as a household coordinator for Pathways, a 24-bed secure memory care unit. Shortly after beginning her career at Three Links, Amanda took advantage of educational opportunities to improve the care she provides and advance her career pathway. She completed the Health Support Specialist Apprenticeship program and now serves as the site coordinator at Three Links, nurturing the career development of those around her while transforming the way the organization serves older adults.

Amanda is motivated to give each resident their best day and has customized programs, services and activities based on each resident’s preferences, so they experience the highest quality of life. She includes residents and their families in planning life enrichment activities so that each resident benefits from the activity in some way. Gruber recently started Google Maps trips where she meets with residents and families to talk about where they grew up, spent a significant amount of time when they were younger, or places they have worked or traveled. She then “maps out” trips that the residents travel via an iPad while reminiscing about their favorite places and memories. 

As a family caregiver to her 85-year-old father, Gruber knows and understands the valuable role family members have in the care of their loved ones. She makes it a priority to collaborate with families to better understand the interests, needs and preferences of their loved ones and uses that information to improve the care she and Three Links provide. Gruber also makes sure to share both the positive outcomes their loved one is achieving as well as a change in their health and wellness.

In addition to her role at Three Links, Gruber is also involved in special projects throughout the broader Three Links organization and is an active volunteer in the Northfield Community, including participation in the Alzheimer’s Association and Age-Friendly Northfield.

To learn more about Amanda, watch Amanda Gruber – Caregiver of the Year.

State

DHS Publishes New Report on Assisted Living Report Card

On February 12, 2020 by Bobbie Guidry

The Minnesota Department of Human Services (DHS) has published a new report related to the development of the Minnesota assisted living report card. Once complete, the report card will measure and report on the quality of assisted living settings across Minnesota.  

The report summarizes feedback from stakeholders on what quality means in assisted living and how we should remeasure it. It builds on a July 2019 report that summarized results from a national literature review and environmental scan on assisted living quality and quality measurement.

You can read the report at DHS – Assisted living report card. 

Enhanced Barrier Precautions for Care Centers

On February 12, 2020 by Jonathan Lips

The Minnesota Department of Health (MDH) Infection Control Assessment and Response Program (ICAR) issued a notice on Jan. 31 to alert care centers that the Centers for Disease Control and Prevention (CDC) released interim guidance on the implementation of Enhanced Barrier Precautions (EBP) in July 2019. 

MDH has responded to outbreaks of novel or targeted multi-drug resistant organisms (MDROs) in Minnesota care centers, which motivated the agency to issue its notice.

The interim guidance is intended for use during a Containment Response to prevent the spread of MDROs. These are uncommon in Minnesota but can cause difficult- or impossible-to-treat infections and can readily spread in healthcare facilities. The goal of containment is to keep new or rare forms of antibiotic resistance from spreading.

MDH has received several questions on EBP and recommends reviewing this webinar that explains the rationale and implementation of EBP: Clinician Outreach and Communication Activity, Preventing the Spread of Novel or Targeted Multidrug-resistant Organisms in Nursing Homes through Enhanced Barrier Precautions.

Care centers should review the full ICAR notice that lists novel and targeted MDROs, links to additional CDC resources, and provides additional guidance for providers.

For questions, email health.icar@state.mn.us or call MDH at 651-201-5414.

MDH Hosts Nursing Home Regulatory Call on March 9

On February 12, 2020 by Jonathan Lips

Save the Date: The Minnesota Department of Health (MDH) will host a statewide Nursing Home Regulatory call on March 9 from 11 a.m. to Noon. 

MDH will release an agenda and information on how to connect to the call soon. In the meantime, please save the date and time on your calendars.

Federal

CMS Urges Healthcare Settings to Prepare for Possibility of Coronavirus

On February 12, 2020 by Jonathan Lips

As concerns arise with the emerging 2019 Novel Coronavirus (2019-nCoV) threat, the Centers for Medicare & Medicaid Services (CMS) is encouraging all healthcare settings to carefully review information provided by the U.S. Centers for Disease Control and Prevention (CDC).  

