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June 27, 2016
Dear Member,
On behalf of the LeadingAge Minnesota Board of Directors, I am pleased to provide you with this comprehensive report summarizing the 2016 Legislative Session. We have designed this summary as a reference tool for you to use to better understand the new provisions in Minnesota law that affect providers of older adult services.
While this Legislative Report covers the outcome of the session, we know that as state agencies begin to interpret these new laws, there will be additional information on implementation that you need to know. Therefore, we will once again make available an expanded version of this report online with links to complete bill language, related state agency bulletins, and other tools and resources for implementation. This members-only benefit will be available at shortly.
As always, we are available to assist you with any questions or technical assistance you may need—don’t hesitate to give us a call.
Along with the LeadingAge Minnesota staff, I want to thank you for your advocacy this year and encourage you to continue this engagement into the 2016 campaign season. We are counting on you and your staff to engage current legislators and candidates in discussions about the important issues surrounding the field of older adult services. While the next legislative session is months away, we have already begun our work on enhancing our advocacy strategy for the 2016 session and beyond.
We are grateful for the opportunity to represent you and your missions of service at the State Capitol.
Sincerely,
Gayle M. Kvenvold
President and Chief Executive Officer
Table of Contents
|Overview: 2016 Session |Page 5 |
|Media Relations |Page 8 |
|General |Page 12 |
|All Payer Claims Database |Page 13 |
|Assault Motivated by Bias (Age) |Page 14 |
|CARE Act |Page 15 |
|Dispense of a 90-day Prescription |Page 16 |
|Dual Training (PIPELINE) Grants |Page 17 |
|Electronic Monitoring Workgroup |Page 19 |
|Health Information Technology (HIT) |Page 20 |
|Loan Forgiveness Promotion |Page 21 |
|Long Term Care Ombudsman Final Rule |Page 23 |
|Medical Cannabis |Page 24 |
|Quality of Care Complaints |Page 25 |
|Temporary Health Care Dwellings |Page 26 |
|Housing/HCBS |Page 29 |
|Anti-Spousal Impoverishment |Page 30 |
|Deletion of Obsolete Home Care Language |Page 31 |
|Disability Waivers DHS Website Update Requirements |Page 32 |
|Exclusions from Home Care Licensure Requirements |Page 34 |
|Group Residential Housing |Page 35 |
|Home Care Advisory Council Changes |Page 36 |
|Immediate Temporary Suspension of Home Care License |Page 37 |
|MnCHOICES Assessment |Page 38 |
|Olmstead Plan |Page 39 |
|Care Centers |Page 41 |
|Moratorium Exceptions Process Funding |Page 42 |
|Nursing Facility Consolidation Program Update |Page 43 |
|Nursing Facility Recodification |Page 44 |
|Pharmacy Collection of Controlled Substances and Other Drugs |Page 45 |
|Scholarship Program Update |Page 46 |
|Technical Correction to Value Based Reimbursement | |
| |Page 47 |
|2017 Session Outlook |Page 49 |
|Our Process |Page 53 |
Overview: 2016 Session
The tone of the 2016 session was beginning to form even before lawmakers returned to St. Paul on March 8 and could be described using one phrase: low-expectation setting. During the interim, lawmakers in both bodies and in both parties were telling their constituents, as well as the media, not to expect much coming out of the short, 12-week session.
Legislative leaders said their work would be laser focused on three major issues considered to be unfinished from last session: transportation, taxes and bonding. The tone of the legislature, paired with a shortened time-frame, made 2016 an uphill battle for many organizations to pass their priorities.
Leading up to the 2016 session, LeadingAge Minnesota began laying the groundwork for our three legislative priorities: secure a 5% rate increase for Home and Community Based Services (HCBS), build the pipeline of professional caregivers through a career promotion campaign and protect the new nursing home reimbursement system. This groundwork occurred through members inviting their lawmakers into their communities to educate them about the importance of HCBS settings, highlight the hard work of our caregivers and showcase the benefits of the new payment system.
The February Budget Forecast was released just days before the Legislature convened, projecting a $900 million surplus for the FY16-17 biennium. Although the forecast revealed a positive projection, this number was $306 million less than the budget projection made in November. The reduction was attributed to lower than projected sales and income tax and a slower growing economy. It was the largest reduction swing since 2007-2008. As a result of the decreased surplus, Senate Majority Leader Tom Bakk urged caution to groups seeking large investments and said “everything got a little harder” with this budget forecast.
It soon became clear with the decreased February forecast that there would not be funding in the education budget to support this workforce package. Nevertheless, our proposal did meet all committee deadlines which enabled LeadingAge Minnesota staff to present our workforce challenges and potential solutions in front of the Higher Education committees in the House and the Senate. This is the first time that long term care issues have been before these committees and provided an opportunity to educate lawmakers about the needs of our aging population.
With respect to the 5% rate HCBS increase, there was bipartisan support throughout session with 82 House authors and 34 Senate authors signed on in support of the bill. LeadingAge Minnesota continued to put the pressure on lawmakers with weekly emails and calls urging them to find the money needed to make this important investment. This message was well-received and supported by lawmakers, with several making comments during committee meetings about the number of grassroots messages they had received. However, despite this support, the Legislature failed to support a rate increase for HCBS this session.
While we were disappointed that HCBS did not receive a rate increase, our messaging and commitment to reform and quality opened the door for waiver reform in upcoming legislative sessions. This sentiment was shared by several lawmakers, including bill author Senator Kent Eken (DFL-Twin Valley) who stated, “I am extremely disappointed that we could not include an increase to the hardworking caregivers working in home and community-based services. There is a workforce crisis in these settings, and I hope to bring back reform to these providers next year.”
Elderly Waiver (EW) Reform work is well underway and began even before the end of the 2016 session with the creation of a joint working group. The working group, composed of members from LeadingAge Minnesota and its partner in the Long Term Care Imperative, is tasked with developing a proposal to reform payment and housing policy for EW clients in time for the 2017 legislative session
Legislative Advocacy
LeadingAge Minnesota was once more joined by our Contract Lobbyist Judy Cook and her team at Cook Girard. LeadingAge Minnesota continues to coordinate advocacy activities at the Capitol with our partners in the Long Term Care Imperative. The Long Term Care Imperative welcomed back Todd Rapp and his team at Himle Rapp and Company, Inc. to assist with public relations and advocacy. Todd Rapp engaged Swim Creative to begin phase two of our Face Aging MN campaign, which is designed to raise awareness and grow the conversation around the challenges facing our aging population.
During session, our team worked together with committee chairs, committee members and staff, provided information at meetings, and testified in several different committees, including a few committees outside of our typical Health and Human Services jurisdiction.
Coalition Work
LeadingAge Minnesota continued to be a member of the Best Life Alliance, formally known as the 5% Campaign. The Best Life Alliance is a broad coalition of advocates for people with disabilities and aging Minnesotans. Through our participation in the Best Life Alliance, LeadingAge Minnesota coordinated grassroots activity such as calls, emails and letters to lawmakers.
Grassroots Advocacy
With the short legislative session, LeadingAge Minnesota’s grassroots advocacy began during the interim – starting as far back as the beginning of September. During this time, LeadingAge Minnesota members hosted 70 lawmaker tours at their communities and sent nearly 1,000 testimonial postcards. These tours and postcards laid the foundation for Elderly Waiver Reform, educated lawmakers on the difference between nursing homes and Home and Community-Based Services options, showcased the importance of the new value-based reimbursement system for nursing homes, and provided the opportunity for lawmakers to hear directly from older adults and their caregivers.
Here are some quotes highlighting the impact these tours had on lawmakers:
Representative Torkelson: “We need to come back in 2017 and reform the Elderly Waiver system like we did with the nursing homes so that it is tied to the true cost of care.”
A caregiver shared with Representative Norton: “As a single mother, this increase [from the new payment system] meant the world to me and my family – thank you.”
A family member explaining what Adult Day Services mean to her family to Representative Youakim, “My husband was diagnosed with early onset Alzheimer’s. Without the partnership of Adult Day Services, I honestly do not know where my husband and I would be. These services, as the disease progresses, are a life-saver.”
“We now have the ability to compensate our workforce at a competitive wage so that we can recruit and retain talented individuals,” said Rob LaHammer to Speaker Kurt Daudt.
“We need more home and community-based services like this in Minnesota in order to continue to serve our growing aging population. As lawmakers we need to make sure that the reimbursement rates at the state allow seniors of any income to live in these types of settings,” said Representative Dave Baker.
Our grassroots advocacy continued with weekly calls and emails from LeadingAge Minnesota members through our Engage network. Over the short twelve-week session, we sent more than 2,600 emails to lawmakers and made hundreds of personal phone calls. Our goal is to continue this strong grassroots advocacy into the campaign season.
Capitol News Update
We again hosted Capitol News Update this year with a slightly different twist. Instead of a live interactive webinar, we sent brief recorded YouTube updates so that members could watch whenever convenient. These broadcasts were open to all LeadingAge Minnesota members and designed to inform our members of our weekly advocacy activities, including meetings with legislators, developments in hearings and key decisions made by lawmakers. We also provided updates on our grassroots advocacy.
Day at the Capitol
Even with the Capitol under construction, we were still able to host our very popular Day at the Capitol. We had nearly 150 members from across the state attend our annual lobby day. After receiving an update on the dynamics of the State Capitol this session, a preview of the upcoming elections, a briefing on our 2016 legislative agenda and tips on how to share our message, the group met with their lawmakers. The day allowed legislators to visit directly with our members and hear their stories.
In the coming months, LeadingAge Minnesota will continue to focus on maintaining and increasing the understanding of our issues by key legislators, legislative leadership, the Administration and the general public, as well as continuing our Face Aging MN campaign to generate broader public support for how the State of Minnesota cares for its growing aging population. We will also turn our attention to the elections, and will be providing tools to help members educate candidates about the challenges we face serving a growing aging population.
Media Relations
With the late start of the legislative session in 2016, LeadingAge Minnesota took full advantage of the extended interim to build awareness and secure ongoing support for our efforts to reform how Minnesota cares for its aging citizens. As part of our grassroots advocacy, we engaged our members in a proactive media relations strategy to spread the word of Senior Care Reimbursement Reform as well as lay the groundwork for the need to similarly reform waivered services for home and community-based services.
We encouraged our members to invite the local press to their site during the lawmaker visit, write thank you letters to lawmakers for their support of Senior Care Reform, and to submit letters to the editor publicly acknowledging the support of their local lawmakers, demonstrate how the increased funding for care centers will be used to improve the quality of lives for seniors and those who provide them with care, and call on lawmakers to join us as we set out to reform waivered services.
The more than 50 visits that took place prior to the start of the 2016 legislative session in February generated many local news stories, and included such headlines as:
• Nursing Homes Get Millions in Funds (Fergus Falls Journal, June 22):
• New Legislation Allows Nursing Homes to Offer More Competitive Pay (Waseca County News, Oct. 20)
• New Year, More Money for Nursing Homes (Rochester Post Bulletin, Jan. 1)
• Nursing Homes See First Big Pay Raise in Years (Ely Timberjay, June 26)
These stories were then cross-promoted via the LeadingAge Minnesota social media channels (Facebook, Twitter) as well as by individual lawmakers.
As we approached the start of the 2016 legislative session, we continued to receive positive media coverage based on lawmaker visits and noticed more mentions of the need to support reform of waivered services that help lower income Minnesotans age in their homes and communities.
Running parallel to our Association’s media relations strategy, was Phase 2 of the Face Aging MN campaign. Face Aging MN, a public information campaign conducted in collaboration with our partner in the Long Term Care Imperative, sparked a conversation on aging in its first phase that helped us raise awareness of the state’s fast growing aging demographics on long term services and supports and secure support from lawmakers to ensure access to quality senior care from experienced caregivers.
