The Minnesota Department of Human Services (DHS) has awarded an Otter Tail County collaborative $1 million as part of a federally funded demonstration to better understand and expand the use of personal health records for older adults and people with disabilities receiving Medicaid-funded long-term services and supports.

The Otter Tail Personal Health Record Collaborative will use the funding from now through March 2018 to demonstrate the use of personal health records in Minnesota’s long-term services and supports system. The collaborative will also work with DHS and the federal government to test a standard for sharing service plans and other information related to community-based long term services and supports.

This initiative will help to make it possible for long term services and supports records to be shared with individuals and service payers across different service settings, including the person’s home, assisted living facilities, group homes, hospitals and clinics.

“The goal of this initiative is to develop a system in which data related to an individual’s long-term services and supports follows the person and is shared with appropriate parties, including the individual, to promote better overall quality of care,” said Loren Colman, assistant commissioner of the DHS Continuing Care for Older Adults Administration. “This system will also help to capture and report, with appropriate permissions, data related to quality and outcomes to improve the overall long-term services and supports system.”

The collaborative includes Otter Tail County Public Health, Otter Tail County Human Services, Lake Region Health Care, LB Homes, Pioneer Care, Lakeland Mental Health Center and Productive Alternatives. (Source: DHS)

 

 

State is fined for assaults

The Minnesota Department of Human Services was fined $63,000—the largest such penalty against a state agency in more than a decade—for failing to protect workers at the St. Peter psychiatric hospital from violent assaults by patients. Minnesota OSHA ordered the fine recently identified nine incidents between early May and mid-July that exposed employees to risk of serious injury or death, underscoring the challenges the state faces in maintaining order in a treatment facility that houses more than 200 of the state’s most violent and mentally ill patients.

The citation was issued within a week after another violent assault at the hospital. According to employees, a male patient attacked a female security counselor before co-workers intervened. The St. Peter Police Department is investigating the incident.

The recent OSHA report lists nine separate violations of state safety regulations in which employees “were not properly protected from workplace violence by an effective workplace violence prevention program.” Each of the violations is described by OSHA as “serious,” meaning death or serious physical harm has resulted or could be expected to result from the violation.

The Minnesota Security Hospital is the state’s largest psychiatric hospital. DHS has worked to make many changes at the hospital. Officials installed new security cameras; intensified staff training on how to de-escalate violent situations; acquired new protective equipment, such as forearm pads, for staff; hired more security counselors; and opened a new admissions unit in spring 2015 to protect new patients from more violent ones.

But state officials and hospital employees say efforts to curb violence have been hampered by a new state law that has forced the security hospital to accept more patients with criminal histories, who may be more prone to violence. In 2013, the Minnesota Legislature passed a law, known as the “48-hour rule,” that requires state psychiatric hospitals to admit county jail inmates within 48 hours after they are committed by a judge for mental illness. (Source: Star Tribune)

 

DHS terminates firm’s payments

The Minnesota Department of Human Services (DHS) has terminated payments to a large Twin Cities mental health provider accused of overbilling Medicaid by millions of dollars. The rare termination is part of a broader state effort to crack down on Medicaid fraud. But it has sparked worries that many people with psychiatric disorders could be stranded without necessary services.

The state agency, which oversees Medicaid, has notified 16 counties that it has stopped making payments to Complementary Support Services, a Richfield-based nonprofit that provides in-home mental health services to hundreds of children and adults across the state. The move comes in the wake of allegations by federal and state prosecutors that the company failed to provide proper supervision of its unlicensed staff and that it padded claims to Medicaid with charges not allowed under state law.

Prosecutors allege that the company broke state law by failing to ensure that its practitioners were properly supervised by licensed professionals. To disguise the agency’s lack of supervision, the agency’s director, Teri Dimond, “batch signed” thousands of patient reports—even while she was on maternity leave, prosecutors said. Other allegations are spelled on in a lawsuit recently filed in U.S. District Court in Minneapolis.

The decision to terminate payments affects about half of the estimated 200 Minnesotans who still receive services from the firm through Medical Assistance. DHS officials are working with counties and other health care plans to ensure that clients are not left stranded and to ensure that people get needed mental health care. But the company’s former and current employees told the Star Tribune that they are worried about people receiving services. (Source: Star Tribune)

 

Kirkbride saga continues in Fergus Falls

The long fight to save a former state institution’s historic buildings continues in 2016. The Fergus Falls City Council, historic preservationists and supporters of saving the former state hospital building in that community want to find a developer or developers for the building.

But the process has played out longer than initially predicted. In December the Fergus Falls City Council asked for more details on “mothballing” the Kirkbride Building in order to preserve and protect it for future use. The council expects to receive a more detailed report in January.