Because coronavirus infections can rapidly appear and spread, CMS states in a Feb. 6 memorandum to state survey agencies, settings must take steps to prepare, including reviewing their infection control policies and practices to prevent the spread of infection.

The CMS memo emphasizes advance preparation by facilities through self-assessment and review of infection control practices and strongly encourages facilities to note the following:

• CDC issued a Health Update Feb. 1, with a link to updated infection prevention and control guidance specific to 2019-nCoV.
• CMS recognized the need to consider “emerging infectious diseases” in a provider’s emergency preparedness plans.
• To ensure health and safety, CMS expects healthcare staff and surveyors (contractors, federal, state, and local) to comply with basic infection control practices.
• Healthcare settings should review appropriate personal protective equipment use and availability, such as gloves, gowns, respirators, and eye protection.

To assist you in self-assessment and review of you own practices, CMS provides links to several resources, including online courses developed in conjunction with CDC focusing on universal infection control practices.

You should also review infection control practices in relation to Novel Coronavirus and be prepared to address questions from MDH about the steps you took should it arise during survey.

The Minnesota Department of Health also maintains a webpage with local information about the virus.

New CMS Block Grant Waivers Could Endanger Funding

On February 12, 2020 by Jodi Boyne

The Centers for Medicare and Medicaid Services (CMS) published a state Medicaid director's letter on Jan. 30 outlining how states can apply for Medicaid block grant waivers. We oppose Medicaid block grants and similar initiatives that would limit Medicaid funding, including per capita caps. 

The new waivers would allow states to establish a block grant, or per capita cap, waiver for adults between ages 19 and 64 enrolled in Medicaid. This guidance allows for such waivers at the option of states and there is no requirement that a state adopts a block grant waiver. Notably, states cannot establish this program for children and older adults 65+. 

CMS said states have the potential to share in savings that result from these waivers and can use those savings to reinvest in their Medicaid programs. CMS Administrator Seem Verma last week said that block grants would not lead to cuts in Medicaid funding and described criticism of the proposal as “fear-mongering.” She noted that Medicaid is either the “largest or second-largest budget item” for states and the block grant waivers would help them prioritize the funding for those who need it most. 

It is very unlikely, however, that any block grant waiver would result in significant funds available for such reinvestment. In fact, the purpose of block grants is to reduce spending on the Medicaid program, often to reallocate state dollars to other programs and policy areas. There is also potential that reduced federal Medicaid funding as a result of these waivers could cause states to make cuts to other aspects of their Medicaid programs to make ends meet, including reduced rates and more restrictive eligibility criteria for long-term services and supports. 

We have advocated against efforts to transform Medicaid into block grants and per capita caps. Because so much of Medicaid goes to long-term services and supports, we are concerned about the very real possibility of cutbacks in our sector. States just would not be able to save enough money to meet the limits of a block grant by reducing spending on other aspects of their Medicaid programs. 

While the guidance focuses on the adults under 65 population, it can have significant effects on health insurance coverage of older residents in affordable housing, which can cause significant downstream impacts including worse health outcomes for older adults as well as cost increases to both the Medicaid and Medicare programs as people age into Medicare eligibility without prior health insurance coverage. 

Read more about block grants and their potential implications for aging services. Members with questions or concerns should contact Brendan Flinn of the LeadingAge staff.

President Trump Releases Budget

On February 12, 2020 by Jodi Boyne

President Donald Trump this week released A Budget for America’s Future, which includes $4 trillion in mandatory and discretionary budget cuts in FY 2021 that would result in significant reductions to federal health care spending, including Medicare and Medicaid and other entitlement programs.  

While the intent of the budget is to reduce waste, fraud, and abuse, it could ultimately limit resources available for long-term care at a time when demand is increasing. In our divided Congress, the President’s budget has no chance of becoming law. However, it does provide deeper look at the President’s agenda and aligned efforts to reduce growing budget deficits. 

