April 7, 2021

Featured News

Senior Care Proposals Unveiled in House and Senate Budget Bills

On April 7, 2021 by Kari Thurlow

Lawmakers resumed legislative activity this week following a one-week break to observe the Easter and Passover holidays. It is a pivotal week as lawmakers unveil budget bills and will need to pass bills out to their respective committees by Friday. Next week, we expect lawmakers will begin to pass these budget bills off the House and Senate floors, which will set up three-way budget negotiations between the House, Senate and Governor as they attempt to complete their work to pass a balanced budget by May 17.

Yesterday, we got the first look at Health and Human Services (HHS) budget bills in the House and the Senate, and there are significant differences. Overall, the Senate HHS budget target aims to reduce spending by $100 million. The House budget target increases spending by $343 million over the base. Although the House closely reflects recommendations in the Governor's budget, a handful of provisions are included in both the House and Senate bills. Those include:

• A proposal to adjust to nursing home assessment practices requires an updated assessment for residents at the end of therapy or isolation. The proposal results in $3.9 million in budget savings for the biennium, including funding for nursing facility cost report auditors, additional costs of the consumer satisfaction survey and a case mix transition study. We are neutral on this group of proposals.
• There are acuity-based limits on customized living payments for clients on disability waivers. This proposal results in budget savings of $2.3 million for the biennium and was one of the proposals considered by the Blue Ribbon Commission in 2020.
• There is also a proposed expansion of an encounter alert system to improve coordination of care during transitions.

We expect that lawmakers may come forward with additional proposals to spend money from the federal American Rescue Plan. Lawmakers have been waiting for guidance about how they can spend the money. Therefore, while neither the House nor Senate Omnibus HHS budget bills have included our priorities for the federal dollars, including hero pay and adult day recovery grants, there may be other bills coming forward that could include these proposals. 

Senate-Only Provisions
Two bills in the Senate make up the HHS budget proposal and will be merged later in the Senate Finance Committee. We are pleased that the Senate has included several of our key priorities, including the following:

• Nursing Home Moratorium Exception Process: The Senate included the LTC Imperative's proposal to fund the nursing home moratorium exception process with an ongoing appropriation of $5 million annually. The proposal will address a backlog of upgrading physical plant needs and improve infection control in care centers. Senator Julie Rosen (R-Fairmont) initially introduced this proposal, and we are pleased the Senate has included it in their Human Services budget bill.
• $155 million for retention payments to Home and Community Based Service providers who serve Medicaid clients: This proposal is like an initiative passed in 2020 to help day service providers address the pandemic's impacts. The proposal uses almost $100 million in federal funds from the enhanced federal match in the American Rescue Plan. We support this provision because it will provide critical resources to adult day providers still needing financial assistance to reopen.
• Funding to conduct the actuarial analysis and put in place administrative structures necessary to implement the Program for All-Inclusive Care for the Elderly (PACE): We support this initiative that represents progress in establishing this new model of care in Minnesota
• An additional $1 million in funding for a grant program that supports quality improvement programs in customized living sites that serve a high percentage of elderly waiver clients
• Creating a floor payment of $122 per day for customized living providers who serve more than 80% elderly waiver clients

The Senate bill includes two proposals that may be of concern to LeadingAge Minnesota:

• Enrollment caps for the disability waiver programs: This proposal saves over $60 million in the biennium and more after that as enrollment counts remain frozen.
• Delaying payments to Medical Assistance managed care plans into the following fiscal year: This proposal saves more than $100 million and is designed not to impact payments to providers, but it is unclear how providers will be held harmless.

House Bill Provisions
Like the Senate, the House has two bills that make up the House's proposed HHS budget.

We are disappointed that the House HHS budget bills contain none of the LTC Imperative's key priorities. Furthermore, the bills include non-consensus language that would modify assisted living licensure provisions. We will continue to work with the House to build support for our priorities in the conference committee and to remove problematic language.

The House bills align closely with the Governor's budget proposal, including some of his proposals, such as Blue Ribbon Commission proposals to better coordinate durable medical equipment purchases and non-emergency transportation services and implement further the combination of the disability waivers under "Waiver Reimagine."

