March 23, 2023
Featured News
Legislative Leaders Announce Joint Budget Targets
On March 23, 2023 by Erin Huppert
This week, legislative leaders and Governor Walz announced they had reached global budget targets for creating Minnesota’s biennial budget (FY2023-2025). This agreement sets the stage for the Legislature to spend the state’s $17.6 billion surplus. According to the agreement, human services has been given a $1.3 billion target for the two-year period, and health care an additional $755 million.
These targets come at a time when the legislative activity remains at an all-time high; the House and Senate both reached 3,000 bill introductions this week, which has never happened in the first year of the biennium (based on records starting in 1983).
What do these targets mean for aging services?
The joint budget targets released this week leave many questions for seniors and their caregivers, like:
- How much of this $1.3 billion is ongoing versus one-time funding?
- Where will other proposals with financial considerations fall within these targets?
We need $1 billion over the next four years to get our caregivers a starting wage of $22 an hour. Other providers in human services also have deep needs, so we worry that $1.3 billion for all of human services is not close to enough to cover the severe needs of seniors, people with disabilities, and professional caregivers.
Committees will begin building their omnibus bills starting next week, so LeadingAge Minnesota is working closely with its Long-Term Care Imperative partner to gather more information on the specifics of these targets.
In the meantime, we must keep pressure on our state representatives and senators. The governor did not prioritize seniors and their caregivers in his proposed budget, so the Legislature needs to show leadership on this Minnesotan value. They need to make the most of that $1.3 budget target and, given a $17 billion surplus, determine if more can be done.
Contact your local legislator today and ensure seniors are included in “One Minnesota.”
State News
Walz’s Revised Budget Addresses Hospital Back-Ups, Not LTC Funding
On March 23, 2023 by Jeff Bostic
Governor Tim Walz recently updated his budget proposal and introduced some new spending initiatives after the most recent budget forecast was released. Unfortunately, those initiatives do not include a rate increase for care centers despite the ongoing staffing and financial challenges. Despite the lack of support from the Governor, the Long-Term Care Imperative continues to work with legislators to advocate for this vitally needed funding.
Proposed hospital discharge funding
The Governor’s revised budget includes a new proposal to address hospital discharge challenges. The revised budget recommends $26.8M in the upcoming biennium to fund a premium pay program for providers that admit people with complex needs from hospital settings. A patient in the hospital is eligible for premium pay if:
- Medically complexity that requires highly specialized care coordination and treatment OR
- Serious aggressive and/or self-harm behavior OR
- Repeated denials of admission to residential settings, service terminations, placement on a waitlist, or other inability of providers to properly support the person in a community setting.
A second component of the proposal includes funding to establish an organizational endorsement system for providers who serve people with complex needs. This endorsement system is not attached or associated with the provider's license type; it is available to MA-enrolled providers across the LTSS spectrum. Providers that choose to become endorsed will have access to enhanced financial incentives through existing grant programs, free access to a consultative clinical panel, free training for positive support capacity building, and the option to participate in a statewide community of practice.
A final component is case mix rate exceptions under Elderly Waiver to allow increased funding for clients with complex support needs. This program is tied to being in a mental health hospital or on a waiting list for those services, so the population covered will have significant needs. That is likely to limit the number of providers who participate, but exceptions to the caps for EW, even in limited circumstances, are a positive step.
What’s next
The revised budget was heard in Senate Committee earlier this week. The testimony did not include any details on the amount of any additional payments for serving these populations. Meanwhile, another bill has been introduced to pay long-term care providers for taking “high acuity” hospital clients. There is no definition of what it means to be “high acuity,” so that will need to be worked out if this bill advances. That bill would pay $150 per day to settings that take these clients, and it has about ten times as much state funding as the Governor’s proposal. However, both proposals are time-limited, one-time money, not designed for providers to make long-term investments to fix ongoing staffing problems.
Our take
While we view these efforts as potentially helpful in the short run, we believe that the best solution to hospital discharge issues is to adequately fund long-term care reimbursement so we can pay caregivers a living wage.