Our national affiliate, Argentum, provided an overview of select provisions included in the President’s budget relating that relate to public policies affected aging services providers: 

Workforce Development

The budget supports additional funding to support opportunities for workers to access job skills to be fully employed including:

• Doubles the American Competitiveness and Workforce Improvement Act of 1998 fee for the H-1B visa program to provide opportunities to prepare American workers for jobs that are currently being filled from overseas, especially in science, technology, engineering and mathematics fields;
• Increases Career and Technical Education by nearly $1 billion to help ensure that every high school has a high-quality vocational program;
• Retools the American Workforce for Jobs of the Future by continuing to support and expand funding for apprenticeship programs to teach students the skills they need to obtain and retain high-wage jobs in a changing market;
• Allows states and localities to provide training and employment services more efficiently by allowing additional flexibility in how they spend their workforce development dollars; and
• Proposes to expand Pell Grant recipients’ eligibility to include high-quality short-term programs, with safeguards to balance students’ needs with protecting taxpayers’ interests.

Health and Human Services (HHS)

The budget requests $94.5 billion for HHS, a 10% decrease from the 2020 enacted level. It proposes $1.6 trillion in net mandatory health savings, reducing longer-term deficits by eliminating wasteful spending while preserving beneficiaries’ access to care, enhancing competition, and prioritizing federal resources for the most vulnerable.

Medicare: The budget includes several proposals that would eliminate excessive spending and distortionary payment incentives; refines reimbursement for uncompensated care and graduate medical education; and realigns incentives through site-neutral payment reform for post-acute care and other sites of care to make payments based on clinical needs of the patient, rather than site of service including:

• Authorizes long-term care hospital site neutral exceptions criteria—The budget proposes to better align payments to long-term care hospitals based on patient need by modifying the criteria for payment. The budget proposes to extend the criterion to at least an eight-day stay in an ICU, as recommended to better identify chronically ill patients who would more likely benefit from a long-term care hospital.
• Modifies payment for hospice care provided to beneficiaries in skilled nursing and nursing homes — Reduces hospice reimbursement by $10 per day to account for the separate Medicare and Medicaid payments already provided for personal care services delivered to beneficiaries who elect hospice in skilled nursing and nursing homes.
• Reforms and expands durable medical equipment competitive bidding—Implements a more rational approach for setting payment rates in competitively bid areas by eliminating the single payment amount and paying winning durable medical suppliers at their bid amounts.
• Expands basis for beneficiary assignment for Accountable Care Organizations (ACOs)—Provides additional flexibilities to increase savings through ACOs by expanding the basis for beneficiary assignment to a broader set of primary care providers, including nurse practitioners, physician assistants, and clinical nurse specialists, moving more beneficiaries from fee-for-service Medicare to value-based care.
• Expands prior authorization to additional Medicare fee-for-service items at high risk of fraud, waste and abuse—Expands the Medicare program's authority to conduct prior authorization on certain items or services that are prone to high improper payments, including, but not limited to, inpatient rehabilitation services.

Administration for Community Living – The budget requests $2.1 billion in discretionary budget authority and $56 million in mandatory funding including:

• $39 million to protect vulnerable older adults to support the presence of ombudsmen in long-term care settings in all states and to support ongoing development of state Adult Protective Service systems in 20 states;
• $19 million for Alzheimer’s Disease activities.;
• $937 million for Senior Nutrition programs;
• $425 million for Home and Community-Based Supportive Services;
• $18 million for the Senior Medicare Patrol program, which supports nearly 7,000 Senior Medicare Patrol team members nationally, who help identify and prevent Medicare fraud across the country;
• $36 million to help seniors through Preventive Health Services and Aging Network Support Activities;
• $27 million for Alzheimer’s Disease Program to fund grants for states, tribes and community-based organizations; and
• $164 million for these programs to support both family and other informal caregivers.