Other provisions with an impact on senior care providers include:

• Paid family leave program: This was also included in the Governor's budget proposal, and the policy is carried in the House Workforce and Jobs bill. However, the HHS budget is impacted because it will have an impact on nursing home spending. The HHS bill includes state funding for startup costs and a 0.6% payroll tax on employers.
• Paid emergency leave for essential workers: The policy language for this bill is also carried in the House Workforce and Jobs bill and is designed to address emergency leave required by the pandemic. The proposal is retroactive to last March and applies to cases where the leave was not already paid by another source. It requires employers to refund Paid Time Off if the employee used PTO for COVID-19 leave. Costs for nursing homes are carried in the HHS bill.
• Authorizes DHS to work with more than one fingerprint collection vendor and extends the fingerprinting waiver to 180 days after the peacetime emergency: We have prioritized addressing the backlog of background checks that has been growing during the public health emergency.

We will continue to monitor these budget bills this week and provide an update in Capitol Conversations later this week.

Moratorium Exceptions Process Available Funding Increased

On April 7, 2021 by Jeff Bostic

Due to a cancellation of a previously approved moratorium exception project, there is now $821,088 in state funding available in the current moratorium exceptions rounds, up from the $702,144 announced in January. The Long-Term Care Imperative is pushing for additional funding in the current legislature to conduct another round later this year and is glad to see the Senate supporting additional funding, which is much needed to upgrade physical plants to make infection control efforts more effective.

The application materials for the current round of the nursing facility moratorium exceptions process are available on the MDH website. Care centers interested in applying will need to complete all of the required application materials and return them to MDH by June 25. Following a presentation to a review committee later this year, MDH will have a list of approved projects by Sept. 3.

Although it may not sound like much, the amount of state funding available in this round will allow for investments in Minnesota care centers. The available state funding, which is applied only to the first-year state cost of approved projects, may cover more than $100 million in much-needed construction on Minnesota care centers.  

Under the nursing facility property rate system, a moratorium exception approval allows the provider to have their entire property rate calculated based on a rental value formula adopted by the 2019 Legislature. That formula is more straightforward and tends to produce a better payback than the old system, so each moratorium exceptions round available will likely be very competitive as the round in 2019 was.

House Includes Proposed Changes to Assisted Living Licensure Laws

On April 7, 2021 by Kari Thurlow

As part of the Minnesota Legislature's budget process, the House of Representatives has included in its Health and Human Services (HHS) omnibus budget bills critical changes to the assisted living licensure law that could significantly disrupt implementation.

Leading Age Minnesota and the Long-Term Care Imperative have worked diligently with MDH and consumer stakeholders over the past three years to create the appropriate framework for assisted living licensure. We have had an unwavering commitment to implementing the 2019 landmark assisted living licensure legislation and reaching consensus and collaboration with our stakeholder partners. As the time for implementation is just weeks away, we continue to work closely with MDH to facilitate implementation, even as we continue to advocate for changes that address concerns with the current law. Unfortunately, some consumer advocate stakeholders have gone outside the consensus process and sought changes to the licensure law through the legislative process.

The House HHS omnibus bills contain three changes to the assisted living licensure law. Two of these changes are supported by all stakeholders and critical to implementation. LeadingAge MN and the LTC Imperative oppose the third proposed change, and it was not part of any stakeholder agreement.

First, the good news: the House includes two essential provisions aimed at addressing technical errors in the current licensure law.

The first provision is consensus language that addresses a serious drafting error in Minnesota Statute 144G, which requires any provider seeking an assisted living with dementia care license to provide residents with access to secured outdoor space and walkways that allow residents to enter and return without staff assistance. Under current law, this "outdoor space" requirement applies to existing and new providers alike. A recent informal survey of LeadingAge Minnesota members revealed that at least 30% of our members could not meet this requirement and, therefore, would be ineligible to apply for an assisted living with dementia care license. This could lead to serious access issues for residents needing this level of care. The language included in the House bill addresses this concern by applying the outdoor space requirement only to new licensees or new construction. We strongly support this provision.

The second provision addresses a technical error in the current law. It clarifies that current HWS providers applying for assisted living licensure on June 1 will be applying for a full license, not a provisional license. The error in the current law is the result of an incorrect cross-reference. We strongly support this provision as well.

But here is the bad news: the House and consumer advocates are playing politics with these badly-needed technical changes by conditioning the inclusion of these provisions on a third provision, which seeks to change the definition of an assisted living provider.

