April 1, 2020
Featured
A Fond Farewell and Debt of Gratitude to a Cornerstone of LeadingAge Minnesota
On April 1, 2020 by Gayle Kvenvold
It is with both tears and cheers that we share the news that Adam Suomala will be transitioning over the course of the next two months to an exciting new opportunity in our field as he becomes the Executive Director of the Minnesota Leadership Council on Aging (MNCLOA).
After two decades of service to LeadingAge Minnesota in roles that spanned legislative affairs, lobbying and grassroots organizing, workforce development, grant writing, strategic affiliations and all things membership, Adam will take the reins of this unique coalition of aging services organizations working together to “create communities and systems that support aging with dignity and a spirit of wellbeing in Minnesota.”
LeadingAge Minnesota is an active member of the Council and helps lead on its board of directors. Adam’s new role will be effective mid-April but he will continue to work on special membership projects with LeadingAge Minnesota on a part time basis until June 1.
We have been blessed by Adam’s unique combination of leadership skills, consensus and relationship building, insight into the needs of our members and solutions-oriented mindset for nearly two decades.
During his time at LeadingAge Minnesota, Adam helped broaden the base of our membership to reflect our growing field and changing service delivery models. He was one of the first to recognize — many years ago — that workforce development would become one of our greatest needs. Adam helped write and secure our earliest grants to test new workforce solutions, guided our merger with the Minnesota Adult Day Services Association and helped countless members with their own strategic planning.
Adam personifies the core values of LeadingAge Minnesota with his spirit of optimism, his respect for others, passion for our field and for his commitment to collaboration. His new role at the Minnesota Leadership Council on Aging will harness those same values in new ways and all of us in the field of aging services will continue to benefit from his many gifts. We are beyond grateful for 20 amazing years of service and contribution — and as reluctant as we are to see him move to the next chapter in his amazing career, we rejoice in this opportunity for him and all the ways he will continue to improve our lives.
Those of you who know Adam know of his gift for communication and so we share with you this excerpt from his letter of resignation:
“Over the past twenty years, I have had the honor to call LeadingAge Minnesota my professional home and have been truly blessed to hold its dedicated leaders and staff as my mentors, colleagues, friends and family. When I look back on my time with this amazing association, it will be in appreciation for the experiences and relationships that have shaped me. It is no small thing to say that I owe all that have to the generosity of one organization, but from my first role as Public Affairs assistant to today, that is my truth. I look forward to carrying forward our “Better Together” value in my new role as Executive Director of the Leadership Council on Aging. I hope to honor the many investments that have been made in me, and to take all that I have learned to advance our shared vision in new and meaningful ways.”
I know you join me in wishing Adam success in all lies ahead — and I know too that he takes with him to his new role our deepest thanks for the difference he has made in our lives and pure joy of having him as a colleague and friend all these years
Care Center Occupancy Data Shows Decline in 2019
On April 1, 2020 by Jeff Bostic
After showing some improvement in 2017, occupancy results for care centers that participated in the Long-Term Care Imperative annual occupancy survey have declined slightly throughout 2018 and 2019. Occupancy for 2019 was the lowest we’ve ever found, 87.1%, and it declined each quarter throughout the year.
Not all regions are experiencing the same occupancy situation. The Twin Cities metro region was above the statewide average occupancy percentage in every quarter of 2018 and 2019, and their occupancy percentage was highest in the state in 2019 at 88.8%. At the other end of the scale, several rural regions of the state had very low care center occupancy throughout the year -- especially southeast Minnesota, which had the lowest occupancy for the year and was under 85% in each of the last three quarters.
Low occupancy is a challenge for care centers for a few reasons, including:
- the state’s surcharge program that charges on a per active bed basis and compensates providers through the daily MA rate; as occupancy declines, losses on the bed surcharge grow.
- the MA payment system pays a daily rate based on historical costs, so if the number of resident days drops, costs used to calculate the rates are not fully reimbursed during the subsequent rate year.
The historically low occupancy figures may be exacerbated by COVID-19, which raises questions about what clients care centers can serve as well as whether people will attempt to avoid placing loved ones in those settings while the disease is spreading. Providers who were already struggling with low occupancy are likely to face even more financial pressure if occupancy drops further due to the current situation.
MN COVIDSitters Resource
On April 1, 2020 by Jenna Kellerman
Students from the University of Minnesota have banned together to offer support to healthcare workers during COVID-19. They are serving both the metro area and central Minnesota, with a toolkit provided to teach students in other areas of the state to start a similar program. Support can be accessed via their website: www.mncovidsitters.org.
Volunteer support services include childcare, pet-sitting, and errands. Simply fill out an application to check out availability of volunteers. All staff in long term care organizations are considered healthcare workers who qualify for this free service.