The goal for second phase of Face Aging MN was to turn awareness raised during the initial phase of the campaign into action – action that helps us create a smarter and better way of supporting seniors in all the places they choose to live and raise up the career of caregiver as one of the most sought after and honored professions in our state.
Elements of the Phase 2 campaign included:
Advertisements in the state’s daily newspapers, including geographic targeting in key legislative districts and in counties with a high population of aging Minnesotans.
Digital media ads that capitalize on the growing trend of social media as a key source of information for our targeted audience.
Billboards in 18 locations across the state, again targeted at key legislative districts in counties with a higher population of aging Minnesotans.
Sponsorship of MPR Programming during periods of high listenership for two of our target audiences – lawmakers and influential stakeholders.
A new, vibrant web site that showcases stories of Senior Care Reimbursement Reform and the caregiving profession, and provides consumers with aging readiness information.
A community relations toolkit members can use to host Face Aging MN meetings with key stakeholders, residents, families and lawmakers to generate more support for the collective action we need to ensure issues related to seniors and their caregivers remain at the forefront of the state policy agenda.
One goal of the campaign was to drive more traffic to the Face Aging MN web site to get people engaged in our campaign to change the way we see aging from a burden we manage to a responsibility we embrace.
Throughout the legislative session, the Face Aging MN campaign’s steady flow of advertisements, radio sponsoring, social media posts and digital media advertisements kept the question focused on how do we shift thoughts on aging from “a burden we manage” to a responsibility we embrace.
“Minnesotans want what we want -- to live well as they age, to grow old in the community they call home, and to be supported by committed, talented and amazing caregivers should they need that help. If we can bring them alongside us in our quest to make our vision of aging well a reality, we will achieve the reforms needed to ensure the services and supports are available to them as they age,” said Gayle Kvenvold, President and CEO, LeadingAge Minnesota when she introduced phase two of the Face Aging MN campaign to members and caregivers at the Institute in February.
In addition to Face Aging MN, LeadingAge Minnesota was also a partner in the Best Life Alliance. The Best Life Alliance, formerly known as The 5% Campaign, is a group of organizations serving seniors and people with disabilities that came together to advocate for a five percent rate increase for home and community-based services at the State Capitol. The Best Life Alliance implemented a dual earned media and social medial strategy heavily focused on sharing stories about the need for increase funding to provide a wage increase to caregivers in these settings.
Throughout the legislative session, the Best Life Alliance secured a steady flow of media coverage that helped secure additional support among lawmakers for its bill. Unfortunately, the bill to provide a five percent rate increase to waivered programs for home and community-based services did not become law this session. The Best Life Alliance called the failure to fund this long overdue and needed investment a disappointment
The upcoming November election will continue to provide LeadingAge Minnesota with opportunities to keep the needs of seniors and their caregivers in the news.
General: In this Section
|All Payer Claims Database |
| |
|Assault Motivated by Bias (Age) |
| |
|CARE Act |
| |
|Dispense of a 90-day Prescription |
| |
|Dual Training (PIPELINE) Changes |
| |
|Electronic Monitoring Workgroup |
|Health Information Technology (HIT) |
|Loan Forgiveness Promotion |
| |
|Long Term Care Ombudsman Final Rule |
|Medical Cannabis |
|Quality of Care Complaints |
|Temporary Family Health Care Dwellings |
All Payer Claims Database
Chapter 179, Section 2
Amends Minne. Stat. §§62U.04, subd. 11
H.F. 3142, Zerwas—R
S.F. 2475, Sheran—DFL
Effective: August 1, 2016
Background
An All-Payer Claims Database (APCD) is a large-scale database that systematically collects medical claims, pharmacy claims, and eligibility and provider files from private and public payers. Minnesota’s APCD includes data from all settings of care, and the purpose is to support the systemic analysis of health care delivery. Because of the sensitivity that surrounds the State’s compiling of health-related information, including information on actual transaction prices (i.e. the payments made by health plans and health plan members for their care), the Minnesota legislature takes an active role in defining what data the APCD includes and what the State is permitted to do with that information.
Summary
Current law authorizes the Minnesota Department of Health (MDH) to use the APCD to analyze variations in health care costs, quality, utilization, and illness burden based on geographical areas or population, but only through July 1, 2016. This provision extends the sunset date to July 1, 2019.
Implications
Extending the sunset date allows MDH to continue using the APCD to conduct research in the variation of health care costs, quality, utilization and illness burden, including by considering demographic and geographic factors. This research could be useful, for example, in analyzing post-acute care delivery and cost trends for seniors in Minnesota. The more we know about how often and where residents access care, and trends in population health, the better prepared we can be to evaluate, shape and participate in new payment models and delivery systems.
Staff Contact
Jonathan Lips jlips@
Assault Motivated by Bias (Age)
Chapter 189, Article 4, Section 14
H.F. 2928, Hilstrom--DFL
S.F. 2680, Latz—DFL
Effective: August 1, 2016 and applies to crimes committed on or after that date
Background
This legislation was brought forward after an incident last fall where a Somali woman was allegedly attached for not speaking English at a restaurant. The alleged attacker was charged with third-degree assault, but not a “hate crime” or what is legally known as a “bias crime.” That is because under Minnesota law, a bias crime could only influence punishment in low-level assaults, not felonies. So, a bias-crime charge would have actually been a lower-level charge.
A similar situation occurred after charging several suspects for opening fire in a crowd of demonstrators in Minneapolis. The change to the law allows for penalties to be enhanced in felony assaults if motivated by bias.
Bill Summary
The legislation enhances the penalties for anyone convicted of felony-level assaults (first, second or third degree assault, as defined by Minn. State. Sections 609.221. 609.222 or 609.223), if the crime was motivated by the person’s actual or perceived race, color, religion, sex, sexual orientation, disability, age or national origin. Under this section, the maximum penalty would be 25 percent longer than the maximum penalty otherwise applicable.
Implications
Because age and disability are included as factors, it is possible persons convicted of assaulting seniors or other vulnerable adults could face enhanced penalties.
Staff Contact
Kari Thurlow kthurlow@
CARE Act
Chapter 107
S.F. 107, Eken—DFL
H.F. 210, Zerwas—R
Effective: January 1, 2017
Background
Minnesota’s chapter of the American Association of Retired Persons (AARP) introduced the Caregiver Advice, Record, Enable (CARE) Act in the 2015 legislative session. AARP has introduced and passed the CARE Act in more than 20 states. The goal behind the legislation is to support the more than 600,000 caregivers in Minnesota by requiring hospitals to support and train caregivers when their loved ones were in the hospital. Due to differences between the House and the Senate language at the end of the 2015 legislative session, the bill did not pass. During the 2016 session, these differences were resolved and the bill was signed into law.
Bill Summary
The CARE Act requires a hospital to provide a patient with the opportunity to designate a caregiver within 24-hours of entry and before the patient is discharged. Once a caregiver is designated, the hospital is to record their name, phone number and address in the medical record. If the patient declines to list a caregiver, this must also be recorded. A patient can choose to change the designated caregiver at any time. This designation does not require the caregiver to perform any aftercare for the patient.
When the patient is to be discharged, the hospital must notify the designated caregiver as soon as possible and issue a discharge plan that includes aftercare needs and instructions for all aftercare tasks to both patient and caregiver. At a minimum the plan must include:
• The name and contact information of the caregiver.
• Instructions for all aftercare tasks necessary. Instructions must include: live demonstration or video of aftercare tasks performed by a professional and provide an opportunity to answer questions. Instructions must be in a culturally competent manner and in accordance with requirements for language access services.
• Contact information for resources and supports needed to carry out the discharge plan.
• Contact information of a hospital representative to answer questions about the discharge and instructions.
This notification will not interfere with the discharge if the caregiver is unable to be reached as long as the hospital made a good faith effort and the CARE Act cannot be used to create a separate action against the hospital.
Implications
Caregivers of older adults will now be provided the opportunity to be listed as a caregiver and receive training on necessary care after hospital stays.
Staff Contact
Danielle Salisbury dsalisbuury@
Dispense 90-day Supply of a Prescription Drug
Chapter 122
Amends Minne. Stat. §§151.21
S.F. 2548, Rosen—R
H.F. 2512, Peterson—R
Effective: August 1, 2016
Background
When clinically appropriate, dispensing a longer supply of medications is beneficial, allowing patients to plan ahead, when needed, and saving time for patients, doctors and pharmacists alike. This common sense proposal passed unanimously in both the House and Senate.
Summary
The bill allows a pharmacist to dispense up to a 90-day supply of a prescription drug to a patient who has completed an initial 30-day supply of the prescription drug if the patient returns to the pharmacy for a refill, when (1) the quantity dispensed by the pharmacist does not exceed the total quantity of the remaining refills authorized by the prescriber, and (2) the pharmacist is exercising professional judgment. The initial 30-day supply requirement is not required if the prescription was previously filled with a 90-day supply.
The bill also provides, however, that a pharmacist may not exceed the number of dosage units prescribed for an initial prescription or subsequent refills if (1) the prescriber specified on the prescription that, due to medical necessity, the pharmacist may not exceed the number of dosage units identified on the prescription; or (2) the prescription drug is a controlled substance.
Implications
This legislation should result in some time savings for older adult services providers, as it allows pharmacists to change the quantity on a prescription up to a 90-day supply without contacting the prescriber, as long as the drug is not a controlled substance and the other specified conditions are met
Staff Contact
Jonathan Lips jlips@
Dual Training Grants
Chapter 86
Amends Minne. Stat. §§136A.246; 175.45, sub. 1
H.F. 2798, O’Neill –R
S.F. 2614, Bonoff –DFL
Effective: April 26, 2016
Background
During the 2014 session, the Minnesota legislature created the Private Investment, Public Education, Labor and Industry Experience (PIPELINE) Project to expand work-based career development training models. Over the past year, the state targeted four economic growth industry sectors for expansion into Minnesota’s apprenticeship system: Advanced Manufacturing, Agriculture, Health Care Services, and Information Technology (IT).
The long-term project goals of the PIPELINE Project are to enhance the number of skilled workers in Minnesota through increased dual-training and registered apprenticeship. In developing the Project, identifying participants and inventorying current workforce initiatives, the Department of Labor and Industry (DOLI) worked closely with staff members from a number of groups, including LeadingAge Minnesota. In the first efforts over the past year, several members have used PIPELINE funds to pay for their Health Support Specialist programs. Going forward, many more organizations will be able to use this funding more easily.
Summary
This grant program through DOLI and the Office of Higher Education helps employers or organizations train employees through a dual education models. The maximum grant per application is $150,000 and the maximum cost of training per employee under this grant is $6,000.
The following is a brief summary of the requirements for the grant:
• Criteria for grant selection include:
o The aggregate state and regional need for employees with the competency to be trained;
o The competency standards (e.g. Health Support Specialist) developed by the commissioner of labor and industry as part of the Minnesota PIPELINE Project;
o The per employee cost of training;
o The additional employment opportunities for employees because of the training;
o The projected increases in compensation for employees receiving the training;
o Amount of employer training cost match, if required, on both a per employee and aggregate basis.
o A large employer must pay for at least 25 percent of the training institution's or program's charge for the training to the training institution or program. A "large employer" means a business with more than $25,000,000 in annual revenue in the previous calendar year.
