Regional News in Review - April 2015

Minnesota receives federal approval for new autism benefit

Minnesota will soon provide early intensive intervention for children and young adults with autism spectrum disorder. The Centers for Medicare and Medicaid Services recently approved the Minnesota Department of Human Services’ (DHS) Early Intensive Developmental and Behavioral Intervention benefit.

Autism spectrum disorder, with its complex symptoms and treatments, is an increasingly prevalent diagnosis. While Minnesota has provided supports in the past for children with autism spectrum disorder under Medical Assistance, the state’s Medicaid program, it has not offered a medically necessary intensive intervention benefit with early intervention services believed to be critical for children on the autism spectrum.

“Evidence shows that the earlier the intervention, the greater possibility for success,” said Human Services Commissioner Lucinda Jesson. “Currently in Minnesota, the average age of diagnosis is four years and up. We are excited to see this benefit move forward because it means we can get children, young adults and their families the help they need earlier so they have their best chance to thrive.”

Under the new benefit, covered services will be designed to improve social interaction, communication and behavioral regulation skills at a critical time in development, promoting fuller participation by children in their family, schools and community life. Over time, services are expected to reduce the need for institutional placement and intensive interventions, and promote successful integration into adulthood. Development of the benefit took many months of planning.

It is expected to start in summer 2015. In the first year, the benefit will serve an estimated 325 individuals with autism spectrum disorders and related conditions from birth to age 21 who meet medical necessity for intensive developmental and behavioral treatment. The number served is expected to grow to about 1,000 per year as provider capacity is developed. The total first-year cost is expected to be $15 million split between the state and federal government. As more children are served, the annual cost will grow in proportion to the numbers served, with a continued state-federal match, however, these early investments are anticipated to reduce costs over an individual’s lifetime, as early interventions decrease the need for more intensive long-term supports.

DHS will continue to develop the details of the new benefit in coordination with other related services and in collaboration with the dedicated community of stakeholders as the projected implementation date nears. More information is available on the DHS webpage about children with autism spectrum disorders. (Source: Minnesota Department of Human Services)

 

 

Group homes may close

Dozens of state-run group homes and job training programs for people with disabilities may close or undergo drastic changes in an effort to slash millions of dollars in spending on Minnesota Department of Human Services (DHS). State officials contend that the services can be provided by the private sector at a significant savings. But the changes are raised concerns among people with disabilities and their family members. The move marks a historic shift away from an institutionalized model of care for hundreds of people with cognitive and other disabilities who are currently housed in state-operated group homes.

Changes would be made over the next two years. Forty-eight group homes around the state are likely to close or be converted to facilities for people with high needs who cannot be cared for in private settings, according to an internal DHS memo obtained by the Star Tribune. Some homes could become placement sites for people with mental illnesses, helping to alleviate the state’s severe shortage of psychiatric beds.

The closures come nearly six years after state lawmakers, hoping to rein in Medicaid spending, imposed a moratorium on new four-person group homes or corporate foster care. That created a shortage of group-home beds for disabled adults in some parts of the state. Families often wait months for placements.

But state-run group homes have come under fire because some are not seen as fully integrating residents into their communities. The high cost is also criticized as is the duplication of service provided by private home providers.

DHS officials say they can no longer afford to operate an expensive network of more than 120 group homes and vocational programs in the face of a daunting, $19 million shortfall in the state’s overall budget for vulnerable populations. A detailed plan has not been worked out, but the 48 targeted homes could be closed, transitioned to private owners or converted to new uses, DHS officials said.

“The system is not sustainable,” Deputy Human Services Commissioner Anne Barry said in an interview. “We are serving people who do not need a safety-net level of care, and that’s not acceptable.” But family members worry that the state cuts will hurt their adult children. “We’re worried that our children will be forgotten,” said Elizabeth Taylor, 71, of Duluth, who has a daughter with Down syndrome living in a state-run group home in Hermantown.

Taylor said she fears her daughter might end up at another group home “hundreds of miles away,” making it impossible for her to visit once a week or go on regular outings for lunch and to the shopping mall. “If I don’t have my Katie close to me, how am I going to keep a relationship with her?” Taylor asked. (Source: Star Tribune)

 

 

Nursing home is cited

A western Minnesota nursing home has been cited for neglect in the case of an elderly resident who died of pneumonia three days after he was rushed to a hospital “malnourished and dehydrated, with severe dry skin and multiple open sores.” A state investigation released last month said staff at Golden Living-Centers Meadow Lane in Benson relied on over-the-counter medications and supplemental oxygen to treat the man’s wild swings in body temperature and troubled breathing, but did not alert his doctor. The resident was hospitalized and died in October 2014, according to the Minnesota Health Department. The health department’s investigation found that the man’s family wasn’t informed of the severity of his illness. Doctors at the hospital where he died raised concerns about his treatment.

According to state officials this is the eighth time since 2011 that the facility’s owner, Texas-based Golden Living Centers, has been cited by the Minnesota Department of Health for incidents of abuse, neglect or financial exploitation. A spokeswoman for the home’s national headquarters in suburban Dallas said Meadow Lane has submitted a plan of correction that was accepted by the Department of Health and [was] found to be in compliance with the regulatory guidelines. Staff has also had additional training. Golden Living Centers, operates 26 nursing homes in Minnesota and 294 nationally, has been cited before for neglect. Patient neglect has been report in recent years at facilities in Olivia and Golden Valley. (Source: Star Tribune)