State
Governor Signs $330 Million Bill to Respond to COVID-19
On April 1, 2020 by Libbie Chapuran
Governor Tim has signed into law an additional $330 million package of initiatives to combat the health and economic challenges due to the COVID-19 crisis. The bill includes, amongst other provisions:
- $200 million for a COVID-19 emergency fund which the Walz Administration can quickly access funding for future needs related to the virus
- $26 million for emergency assistance for homeless populations
- $30 million for grants to child care providers to remain open & care for children of essential workers
- Codifying provisions from some of the Governor’s Executive Orders
Background Check: BCA Authorized to Delay Fingerprint Submission
The bill empowers the Minnesota Bureau of Criminal Apprehension (BCA) to delay the submission of fingerprints needed for background checks of essential workers during the current emergency.
The BCA will consult with other state agencies to determine what workers will be covered, and we are cautiously optimistic that this clears a path for the BCA to delay submission of fingerprints for checks required by the Minnesota Department of Health and Minnesota Department of Human Services.
Our initial read is that background checks would continue to be conducted, but the submission of fingerprints by study subjects would be delayed until 30 days after the end of the peacetime emergency.
The BCA has not yet made a formal determination under this new authority. We are making progress in getting more details on this issue and we will share that with you when available.
15% Housing Support Increase Included in Bill
The bill includes a temporary 15% increase in Housing Support (GRH) and Supportive Services limits and rates under Statute 156I, subdivision 1 & 1a. The funding is increased from March 1 - May 31 and is meant to maintain access to room and board for eligible individuals by assisting providers in funding activities to comply with federal and state health and safety guidance in response to COVID-19.
Providers must submit documentation by Oct. 1, 2020 demonstrating that the increased funding was used for needs related to COVID-19. Examples of items that may apply include, but are not limited to:
- increased building-related cleaning products and protocols for infection control;
- disposable dishes and utensils for in room meal delivery to confine individuals who are symptomatic or to support social distancing; and,
- increased staff costs to provide meal service to resident apartments or additional cleaning.
We will continue to seek clarity and provide additional information as it is available.
Legislative Work Continues, Despite Required Social Distancing
This package is being viewed as another step to address COVID-19 and have acknowledged many other needs awaiting to be addressed. While this bill addressed a significant issue we had on background checks, we continue to advocate on your behalf to ensure you have the resources you need to respond to a COVID-19 outbreak.
Both the House and Senate have adjusted their rules to allow for temporary distance voting or remote/proxy voting during the duration of the COVID-19 emergency in case they are prevented from meeting in person for committee or floor votes. At this time, they are not scheduled to come back in floor session until April 14 unless agreements are reached between the leaders on specific issues. We will continue to keep you updated as legislative work continues.
Have you thanked your lawmakers?
While the most recent bill was not targeted at long-term care providers, a bill passed a few weeks ago set aside $200 million for health care providers including those providing senior services. Send a quick email to your lawmakers or make a call to thank your lawmakers for what they’ve done so far. Here are three steps:
- CLICK https://p2a.co/yBt6i8m and enter your contact information.
- CHOOSE whether you’d like to send an email, make a call or both by clicking the message or phone options at the top of the screen.
- SHARE your thoughts with your lawmakers. Your messages, whether you call or email, will be pre-loaded on your screen. We encourage you to personalize your messages to make a bigger impact. Then share with others and encourage them to take action too!
Temporary Change in Ombudsmen Services
On April 1, 2020 by Jodi Boyne
The state Ombudsmen for Long-Term Care resolve complaints, protect rights, and promote access to services for residents before, during and after emergencies like COVID-19. While the Ombudsman has temporarily discontinued in-person visits in long-term care settings under its scope of authority due to COVID-19, residents still have the right to access the Ombudsman program. Below is an excerpt from a letter for Cheryl Hennen, the state Ombudsman, and phone numbers and a brochure to share with residents and families:
“I recognize and respect that residents, especially the elderly, are at high-risk for the virus. Under these circumstances, ombudsmen must value the needs and rights of residents in facilities that limiting visitation, under quarantine, or in which there is a risk of exposure, at the same time attend to their own health and safety.
Until further notice Regional Ombudsmen staff will provide advocacy services via virtual visitation such as telephone, email, or other electronic communications. This will require assistance/support from facility staff.
I sincerely respect facility staff may be under stress and strain to serve residents and comply with many new provisions due to COVID-19. My ask for support and assistance may be of help to facility staff should conflicts arise as we work to collaborate and resolve problems, at the very least help calm anxiety. My staff may ask for help from facility staff to receive proper consent to assist people and other requests but mindful of work assignments. During this time, we thank facility staff for facilitating resident communication (by phone or other format) with the Ombudsman program.