Changes made to the program in 2016 include:
• Funding can now be paid directly to employers after presenting satisfactory evidence that the organization paid the training institution (previously it was limited to the state paying the training provider directly) or by demonstrating an inability to pay the training institution in advance, funds can still be paid directly from the state to the training institution;
• Providers now have until the training starts to employ the individual(s);
• Ineligibility of staff who already received prior grant funding was removed as long as the employee receives an industry recognized degree, certificate or credential upon successful completion of the training;
• Applications must now include the number of employee trainees who graduated from high school or passed the GED in the current or immediately preceding calendar year and these students get preferential funding;
• Clarification that funding awards will be approximately equal between greater Minnesota and the metropolitan area;
• The cost of training was further defined as including “tuition, fees, and required books and materials;”
• On-the-job training employees receive is now part of what will be considered in determining grant awards;
• Grants may not exceed $6,000 per year for a maximum of four years per employee; and
• Employees who are attending an eligible institution must now apply for Pell and state grants as a condition of payment for training funds.
Implications
While many providers have expressed interest in implementing the Health Support Specialist Registered Apprenticeship Program, finding the resources to cover the $1,800/person tuition costs of training have been a barrier. While other state grant programs, such as the Minnesota Nursing Facility Scholarship Program and Home and Community-Based Services Scholarship Program reimburse providers 100 percent of HSS expenses, this PIPELINE grant program represents a solution to provide upfront resources and remove financial barriers for all provider types. To learn more about Health Support Specialist, visit .
Staff Contact
Adam Suomala at asuomala@
Electronic Monitoring Workgroup
Chapter 179, Article 39
S.F. 2475, Sheran - DFL
H.F. 3142, Zerwas - R
Effective: July 1, 2016
Background
Throughout the country, there is a growing trend of state legislatures passing state laws to allow for electronic monitoring devices to be installed in senior care settings in certain situations. Late in the legislative session, a bill was introduced that would authorize electronic monitoring in nursing facilities (SF3380, Johnson, DFL-Blaine/HF3746, Newton, DFL-Coon Rapids). The bill was modeled after legislation that had recently passed in Illinois. That bill did not receive a hearing before the committee deadlines in either the House or the Senate.
However, after deadlines had passed, but before the legislature adjourned, the Senate Health and Human Services Policy Committee conducted an informational hearing on the bill. At that hearing, Senator Johnson “amended” her bill (though no formal committee vote was taken to amend the bill) so that it would only apply to housing with services and home care settings but not nursing homes. One of Senator Johnson’s primary concerns was to prevent retaliation against families and residents who may install cameras. LeadingAge MN testified at the hearing that while the provider community did not oppose legislation in this area, there needed to be a better review of privacy and consent issues involved and pledged to continue to work with a broad stakeholder group on the issue.
Despite the fact that no committee had taken any votes on the bill, Senator Johnson successfully amended her proposal onto a larger Omnibus policy bill on the Senate Floor. In Conference Committee, the House and the Senate agreed to take out Senator Johnson’s language and replace it with the creation of a workgroup on the issue.
Bill Summary
The bill requires the Department of Health to establish a workgroup to create recommendations for legislation that authorizes the use of voluntary electronic monitoring to protect vulnerable children and adults and hold accountable perpetrators of abuse. There are 16 members of the workgroup, including two members of each respective legislative body. LeadingAge MN is included in the workgroup. The group must begin its work no later than July 1, 2016 and must issue a report to the legislature by January 15, 2016.
Implications
It is likely that a legislative proposal that permits electronic monitoring devices in senior care settings will be the result of the workgroup recommendations and will be a topic of discussion in the 2017 legislative session. In the meantime, current law will remain unchanged, which does arguably permit electronic monitoring in certain circumstances.
Staff Contact
Kari Thurlow, kthurlow@.
Health Information Technology
Chapter 189, Article 20, Sections 5-6
Amends Minne. Stat. §§62J.495, subd. 4
H.F. 2749, Knoblach—R
S.F. 2356, Cohen—DFL
Effective: July 1, 2016
Background
The Minnesota Department of Health (MDH), in consultation with its e-Health Advisory Committee, works to support efforts to use health information technology (HIT) to improve the quality and coordination of health care and the continuity of care among health care providers, to reduce medical errors, to improve population health, to reduce health disparities, and to reduce chronic disease. This provision revises existing law to fund health information exchange (HIE) activities that MDH believes can more effectively improve care coordination and quality.
Bill Summary
The bill directs MDH to add the following to its work relating to HIT and HIE in Minnesota:
• provide financial and technical support to Minnesota health care providers to encourage implementation of admission, discharge and transfer alerts, care summary document exchange transactions and to evaluate the impact of health information technology on cost and quality of care;
• provide educational resources and technical assistance to health care providers and patients related to state and national privacy, security, and consent laws governing clinical health information, including the requirements of the Minnesota Health Records Act (MHRA);
• assess Minnesota's legal, financial, and regulatory framework for health information exchange, including the MHRA requirements, and make recommendations for modifications that would strengthen the ability of Minnesota health care providers to securely exchange data in compliance with patient preferences and in a way that is efficient and financially sustainable; and
• seek public input on both patient impact and costs associated with requirements related to patient consent for release of health records for the purposes of treatment, payment, and health care operations and provide a report by Feb. 1, 2017.
Implications
Some level of funding will be available to support health information exchange activities by providers, but MDH is not expected to release eligibility criteria and other detail about the funding until Fall 2016. LeadingAge Minnesota will advocate for those funds to benefit older adult services providers. Written resources will become available to guide providers in understanding and applying state and federal requirements affecting a provider’s ability to share protected health information, including patient consent requirements. The required MDH study will inform a 2017 policy discussion about whether to amend state law in a way that would streamline the process of obtaining patient consents, which is critical to successful HIE.
Staff Contact
Jonathan Lips jlips@
Loan Forgiveness Promotion
Chapter 189, Article 1, Section 16
H.F. 2749, Knoblach—R
S.F. 2356, Cohen—DFL
References the Federal Loan Forgiveness Program under Code of Federal Regulations, title 34, part 685 as well as Public Service Loan Forgiveness Program and Public Service Organization definitions under Code of Federal Regulations, title 34, part 685, section 219.
Effective: January 1, 2017 (employer notification requirement)
Background
In the coming years, some employees of select LeadingAge Minnesota member organizations may be eligible to participate in the Public Service Loan Forgiveness (PSLF) Program, which was designed to encourage individuals to enter or continue full-time work in public service jobs. Under the program, people may qualify for forgiveness of the remaining balance on their William D. Ford Federal Direct Loan Program loans after making 120 qualifying payments while being employed full-time by certain public service employers. This issue is relevant now, because starting in October, 2017 the first eligible federal student loans (issued after Oct. 1, 2007) will begin to be forgiven.
Loans covered under the program include Direct Subsidized Loans, Direct Unsubsidized Loans, Direct PLUS Loans (for parents and graduate or professional students), and Direct Consolidation Loans. Certain Health Profession and Nursing Loans may also be consolidated into Direct Consolidation Loans to qualify for this program. For more information on the specific loan repayment requirements and the process, visit repay.
Summary
Legislation passed this session directs the Minnesota Office of Higher Education Commissioner to develop materials that promote this program.
It also requires public service organizations to notify their employees annually. LeadingAge Minnesota members meeting the definition of “Public Service Organizations” include:
(1) A Federal, State, local, or Tribal government organization, agency, or entity;
(2) A public child or family service agency;
(3) A non-profit organization under section 501(c)(3) of the Internal Revenue Code that —
(i) Is exempt from taxation undersection 501(a) of the Internal Revenue Code; and
(ii) Is not an organization engaged in religious activities, unless the qualifying activities are unrelated to religious instruction, worship services, or any form of proselytizing;
(4) A Tribal college or university; or
(5) A private organization that —
(i) Provides the following public services: Emergency management, military service, public safety, law enforcement, public interest law services, early childhood education (including licensed or regulated child care, Head Start, and State funded pre-kindergarten), public service for individuals with disabilities and the elderly, public health (including nurses, nurse practitioners, nurses in a clinical setting, and full-time professionals engaged in health care practitioner occupations and health care support occupations, as such terms are defined by the Bureau of Labor Statistics), public education, public library services, school library or other school-based services; and
(ii) Is not a business organized for profit, a labor union, a partisan political organization, or an organization engaged in religious activities, unless the qualifying activities are unrelated to religious instruction, worship services, or any form of proselytizing.
Implications
As a positive, many LeadingAge Minnesota members qualify as public service organizations and will find this another tool to assist with efforts to recruit or retain employees interested in having their loans forgiven.
However, effective January 1, 2017 those organizations will also be required to:
• Annually provide each employee information about their potential eligibility for the federal public service loan forgiveness program in written or electronic form;
• Provide a newly hired employees with the same information within two weeks of their first day of employment; and
• At an employee’s request, provide them with a copy of an employment certification form used by the United States Department of Education.
A one-page letter, fact sheet and frequently asked questions document are to be developed and provided by Minnesota’s Office of Higher Education. Additional details about how to market this benefit of public service in the aging services field and how to access and share template materials with employees will be featured on the LeadingAge Minnesota Workforce Center when available.
Staff Contact
Adam Suomala at asuomala@
Long Term Care Ombudsman Final Rule Changes
Chapter 163, Article 1, Sections 1-5
Amends Minne. Stat. §§256.974; 256.9741, subd. 5; 256.9741, adding subd. 7 and 8; 256.9742
S.F. 2414, Wiklund—DFL
H.F. 3199, Albright—R
Effective: Day following final enactment
Background
In February 2015, the Federal Government published the Ombudsman Final Rule and gave states until July 1, 2016 to become in compliance with the Rule. The purpose of the Final Rule was to ensure high quality Ombudsman services for older adults, provide clarity to the Ombudsman sections of the Older Americans Act (OAA) and to improve consistency of Ombudsman programs throughout the states. Many of the final rule requirements were already implemented in Minnesota. Therefore, the Minnesota Long Term Care Ombudsman Program brought forward only a few proposed statutory changes to clarify the internal function and administration of the office.
Bill Summary
The bill makes the following changes to the Office of Ombudsman for Long Term Care (LTC):
• Clarifies that the Office of Ombudsman for LTC is not a program within the Minnesota Board on Aging but instead is a program distinct from any state agency.
• Updates the definition of “office” to clarify that the office is a distinct unit headed by the state long-term care ombudsman and provides a new definition for long-term care ombudsman stating that this individual, through their capacity or through representatives, is responsible to fulfill the duties outlined in the section.
• Creates a new definition for Representatives of the Office, which consists of employees of the office, regional ombudsman and volunteers. The bill also updates existing language to reflect this newly defined term.
Implications
The changes to the Long Term Care Ombudsman Office are primarily technical in nature.
Staff Contact
Danielle Salisbury dsalisbuury@
Medical Cannabis
Chapter 179, Sections 11, 27
Amends Minne. Stat. §§144A.4791; 152.29, subd. 14
H.F. 3142, Zerwas—R
S.F. 2475, Sheran—DFL
Effective: August 1, 2016
Background
Legislation passed during the 2014 Minnesota legislative session created a new process allowing seriously ill Minnesotans to use medical cannabis to treat certain qualifying conditions. This bill includes several updates to Minnesota’s medical cannabis law.
Summary
Two provisions of the bill directly affect older adult services providers:
• The bill amends the home care licensing law to make clear that home care providers are covered by Minnesota Statutes section 152.34, which allows healthcare providers to impose reasonable restrictions on a patient’s use of medical cannabis, and provides protections to employees that play a role in a person’s use of cannabis. The Minnesota Department of Health had already interpreted section 152.34 as if it did apply to home care, but this formal clarification provides greater comfort to providers.
• Effective August 1, 2016, the list of qualifying conditions will expand to include any inflammatory bowel disease (previously limited to Chrohn’s disease).