The cost of the mothballing process will likely require most, if not all, of the nearly $4 million in grant funds the city has access to from the Minnesota Legislature.

What happens when the mothballing is finished is anyone’s guess. One possibility is allowing for more films to be shot on the property. City officials met with a representative of the Minnesota Film and TV Board last week to discuss that, and a committee will be looking into the issue of filming and what guidelines should be used for allowing access to the building.

The Fergus Falls Regional Treatment Center is a former hospital located in Fergus Falls. It was built in the “Kirkbride Plan” style and opened to patients in 1890. Over the next century it operated as one of the state’s largest hospitals for the mentally ill. Persons with developmental disabilities and chemical dependency issues also were housed and treated on its campus. The hospital closed in 2005.

The building was added to the National Register of Historic Places in 1986. Various proposals have been made to repurpose the site and buildings since its closure but none have come to fruition. (Source: Fergus Falls Daily Journal)

 

Brain injury treatment scrutinized

The Department of Veterans Affairs has been using unqualified medical personnel to do examinations—and deny benefits—for traumatic brain injuries (TBI) at the Minneapolis VA Medical Center, according to records obtained during a year-long KARE 11 News investigation.

Instead of being examined by a specialist, records reveal more than 300 cases in which a veteran was examined by a doctor not qualified to diagnose traumatic brain injuries according to the VA’s own policies.

VA policy indicates that the initial diagnosis for TBI must be made by one of four specialists. But records obtained by KARE 11 through the Freedom of Information Act show that between 2010 and 2014, only one of the 21 medical professionals who conducted initial TBI exams at the Minneapolis VA was a qualified specialist. The disclosure has prompted a federal investigation to determine whether similar improper exams were done at other VA facilities nationwide.

VA data revealed the number of veterans affected. Instead of being examined by a TBI specialist, records reveal 321 cases in which a veteran was examined by a doctor VA policy shows was not qualified to diagnose traumatic brain injuries.

To date, the Minneapolis, VA has re-examined 181 of those veterans and determined the unqualified doctors made quite a few mistakes. In 50 cases, an exam by a TBI specialist revealed the veterans did in fact have brain injuries and should be getting treatment and benefits previously denied. Now a nation-wide review mandated by Congress into how the VA has handled traumatic brain injury benefits exams is currently underway. KARE 11 and its parent company are fighting to get VA records nationwide. (Source: KARE 11)

 

Abuse allegations delay hiring

The Minneapolis School Board has suspended contract negotiations with the man selected to the new superintendent for Minneapolis Public Schools, in the wake of allegations of possible student abuse by staff in Sergio Páez’s previous district.

The board suspected the hiring in December and will revisit the issue January 12. Members launched their own fact-finding mission in Massachusetts. The Disability Law Center of Boston, a federally funded group, brought the abuse allegations to light in a report issued last week that alleged “a disturbing pattern of excessive physical restraint and psychological abuse of youngsters with disabilities by staff at the Peck School in Holyoke, Massachusetts.”

The Peck School is where Páez previously served as superintendent. That county’s prosecutor is doing a separate criminal investigation.

“It’s serious, it’s absolutely serious—it’s concerning obviously,” said Páez in a phone interview with KSTP-TV. “I’m working very closely with the state so we have a response to the allegations.” Páez said he was unaware of some of the allegations mentioned in last week’s report.

Minneapolis school officials had paid the search firm, Hazard, Young, Attea and Associates up to $85,000 to screen candidates—a process that involves background checks, interviews and credit history. But the examination of Páez’s work history failed to turn up allegations of excessive restraint. (Source: KSTP-TV)

 

Sheltered workshops to make changes

Sheltered workshops that employ thousands of Minnesotans with disabilities, often for just pennies an hour, would be forced to make drastic changes under a state proposal to eliminate a share of their public subsidies. The Minnesota Department of Employment and Economic Development is expected to approve a plan that would phase out nearly $2 million in annual subsidies and replace them with incentives to move employees into the general workforce.

“It’s time to say, ‘No more,’ to this assumption that people with disabilities can’t work” in the community, said Kim Peck, director o vocational rehabilitation services at the department, told the Star Tribune. “Let’s throw that out and say, everyone needs to contribute and can contribute and how can we … make that happen.”

A recent Star Tribune investigation found that many of these workshops segregate people in cloistered work environments at low pay and with little hope for advancement into the competitive workplace. The proposal would be phased in over five years and affects just a small part of the state’s total spending on sheltered workshops, it marks the first major step in decades to reform facilities that have long been a mainstay of Minnesota’s system of support for people with disabilities. With reduced funding, many of the state’s no profit workshop operators will be pushed to redirect their focus to supporting workers in typical jobs in the community that pay at least the minimum wage, state officials said. (Source: Star Tribune)