What’s next
The Governor’s proposed budget updates are notable. However, the legislature is ultimately tasked with passing a balanced budget and sending it to the Governor for approval. Lawmakers will consider his recommendations – in fact, many have been discussed in committee – but they will decide which of the Governor’s spending proposals move forward in the legislative process.
New Housing Support Rate Effective July 1
On March 23, 2023 by Libbie Chapuran
On July 1, the Housing Support maximum monthly room and board rate will increase to $1,135.
The annual recalculation of the Housing Support, formerly Group Residential Housing (GRH), which covers rent and raw food for eligible participants, will increase by $94 per month. The new rate of $1135 will be effective July 1, 2023 through June 30, 2024.
Housing Support is a state-funded program that provides an income supplement to approximately 20,000 recipients each month to pay for rent and food. The amount of a Housing Support payment is based on a federal and state standard of what an individual would need, at a minimum, to live in the community. All of those supported by the program are at risk of institutional placement or homelessness.
Federal News
Safe Care Addresses CMS Focus on Patient Safety
On March 23, 2023 by Julie Apold
During National Patient Safety Awareness Week, the Centers for Medicare and Medicaid Services (CMS) highlighted their renewed focus on patient safety because harm is still too common and often preventable in a blog published on its website. Progress in patient safety has significantly declined since the beginning of the pandemic erasing previous patient safety gains.
Safety science shows us that serious safety events are most often the result of issues with our systems; rarely are they the result of one individual error. CMS mentions several efforts going forward to drive systems improvements across programs:
- Incentivizing health care providers to make meaningful improvements – rewarding patient safety improvements; penalizing when standards are unmet.
- Issuing guidance to implement an effective, data-driven quality assessment and performance improvement program – including tracking and monitoring medical errors.
- Updating requirements for providers who participate in Medicare and Medicaid to better address inequities in quality of care and access.
Safe Care addresses CMS-highlighted patient safety best practices
The LeadingAge Minnesota quality initiative – Safe Care, which is grounded in safety science – provides resources to address the best practices mentioned by CMS (and other vital practices) in the re-engineering of safe systems of care by:
- Ensuring a culture of safety
- Improving teamwork and communications
- Carefully analyzing errors [and near misses] to identify root causes
- Improving patient and caregiver engagement
Learn more about Safe Care
As CMS renews its focus on patient safety, it is an excellent time to re-evaluate our culture and systems to continue working toward our Safe Care goal of eliminating preventable harm during caregiving. To get started (or restarted) on your Safe Care journey, explore the following tools:
- About Safe Care
- Implement the 5 Safe Care Actions
- Safe Care Virtual Workshop
- Take the Safe Care Pledge
Contact Julie Apold, Vice President of Quality & Performance Excellence, to learn more.
Notable News
Member News
Gene Gustason Announces Retirement
On March 23, 2023 by Libbie Chapuran
Gene Gustason, a long-time LeadingAge Minnesota member, has announced his retirement from the Stewartville Care Center effective at the end of March. He completes his career in the sector after 29 years at the skilled nursing setting in Stewartville. The Stewartville Care Center is an 85-bed skilled nursing facility for residential and rehabilitative care.
Gene has spent his career in the long-term care field and has been an active member of LeadingAge Minnesota throughout his tenured career. He announces his retirement on the heels of his wife, Cheryl, who also spent her career in the field.
The team at Stewartville Care Center would like to extend an invitation to LeadingAge Minnesota members to attend Gene’s retirement celebration on March 29 from 2-4 p.m. The open house will be held at the Stewartville Care Center (120 4th St. NE, Stewartville, MN).
Join us as we show our appreciation for Gene for his decades of service and dedication to his community and our association. Congratulations, Gene!
LeadingAge Minnesota Education Solutions
Communication and Conversations with Direct Care Staff – Access in the Resource Library
On March 23, 2023 by Sharon Hollister
This new resource includes a 10-minute recording with an accompanying exercise and discussion handout. Gather your nurses, particularly staff nurses and direct care nurses, to watch the recording and work through the exercise together.
Communication and Conversations with Direct Care Staff can be accessed in the complimentary members-only Resource Library.