The language would amend the definition of assisted living to address what consumer advocates perceive as a "loophole" in the assisted living licensure law. The proposed new definition would expand the scope of providers that would be required to obtain an assisted living license and would include any facility where an operating person or legal entity, either directly or through contract, business relationship, common ownership, or other arrangement with another person or entity, provides sleeping accommodations and assisted living services to one or more adults in the facility.

We believe that this definition greatly expands the number of housing providers required to obtain an assisted living license and will loop in what are otherwise independent senior housing providers. Here are a couple of examples of arrangements that might be affected by this overly broad language:

• A home care agency rents commercial space in an apartment building. Some residents choose to contract for services from that home care provider. Arguably, because the housing provider is a landlord to the home care agency, the entities meet the definition of having an arrangement, and therefore the building must have a license.
• An independent senior housing provider has a small ownership interest in a home care agency. A tenant of the housing provider contracts with the home care agency for services. The tenant has no knowledge that the housing provider has an ownership interest in the home care agency. The housing provider has no knowledge that the tenant is contracting for services. Nonetheless, because of the common ownership interest, the setting must be licensed.
• This proposal has never received a hearing in the House, and legislators have not heard from providers about this proposal's impact. Moreover, the legislation demonstrates a problematic trend that has too often been at the forefront of the licensure rulemaking process: hasty, overreaching policies set into place without full consideration for the consequences.

We have several concerns, including the following:

• If this legislation becomes law, in whole or in part, it will threaten Minnesota's goals of promoting senior setting choices, independent living, lowering costs and preserving quality of life for as long as possible.
• Extending new regulatory burdens beyond assisted living will serve as a strong disincentive for providers to offer independent apartments and reduce interest in the investments needed to provide housing and care for a growing senior population.
• Changing the definition just weeks before the application deadline is reckless and could result unfairly impact housing providers that are not currently planning for licensure.
• There is no evidence that a loophole even exists in the licensure law. Consumer advocates are proposing solutions that are in search of a problem. We believe a better approach would be to implement the law and understand if there are entities that have been left out. 

We ask you to contact your lawmakers and urge them to oppose this provision. To send an email to your lawmakers, CLICK HERE, enter your address and click send. You can personalize your message if you’d like to share specific examples of how this law will affect the seniors living in your senior apartments. These provisions are moving quickly, and we will need you to act this week. Please watch your email for details.

COVID-19

Provider Community and MDH Continue Working Toward Vaccination Goal

On April 7, 2021 by Jeff Bostic

In the most recent Minnesota Department of Health (MDH) update, staff rates for full vaccination were 55% in all reporting care centers and 47% in all reporting assisted living settings. These numbers increased slightly in the last week, which is good to see. To reach the MDH goal of 70% staff vaccination rates, providers will need to continue encouraging vaccinations among staff.

MDH is now limiting reporting for providers who are meeting the goal rates for residents and staff, and as of the most recent report, 19% of providers were meeting the goal.

The Long-Term Care Imperative recently did a survey looking into what incentives providers are using to encourage staff vaccination. The survey found that 15% of providers are using some sort of financial incentive currently. Providers who are not using financial incentives cited several reasons for not doing so: legal concerns, ethical concerns, no need for incentives, and questioning the effectiveness at overcoming hesitancy. The top reason cited: a lack of a clear funding source. When asked what they thought would be the most effective financial incentive, providers cited bonuses to individual employees as most likely to work.

Resident vaccination rates are well above the 70% goal, with 81% of care center residents and 87% of assisted living residents fully vaccinated.

The LeadingAge Minnesota staff and resident vaccination rates match the statewide rates in the MDH report on all providers very closely. Our members have 56% care center staff and 47% assisted living staff fully vaccinated rates, and our resident vaccination rates are 82% in care centers and 88% in assisted living.

The MDH report also looks at regional differences in vaccination rates. The Twin Cities Metro area has the highest staff vaccination rates of any region, at 62% in care centers and 51% in assisted living. Meanwhile, the MDH central region, which includes St. Cloud and the Brainerd area, has the lowest rates at 43% in care centers and 35% in assisted living.