Medical Liability – To reduce health care costs and health insurance premiums, the budget proposes to reform medical liability beginning in 2021. The proposal which must be further developed is expected to reduce medical liability insurance premiums and defensive medicine practices.

Notable

New Study Will Identify Economic Benefit of Workforce Investments

On February 12, 2020 by Jodi Boyne

What’s the Economic Benefit of Workforce Investments? A new LeadingAge study will attempt to answer this question by exploring how increased compensation for direct care workers could favorably impact the national economy, the field of long-term services and supports and individual direct care workers.  

The study, expected to be completed this summer, will focus on three specific areas in which investments in the direct care workforce could have a beneficial impact on:

• The overall economy: Researchers will study the existing minimum wage literature to determine how the national economy is likely to benefit as direct care workers with rising incomes increase their spending.
• The long-term services and support field: Researchers will explore how higher pay and more stable incomes can reduce turnover in our field and how these turnover reductions could lower hiring costs, offer savings to payers, and produce increases in productivity.
• Individual workers: Researchers will explore how workforce investments can reduce the risk of poverty among direct care workers and lessen their dependence on public assistance programs.

The final report will help raise awareness about the economic importance of our workforce among policy makers who are positioned to develop and support federal and state initiatives that could strengthen the direct care workforce.

Member

12 Providers Recognized for Quality and Performance Excellence

On February 12, 2020 by Julie Apold

LeadingAge Minnesota last week recognized 12 aging services providers for their achievements in quality, continuous improvement and performance excellence. Awards of Merit for Performance Excellence in Aging Services were provided to eight members and four members were recognized with the advanced Award of Honor. The providers are:  

Awards of Merit:

• Carris Health Care Center and Therapy Suites in Willmar
• St. Francis Health Services of Morris
• Vista Prairie at Copperleaf in Willmar
• Vista Prairie at Garnette Gardens in Redwood Falls
• Vista Prairie at Goldfinch Estates in Fairmont
• Vista Prairie at Monarch Meadows in North Mankato
• Vista Prairie at River Heights in South St. Paul
• Vista Prairie at Windmill Ponds in Alexandria

Awards of Honor:

• Benedictine Living Community of Duluth
• Madonna Living Community of Rochester
• Knute Nelson in Alexandria
• Walker Methodist

“Quality improvement in long-term services and supports is a continuous process, bettering our best each day to provide exceptional care and services to older adults,” said Gayle Kvenvold, President and CEO, LeadingAge Minnesota. “Through their dedication to quality and the outcomes they have achieved through Performance Excellence in Aging Services, these providers and their dedicated caregiving staff are delivering quality care, services and support to the older adults they serve.” 

Read more: LeadingAge MN Recognizes 12 Aging Services Providers for Achievement in Quality and Performance Excellence.

Start Your Journey to Performance Excellence

LeadingAge MN will host two events to help member get started on their journey to performance excellence. Save these dates and watch for more information in Advantage and via your email:

• INTRODUCTORY WEBINAR: March 4 from 11–11:30 a.m.: Join us to learn more about Performance Excellence in Aging Services.
• INTENSIVE WORKSHOP: March 30: Participate in  an all-day workshop in Saint Paul that will provide you with the tools, resources and action plan to launch Performance Excellence in Aging Services in Your Settings.

38 Leadership Academy Fellows Recognized at Institute

On February 12, 2020 by Jodi Boyne

Leadership Academy celebrated its 10th Anniversary and 300th graduate when 38 fellows were recognized during last week’s Institute & Expo.

This year’s fellows featured a diverse group of professionals from around the state, representing virtually every service sector, profession and geographic region within the LeadingAge Minnesota membership.  

“The growth and success of Leadership Academy is because of our members coming together and taking charge of your own future; advancing your promising leaders and preparing them to create the future that we all want to see for our organizations, our staff, and most importantly for the people we serve in their later years,” said President & CEO Gayle Kvenvold.

