Regional News -- September 2021

Regional News -- September 2021

Compassionate Allowances to save time

Kilolo Kijakazi, acting commissioner of the Social Security Administration, has announced 12 new Compassionate Allowances conditions:  Charlevoix Saguenay spastic ataxia (ARSACS), choroid plexus Carcinoma, CIC-rearranged sarcoma, congenital zika syndrome, desmoplastic mesothelioma, Duchenne muscular dystrophy – adult, pericardial mesothelioma, refractory Hodgkin lymphoma, Renpenning syndrome, SCN8A related epilepsy with encephalopathy, SYNGAP1-related NSID, and Taybi-Linder syndrome.

Compassionate Allowances is an initiative that quickly identifies severe medical conditions and diseases that meet Social Security’s standards for disability benefits.

“Everyone who is eligible for benefits under the programs we administer should receive them,” said Kijakazi. “Our Compassionate Allowances program helps us address barriers by helping accelerate the disability application process for people who are likely to get approved for benefits due to the severity of their medical condition.”

The Compassionate Allowances program quickly identifies claims where the applicant’s condition or disease clearly meets Social Security’s statutory standard for disability. Due to the severe nature of many of these conditions, claims are often allowed based on medical confirmation of the diagnosis alone; for example, certain cancers, amyotrophic lateral sclerosis (ALS), and a number of rare disorders that affect children. To date, more than 700,000 people with severe disabilities have been approved through this accelerated, policy-compliant disability process, which has grown to a total of 254 conditions.

When a person applies for disability benefits, Social Security must obtain medical records in order to make an accurate determination. The agency incorporates leading technology to identify potential Compassionate Allowances cases and make quick decisions.  Social Security’s Health IT brings the speed and efficiency of electronic medical records to the disability determination process. With electronic records transmission, Social Security is able to quickly obtain a claimant’s medical information, review it, and make a fast determination.

For more information about the program, including a list of all Compassionate Allowances conditions, visit www.socialsecurity.gov/compassionateallowances. To learn more about Social Security’s Health IT program, please visit www.socialsecurity.gov/hit. People may apply online for disability benefits by visiting www.socialsecurity.gov. To create a my Social Security account, visit www.socialsecurity.gov/myaccount.

Check new state provider list

The state’s new assisted living protections began August 1, so families can easily check a facility’s status. The Minnesota Department of Health (MDH) has posted an online list of the facilities approved to be licensed as assisted living facilities. The new list of facilities will be updated daily at the Assisted Living Information for Consumers, Families and Caregivers site. The site also offers other resources including the Minnesota Assisted Living Bill of Rights and frequently asked questions for consumers.

“Checking to see whether your facility was approved for an assisted living license can be a simple way to confirm that your facility is on track with this process,” said Health Commissioner Jan Malcolm. “This is an important time to be aware of these changes and to be in communication with your provider about any possible changes in services.”

The number of providers applying for assisted living licenses exceeded expectations given the number of assisted living-type facilities in the state. MDH accepted a total of 2,006 applications (1,414 assisted living facility applications and 593 assisted living with dementia care facility applications) for a total capacity of 57,636 residents.

Minnesota’s assisted living-type facilities mostly serve seniors. Most of those who live in an assisted living-type facility, dementia care or housing with home care will not experience significant changes in their services due to the new licensing program. However, some residents may have seen changes in August, and in some cases those changes may make it necessary for residents to find a new service provider or even a new place to live. Providers were required to notify residents of their licensing plans by May 31.

MDH also announced adoption of the new state rules that, paired with the new statutory regulations, will govern assisted living facilities. These rules were published in the State Register on July 19.

Some of the new benefits and protections for residents in the rules include the following:

Assisted living facilities will be required to develop an emergency preparedness plan that is uniquely tailored to the facility to ensure it has sufficient training, supplies and leadership to address a broad range of emergencies.

Registered nurses must conduct initial assessments and reassessments of residents in the assisted living setting.

Assisted living licensure rules establish staffing appropriate to best protect the health and safety of residents no matter their vulnerability, requiring facilities to have a staffing plan that guarantees the facility staffing levels that meet the needs of residents. 

Residents in assisted living facilities now have the right to appeal an eviction or termination of housing and services to allow the Office of Administrative Hearing to determine if termination was fair and just.