Drive for 75: River Pointe of Moorhead Reaches 75% Staff Vaccination Rate Goal

On April 7, 2021 by Julie Apold

As we work toward the LeadingAge goal of 75% of staff receiving their COVID-19 vaccination by July 1, we will be tracking our progress across the LeadingAge Minnesota membership and will be highlighting organizations that have reached or exceeded the Drive for 75 vaccination goal. 

We are proud to highlight River Pointe of Moorhead, where 99% of the staff are vaccinated, and take a moment to learn from their success.

A conversation with Carmen Escobar, Executive Director, River Pointe of Moorhead

What is your current staff vaccination rate? We are now at 99%.

What strategies did you find most effective in impacting your rates? Education to staff about the vaccine. We took the time during huddles to go over facts, went on walks with staff and discussed vaccine options. We had a pharmacist available for questions leading up to vaccine clinic dates so that staff could have a private conversation with a professional. We also celebrated as each staff member said Yes to the vaccine. And we had amazing, fun vaccine parties throughout the clinics. We were proud to get the vaccine to keep River Pointe an enjoyable place to be.

Any lessons learned to share with colleagues? It is hard to take the untruths that staff would hear and discuss them seriously. We really tried to stick to only facts, and fact sheets that the CDC shared. I really am humbled every day by the number of staff that received the vaccine. We are a small building that sticks together to provide quality care, and my staff showed up each day during the pandemic and were happy to get the vaccine. I think the biggest thing that we did throughout River Pointe was, we took the time to be there for the staff - we had PPE parties, we had vaccine discussion talks, daily huddle included fun facts about the vaccine, meetings about life after quarantine. I showed up for my staff and they showed up for the residents.

Congratulations to River Pointe in Moorhead and thanks to Carmen for sharing their experiences.

Resilience Tip: Yourself as Medicine

On April 7, 2021 by LeadingAge

Featuring Dr. Alyson VanAhn from Associated Clinic of Psychology

In senior care communities, there are a lot of medications passed in the hopes of improving or maintaining the health of residents. What’s often overlooked is all the care that you provide—for residents, colleagues and your own families—is essential medicine, too.

You listen, you show up, you provide warm greetings and validation. You deliver medication in pill form or alert nurses that it’s time to do that, but do you realize that you’re providing medicine as well?

It's possible to be very good at delivering this type of healing “medicine” to others and struggling to do this for ourselves. For this week, don’t discount your value in improving the lives of others. Also, try to use your own best medicine on yourself. It can go a long way.

• Notice which residents, staff or family members are most comfortable and calm with you. Congratulate yourself and keep this medicine coming for them. It may just fill you up as well.
• Where do you feel most calm and comfortable right now? Go to those places, talk to those people that provide “medicine” for you.
• How long has it been since you had a break – large or small? It’s not possible to remain helpful to others when you are too depleted yourself. Use the five-second breath, stretching, pausing or other techniques we’ve discussed in previous resilience tips to get a mini break to start…and plan for a larger one or an event to look forward to during your time off.
• Humor and kindness go a long way to provide stress relief and the “medicine” we all need as we continue on the long haul the COVID pandemic presents. Take a look at some funny quotes, kind appreciations and post them for yourselves and others to have as constant reminders of the medicine you’re providing.

For more information about stress relief during COVID-19, go to www.leadingagemncoaching.com.

At no charge, you can arrange virtual staff support groups through LeadingAge Minnesota Foundation’s COVID-19 Staff Coping & Support Line project. Contact Terri Foley at tfoley@leadingagemn.org or 651-815-8137

Reducing Staff Vaccine Hesitancy through Individual Conversations

On April 7, 2021 by Terri Foley

The most effective way to address vaccine hesitancy is through conversations with trusted peers, according to the Institute of Healthcare Improvement. With these findings, LeadingAge Minnesota has developed a set of resources to help leaders improve staff vaccination acceptance through a new Safe Care for Staff initiative.

We have collected useful tools and resources to guide vaccine hesitancy conversations with an emphasis on peer-to-peer support. 

In addition to the resources, LeadingAge Minnesota is piloting a 45-minute training session for COVID-19 Vaccine Ambassadors this week and will offer a second round of Vaccine Ambassador training in late April. For more information, contact Jenna Kellerman at jkellerman@leadingagemn.org.  

“Regardless of staff vaccination status, it is important that leaders find ways to foster team resilience for everyone as the pandemic continues,” says Dr. Alyson VanAhn, from Associated Clinic of Psychology and lead faculty for the Safe Care for Staff’s COVID-19 Vaccine Ambassador Program.