It is also important to remind members that intractable pain will also be a qualifying condition as of August 1, as a result of a decision earlier this year by Department of Health Commissioner, Dr. Edward Ehlinger. Intractable pain means a state “in which the cause of the pain cannot be removed or otherwise treated with the consent of the patient and in which … no relief or cure of the cause of the pain is possible, or none has been found after reasonable efforts.”
The bill makes other changes to the cannabis law that do not directly impact older adult service providers, including that the consultation that must occur between a patient and the pharmacist on staff at the cannabis dispensary may occur by video conference if certain conditions are met.
Implications
The provision relating to home care brings certainty that those providers may exercise the
authority granted under, and are subject to the protections in, section 152.34. The broadening of the bowel disease category of qualifying condition, and the inclusion of intractable pain, may significantly increase the number of people using medical cannabis in Minnesota.
Staff Contact
Jonathan Lips jlips@
Quality of Care Complaints
Chapter 189, Article 20, Sections 2-4
Amends Minne. Stat. §§62D.04, subd. 1; 62D.08, subd. 3; creates §§62D.115.
H.F. 2749, Knoblach—R
S.F. 2356, Cohen—DFL
Effective:
Background
Based on concerns voiced by consumers that Minnesota’s health maintenance organizations (HMOs) ought to play a stronger role in assuring the quality of care delivered by providers in their networks, this bill directs HMOs to take certain steps when they receive a care-related complaint from an individual enrolled in a health plan, and directs the Minnesota Department of Health (MDH) to define complaints that are subject to peer protection confidentiality in accordance with state and federal law by January 1, 2018.
Bill Summary
The bill defines a quality of care complaint to mean an “expressed dissatisfaction regarding health care services resulting in potential or actual harm to an enrollee,” and requires HMOs to develop and implement a quality of care complaint investigation process that includes specified elements, including detailed documentation of the process and result of each investigation. Each quality of care complaint must be tracked and trended for review by the HMO according to the type of provider involved and the type of complaint. Beginning in calendar year 2018, Managed Care Organizations (MCOs) will report to MDH the number of complaints they receive on an annual basis, grouped by categories such as access, communication and behavior, health plan administration, facilities and environment, coordination of care, and technical competence and appropriateness.
Significantly, the bill also authorizes MDH, in consultation with stakeholders, to define complaints that are subject to peer protection confidentiality in accordance with state and federal law by January 1, 2018.
Implications
For the most part this new law appears to have limited impact for LeadingAge Minnesota members. It regulates HMOs – not providers – and it does not apply to quality of care complaints received by an HMO from an enrollee who is covered under Medical Assistance or MinnesotaCare. However, we will follow it very closely because of the authority it grants MDH to define what complaints are subject to peer protection confidentiality. An initial draft of this bill would have granted MDH access to the work of “peer review” bodies, including nursing home quality assurance committees. We will remain vigilant to be sure MDH does not use its authority to define “peer protection” in a way that will undermine the confidentiality and effectiveness of quality assurance and improvement efforts by providers.
Staff Contact
Jonathan Lips jlips@
Temporary Family Health Care Dwellings
Chapter 111
Amends Minne. Stat. §§144D.01 subd. 4, adding chapters 394; 462
S.F. 2555, Hoffman—DFL
H.F. 2497, Peterson—R
Effective: September 1, 2016
Background
At the Minnesota State Fair, Next Door Housing set up a booth offering Temporary Family Health Care Dwellings to individuals who are physically or mentally impaired and their families. A Temporary Family Health Care Dwelling is a 300 square feet home that resembles that of a large trailer but has a full kitchen, bathroom and bedroom that comply with American Disabilities Act requirements. These homes, located on the property of another individual, would allow family members to care for their loved ones needing care for a short period or on hospice.
Many individuals signed up to rent or buy these homes. However, Next Door Housing ran into several barriers with the city permit process preventing access to these homes. The regular city process for a permit took too long and failed to meet the quick needs of the individuals or were not allowed by some counties. Therefore, Next Door Housing sought legislation to allow for Temporary Family Health Care Dwellings permits and ensure the approval process for these permits to be timely.
Bill Summary
The bill allows a mobile dwelling unit to be placed on a caregiver or relative’s property to facilitate the care needs for an individual with physical or mental impairments needing assistance with two or more instrumental activities of daily living. The caregiver or relative can apply for a temporary dwelling permit lasting six months. If after six months a care need is still present, the applicant can renew the permit for an additional six months. The permit is limited to one year. These settings are excluded from the housing with services definition.
In order to be approved for a permit the following must occur: a need for the unit must be documented by a physician, a physician’s assistant of an advanced practice nurse, several structural requirements must be met, and it must comply with both state and local ordinances. Only one dwelling is allowed per lot and is limited to one occupant.
Due to the time sensitivity for a need for such dwelling, the county does not need to hold a public hearing on the application. The county then has 15 days to issue a permit or deny it, except in cases where they county board only meets once a month. In these situations, the county has 30 days to issue a permit or deny one. If the application does not have all of the needed information, the 15 or 30-day limit starts over only if the county sends written notice of the missing information within five business days. Counties may opt out if they do not want these homes in their communities.
The dwelling may be inspected to ensure compliance. If the permit holder violates any requirement, the city may revoke the permit. The permit holder has 60 days from revocation to remove the dwelling.
Implications
Temporary Health Care Dwellings will now be an option for those with a physical or mental impairment to receive care for a short period of time.
Staff Contact
Danielle Salisbury dsalisbuury@
Housing/HCBS: In This Section
|Anti-Spousal Impoverishment |
|Deletion of Obsolete Home Care Language |
|Disability Waivers DHS Website Update Requirements |
|Exclusions from Home Care Licensure Requirements |
|Group Residential Housing Changes |
|Home Care Advisory Council Changes |
|Immediate Temporary Suspension of Home Care License |
|MnCHOICES Assessment Process |
|Olmstead Plan |
Anti-Spousal Impoverishment
Chapter 189, Article 19, Sections 4-8
Amends Minne. Stat. §§256B.059, subd. 1-3, 5 and adding a subd.
S.F. 2356, Cohen – DFL
H.F. 2794, Knoblach – R
Effective: June 1, 2016
Background
The impoverishment protection rules allow a married person to achieve financial eligibility for Medical Assistance (MA) without spending all of the married couple’s income and assets. The Affordable Care Act (ACA) requires states to use spousal impoverishment protection rules when determining MA eligibility for home and community-based services (HCBS) waivers for five years, beginning January 2014. In Minnesota, protection rules have long been in place for married couples, however, MN used a different, and more generous approach related to HCBS waivers: CAC, CADI, BI, and DD, called a “deeming waiver.” With a “deeming waiver,” only the income and assets of the person applying for MA counts when determining financial eligibility, and an applicant is able to transfer excess assets to the applicant’s spouse without penalty to achieve financial eligibility. In 2013, the Minnesota Legislature directed the MN Department of Human Services to seek a waiver of the ACA mandate. The waiver was not granted by the Centers for Medicare and Medicaid Services (CMS), so, consequently, DHS is required to implement the ACA mandate for the BI, CAC, CADI and DD waiver programs.
Summary
The Legislature sought to meet the CMS requirements while maximizing the assets that a community dwelling spouse may retain as detailed in Federal Law. The Minnesota Legislature passed legislation, effective June 1, 2016, that:
• Requires the use of the spousal impoverishment protection rules in the BI, CAC, CADI, and DD waiver programs;
• Increases the community spouse asset allowance to the maximum amount allowed under federal law; and
• Establishes additional hardship waiver criteria to allow approval of MA when a community spouse refuses to make assets available to the person requesting MA-LTC.
The Community Spouse Asset Allowance (CSAA) is now the maximum amount allowed under federal law, currently $119,220. This amount is adjusted on January 1 of each year by the percentage increase in the Consumer Price Index for All Urban Consumers.
Implications
This has implications for clients of HCBS who are under 65, receiving CAC, CADI, BI, or DD Waiver support, and have a community dwelling spouse. For those individuals, it is likely they will move to a private pay status until they meet the MA guidelines for CSAA.
Staff Contact
Bobbie Guidry bguidry@
Deletion of Obsolete Home Care Language
Chapter 179, Sections 12, 15-18
Amends Minne. Stat. §§144A.4792, subd. 13; 144A.482; 144D.01, sub. 2a; 144G.03, subd. 2, 4
S.F. 2475, Sheran - DFL
H.F. 3142, Zerwas - R
Effective:
Background
In the 2013 legislative session, the Minnesota Department of Health (MDH) combined the Class A and Class F Home Care Licenses into a single license called the Comprehensive Home Care License. As part of the change, the obsolete Home Care Rules were eliminated from language.
Summary
The bill deletes all language, terminology and legal references of the obsolete Home Care Rules and replaces the language with new language referencing the Comprehensive Home Care License.
Implications
There are no significant changes or implications for providers with these updates to the law.
Staff Contact
Bobbie Guidry bguidry@
Disability Waivers DHS Website Update Mandate for Rates
Chapter 143
Amends Minne. Stat. §§256B.0916, subd. 8
S.F. 2857 Hoffman-- DFL
H.F. 3486 Peterson--R
Effective: August 1, 2016
Background
While there are already requirements in law for the Department of Human Services (DHS) to collect and share data regarding the new Disability Waiver Rate System (DWRS), legislation was passed this session that requires DHS to streamline how and where this data is to be posted. The language passed into law delineates the information that must be made available and the frequency with which it must be updated, and also requires the data to be available on the DHS website.
Bill Summary
In addition to financial information, counties and tribes must also make available to the public on the Department’s website, wait list information for those awaiting approval or funding through disability services.
Included in the information are:
• The amount of resources allocated,
• The amount of resources authorized, and
• The amount of allocated resources not authorized and not used
Wait list information must be provided quarterly and include:
• The number of persons screened and waiting for services – listed by urgency category, the number of months on the wait list, age group, and type of services requested by those waiting;
• The number of persons beginning waiver services who were on the waiting list and the number of persons beginning waiver services who were not on the waiting list;
• The number of persons who are left the waiting list but did not begin waiver services; and
• The number of persons on the waiting list with approved funding but without a waiver service agreement and the number of days from funding approval until a service agreement is effective for each person.
Also included is a directive to the Governor to consider including in the 2018-19 biennium budget and floors for HCBS Waiver programs, after the completion of the current “banding” period.
Implications
These changes primarily apply to clients or applicants seeking services from LeadingAge Minnesota providers of 245D or Adult Day Services (245A). The additional information will be helpful in gaining an awareness of the number of individuals seeking HCBS disability services who are experiencing delays or lack of funding.
Staff Contact
Bobbie Guidry bguidry@
Exclusions from Home Care Licensure
Chapter 179, Section 6
Amends Minne. Stat. §§144A.471, subd. 9
S.F. 2475, Sheran - DFL
H.F. 3142, Zerwas - R
Effective: July 1, 2016
Background
Tenants of a housing with services setting raised a concern to their Legislator that a provider had changed their practice of occasionally providing minor nursing services for free when a need arose within their campus setting for non-home care clients. The tenants believed the change in practice to be associated with the new Comprehensive Home Care License. The Legislator pursued a change to the Home Care Law.
Bill Summary
The bill expands the exclusion to Home Care licensure and requirements to a home care provider when responding to occasional emergency calls from individuals residing in a residential setting that is attached to or located on property contiguous to the location where home care services are also provided. The same exclusion was already in the law for an employee of a nursing home or boarding care home. In addition to emergency response, a new exclusion from licensure requirements was added allowing an employee of a nursing home, home care provider or a boarding care home to provide occasional minor services free of charge to individuals residing in a residential setting that is attached to or located on property contiguous to the nursing home, boarding care home, or location where home care services are also provided.
