MN Senate COVID-19 Response Working Group Focuses on Long-Term Care

Posted on April 8, 2020 by Libbie Chapuran

The Minnesota Senate COVID-19 Response Working Group met yesterday, focusing their work on the impact on the long-term care community. LeadingAge Minnesota member Deb Barnes, Executive Director at Lakeview Methodist Health Care, began the hearing with testimony about the impact of COVID-19 in long-term care settings.  

Deb shared all the precautions long-term providers have taken and are actively taking to prevent the spread of the disease in congregate communities. Most notably, she shared that these precautions are being taken during staffing shortages due to COVID-19.

Following Deb’s impactful testimony, LeadingAge Minnesota and our Long-term Care Imperative partners shared additional challenges facing providers and policy solutions to help providers respond to COVID-19. Here are some of the highlights of Kari Thurlow’s requests of the legislature:

Workforce:

• We propose that Registered Nurses, Licensed Practical Nurses, Trained Medication Aides, Registered Nursing Assistants, or Health Aides  that are in good standing with the licensing board, and have been furloughed or laid off from a hospital, clinic or other health care setting be immediately eligible for hire in health care settings, including senior care, without further screening, background check, TB testing or other vetting in a long-term care/senior care setting. We would propose the same for any other individual that is currently in good standing with the licensing board who may not be currently working in a direct care capacity.
• We propose an expedited (24-48 hours) process to allow any Registered Nurse, Licensed Practical Nurse, Trained Medication Aide, Registered Nursing Assistant, or Health Aide, that has let their license or registration lapse to be reactivated and thus immediately eligible for hire.
• We ask that lawmakers act to immediately allow nursing facilities to hire Basic Care Aides (BCA) who can provide personal care for residents including but not limited to activities of daily living, infection prevention and control, documentation, and comfort care. Basic Care Aides would receive 8 hours of training and their competency would be verified by a licensed nurse.
• We are further requesting that lawmakers act to waive home health aide, nursing assistant training, and feeding assistant training requirements found in Chapter 144A or Minnesota Rules Part 4658 to mirror our federal Section 1135 waiver request for hiring flexibility.

PPE: It is important that senior care providers are considered a priority in the distribution of this equipment so that we can protect those most vulnerable to the virus and the employees caring for them.

Testing: Providers are doing everything they can to control the spread of this virus. But, because we know that this virus can spread through asymptomatic carriers, we need better access to testing.

Gaps created by the closure of adult day services: Many of these providers closed even before they were ordered to do so by DHS. However, this has left thousands of seniors and persons with disabilities without needed services. It has also left many adult day providers financially frail and questioning whether they will even be viable after this public health emergency. Adult day providers are willing to help fill service gaps by providing virtual or remote adult day services and have requested that lawmakers consider passing legislation to reimburse for these services. This is a model that several other states have adopted.

Step down settings: Senior care providers will play an important role in helping hospitals maintain capacity by serving as discharge locations for COVID-19 patients that are improving. Current guidance is that not every senior care setting should be a discharge location, but that we should identify certain senior care providers to serve as “step-down” providers. Minnesota health care providers have begun these discussions, but there are likely future policy issues that will need to be addressed, including reimbursement issues.  It should also be recognized that these step-down providers will have a cohort of COVID-19 residents, by design. These settings should not be portrayed as having an outbreak or poor infection control procedures.

Cheryl Hennen, the Ombudsman for Long-term Care, shared some of the challenges and successes she and those in the Ombudsman’s Office are seeing during these times. Additionally, Kris Ehresmann of the Minnesota Department of Health, highlighted the valuable collaboration between providers, the Department, the state associations, and others.

If you would like to watch the work group, visit Senate.mn.