“Building a non-judgmental culture that is open and accepting of individual decisions can be challenging. Transparent communication about side effects, and the experiences of people who were hesitant then eventually took the vaccine, can reduce fears,” reminds Dr. VanAhn.

To assist you in creating this welcoming environment, here are a few Safe Care for Staff tools from the Vaccine Ambassador program to help, as well as a synopsis of the Minnesota Department of Health’s (MDH) first Vaccine Champions webinar from March 25, 2021.

• Quick Reference Guide for COVID-19 Vaccine Conversations: This 2-page resource summarizes the basics of having a supportive and validating conversation with a person who decided not to get the vaccine yet. It contains tips developed by Alyson VanAhn, Ph.D. LP from Associated Clinic of Psychology, and COVID-19 vaccine facts provided by Simon Mittal, MD, Envisage Health, Inc.
• Implementation plan to support peer-to-peer vaccine conversations ambassador program: Whether or not you choose to sign on to the Safe Care for Staff COVID-19 Vaccine Ambassador program, you can use the four steps outlined in the implementation plan to developing a peer-to-peer vaccine conversation program.

1. Build a team approach to address vaccine hesitancy.
2. Empower and train peers to have COVID-19 vaccine conversations.
3. Establish referral contacts internally so that peers can refer their colleagues to them when out-of-scope questions arise.
4. Communicate ongoing access to vaccines.

• Vaccine hesitancy tools website: The website designed to be used by peers to have COVID-19 conversations includes facts, videos and resources to address major concerns such as safety, religious considerations and explanations in Spanish and Hmong and from the African American cultural perspective.
• Minnesota Department of Health (MDH) LTC Vaccine Champion Webinar Series: MDH is hosting a series of short webinars featuring senior care sites discussing best practices for achieving high staff vaccine rates and sharing their lessons learned.

“People who have decided to not vaccinate often have understandable fear and plenty of misinformation about the shot itself,” reminds Dr. VanAhn. “Questions from colleagues and from residents about whether or not you or your staff have been vaccinated can be a source of stress and add to an already tense work environment.”

The tools presented here focus on how you can embrace the diversity of values that make your organization great —even in the context of vaccine tensions. We are sharing what we know from science in order to address the most common reasons people are hesitant. We hope this will foster resilience by starting a forum for conversations.

To learn more about the Safe Care for Staff COVID-19 Vaccine Ambassador program, contact: Julie Apold; japold@leadingagemn.org.

State News

DHS Issues Instructions for Customized Living Providers Transitioning to Assisted Living Licensure

On April 7, 2021 by Bobbie Guidry

In a letter to Customized Living providers dated April 1, DHS updated their previous guidance from February 2021. Providers need to consider and act on the following instructions that apply to their setting. Of particular concern is the intention of DHS to suspend payment for Customized Living services to a provider who has not provided evidence of either their AL License or their exemption. LeadingAge Minnesota is working to resolve issues that could arise if applications have been submitted but licenses are not yet available by Aug. 1.

For providers that will require an assisted living license: After receiving the assisted living facility license from MDH for each setting providing Customized Living Services, upload a copy of each license to the Minnesota Provider Screening and Enrollment (MPSE) online portal, or fax to 651-431-7493.

For providers who are delivering services in an exempt setting and do not require an assisted living facility license: DHS is in the process of creating a provider assurance statement which providers will need to complete and submit with their comprehensive home care license to Provider Eligibility and Compliance.

Providers who no longer want to provide customized living services: Notify current residents no later than May 31, 2021, that you will no longer provide the customized living service as required in Minnesota Statute, 144G.191, subd. 3(c) and work with residents and their case managers or care coordinators to transition them to an eligible provider. Also, notify Provider Eligibility and Compliance to end the service or terminate your enrollment record.

Providers who choose to stop providing customized living services are also to: submit an enrollment record request in the MPSE portal, or fax the completed HCBS Programs Service Request Form, DHS-6638 (PDF) to Provider Eligibility and Compliance at 651-431-7493.

Providers who choose to terminate their provider enrollment for all services: submit an enrollment record request in the MPSE portal, or fax the completed Organization – MHCP Provider Profile Change Form. DHS-3535A (PDF) to Provider Eligibility and Compliance at 651-431-7493.