Implications
Providers may choose to offer emergency response services or occasional minor services free of charge to non-home care clients residing in, or on a contiguous property to a setting where home care or nursing home care is provided. If the provider chooses to offer these services to a non-home care client, these minor or emergency services would be excluded from the requirements of the Comprehensive Licensure. The bill does not require a provider to offer these services.
Staff Contact
Bobbie Guidry: bguidry@
Group Residential Housing Changes
Chapter 163, Article 3, Sec. 10.
Amends Minne. Stat. §§256I.04, subd. 2a
S.F. 2414, Albright – R
H.F. 3199, Wiklund – D
Effective: The day following final enactment
Background
In 2016, the Department of Human Services (DHS) put forth several reforms to Group Residential Housing (GRH) including several relating to staff qualifications for employees that have direct contact with recipients of services. One of these requirements included having a Minnesota driver’s license if required to transport recipients. This became a challenge for providers located near a boarder state who may have employees living in another state and therefore do not have a Minnesota driver’s license.
Another requirement was that employees either have a skills or knowledge acquired through a course of study in health or human services leading to a bachelors or associates degree, one-year experience with the population, experience as a certified peer specialist or meet the requirements under 144A.43 to 144A.483. There was a desire to further clarify that the certified peer specialist must be specific to mental health.
Summary
The language change removed the word “Minnesota” from the driver’s license requirement. This will allow employees living in another state to work in a GRH setting as long as they have a valid driver’s license from that state.
The language also adds “mental health” before certified peer specialist for clarification of this requirement for staff.
Implications
LeadingAge Minnesota providers that serve GHR recipients will now be able to employee individuals that with a valid driver’s license from any state if that employee must transport recipients. If the employee obtains skill or knowledge through their experience as a certified peer specialist this training must be specific to mental health.
Staff Contact
Bobbie Guidry bguidry@
Home Care Advisory Council Changes
Chapter 179, Sections 13-14
Amends Minne. Stat. §§144A.4799, subd. 1, 3
S.F. 2475, Sheran - DFL
H.F. 3142, Zerwas - R
Effective:
Background
A Home Care Advisory Council was established for the purpose of providing advice to the Home Care Program, not the Home Care and Assisted Living Program, in the Health Regulation Division of the Minnesota Department of Health (MDH). In the 2016 legislative session, the name of the council changed along with the addition of a duty for the council.
Summary
The name of the Advisory Council was changed to the “Home Care and Assisted Living Program” advisory council, due to the fact that much of their work focuses on home care provided within assisted living program settings and that the name of program within MDH had changed as well.
An additional duty for the Council was also delineated, directing the Council to make recommendations for studies to be conducted based on data gathered, including studies concerning costs related to dementia and chronic disease among the population over 60 and associated additional long-term care costs.
Implications
This bill provides no significant implications for providers. However, there may be opportunities for studies that could support our work as a result of the guidance to the Council for recommend studies, and with funds potentially available through collection of Home Care Licensee fines.
Staff Contact
Bobbie Guidry bguidry@
Immediate Temporary Suspension of Home Care License
Chapter 179, Sections 7-10
Amends Minne. Stat. §§144A.473, subd. 2; 144A.475, subd. 3, 3b
S.F. 2475, Sheran - DFL
H.F. 3142, Zerwas - R
Effective:
Background
Since the transition to the revised Minnesota Home Care Law, several issues have arisen where the Minnesota Department of Health (MDH) felt unable to intervene appropriately in situations where they were concerned related to the care or safety of Home Care clients. Changes were introduced by MDH in the 2016 session to correct this in the Home Care Law.
Summary
Two issues are addressed in this amendment. First the issuance of a temporary license for a new provider is changed from being issued for a year to now being issued for “up to” a year. Therefore, if a temporary licensee is not continuing to pursue a license, or if there are significant concerns about the ability of the provider to meet the license requirements, the temporary license does not need to be in place for a full year.
Secondly, the Department sought the ability to immediately temporarily suspend, or initiate a conditional license to a Home Care Licensee where significant concern has arisen related to care or safety of the clients and the provider appears unable to make timely corrections which places clients at significant immediate risk. The Commissioner may now immediately temporarily suspend a license or prohibit delivery of services by a provider for not more than 90 days, or issue a conditional license, if the commissioner determines that there are level 4 violations or violations that pose an imminent risk of harm to the health or safety of persons in the provider’s care. A licensee whose license is temporarily suspended must comply with the requirements for notification and transfer of clients. The requirements remain if an appeal is requested. An expedited hearing process was also added to the process in these circumstances.
Implications
While this is expected to be a very rare circumstance, providers should be aware that MDH does have the ability to Immediately Temporarily Suspend or institute a Conditional License for a provider if significant issues are observed, as well as the process that would then take place to transition care of home care clients.
Staff Contact
Bobbie Guidry bguidry@
MnCHOICES Assessment Process
Chapter 163, Article 3, Sec. 8.
Amends Minne. Stat. §§256B.0911, subd. 3a
S.F. 2414, Albright – R
H.F. 3199, Wiklund – D, Sheran – D
Effective: Immediate
Background
Included in instructions for the MnCHOICES Assessment process for the Department of Human Services (DHS) is who can and who cannot be present during the face-to-face assessment. Because all of the requirements were listed in one sentence, there was room for interpretation of who can be present. The change in the 2016 legislation clarifies who can participate.
Summary
The bill changes simply clarify who can and cannot participate in the face-to-face interview with the person being assessed related to their service needs and preferences. The effect of the rewording clarifies that the person being assessed may invite family members to participate in the assessment, even if they could be considered to have a financial interest in the provision of services. Except for the legal representative and family members invited by the person, persons participating in the assessment may not be a provider of service or have any financial interest in the provision of services.
Implications
There is no significant change to the process already in place related to provider participation in the MnCHOICES assessment process.
Staff Contact
Bobbie Guidry bguidry@
Olmstead Plan
Chapter 163, Article 3, Section 12
S.F. 2414, Wiklund—DFL
H.F. 3199, Albright—R
Effective: January 1, 2017
Background
In 2011, the Minnesota Department of Human Services (DHS) entered into a settlement agreement that required the development of what is now called the Minnesota Olmstead Plan. The goal of the plan is to ensure that people with disabilities are able to live, learn and work in the most integrated setting of their choosing. Minnesota had submitted several drafts of the state’s plan to the Court since November of 2013. On September 29, 2015, the Plan was approved by the U.S. District Judge Donovan Frank.
Bill Summary
New language was passed in 2016 that requires the commissioners of DHS, Education, Housing Finance Agency, Employment and Economic Development, and Information Technology, in consultation with stakeholders, to develop an action plan to increase community integration of people with disabilities in alignment with the approved plan. The priorities of the action plan should focus on actions that align policies and funding, streamline access to services and increase interagency collaborations. Recommendations from the group should include a method that allows those receiving services from state agencies to access a unified records of services and provide information to multiple agencies about their service preferences. These recommendations must include proposed changes needed to implement these actions and are due to the legislature by January 1, 2017.
Implications
Providers should expect legislation to be introduced in the 2017 legislative session related to the action plan developed by the agencies and stakeholders to implement the Olmstead Plan.
Staff Contact
Danielle Salisbury dsalisbuury@
Care Centers: In This Section
|Moratorium Exceptions Process Funding |
| |
|Nursing Facility Consolidation Program Update |
| |
|Nursing Facility Recodification |
| |
|Pharmacy Collection of Controlled Substances and Other Drugs |
|Scholarship Program Update |
| |
|Technical Correction to Value Based Reimbursement |
| |
Moratorium Exceptions Process Funding
Chapter 189, Article 18, Sections 1-3
Amends Minne. Stat. §§144A.073, subd. 13 and 14; 144A.073, adding subd. 15
H.F. 2749, Knoblach—R
S.F. 2356, Cohen—DFL
Effective: July 1, 2016
Background
Periodically the Legislature provides funding for the moratorium exceptions process, which is the primary vehicle for funding significant renovations and replacements of care centers in the Medical Assistance (MA) program. The state investment in upgrading care centers improves services to consumers, and provides a good investment for the state – for each million invested in the program, $100 million or more in construction is completed.
Bill Summary
One of the Long Term Care Imperative’s top priorities for the year was obtaining an additional $1 million in funding for moratorium exceptions projects, which was included in the supplemental budget bill. The language also clarifies that the amounts appropriated are subject to a provision that carries over unused funds to future years, which was language passed almost a decade ago that has been implemented by both the Minnesota Department of Health (MDH) and the Department of Human Services (DHS) on all appropriations since that time.
Implications
The funding provided, combined with an existing balance in the moratorium fund of close to $500,000, will support construction spending of well over $100 million. Interest in this funding is likely to be significant, since the reform of operating rates has reduced one of the barriers to making significant property investments. Providers who are interested in applying for funding should be able to do so later this year, with project approvals likely to be made by MDH in early 2017. The actual property rates paid for these projects will be subject to property rate reform that is expected to be considered in the 2017 legislative session. The new system is intended to reward these types of property investments and should not be a deterrent to providers who are interested in applying for funding to update or replace their building.
Staff Contact
Jeff Bostic jbostic@
Nursing Facility Consolidation Project Update
Chapter 140
Amends Minne. Stat. §§144A.071, subd. 4c and 4d; 256B.441, subd. 13 and 53
H.F. 2607, Kelly—R
S.F. 2325, Schmit—DFL
Effective: January 1, 2017
Background
Over a period of time, two specific projects were approved by the Legislature where a new nursing facility was funded by the consolidation of two nursing facilities, using the savings from the reduction in the number of beds as a budget neutral funding source. Subsequent to approval of those projects, language was added allowing the nursing facility consolidation process to be used without specific legislation authorizing a project.
Bill Summary
The bill has two purposes. First, it updates some of the details of a specifically authorized project in Red Wing, which had not yet moved forward but will now be proceeding. The bill also clarifies that, under the new Value Based Reimbursement (VBR) payment system, the rate adjustments tied to consolidation projects will be included in the external fixed portion of the rates.
Implications
This bill allows the Red Wing project to go forward as currently conceived and to receive a rate adjustment in the external fixed portion of the rate. It also transfers existing consolidation adjustments to the external fixed portion of the rate. The legislation has no cost to the state, since the consolidation adjustments were already in the rates, and the Red Wing project had existing authorization to move forward at any time. Shifting the consolidation adjustments to external fixed gives them some protection as property rate reform moves forward, but when that package is considered by the Legislature they are likely to take into account the consolidation adjustments these facilities are receiving in the external fixed rate.
Staff Contact
Jeff Bostic jbostic@
Nursing Facility Recodification
Chapter 99
S.F. 2539, Lourey—DFL
H.F. 2851, Schomacker—R
Effective: August 1, 2016
Background
During the work on the 2015 legislation instituting a Value-Based Reimbursement (VBR) system for care centers, legislative staff identified a need to reorganize all of the existing nursing home statutes to make them easier to follow and understand. Language calling for a “recodification” effort was included in the payment reform legislation, and a recodification bill was developed over the interim by legislative staff in consultation with the Department of Human Services and provider representatives.
Bill Summary
The bill creates a new statutory section, 256R, to contain all of the statutes related to payment to nursing homes, including existing language on payment rates, as well as language from other sections covering equalization, pre-admission screening, and audits. Most of the language in the previous payment sections (256B.431, 256B.434 and 256B.441) was repealed, with the exception of language related to property rates. The current property rate language is presumed to be replaced by a new property rate proposal in the next legislative session but will be needed until new legislation is passed.
