Regional News – April 2024

“Unwinding” process for health care programs winding down  The expiration of the continuous enrollment condition authorized by the Families First […]

MN Department of Human Services: MinnesotaCare Medical Assistance card.

“Unwinding” process for health care programs winding down 

The expiration of the continuous enrollment condition authorized by the Families First Coronavirus Response Act (FFCRA) was a very significant health coverage transition event. States were required to maintain enrollment of nearly all Medicaid enrollees during the COVID-19 Public Health Emergency. 

Continuous coverage helped Minnesotans access care during a global pandemic and maintained high insurance coverage rates in the state. It also allowed the state to receive billions in additional federal funding under the Families First Coronavirus Response Act, the first major federal stimulus package passed by Congress. Those federal funds were used during the public health emergency to help pay for health care services, make COVID-19 testing and treatment accessible at no cost to Minnesotans, and help support the direct care workforce, however the majority went into the state’s general fund. 

The end of the continuous enrollment condition on March 31, 2023 ,meant that states had up to 12 months to return to normal eligibility and enrollment operations. 

Minnesota’s unwinding performance continued to improve, according to the Minnesota Department of Human Services (DHS). Roughly 260,000 Minnesotans were in the December and March renewal groups and needed their eligibility reviewed by February 29. Approximately 175,000 of those enrollees, or 67 percent, remained eligible, based on the latest data released by DHS. 

There were about 15,000 Minnesotans, or 7 percent, ineligible for Medical Assistance or MinnesotaCare, with some qualifying instead for affordable insurance through MNsure, the state’s health insurance marketplace. Around 70,000, or 27 percent, closed for procedural reasons, or not completing their renewal paperwork. 

Increasing automatic renewal rates have greatly improved Minnesota’s renewal results. 
Minnesota is nearing the end of the Medicaid unwinding. More than 1.2 million enrollees have been through the renewal process and only a couple months remain in the year-long effort. 

Learn more at https://mn.gov/dhs/renewmycoverage/tools-for-partners/background/ and at https://www.cbpp.org/research/health/unwinding-watch-tracking-medicaid-coverage-as-pandemic-protections-end 

(Source: Minnesota DHS, CMS) 

SAVE seeking stories 

SAVE-Suicide Awareness Voices of Education, www.save.org, announced that it has created a website for Minnesota parents to share stories about how social media platforms have harmed their children’s mental well-being, and by association, resulted in suicidal ideation, self-harm and suicide. 

The website is www.save.org/mnkidscode. It offers parents the opportunity to share detailed experiences of their children’s encounters with social media platforms. While all information provided will be confidential unless authorized by a parent, the website will provide insight into growing concerns that social media platforms are ignoring the negative impact that social media is having on children today. 

“SAVE believes that Big Tech has an obligation to create products that are safe for children before they put them into the marketplace,” said Erich Mische, executive director of SAVE. “The Minnesota Kids Code bill does nothing more than that – requires them to create nothing, market nothing, and profit from nothing that harms and hurts our kids. We’ve heard Big Tech’s reasons why they can’t make their products safe – it’s now time for us to hear from parents what those unsafe products have done to their children.” 

More parents and organizations supporting making social media platforms safe for children and youth are joining the fight to pass legislation like the Minnesota Kids Code. This has led to more pushback from Big Tech giants to keep any legislation requiring social media platforms from changing their business practices. 

“We’ve heard just the tip of the iceberg of stories from parents whose children are being bullied, stalked, and terrorized on social media platforms,” said Mische. “The increasing body of evidence that shows that repeated exposure to violent content, and content that is targeted specifically to young children, is creating mental health trauma and in turn higher rates of suicidal ideation and suicides, demands we act now to protect children.” 

Anyone have a story about how a child’s mental health was negatively impacted by social media, or resulted in suicidal ideation or suicide, can go to www.save.org/mnkidscode 

(Source: SAVE) 

Trail plan is rejected 

The Minneapolis Park & Recreation Board opted March 20 not to move forward with the Soo Line Community Garden trail project. The project was seen as a way to increase disability access to the Whittier neighborhood garden and Midtown Greenway. 

Disability rights advocates including the Minnesota Council on Disability point out that there is an almost 1.5 mile trail section that is completely inaccessible to the bare minimum access standards under the Americans with Disability Act (ADA). 

The project was brought forward six years ago by Hennepin County transportation planners. Planners said the garden is the best place to build a paved trail to the Midtown Greenway bikeway, within the stretch between Humboldt and Stevens avenues. That stretch lacks ADA-compliant ramps. Planners say the trail would only take a small area. 

Project foes disagreed about potential impacts. They said the trail would remove a community gathering space and create an unsafe situation for children in the garden. 