Payment information
Starting Aug. 1, Provider Eligibility and Compliance will suspend reimbursement for customized living services until providers have submitted proof of either 1) required assisted living facility licensure, or 2) a comprehensive home care license and the applicable assurance statement form that verifies the provider is delivering services in an exempt setting, defined under Minnesota Statutes, 144G.08, subd. 7, paragraphs 11-13.

If there is a lapse in the provider’s license (an effective date after Aug. 1), DHS will not pay for services during the lapse. DHS will cover services on or after Aug. 1, with proof of license effective Aug. 1, even if proof of licensure is received after the effective date.

MDH Names New Health Regulation Division Director

On April 7, 2021 by Jonathan Lips

The Minnesota Department of Health (MDH) has selected Martha Burton Santibáñez to be the Director of the Health Regulation Division (HRD). The HRD includes various programs affecting aging services providers, including Case Mix Review, Engineering Services, the Office of Health Facility Complaints, Health Occupations, Home Care & Assisted Living, and Licensing & Certification. Prior to assuming the Director position, Ms. Burton Santibáñez served four years as an Assistant Division Director.

When informing LeadingAge Minnesota of the appointment, acting Assistant Commissioner Diane Rydrych noted, “Martha brings so much to the table – a strong vision for HRD’s future, a passion for transformative leadership, wide-ranging knowledge of the division’s work, and a commitment to ensure that HRD is a place where people know that they are contributing to MDH’s mission.”

Ms. Burton Santibáñez assumed her new role effective March 24, and we look forward to working with her in the months ahead.

DHS Selects New Background Studies Fingerprinting Vendor

On April 7, 2021 by Jonathan Lips

The Minnesota Department of Human Services (DHS) has selected IDEMIA Identity & Security USA LLC (IDEMIA) as the new vendor to provide statewide fingerprint and photo services for background studies submitted to DHS. IDEMIA was selected through a competitive bid process with cost, quality and reliability of service locations considered in proposal evaluations.

Nothing will change immediately. As we know, under the Governor’s Executive Order 20-12, DHS temporarily modified certain background studies processes and waived fingerprinting requirements due to COVID-19 and the peacetime emergency. A date has not been set to return to fingerprint-based background studies; however, IDEMIA will be prepared to provide fingerprinting and photo services in August 2021.

The DHS webpage provides more information, including answers to frequently asked questions about the transition to IDEMIA from the current service vendor, Thales (formerly Gemalto Cogent and 3M Cogent). 

IDEMIA will have over 80 fingerprint and photo locations throughout the state, and fingerprinting services will transition from the current vendor to IDEMIA by August 2021. DHS will post information about the locations in mid-July. DHS and IDEMIA will monitor demand for fingerprinting services, and IDEMIA will take steps to add capacity based on the data and a transaction formula. Actions may include adding additional fingerprinting and photo service locations or more live scan equipment at locations to ensure sufficient capacity to meet ongoing demand. 

There will be changes related to health care providers serving as public fingerprinting sites, or providers acquiring equipment to use privately with their own new hires. The DHS FAQ notes as follows:

• Entities that provide health and human services or child care services will generally not provide public fingerprinting and photo services due, in part, to concerns about possible conflicts of interest.
• Entities may purchase fingerprinting equipment for use exclusively with their own employees, but only if the entity submits a minimum of 100 background study transactions per month in NETStudy 2.0; or operates 50 or more programs required to use NETStudy 2.0.
• And, once the contract with Thales expires, entities cannot use live scan equipment purchased from Thales for DHS fingerprinting. Thales will contact entities that purchased live scan equipment to provide further information and instructions.

We will follow this news and provide more information about DHS’s transition to IDEMIA in the weeks ahead.

Providers Serving Individuals Eligible for Disability Waivers Invited to Waiver Reimagine Information Sessions

On April 7, 2021 by Bobbie Guidry

DHS Disability Services Division (DSD) now hosts monthly office hours for providers serving individuals eligible for disability waivers.

In 2019, the Minnesota Legislature authorized DHS to streamline services and simplify the service menu for people who access services through Minnesota’s disability waiver programs:

• Brain Injury (BI);

• Community Alternative Care (CAC);

• Community Access for Disability Inclusion (CADI); and

• Developmental Disabilities (DD).