Implications
This bill was designed to have no impact on the calculation of rates. That said, it does contain some improvements in addition to improving the organization of the payment statutes. The bill includes a rewrite of the formula for the care-related limit that is easier to understand, and it corrects some poorly worded sections of last year’s payment reform bill, including a rate exception for a specialized nursing home in Golden Valley that was not appropriately worded. The primary benefit of the legislation will be for those who want to understand how Medical Assistance payment for nursing facilities works, which they will be able to determine much more easily than in the past by reading the new section 256R.
Staff Contact
Jeff Bostic jbostic@
Pharmacy Collection of Controlled Substances and Other Legend Drugs
Chapter 124
Amends Minne. Stat. §§151.37
S.F. 1425, Rosen—R
H.F. 1503, Barrett—R
Effective: May 20, 2016
Background
In 2014 the United States Drug Enforcement Agency finalized a rule creating new ways to collect controlled substances in long term care facilities. That federal rule permits retail pharmacies and hospitals/clinics with an on-site pharmacy to operate collection receptacles at long term care facilities. However, pharmacies have not exercised this option in Minnesota because state law has prohibited them from doing so. This bill amends state law to align with the federal rule. The hope is this provision will contribute to the fight against the epidemic of opioid abuse by providing a method for the collection of unused/unwanted controlled substances.
Summary
The bill provides that a Minnesota-licensed pharmacy may collect a legend drug from an ultimate user, or from a long-term care facility on behalf of an ultimate user who resides or resided at the long-term care facility, for the purpose of disposing of the legend drug as pharmaceutical waste, provided that a pharmacy may collect and dispose of Schedule II, Schedule III, Schedule IV, and Schedule V controlled substances only as allowed under federal law (Code of Federal Regulations, Title 21, parts 1300, 1301, 1304, 1305, 1307, and 1317).
NOTE: LeadingAge Minnesota interprets the term “long-term care facility” to mean a licensed nursing home or licensed boarding care home; if we learn that the Board of Pharmacy will interpret the term more broadly, we will advise members through a separate communication.
The bill also states that a pharmacy that has established a controlled substance disposal program may also collect and dispose of non-controlled substance legend and non-legend drugs, but only in the same manner in which it collects and disposes of controlled substances.
The law allows pharmacies to operate collection receptacles but does not require them to do so.
Implications
Providers should meet with pharmacy partners to discuss how the new law can provide a pathway to secure disposal of unused/unwanted controlled substances and other legend drugs. But note that there are related state regulatory questions to address prior to implementation of receptacle arrangements: (1) application of Minnesota Department of Health (MDH) rules governing disposition of medications (Minn. Rules part 4658.1350); and (2) application of Minnesota Pollution Control Agency (MPCA) requirements under section 116.07 and related rules governing the disposal of hazardous waste. LeadingAge Minnesota will work with the Board of Pharmacy, MDH and MPCA to help providers take advantage of this new disposal opportunity.
Staff Contact
Jonathan Lips jlips@
Scholarship Program Update
Chapter 189, Article 18, Sections 4-6
Amends Minne. Stat. §§144A.611, subd. 1 and 2; 144A.611, adding subd. 6
H.F. 2749, Knoblach—R
S.F. 2356, Cohen—DFL
Effective: October 1, 2016
Background
In the last two legislative sessions adult basic education programs, which provide training at no charge to participants, have attempted to access reimbursement for nursing assistant training through the Minnesota nursing facility scholarship program. Language to implement that was included in the supplemental budget bill that passed this year.
Bill Summary
The language changing the nursing facility scholarship program accomplishes two main goals, both related to nursing assistant training:
• Includes textbooks as a cost that is covered by the scholarship program for individuals who go through nursing assistant training.
• Allows adult basic education programs to bill nursing facilities for employees who receive training through those programs for the cost of the program, plus up to an additional thirty percent to cover other necessary education related to math, literacy and workplace skills. The nursing facility does not have to pay the adult basic education program for these costs until the individual who received the training has been employed for ninety days. These changes to the nursing assistant training portion of the scholarship program take effect with the cost report year beginning October 1, 2016.
Implications
This language allows individuals participating in nursing assistant training to have their textbook costs covered, and it allows adult basic education programs to access Medicaid funding to cover the cost of providing nursing assistant training to individuals who take jobs in nursing facilities. Adult basic education was unable to access Medicaid funds previously because nursing facilities reimburse the cost of training programs to individuals and these programs do not charge participants in the program. By making these changes effective with the cost report year starting October 1, 2016, these changes have no impact on the state budget, or nursing home rates, until the rate year that starts January 1, 2019.
Staff Contact
Jeff Bostic jbostic@
Technical Corrections to Value Based Reimbursement
Chapter 105
Amends Minne. Stat. §§256B.441, sub. 30
S.F. 2430, Lourey—DFL
H.F. 2833, Schomacker—R
Effective: January 1, 2016
Background
The 2015 Legislature passed legislation instituting a Value-Based Reimbursement (VBR) system for care centers effective January 1, 2016. This large piece of legislation included a technical error that could have had a detrimental impact on the functioning new rate system. A letter was sent to the Department of Human Services (DHS) Commissioner by both Chairs Dean and Lourey regarding the legislative intent and that a technical correction to the language would be pursued next session. A response was sent back by the Commissioner acknowledging the letter and implementation of VBR would reflect the language as intended by the legislature until corrected in the 2016 legislative session.
Bill Summary
VBR as initially passed had a reference to the “direct care cost” that should have referred to the “total care related per diem.” The difference between the two similar terms is that total care related includes the non-case mix adjusted portions of care related (social services, activities, food) and direct care does not. That mistake could have had the impact of excluding an entire portion of facility costs from the new rates. This bill changed the reference to use the correct term, and made it retroactive to the start of VBR on January 1, 2016.
Implications
The practical impact of this legislation is essentially nonexistent. DHS had calculated rates as if the language had already been corrected, and the sponsors of last year’s bill agreed to carry corrective legislation with a retroactive date. In addition, the recodification bill that also passed this year completely replaces the language for calculating rates, making this correction unneeded for calculating future VBR rates.
Staff Contact
Jeff Bostic jbostic@
2017 Session Outlook
The 2016 session will be remembered for all that was not accomplished—no comprehensive transportation funding package, no tax bill and no bonding bill, despite the fact that legislative leaders on both sides of the aisle and the Governor had identified these as top priorities for this year. In the end, only $182 million of the state’s $900 million surplus was spent in the supplemental budget bill—which was hastily crafted in the last 36 hours of the legislative session. The bill included funding for increased broadband access, funding to address racial and economic disparities, funding for Minnesota’s state operated services at Anoka and St. Peter and the Governor’s pre-kindergarten proposal.
Perhaps the biggest disappointment of the session, was the lack of any new funding included for Medicaid-funded home and community based services for the elderly for the second year in a row.
Yet, for all of the criticism that can be made about this particular legislative session, in the context of the biennium, there were significant advancements in the area of senior care:
The Establishment of a Legislative Committee Focused on Seniors
For the first time ever, the House took the step in 2015 to establish a committee on Aging and Long Term Care Policy as a direct result of advocacy work by LeadingAge MN and its members. This was significant, because it allowed lawmakers to step back and ask questions about whether Minnesota is headed in the right direction for its aging population. It helped to shed light on the caregiving workforce crisis, the need for senior care reimbursement reform and the need for additional work in the area of Long Term Care Financing Reform. Our work in the next session will focus on encouraging the House to maintain this committee, no matter which party is in control and to continue to advocate that the Senate create a similar body in the next biennium.
Advancements in Senior Care Reform
LeadingAge MN successfully advocated for the passage of a comprehensive senior care reform package, which included $138 million of new investments in care centers and in Elderly Waiver customized living services. The implementation of a new payment system for care centers started in January of this year and the implementation of elevated caps for Elderly Waiver customized living will begin in July of this year. Lawmakers will return to the capitol next year fully aware of the budget implications of these reforms, so it is essential for LeadingAge MN and our members to fully engage with lawmakers so that they can understand at a local level how crucial these reforms were and how important it is to maintain these reforms going forward.
Workforce
LeadingAge MN successfully advocated for some significant improvements to help in workforce training and retention in the past two years, including the establishment of a new HCBS scholarship program and enhancements to the nurse loan forgiveness program and the care center scholarship program. Looking ahead to next year, there will be work to reauthorize the HCBS scholarship program and make it a permanent feature of the state budget process. It will be important for members that have benefitted from this program to help us showcase the importance of this program. Also, in the bucket of unfinished business is advocacy to support a proposal to support a promotional campaign for careers in the field of senior care.
Elections
All 201 members of the House and Senate are up for election in the November this year. Aside from the Presidential election, these legislative races will be the focal point of the elections in Minnesota, as there are no statewide races. While it seems that rhetoric will be largely focused on the “do nothing” session that just concluded, lawmakers will be looking for some positive accomplishments that they can highlight. Senior care issues are likely a prime candidate, and given that there were 148 lawmakers that supported the final passage of some of the reforms and investments of 2015, it is likely that provider members will be receiving many requests from candidates to publicly discuss these reforms. This is an important opportunity that should not be passed up. Not only is it to support all of those lawmakers that supported senior care over the past two years, it is also an opportunity to discuss what is next in terms of our agenda to enhance the experience of aging in Minnesota.
It is not clear which party will control either body of the Legislature, but there is sure to be significant turnover, due to a large number of retirements this year. In addition, there are a number of very close races, especially in greater Minnesota. It is important for providers, caregivers, families and residents to stay engaged this session and talk to candidates from all parities about the work that lies ahead.
Interim Policy Work
Campaigns and door knocking won’t be the only thing that keeping policymakers busy this summer and fall. There are many interim work groups underway that LeadingAge MN is actively involved in:
EW Reform for Assisted Living and Adult Day Providers
A traditional approach of requesting a rate-on-rate increase for all HCBS Waiver programs has not gained traction for several years. Lawmakers are looking for a different approach that is more targeted to addressing issues within the Waiver programs and that are tied to outcomes. To that end, LeadingAge MN, along with our partners in the LTC Imperative, have appointed a joint workgroup of members and business partners to help design a proposal to reform the EW program as it related to assisted living settings. As this proposal is developed, it will be shared with members and external stakeholders, and the goal is to share the proposal with legislative candidates this fall so that it is ready for introduction in the 2017 session.
For adult day providers, LeadingAge MN has convened a group of our adult day members to develop a reform proposal as it relates to adult day services.
Electronic Surveillance in Senior Care Settings
The circumstances in which a resident or family member can install hidden electronic surveillance equipment in a resident’s room or unit was questioned in this legislative session. As a result, a workgroup has been appointed by the Minnesota Department of Health to look at making recommendations to the legislature for next session. LeadingAge MN has an appointee to the workgroup, and we expect legislation to come out of this group next year.
Swing Beds/Hospital Discharge
Another unresolved issue in 2016 was the proposal to increase the state limit on swing bed days in critical access hospitals. While a workgroup was not legislatively mandated, LeadingAge MN made commitments to continue working on this issue over the interim, and currently we are working with the Office of LTC Ombudsman, who plans to convene a working group on swing beds as well as hospital discharge procedures.
Property Reimbursement Reform for Care Centers
An unfinished aspect of senior care reimbursement reform was the reform of the care center property reimbursement system. Currently, appraisals are underway of all care centers to help inform this work, and LeadingAge MN and our members are actively involved in a DHS stakeholder group on this issue.