This decision to modify advocacy services delivered from this office has not been made lightly. I recognize and respect that residents, especially the elderly, are at high-risk for the virus. I acknowledge staff of the MN Long-Term Care Ombudsman Programs must do our part to slow the spread of this virus while continuing to serve residents and protecting their safety and rights.
Residents still have the right to access the Ombudsman program and we will continue to respond to, and investigate complaints brought forward by residents, family members, and/or other community members. I have a great team of advocates and strongly emphasize their health and well-being comes first.”
The Ombudsmen for Long-Term Care can be reached at 800-657-3591 or 651-431-2555. They also provided a link to their office brochure and we encourage you to share it with residents and families.
Federal
Department of Labor Defines “Health Care Provider” Exempted Under Families First Act
On April 1, 2020 by Kari Thurlow
While the Families First Corona Response Act (FFCRA) requires private employers with fewer than 500 employees to provide paid leave and paid expanded FMLA leave to employees unable to work or telework for several specific COVID-19 reasons, it allows employers to exclude “health care providers” from receiving the paid leave and paid expanded FMLA leave.
Initially, the definition of “health care provider” was unclear. Under existing FMLA, physicians, nurse practitioners, and physician assistants fall within the “health care provider” definition. However, that definition does not include LPNs, RNs, and CNAs or employees key to the operation of a health care setting.
Over the weekend, the Department of Labor (DOL) supplemented its previously issued Q&A guidance to define a “health care provider” who may be excluded by their employer from paid sick leave and paid expanded FMLA leave. In general, the definition appears to provide significantly more flexibility for senior care providers than initially expected.
In Question No. 56, the DOL defined broadly who is a “health care provider” who may be excluded by their employer from paid sick leave and paid expanded FMLA leave:
[A]nyone employed at any doctor’s office, hospital, health care center, clinic, post-secondary educational institution offering health care instruction, medical school, local health department or agency, nursing facility, retirement facility, nursing home, home health care provider, any facility that performs laboratory or medical testing, pharmacy, or any similar institution, employer, or entity.
A health care provider also “includes any permanent or temporary institution, facility, location, or site where medical services are provided that are similar to such institutions” and “any individual employed by an entity that contracts with any of the above institutions, employers, or entities institutions to provide services or to maintain the operation of the facility [and] … anyone employed by any entity that provides medical services, produces medical products, or is otherwise involved in the making of COVID-19 related medical equipment, tests, drugs, vaccines, diagnostic vehicles, or treatments.” Finally, the definition includes “any individual that the highest official of a state … determines is a health care provider necessary for that state’s … response to COVID-19.”
While DOL has defined this exempt category of employees broadly, it has encouraged employers to help minimize the spread of the virus by being judicious in exempting health care providers.
Essentially, DOL is asking providers to craft policies at their individual sites that balance the need to minimize the spread of the virus by keeping people home with the need to continue to operate and be adequately staffed to combat the COVID-19 pandemic. It will be up to employers to craft policies at their individual locations to determine which employees will be exempt from the FFCRA provisions.
The guidance with respect to independent senior housing or assisted living is not crystal clear. An argument may be made that employees of these providers would be covered by the definition, and we continue to advocate to make this explicit.
Finally, even if an employer elects to exempt health care providers from receiving paid sick leave and paid expanded FMLA leave under the FFCRA, the employee still may be eligible for other benefits, such as traditional unpaid FMLA or paid leave provided under Minnesota state law or local ordinances.
Remember: This exemption is optional and should be evaluated on a case-by-case basis in order to minimize the spread of the virus.
CARES Act Expands Federal Small Business Loans, Can Support Aging Services
On April 1, 2020 by Roni Falck
About $350 billion of the $2 trillion economic stimulus package signed into law last week are directed to provide loans to small businesses, with the opportunity for loan recipients to receive forgiveness and not have to repay the amount borrowed. On April 3, smaller 501c(3) organizations will be able to access these funds. This article provides a summary of the provisions and guidance for borrowers and lenders.
Primary Takeaways of this article:
- Access the Paycheck Protection Program Application Form.
- Review the guidance for potential borrowers
- Review the guidance for lenders
The Paycheck Protection Program
The Paycheck Protection Program is the primary small business loan program that is open to 501(c)(3) organizations with fewer than 500 employees. The threshold includes all full- and part-time employees and those with other statuses (e.g., per diem/TAR). Not-for-profit entities seeking loans through this program are subject to the Small Business Administration’s (SBA) affiliation standards that prospective borrowers should review in detail.