Initially designed for lead agencies, DHS is now inviting providers to participate in office hours on the second Friday of the month starting April 9 through July 9. For providers who are interested in signing up, find the registration on TrainLink: Webinar announcement: Waiver Reimagine2021 Office hours (state.mn.us)

DHS wants the second Friday of the month to be a time for providers to gather with DSD subject matter experts and receive answers regarding the waiver reimagine streamlined services changes. 

You can submit questions related to waiver reimagine streamlined services can throughout the week to DSD.WaiverPolicy@state.mn.us. Include the subject line “Waiver Reimagine Office Hours.”

Federal News

“Information Blocking” Rule Takes Effect But Enforcement Mechanism Is Delayed

On April 7, 2021 by Jonathan Lips

A set of rules took effect this week that are designed to support secure patient access to electronic medical records, as well as smooth electronic exchange of patient information. The so-called “Information Blocking” rule was developed by the United States Department of Health and Human Services’ (HHS) Office of the National Coordinator for Health Information Technology (ONC).

Applicability and implementation began April 5; however, the ONC has not put an enforcement mechanism for the rule in place and is still receiving requests for clarifications about the rule and requests to delay enforcement.

In general, information blocking (IB) is a practice by a health IT developer of certified health IT, health information network, health information exchange, or health care provider that, except as required by law or covered by an exception in the ONC’s rules, is likely to interfere with access, exchange, or use of electronic health information (EHI). This essentially means that, if a health care provider receives a request from a patient/resident/client for electronic health information, the provider must not respond to that request in a way that unreasonably blocks the individual’s access to the information requested.

The rule defines health care provider broadly, to include “a hospital, skilled nursing facility, nursing facility, home health entity or other long term care facility,” among other categories. As this definition is written, it could apply to licensed assisted living facilities in Minnesota, but we are working to confirm.

The rule is complicated to understand because the definition of “information blocking” is written in such an open-ended way. Also, rather than give examples of activities that do constitute IB, the ONC rule provides examples of certain activities that do not constitute IB. For example, it does not constitute IB if a provider does not fulfill a request for electronic health information because it is not feasible for the provider to provide the information; or if the provider cannot provide the EHI in the specific manner the patient requests it, so long as certain specific conditions are met, including that the provider offers an alternative format. Finally, the IB rule is meant to live alongside a patient’s rights to access their health information under HIPAA.

LeadingAge is working with other associations who are partners in the Long-Term and Post-Acute Care Health IT Collaborative to seek clarification from HHS and advocate for more support for LTC providers. According to LeadingAge, the rule is intended to prod hospitals, physicians, and certified health IT developers who benefited from “meaningful use” health IT financial incentives relating to exchange of information. Because long-term care providers did not receive health IT incentives and do not have Certified Health IT or interoperability and electronic information exchange capabilities that match the acute care sector, LeadingAge believes our field should not, and as a practical matter will not, be subjected to the same expectations as those other sectors.

We are tracking implementation of the rule, as well as the efforts of LeadingAge, and we will provide additional information and education for our members as soon as we can to help you understand the rule and the enforcement timeline, how the rule interacts with HIPAA, and what expectations providers must meet when receiving a request from residents/clients or others for access to electronic health information.

Notable News

Grants Available for Online Dementia Care Training Program

On April 7, 2021 by Lori Meyer

The Minnesota Department of Human Services (DHS), through the Nursing Facility Rates and Policy (NFRP) Division and the State Civil Monetary Penalties (CMP) Initiative, is seeking proposals from qualified Minnesota Medicaid-Certified Nursing Facilities that are interested in implementing an online Dementia Care Staff Training Program.

The HCI-CARES program offers online dementia-care training modules covering a variety of topics from dementia basics to end-of-life care. This training package includes dementia basics and dementia-related behavior training for facility staff, as well Dementia Specialist credentialing for up to 5 staff members per facility. Optional monthly webinars will be offered for educators and administrators to provide strategies to improve dementia care for residents. All training and consultation will be provided by HealthCare Interactive (HCI), a nationally recognized leader in Alzheimer’s and dementia-care online training. 

An informational webinar will be held on Wednesday April 14th, at 2 p.m.

To read more about this funding opportunity or to register for the (virtual) webinar, please visit DHS's website.