Bicycling groups disagreed on where a trail should go, with some wanting the route through the garden and others asking for a different route that bypasses the garden.

The other potential route is county land, which was set aside years ago for a future rail project. 

The Park Board and county officials have clashed over project engagement as well as the trail location. Last year, Hennepin County asked to extend the project by one year in order to improve engagement. The project has a $1.1 million federal grant that hangs in the balance if the project plans are not completed. 

But gardeners will not be tilling the soil at Soo Line at all this year. Just before the March 20 meeting, the Park Board announced that polluted soil found at the garden means it will be closed for this growing season. 

(Source: Access Press, Star Tribune, Minneapolis Park Board) 

Care careers promoted 

Minnesota is taking an innovative approach to support new Americans to develop careers in the long-term care workforce. 

The state will offer grants to organizations to support new Americans to get and keep jobs and grow careers in long-term care. Applications for the first round of grants opened in mid-March. 

With a workforce shortage impacting care providers across Minnesota, the grants will simplify the path to long-term care careers for people born outside the U.S. regardless of their immigration status. 

“These grants bring together a great opportunity with a tremendous human resource,” said Minnesota Department of Human Services Commissioner Jodi Harpstead. “We’re grateful the legislature and Governor Walz created this tool to help new Americans while addressing one of our major workforce challenges.” 

Grants will go to organizations that can connect new Americans with employment, help them navigate language and cultural barriers, and provide supportive services like training and licensing. Funds will also support career enhancement and growth, including services like transportation and child care supports. 

The first round of grant applications will be open until May 6. The Minnesota Department of Human Services will announce the grant awards later this year. 

(Source: Minnesota DHS) 

Hospital reduces services 

Financial pressures are forcing North Memorial Health to eliminate 103 jobs as well as outpatient mental health services at its flagship hospital. 

Officials said the health system is struggling at its Robbinsdale medical center with continued growth in patients covered by government-sponsored health plans, which pay less for services than commercial health insurers. Elimination of a $22 million subsidy from Hennepin County is also a factor. 

Staff it will work with about 3,400 current mental health patients to find new outpatient providers between now and August 30, which is the expected close date. 

North Memorial is also planning to eliminate its level-two neonatal intensive care unit in Robbinsdale, which means the hospital’s nursery will be staffed and equipped only for newborns with normal deliveries. 

“We’re truly at a point where we’re struggling to survive the headwinds that are facing all of health care, but more importantly survive the payer mix that we serve here in Robbinsdale,” Trevor Sawallish, North Memorial chief executive. “And it’s reaching a critical point.” 

The share of inpatients covered by lower-paying Medicare and Medicaid government insurance programs is significantly higher at the Robbinsdale hospital, Sawallish said, than the statewide average. North Memorial’s Maple Grove community hospital, meanwhile, had the highest share of commercial insurance coverage of any hospital in Minnesota in 2022, according to state Health Department data. 

Commercial insurers are thought to provide the highest reimbursement rates, in general, to health care providers. Medicare payments typically are lower, followed by rates from Medicaid and related state-federal programs for lower-income residents. 

The announcement raises red flags for health care professional groups and those in Minnesota’s mental health services community.  North Memorial Health becomes the third Hennepin County-based health system to cut a significant number of jobs in less than a year. 

(Source: Star Tribune) 

St. David’s to expand 

The downtown Minneapolis YWCA building on Nicollet Mall will soon be occupied by St. David’s Center for Child and Family Development. The Minnetonka-based nonprofit provides mental health and autism services to children. 

St. David’s announced in March that it’s buying the 120,000-square-foot building. The sale comes more than six months after the YWCA announced that it would close the facility. The YWCA has been on Nicollet Mall for almost 100 years. The November 2023 closing sent facility users and members scrambling for new options. The YMCA also closed its Minneapolis Uptown facility. 

St. David’s Center currently works with 5,000 children a year in its preschool, mental health and autism services. The nonprofit plans to expand its programs to serve an additional 1,500 children a year in the new building, helping it meet the rising demand for mental health help. 

“Families are struggling and children are struggling more than they ever had,” said Julie Sjordal, CEO of St. David’s. “We have to increase capacity in order to meet community need.” 

YWCA CEO Shelley Carthen Watson indicated that the nonprofit received three offers for the downtown building, including from private developers and other nonprofits, but the organization prioritized a deal that would keep its early childhood center open on site, which St. David’s will do. 

No details have been announced about the future of the Uptown facility. 

St. David’s and the YWCA signed a purchase agreement for the downtown building in February and hope to close the sale by summer, pending approvals from the state and Hennepin County due to previous bonding funding. 

(Source: Star Tribune, WCCO-TV) 

Student absences cited 

Since the start of the pandemic, the number of students with disabilities who are chronically absent from Minneapolis Public Schools has doubled or nearly doubled in more than a third of schools. More than 1,600 do not attend classes on a regular basis, according to The 74, a nonprofit news site. 