All of these efforts could result in legislation in the 2016 session. In addition, LeadingAge MN is actively involved in other state agency initiatives, including the continued discussion about the Minnesota Food Code revisions, implementation of the CMS Home and Community Based Services Settings Rule, and the Disability Waiver Rate Setting Methodology revisions.
2017 will be a budget year, where the primary task of lawmakers will be to craft the state budget for the next two years. As you can see, 2017 is shaping up to be significant in terms of the advocacy agenda that LeadingAge MN will present. We will count on members to help us with these efforts again next year, building upon the strong grassroots advocacy over the past two years.
The 90th Legislative session will begin January 3, 2017.
Our Process
The heart of LeadingAge Minnesota’s advocacy process is our cabinet structure. Our cabinets are divided by lines of business and are open to all LeadingAge Minnesota members. Our cabinets help identify legislative priorities, participate in the development of grassroots strategy, provide critical data and feedback, monitor regulatory issues, and review implementation of new laws.
Our agenda development begins with an idea exchange—we ask our cabinets about the top issues they would like lawmakers to address. It is a discussion with our members regarding their present-day concerns and their hopes for the future. Through these conversations, we identify both long-term goals and short-term deliverables. We then gather all of the feedback provided during those discussions, and develop staff recommendations that form a proposed agenda. The agenda is presented to the LeadingAge Minnesota Board of Directors where it is further discussed and refined.
LeadingAge Minnesota also coordinates our legislative priorities with the Long Term Care Imperative through the Long Term Care Imperative Steering Committee.
Throughout our process, we encourage our members to participate in the discussion and vocalize questions or concerns they may have.
Leadership
We would like to thank the following members who have played a leadership role in our advocacy this session.
|LeadingAge Minnesota Board of Directors |
|OFFICERS: |
|Jon Lundberg |Chair |Ebenezer |Minneapolis |
|Jon Riewer |Immediate Past Chair |Eventide |Moorhead |
|Mark Anderson |Chair-Elect |Knute Nelson |Alexandria |
|Nancy Stratman |Secretary-Treasurer |Cuyuna Regional Medical Center |Crosby |
|Gayle Kvenvold |President & CEO |LeadingAge Minnesota |Saint Paul |
|DISTRICT DIRECTORS: |
|Michele Halvorson |District A |Thief River Care Center |Thief River Falls |
|Cheri High |District B |St. Michael’s Health and Rehabilitation Center |Virginia |
|Nathan Johnson |District C |PioneerCare |Fergus Falls |
|Annette Greely |District D |Park View Care Center |Paynesville |
|Pamela Adam |District E |Rice Care Center |Willmar |
|Cheryl Gustason |District F |Field Crest Care Center & Assisted Living |Hayfield |
|Melissa Kirchhoff |District G |McKenna Crossing Commons, Arbor and Hearth |Prior Lake |
|ELECTED DIRECTORS: |
|Craig Abbott |Director-at-Large |Health Dimensions Group |Minneapolis |
|Angela Brown |Director-at-Large |Elim Care |Eden Prairie |
|Linda Kappel |Director-at-Large |St. Benedict’s Senior Community |St. Cloud |
|Dan Johnson |Director-at-Large |Catholic Eldercare, Inc. |Minneapolis |
|Shelley Kendrick |Director-at-Large |Ecumen |Shoreview |
|Paul Libbon |Director-at-Large |Ecumen |Duluth |
|Kris Neff |Director-at-Large |Guardian Angels |Elk River |
|Linda Shell |Director-at-Large |Volunteers of America National Services |Eden Prairie |
|Mike Stordahl |Director-at-Large |Clara City Care Center |Clara City |
|APPOINTED DIRECTORS-AT-LARGE: |
|Rocky Chapin |Director-at-Large |Benedictine Health System |Shoreview |
|Daniel Dixon |Director-at-Large |Guardian Angels |Elk River |
|Erin Hilligan |Director-at-Large |Ebenezer Ridges Care Center |Burnsville |
|Kristi Kane |Director-at-Large |ElderCircle Adult Day Service |Grand Rapids |
|Craig Kittelson |Director-at-Large |Augustana Care |Minneapolis |
|Traci Larsen |Director-at-Large |Presbyterian Homes and Services |Roseville |
|Scott Riddle |Director-at-Large |Walker Methodist |Minneapolis |
|Gail Skoglund |Director-at-Large |Augustana Care |Minneapolis |
|LuAnn McCormick |Director-at-Large |Grand Living |Excelsior |
|EX-OFFICIO/INVITED GUESTS: |
|Rahul Koranne |Chair-Appointed Director|Minnesota Hospital Association |St. Paul |
|Barb Blumer |Ex-Officio |Barb Blumer Law, P.A. |Eagan |
|Wayne Olson |Ex-Officio |LeadingAge Minnesota Solutions Board Chair, |Eden Prairie |
| | |Volunteers of America National Services | |
|Todd Novaczyk |Ex-Officio |ALFA Board Member, New Perspective Senior Living|Eden Prairie |
|Dan Lindh |Ex-Officio |LeadingAge Board Member, Presbyterian Homes and |Roseville |
| | |Services | |
|Kathryn Roberts |Ex-Officio |LeadingAge Chair-Elect, Ecumen |Shoreview |
|Jody Bjerke |Guest |Health Care Auxiliary of Minnesota (HCAM) |Dawson |
| | |Liaison | |
|Jennifer Parker |Guest |MN-DONA Liaison, Parkview Home |Belview |
|Robert Dahl |Guest |LeadingAge Policy Congress |Eden Prairie |
|LeadingAge Minnesota Public Policy Steering Committee |
|Mark R. Anderson |Chair |Knute Nelson |Alexandria |
|Roman Bloemke |Member |Welcome Home Management Company |Hutchinson |
|Dodie Derynck |Member |Morningside Heights Care Center |Marshall |
|John Huhn |Member |Volunteers of America National Services |Rochester |
|Sharon Klefsaas |Member |Presbyterian Homes and Services |Roseville |
|Dustin Lee |Member |Prairie Senior Cottages of Albert Lea |Albert Lea |
|Donna Loomis |Member |Benedictine Health System |Shoreview |
|Katie Lundmark |Member |Perham Living |Perham |
|Tim Middendorf |Member |Augustana Care |Minneapolis |
|Kyle R. Nordine |Member |Northfield Retirement Community |Northfield |
|Anneliese Peterson |Member |Walker Methodist |Minneapolis |
|Michael S. Pochowski, MPPA |Member |Brookdale Senior Living |Milwaukee, WI |
|Carol A. Raw |Member |St. Francis Health Services |Morris |
|Kimber Wraalstad, FACHE |Member |North Shore Care Center |Grand Marais |
|Cory Kalheim |Ex-officio |LeadingAge |Apple Valley |
|Michael S. Pochowski |Ex-officio |Argentum |Washington |
|LeadingAge Minnesota Housing-with-Services/Assisted Living Cabinet |
|Kathy Olson |Chair |Milstream Commons Assisted Living |Northfield |
|Lisa Alipate-Albain |Member |Founders Ridge |Bloomington |
|Jessica Andrist |Member |Mary T., Incorporated |Coon Rapids |
|Shelli Bakken |Member |Summerwood of Plymouth Terrace |Plymouth |
|Catie Barness |Member |Three Links Care Center/Home Care Link |Northfield |
|Josh Berg |Member |Accessible Space, Inc. |St. Paul |
|Courtney Blomquist |Member |Cerenity Residence on Humbolt |St. Paul |
|Barbara J. Blumer |Member |Barb Blumer Law, P.A. |Eagan |
|April J. Boxeth |Member |Voigt, Rodè & Boxeth, LLC |Saint Paul |
|Sue Boyd |Member |Elim Care, Inc. |Eden Prairie |
|Suzon Braun |Member |Essentia Health St. Mary's |Detroit Lakes |
|Allison Buersken |Member |Good Shepherd Community |Sauk Rapids |
|Tonya T. Clem, RN |Member |Essentia Health St. Mary's |Detroit Lakes |
|Heidi Clobes |Member |Prairie Senior Cottages of Albert Lea |Albert Lea |
|Samantha Colbenson |Member |Good Shepherd Lutheran Services |Rushford |
|Anthony J. D'Antonio |Member |Sodexo Senior Living |Downers Grove |
|Mary Beth Davis |Member |Ebenezer Loren on Park |Minneapolis |
|John Decker |Member |Decker’s Family Care, Inc. |International Falls |
|Deborah Delaney |Member |Touching Lives Adult Day Services |Savage |
|Victoria Duvall |Member |Trillium Woods |Plymouth |
|Tori Edie |Member |Essentia Health First Care Living Center |Fosston |
|Lakeesha Epps |Member |MainStreet Lodge Assisted Living |Minneapolis |
|Andrea Erickson |Member |Engel Haus |Albertville |
|Denyse Ethridge |Member |Avinity |Richfield |
|Donna Flaata |Member |Brookdale Senior Living |Brentwood |
|Lucinda Gardner |Member |Copperfield Hill |Robbinsdale |
|Cindy Glynn |Member |Crest View Senior Communities |Columbia Heights |
|Annette C. Greely |Member | Park View Care Center |Paynesville |
|Andrea Gregerson, LPN |Member |Shepherd of Grace Senior Community |Becker |
|Eugene F. Gustason |Member |Stewartville Care Center |Stewartville |
|Jacki Johnson |Member |St. Benedict’s Senior Community |Saint Cloud |
|Jared Keeney |Member |The Homestead at Anoka |Anoka |
|Melissa K. Kirchhoff |Member |McKenna Crossing Commons, Arbor and Hearth |Prior Lake |
|Michelle Klegon |Member |Klegon Law Office, Ltd. |Minneapolis |
|Pamela Klingfus |Member |Ecumen |Shoreview |
|Chanda Knoof |Member |Walker Plaza |Anoka |
|Amy Koehnen |Member |Lino Lakes Assisted Living |Lino Lakes |
|Donna Krivinchuck |Member |Ecumen |Shoreview |
|Rochelle Langlois |Member |Progressive Care LLC |Grand Rapids |
|Rachelle Lavalier |Member |Martin Luther Care Center |Bloomington |
|Dustin Lee |Member |Prairie Senior Cottages, LLC |Minnetonka |
|Danielle Lesmeister, RN |Member |St. Francis Health Services |Morris |
|Larry Lester |Member |Wipfli LLP |Eau Claire, WI |
|Carli Lindemann |Member |Grand Arbor |Alexandria |
|Dereck Mattson |Member |Health Care Insurance Services |Minnetonka |
|Craig McDaniels |Member |Augustana Care |Minneapolis |
|Janelle Meyers |Member |Ecumen Prairie Lodge at Earle Brown Farm |Brooklyn Center |
|Janel Miller |Member |Croixdale Arbor and Commons |Bayport |
|Amy O. Miller |Member |Primrose Retirement Community of Austin |Austin |
|Kristin K. Neff, LNHA, MBA |Member |Guardian Angels |Elk River |
|Chuck Ness |Member |Colonial Manor of Balaton |Balaton |