LeadingAge MN Foundation Scholarships Available

On April 7, 2021 by Lori Meyer

Investing in the professional development of the aging services workforce is more important now than it has ever been. The LeadingAge Minnesota Foundation is excited to offer educational scholarships to eligible caregivers and other employees of our member organizations for 2021.

To qualify, applicants must:

• Be 17 years of age or older;
• Be employed by a provider member of LeadingAge MN (care center, senior housing, assisted living, adult day, etc.);
• Be currently enrolled (or enroll no later than Fall of 2021) in an accredited post-secondary institution of higher education;
• Complete the online scholarship application; and
• Provide two letters of recommendation.

Scholarship awards range from $500 to $1,500, and one $2500 scholarship may be awarded for an applicant that demonstrates exceptional commitment to aging services.

Scholarships are a great way to help your employees achieve their higher education goals and advance their careers within the aging services field where they are so needed. You can promote the scholarship program in your setting with a flyer which includes additional details.

Applicants can apply here. Applications must be received by 5 p.m. on Monday, June 7.

These scholarships are made possible thanks to the generosity of the organizations and individuals who support the Foundation’s Annual Golf Tournament and Silent Auction.

BELTSS Seeks Applicants for Director of Assisted Living position – deadline Friday, April 9

On April 7, 2021 by Bobbie Guidry

The Minnesota Board of Executives for Long-Term Services and Supports posted the newly created Director of Assisted Living position on the state careers website. The person in the role will lead in the development of all Assisted Living Director (ALD) practice standards. The Board seeks a person with assisted living experience or senior living administration with the core knowledge to assist in implementing course objectives, the ALD-In Residence program, examinations, and continuing education as the AL subject matter expert.

The posting will close on April 9, 2021. To review the position description or apply, visit Minnesota Careers and search for BELTSS in the “keywords” box.

Member News

eMenuCHOICE to Host Free Webinar on Dining Requirements for Assisted Living Licensure

On April 7, 2021 by Libbie Chapuran

eMenuCHOICE, a LeadingAge Minnesota business partner and partner of the Savings & Solutions Center, is hosting a free webinar on April 13 from 1:30 – 2:30 p.m. to review new dining requirements associated with assisted living licensure. Effective Aug. 1, assisted living settings in Minnesota must be licensed and, as a condition of licensure, assisted living providers must adhere to several new standards related to menus and food requirements, including:

• at least three nutritious meals daily with snack available seven days per week
• menus must be prepared at least one week in advance, and made available to all residents
• food must be prepared and served according to the Minnesota Food Code, Minnesota Rules, chapter 4626
• the facility cannot require a resident to include and pay for meals in their contract

The webinar will review how to manage these changes and new dining charges to help you prepare for implementation. 

For more information on the webinar, visit www.emenuchoice.com/webinar.

Education Solutions

April 12 Webinar Sheds Light on Navigating Assisted Living Licensure Laws & Rules

On April 7, 2021 by Heidi Simpson

A significant step in preparing for Assisted Living (AL) Licensure is reading and understanding the Minnesota statutes, laws and rules that govern it. AL directors are required to attest to having completed this requirement on both the AL licensure application and their application to become a licensed assisted living director.

The magnitude of this requirement can be daunting for anyone without a law degree. A webinar on April 12, Navigating the Laws and Rules of Assisted Living Licensure, helps individuals through this process and provides essential resources and guidance.

Sam Orbovich, attorney/shareholder at business partner firm Fredrickson & Byron PA, Minneapolis, will lead the webinar. Find details and registration here.

Leadership Academy Application Deadline Approaching – April 26

On April 7, 2021 by Barbara Landeen

The deadline to apply for LeadingAge Minnesota’s Leadership Academy is Monday, April 26. Leadership Academy has an 11-year track record of developing and growing leaders in our field by exploring leadership theory, applied learning and coaching by seasoned mentors. More than 300 leaders have graduated from this annual program.

Leadership fellows study a variety of leadership theories and concepts during four multi-day sessions from June through December:

• Authentic Leadership (with guest speaker Gayle Kvenvold, LeadingAge Minnesota President & CEO)
• Rethinking Thinking
• Motivating and Leading Teams
• Transformational Leadership

Increased financial assistance is available for organizations experiencing hardship through generous scholarship funds from the LeadingAge Minnesota Foundation.

Find complete details and application here.