Small entities are allowed to borrow up to 250% of their average monthly payroll costs (averaging payroll costs for each month in the year preceding the loan date). If an adult day services provider, for example, had an average monthly payroll of $100,000, it could access up to $250,000 in loans through this program.
Loan payments will be deferred for six months for any loan principal that is not forgiven (although interest will accrue).
Certain payroll costs are excluded, including payroll taxes and compensation for higher wage employees. Up to 100% of the amount borrowed can be forgiven. Unlike other types of SBA loans, these loans do not require collateral, do not require a personal guarantee and borrowers do not need to first look elsewhere for funds. Loans can originate from April 3 – June 30.
Loans through this program are forgivable if a small entity maintains its payroll for 8 weeks after receiving the loan. Loans can be forgiven for funds used to cover payroll, rent, mortgage interest and utility bills. If an entity has already laid off staff, they could be eligible for forgiveness if they use loan funds to re-hire. If after 8 weeks payroll is maintained, the loan is forgiven. If a borrower has unforgiven loan principal (e.g., if an organization receives a loan but does not maintain its payroll), the interest rate for these loans will be 0.5% with a term of 2 years.
Below is an excerpt from guidance for potential borrowers from the U.S. Department of Treasury on forgiveness criteria.
How much of my loan will be forgiven? You will owe money when your loan is due if you use the loan amount for anything other than payroll costs, mortgage interest, rent, and utilities payments over the 8 weeks after getting the loan. Due to likely high subscription, it is anticipated that not more than 25% of the forgiven amount may be for non-payroll costs. You will also owe money if you do not maintain your staff and payroll.
- Number of Staff: Your loan forgiveness will be reduced if you decrease your full-time employee headcount.
- Level of Payroll: Your loan forgiveness will also be reduced if you decrease salaries and wages by more than 25% for any employee that made less than $100,000 annualized in 2019.
- Re-Hiring: You have until June 30, 2020 to restore your full-time employment and salary levels for any changes made between February 15, 2020 and April 26, 2020.
Potential borrowers should review the Treasury guidance for borrowers in full before proceeding with a loan application.
Organizations interested in these loans should reach out to banks in their area. According to the Treasury guidance, borrowers can receive loans from "any existing SBA lender or through any federally insured depository institution, federally insured credit union, and Farm Credit System institution that is participating" in the Paycheck Protection Program. As reference, Treasury also issued guidance on these loans for lenders.
Additional documents you should review as you plan your next steps:
- U.S. Senate Small Business Committee Paycheck Protection Program FAQs
- U.S. Chamber of Commerce Small Business COVID-19 Emergency Loan Guide
- Small Business Administration Paycheck Protection Program Webpage
Economic Injury Disaster Loan
The the Economic Injury Disaster Loan program, in which borrowers receive funds directly from SBA, was expanded. These loans are generally not forgivable and may carry a longer term and/or lower interest rate than the Paycheck Protection Program loans. For not-for-profit organizations, the interest rate for these loans is 2.75%. Find information and a streamlined application here. Some key items that must be included in your loan application include:
- Gross Revenues for the 12 Months Prior to the Date of the Disaster (Jan. 31, 2020)
- Non-Profit Cost of Operation for 12 Months Prior to the Date of the Disaster (Jan. 31, 2020)
- Number of Employees (As of Jan. 31, 2020)
- Date Business Established
- Description of business activity (e.g., which services an organization provides)
- Borrowers may also be eligible for a $10,000 emergency fund award that may be forgivable.
If an organization took out an Economic Injury Disaster Loan (EIDL) previously and wants to pursue a Paycheck Protection Program loan to be eligible for loan forgiveness, they may be able to refinance the EIDL in consultation with their bank.
Notable
1,000 Nursing Assistant Students Trained by OnTrack
On April 1, 2020 by Jenna Kellerman
More than 1,000 Nursing Assistants have been trained using the OnTrack Nursing Assistant Training curriculum. With a pass-rate trending higher than the state average, OnTrack continues to see success in the second year of operation.
“OnTrack has been such a positive addition to our in-house Nursing Assistant training program,” says Cheryl Gustason, Administrator, Field Crest Care Center. “The flexibility of the online coursework lets us start new employee training upon hire, allows students to learn at their own pace, does not limit the size of the class, and frees up time for our RN instructor. The curriculum uses a variety of learning methods to enhance the students learning experience. I would highly recommend the OnTrack program to other care centers.”
Since Field Crest Care Center began using OnTrack, they have had 27 employees complete the coursework and pass their CNA test out, and have 13 employees in the process of completing the OnTrack coursework.
Sign up for the MDH-approved OnTrack Nursing Assistant Training program today! Call 651.425.1110 to schedule your OnTrack demo today.