|Andrea Nye |Member |Apple Valley Villa |Apple Valley |
|Chris Palkowitsch |Member |BKV Group |Minneapolis |
|Deborah A. Perry |Member |Volunteers of America National Services |Eden Prairie |
|Anneliese Peterson |Member |Walker Methodist |Minneapolis |
|Marilyn Pint |Member |The Villages of Lonsdale |Lonsdale |
|Pat Rafferty |Member |Northfield Retirement Community |Northfield |
|Robert F. Rodè |Member |Voigt, Rodè & Boxeth, LLC |Saint Paul |
|Brittany Ross |Member |Prairie Senior Cottages of Isanti |Isanti |
|Sheri Ruehle |Member |Elim Care, Inc. |Eden Prairie |
|Jenna Seal |Member |Cerenity Residence – Marian of St. Paul |St. Paul |
|Natalie Seehausen |Member |Vista Prairie Communities |Hopkins |
|Arlyce Severson |Member |The Wellshire of Bloomington |Bloomington |
|Jason Sieg |Member |Wipfli LLC |Edina |
|Joe Skgnore |Member |Ecumen |Shoreview |
|Jodi Speicher |Member |Good Shepherd Lutheran Home |Sauk Rapids |
|Jennifer Stebbins |Member |Carondelet Village |Saint Paul |
|Roxanne Stelter |Member |Ecumen |Shoreview |
|Megan Stewart |Member |Folkstone |Wayzata |
|Jim Stumpf |Member |Walker Methodist |Minneapolis |
|Bonnie Tendrup |Member |Bigfork Valley Villa |Bigfork |
|Robin Theis |Member |St. Benedict's Senior Community (St. Cloud Hospital) |Saint Cloud |
|Mary Jo Thorne |Member |Augustana Care |Minneapolis |
|Vicki M. Tobroxen |Member |Augustana Regent at Burnsville |Burnsville |
|Corey Trembath |Member |Cottagewood Senior Communities Assisted Living |Buffalo |
|Marie Tysdal |Member |Alcott Manor |Fergus Falls |
|Lores Vlaminck |Member |Lores Consulting |Rochester |
|Lisa Vogel |Member |LB Homes |Fergus Falls |
|Debra Waedt-Nevin |Member |Presbyterian Homes and Services |Roseville |
|Victoria Wagner |Member |Vista Prairie Communities |Hopkins |
|Kim R. Webster |Member |StuartCo |Bloomington |
|Ruth Weispfenning |Member |Charter House/Mayo Clinic |Rochester |
|Dana Wollschlager |Member |Plante Moran Living Forward |Elgin, IL |
|Adam K. Worke |Member |Colony Court |Waseca |
|LeadingAge Minnesota Home Care Cabinet |
|Danielle Lesmeister, RN |Chair |Skyview Court |Moris |
|Taryn Bartz |Vice Chair |The Homestead at Maplewood |Maplewood |
|Angela Aanenson, RN |Vice Chair |Perham Living Home Care |Perham |
|Jessica Andrist |Member |Mary T., Incorporated |Coon Rapids |
|Sara Aschenbrener |Member |Lifesprk |Edina |
|Shelli Bakken |Member |Walker Senior Club Adult Day |Minneapolis |
|Josh Berg |Member |Assessable Space, Inc. |St. Paul |
|Barbara J. Blumer |Member |Barb Blumer Law, P.A. |Eagan |
|April J. Boxeth |Member |Voigt, Rodè & Boxeth, LLC |Saint Paul |
|Sue Boyd |Member |Elim Care, Inc. |Eden Prairie |
|Suzon Braun |Member |Essentia Health St. Mary’s |Detroit Lakes |
|Janet M. Byrnes |Member |Lyngblomsten Care Center |Saint Paul |
|Tonya T. Clem, RN |Member |Essentia Health St. Mary’s |Detroit Lakes |
|Deborah Delaney |Member |Touching Lives Adult Day Services |Savage |
|Sierra DeVries |Member |Benedictine Health System |Cambridge |
|Victoria Duvall |Member |Trillium Woods |Plymouth |
|Tony Enquist |Member |Charter House/Mayo Clinic |Rochester |
|Denyse Ethridge |Member |Avinity |Richfield |
|Frances Fernandez |Member |Ecumen Twin Cities |Coon Rapids |
|Annette C. Greely |Member |Park View Care Center |Paynesville |
|Jani Helm |Member |Knute Nelson Care Center |Alexandria |
|Shawna Jokinen |Member |Ecumen |Shoreview |
|Teresa Kay |Member |Millstream Commons Assisted Living |Northfield |
|Michelle Klegon |Member |Klegon Law Office, Ltd. |Minneapolis |
|Pamela Klingfus |Member |Ecumen |Shoreview |
|Donna Krivinchuck |Member |Ecumen |Shoreview |
|Danielle Lesmeister |Member |St. Francis Health Services of Morris |Morris |
|Terry Mahar, RN |Member |Ecumen |Shoreview |
|Dereck Mattson |Member |Health Care Insurance Services |Minnetonka |
|Ashley McNally |Member |Ecumen Detroit Lakes |Detroit Lakes |
|Heather Nelson, RN |Member |Minnesota Veterans Home – Fergus Falls |Fergus Falls |
|Emily Nyberg |Member |Jones Harrison |Minneapolis |
|Jonathan Nelson |Member |Carondelet Village |St. Paul |
|Kris Odaqwe |Member |St. Therese at Oxbow Lake |Brooklyn Park |
|Kathy Olson |Member |Millstream Commons Assisted Living |Northfield |
|Anneliese Peterson |Member |Walker Methodist |Minneapolis |
|Patrick J. Rafferty |Member |Northfield Retirement Community |Northfield |
|Mandy Rice |Member |Skyview Plaza |Morris |
|Robert F. Rodè |Member |Voigt, Rodè & Boxeth |St. Paul |
|Stephanie Ross, MBA |Member |Health Dimensions Group |Minneapolis |
|Brittany Ross |Member |Prairie Senior Cottages of Isanti |Isanti |
|Coleen Sanford |Member |Vernon Terrace |Edina |
|Natalie Seehausen |Member |Vista Prairie Communities |Hopkins |
|Roxanne Stelter |Member |Ecumen |Shoreview |
|Bonnie Tendrup |Member |Bigfork Valley Villa |Bigfork |
|Mary Jo Thorne |Member |Augustana Care |Minneapolis |
|Lores Vlaminck |Member |Lores Consulting |Rochester |
|Victoria Wagner |Member |Vista Prairie Communities |Hopkins |
|Stephanie Youngberg |Member |BrightStar Care St. Croix Valley |Lake Elmo |
|LeadingAge Minnesota Care Center Cabinet |
|Jeff Heinecke |Chair |Lyngblomsten Care Center |St. Paul |
|John Zwiers |Vice Chair |LB Homes |Fergus Falls |
|Dennis Anderson |Member |Pathway Health Services, Inc. |White Bear Lake |
|Barbara Axness |Member |Pelican Valley Health Center |Pelican Valley |
|Christine M. Bakke, NHA, MHA |Member |St. Benedict’s Senior Community |Saint Cloud |
|Jody Barney |Member |Martin Luther Care Center |Bloomington |
|Justin Birkeli |Member |Central Towers |St. Paul |
|Austin Blilie |Member |Health Dimensions Group |Minneapolis |
|Steve Bode |Member |Saint Therese Foundation, Inc. |Minneapolis |
|Sue Boyd |Member |Elim Care, Inc. |Eden Prairie |
|Dave Brenne |Member |Wipfli LLP |Edina |
|James D. Broich |Member |Cokato Manor |Lamberton |
|Cindy Bunting |Member |Volunteers of America National Services |Eden Prairie |
|Beth Carlson |Member |Health Dimensions Group |Minneapolis |
|Tyler Champ |Member |Pioneer Memorial Care Center |Erskine |
|Jean M. Cole |Member |Augustana Health Care Center of Minneapolis |Minneapolis |
|Nancy Curtis |Member |Benedictine Health System |Shoreview |
|Jason Czycalla |Member |Medline Industries, Inc. |Lakeville |
|Mark Dale, CPA |Member |Eide Bailly LLP |Minneapolis |
|Kari Everson |Member |Volunteers of America Maplewood Care Center |Maplewood |
|Elizabeth Ann Fetner |Member |Trillium Woods |Plymouth |
|Murray Finger |Member |Clarkfield Care Center |Clarkfield |
|Blaine Gamst |Member |Ecumen of Litchfield |Litchfield |
|Maria Garrity |Member |Johanna Shores |Arden Hills |
|Bruce A. Glanzer |Member |Good Shepherd Community |Sauk Rapids |
|Annette Greely |Member |Park View Care Center |Buffalo |
|Cheryl A. Gustason |Member |Field Crest Care Center & Assisted Living |Hayfield |
|Eugene F. Gustason |Member |Stewartville Care Center |Stewartville |
|Quintin Harris |Member |Lancaster Pollard |Excelsior |
|Melissa Heesch |Member |Eventide Senior Living Communities |Moorhead |
|Heather Heijerman, LNHA |Member |Johanna Shores |Arden Hills |
|Tim Hokanson |Member |Mount Olivet Careview Home |Minneapolis |
|Vickie Holtz, RN |Member |Oak Terrace Health Care Center |Gaylord |
|Shawna R. Jokinen |Member |Grand Village |Grand Rapids |
|Jeff King |Member |Three Links Care Center |Northfield |
|Kimberly King |Member |Catholic Eldercare on Main |Minneapolis |
|Wendy Kaye Kingbay, LNHA |Member |Boutwells Landing |Oak Park Heights |
|John T. Korzendorfer |Member |Ecumen Lakeshore |Duluth |
|Lisa Lauderdale |Member |Elim Care, Inc. |Eden Prairie |
|Eric R. Lunde |Member |Piper Jaffray & Company |Minneapolis |
|Katie Lundmark |Member |Perham Living |Perham |
|Dereck Mattson |Member |Health Care Insurances Services |Minnetonka |
|Patrick McDonald |Member |Cerenity Care Center of White Bear |White Bear |
|Gavin Middleton |Member |Carondelet Village |St. Paul |
|Kris Neff |Member |Guardian Angels |Elk River |
|Kelsey Nelson |Member |Voigt, Rode & Boxeth, LLC |St. Paul |
|Chuck Ness |Member |Colonial Manor of Balaton |Balaton |
|Danielle Olson |Member |Sunnyside Care Center |Lake Park |
|Sam Orbovich |Member |Fredrikson & Byron, P.A. |Minneapolis |
|Mark Pederson |Member |Folkstone |Wayzata |
|Cami C. Peterson-DeVries |Member |St. Francis Health Services of Morris |Morris |
|Jennifer D. Pfeffer |Member |Ecumen Pathstone Living |Mankato |
|Colleen Rempfer |Member |Jones-Harrison |Minneapolis |
|Tim Ritter, CPAQ |Member |Wipfli LLP |Edina |
|Frank Robinson |Member |Ramsey County Care Center |Maplewood |
|Mark Rust |Member |Buffalo Lake Health Care Center |Buffalo Lake |
|Kevin Rymanowski |Member |Benedictine Health Systems |Shoreview |
|Molly Senske |Member |Johanna Shores |Arden Hills |
|Jason Sieg |Member |Wipfli LLP |Edina |
|Penny Solberg |Member |Spring Valley Senior Living |Spring Valley |
|Roxanne Stelter |Member |Ecumen |Shoreview |
|Michael T. Stordahl |Member |Parkview Home |Belview |
|Wade Stubson |Member |Eventide Senior Living Communities |Moorhead |
|Michelle Sullivan |Member |Presbyterian Homes of Bloomington |Bloomington |
|Michael L. Syltie |Member |West Wind Village |Morris |
|Greg TaBelle |Member |CliftonLarsonAllen LLP |Minneapolis |
|Jeff Thorne |Member |Volunteers of America National Services |Eden Prairie |
|Angie Urman |Member |Knute Nelson |Alexandria |
|Pennie Viggiano |Member |Health Dimensions Group |Minneapolis |
|Sue Voigt |Member |Voigt, Rode & Boxeth, LLC |St. Paul |
|Jeffery Vrieze, CPA |Member |CliftonLarsonAllen LLP |Minneapolis |
|Michael Warden |Member |Saint Therese Foundation, Inc. |St. Louis Park |
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