In four schools, the number has tripled, and in two there has been more than a four-fold increase. Attendance has improved in just six of the 55 traditional schools for which the district recently released five years of school-level attendance data.  The district did not post data regarding 14 specialized schools that serve students with profound needs, including self-contained special education programs. At some of those programs, attendance is not reported at all.  The numbers illuminate a largely unexamined facet of a national crisis coming out of the pandemic’s school disruptions.

Historically, students with disabilities are the demographic group most likely to suffer from high rates of absenteeism. And they are so vulnerable to the resulting harms that federal civil rights laws require educators to take special care to make sure they get to school — and that they get help catching up once they are there.  Indeed, within weeks of the first COVID school closures in 2020, the U.S. Department of Education warned that shifts to remote learning did not absolve education leaders of their responsibilities to this population. Minnesota was quick to adopt a law requiring school systems to identify special education students who needed extra help making up academic and developmental losses, and offering to help defray the cost. It’s unclear how many received these recovery services.  Overall, according to data recently posted by the Minneapolis district, the number of students with disabilities who are chronically absent rose from 29 percent in the academic year that ended in 2019 to a peak of 53 percent in 2022 and then 46 percent in 2023. However, those averages conceal huge variations among individual schools, ranging from 21 to 80 percent in 2023. 

The state and the district use different calculations to determine whether a student is chronically absent. Under the state’s definition — students who miss 10 percent or more of school days for which they were enrolled  — Minneapolis’s 2022 special education absenteeism rate was 61 percent, versus 39 percent statewide. The district counts only students who are enrolled for 95 or more days. 

Minneapolis officials declined The 74’s request for an interview for this story. In a statement, special education officials said attendance is a topic of quarterly discussions district leaders have with school administrators about student learning outcomes in general. They also suggested that families are keeping children with disabilities home over health concerns. 

The Individuals with Disabilities in Education Act, the law that guarantees disabled children’s rights, requires districts to identify children who need supports — a mandate that extends to tracking down missing pupils and investigating whether their disability factors into why they are not in school. If it does — common reasons include an environment that is hostile or overwhelms a child with sensory issues — the school must make appropriate accommodations. 

(Source: The 74) 

Hospital plans are opposed 

The Minnesota Department of Health (MDH) has found that moving forward with a new, freestanding rehabilitation hospital in Roseville is not in the public interest based on a required review by the agency’s Health Economics Program of statutory criteria and other requirements. 

MDH’s analysis of the project found that the proposed 60-bed rehabilitation hospital would establish unneeded, costly capacity and may destabilize the existing rehabilitation care delivery system in the Twin Cities metropolitan service area where the facility is intended to be built. 

“MDH and its Health Economics Program take our statutory role in the public interest review process seriously and go to great lengths to provide transparent, impartial reviews of all proposals for new hospitals,” said Minnesota Commissioner of Health Brooke Cunningham. “As Minnesota is facing high and rising health care costs, it is important we ensure that any proposal truly is in the best interest of all Minnesotans.

By law, there is a high bar to clear. Our analysis indicates that this project does not meet that burden and, therefore, MDH is unable to recommend that it is in the public interest.” 

Minnesota law prohibits the construction of new hospitals, expansion of bed capacity at existing hospitals, or redistribution of beds within the state without specific authorization from the legislature or unless a proposal meets defined statutory exceptions. Minnesota Statute, section 144.552 allows an organization seeking to obtain a hospital license, and with it an exception to the moratorium, to submit a proposal to MDH for review and assessment as to whether it is in the public interest. The final decision to grant an exception for a proposal rests with the Minnesota Legislature. 

In 2023, Nobis Rehabilitation Partners submitted a letter of intent notifying MDH of its plan to construct a $42.9 million, 60-bed, freestanding specialty hospital to serve certain patients with rehabilitation needs residing in the seven-county Twin Cities metropolitan area. The final application was deemed complete and ready for review last fall. A public meeting was held in December 2023. 

MDH made its findings after a detailed evaluation. The finding is based on the assessment of the statutory criteria for documented need, an analysis of potential financial impact on other acute care hospitals offering rehabilitation services, the ability for current hospitals to maintain staff, the extent to which the new hospital would serve nonpaying or low-income patients, and the views of affected parties. 

“The current and future health care needs of our communities require innovative and novel approaches to complex problems,” MDH State Health Economist Stefan Gildemeister said. “We appreciate the proposal for a freestanding hospital Nobis has brought forward. However, our analysis indicates that this project attempts to solve a problem that does not exist within the proposed service area and, in fact, could create greater systemic challenges if approved.” 

(Source: MDH) 

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