She also expressed appreciation to the 191 organizations who have invested in their emerging leaders and annual Bronze Sponsor member organization Healthcare Services Group for its consistent sponsorship of Leadership Academy since its formation.

“I want to especially thank the group of volunteer coaches for their extraordinary contributions of time and talent.” Kvenvold said. “Coaches are Academy graduates who go above and beyond their regular work to guide and invest in our future leaders. This program simply could not exist without them.”

2019 coaches were Michelle Harris, Sholom; Annette Greely, Jones-Harrison Residence; Joanie Lennick-Goulart, Ebenezer Tower Apartments; Kathy Olson, Three Links Millstream Commons Assisted Living; Emilee Sames, Episcopal Homes of Minnesota; and Jen Zinnel, The Glenn Hopkins.

Leadership Academy begins in May. Applications are due March 2. Learn more and apply.

VOA Receives Section 2020 Housing for the Elderly Grant

On February 12, 2020 by Jodi Boyne

Volunteers of America in Minnesota is one of 18 aging services providers who received new grant funding from the U.S. Department of Housing & Urban Development (HUD) to support affordable housing for older adults. 

Following years of aggressive advocacy by LeadingAge to renew funding for Section 202 Housing for the Elderly, HUD last week awarded $51 million in grant funding to aging services providers across the country.   

The need for affordable housing among older adults is significant and expanding. Since its founding in 1959, the Section 202 program has provided valuable support for older adults who are priced out of housing markets nationwide. Despite growing demand, new funding has not been allocated since 2011.

The $51 million awarded last week is the first portion of $251 million Congress has provided for new Section 202 homes since the program was revived in 2017.

Education

Engage Front Line Staff in ICan to Improve Quality

On January 21, 2020 by Jenna Kellerman

Are you ready to engage your front-line staff in quality improvmeent?  Register today for a webinar on Feb. 25 at 10 a.m. to learn more about our ICan: Driving Quality and Innovation from the Front-Line program and how your team could win $500 in our kick-off conteast. 

ICan’s goal is to engage leaders at all levels of your organization with a special focus on front-line staff. Watch this 20-minute video for more detail.

ICan teaches staff to:

• Identify challenges within their scope of practice
• Pull together and lead an interdisciplinary team to solve the challenge
• Identify possible solutions
• Complete the Plan-Do-Study-Act quality improvement cycle
• Track data to demonstrate success of the identified solution
• Speak to others about the successes and challenges of their work

Dozens of ICan projects have been led by frontline staff around the state over the last three years. Read about our 2019 contest winners here. Other ICan projects have included:

• Increasing the safety of resident transfers by adjusting wheels on lifts to reduce the risk of falls, ease movement over floor transitions, make residents feels safer and reduce physical stress on caregivers.
• Using an aromatherapy program to promote patient comfort and reduce the use of opioids for pain management.
• Updating the contents, stocking process and efficiency of first aid kits.
• Initiating the use of Communication Boards.
• Improving resident grooming practices and staff accountability.
• Relaunching onboarding and training practices to impact retention of staff.

Interested in engaging your team in quality improvement? Contact Jenna Kellerman.

Your Journey to Performance Excellence Begins in March

On February 12, 2020 by Julie Apold

When it comes to quality, you can’t afford to wait. Simply addressing and attempting improvement opportunities as individual initiatives is not enough. Join us in March for two opportunities to start your comprehensive journey that will align your existing work and resources to help you achieve Performance Excellence in Aging Services. 

Save the Dates and Look for More Information Soon:

LeadingAge MN will host two events to help you get started on your journey to performance excellence. S

• INTRODUCTORY WEBINAR: March 4 from 11–11:30 a.m.: Join us to learn more about Performance Excellence in Aging Services.
• INTENSIVE WORKSHOP: March 30: Participate in all-day workshop in Saint Paul providing with the tools, resources and action plan to launch Performance Excellence in Aging Services in Your Settings. 

To learn more about the program, visit Performance Excellence in Aging Services.