There are now two licensure types. assisted living license and assisted living license with dementia care. The two licenses replace the combined Comprehensive Home Care License and the Housing with Services registration, which were discontinued July 31.  The new assisted living reforms set higher expectations for providers and create more protections for people living in assisted living establishments. They also create clear pathways for accountability and better services for residents of assisted living facilities.

(Source: Minnesota Department of Health)

Human rights turnover is a worry

St. Paul’s Department of Human Rights and Equal Economic Opportunity, or HREEO, has been led by five directors or interim directors in three years, injecting uncertainty into day-to-day operations at a time when disability rights and a slew of other issues are increasingly taking priority in the city.

The department is currently led by interim director Kristien Butler, following the abrupt departure of former director Valerie Jensen in April.

“They’ve really got to find someone to restore morale,” said a former member of the HREEO Commission, a citizen board that meets monthly to discuss the work of the department. “Really, it’s a morale thing. Staff morale is just so low.”

“Over the past several years, the Department of Human Rights and Equal Economic Opportunity has experienced a number of workplace challenges involving individuals no longer employed by the city,” said Deputy Mayor Jaime Tincher. “Much of the information surrounding the circumstances of these personnel matters are not public under Minnesota law. Despite those challenges, we have continued to benefit from the incredible work of our HREEO staff who have worked tirelessly throughout the pandemic.”

The department has had a number of lower-level positions turn over or sit vacant. From human rights investigators to contract compliance officers, several employees say they’re juggling the jobs of two or three workers. Even entry-level employees have been forced to absorb job duties that would ordinarily fall to more seasoned supervisors.

In October 2018, the St. Paul City Council approved a $250,000 settlement agreement with Kingston, who had accused the police department of unprofessional conduct toward her and her staff, a claim the police chief denied. As part of the agreement, Kingston agreed to drop a state human rights complaint and not try to get her job back.

(Source: Pioneer Press)

Responses changed to certain calls

A change to the state’s use-of-force laws puts officers in a bind, some law enforcement agencies contend, because it makes unclear their liability if they reach for their gun to defend themselves or others in a “suicide by cop” situation. Rather than risk breaking the law, some departments have declined to send officers for calls about people in a mental health crisis.

“We have had now police and sheriffs refuse to respond to suicide calls. And it’s hugely problematic,” National Alliance on Mental Illness (NAMI) Minnesota Executive Director Sue Abderholden said. “We just really believe that yes, ‘suicide by cop’ is a real thing but it is a very small percentage. And we do need officers at times responding to suicide calls.”

The Minnesota Legislature in 2020 passed a slate of police accountability measures months after George Floyd was murdered by an officer while in the custody of Minneapolis police. The measure’s supporters said that in the wake of Floyd’s murder, the state needed to do more to prevent police violence and to hold bad officers to account. Lawmakers limited the conditions in which law enforcement officers can deploy deadly force.

The law states that officers can use lethal force only when an officer or a bystander is at risk of serious injury or death. The officer needs to be able to prove based on what they knew at the time that the force was justified.

That language has spurred confusion about when officers could use deadly force against a person who is attempting to hurt himself or herself. And while police and mental health groups are working to provide best practices for approaching the situations, departments have put forth different guidance to officers in the meantime.

Concerned Minnesotans brought the issue to NAMI’s attention, Abderholden said, but it wasn’t clear how many mental health crisis calls had gone unanswered due to different interpretations of the deadly force policy. Abderholden said the statute has also prompted some officers to avoid mental health transport calls out of concerns for officer liability in communities around the state.

House Public Safety Committee Chairman Carlos Mariani (DFL-St. Paul), wrote the 2020 police accountability package and worked to get it passed through the divided Legislature. He said stakeholder groups involved in crafting the legislation failed to raise concerns about potential issues at the time.

Minnesota Chiefs of Police Association Executive Director Jeff Potts said individual police departments had to weigh the risk to the person in crisis against the potential risk to the officer responding. They also had to consider their liability in meeting their duty of care to the community.

Law enforcement groups, mental health advocates and the Minnesota Attorney General’s Office since June have been meeting to clarify the policy and to write recommendations for how officers should approach it. Leaders involved in those talks said they hoped to have guidance finalized soon.

(Source: Forum News Service)

Northland company welcomes increase

This summer dozens of people who work as direct care staff for people with disabilities got some welcome news: Their wages were increasing by about 20 percent, to at least $16 an hour. In Greater Minnesota where hiring can be a huge issue for many businesses, the increase is especially welcomed.

Tender Loving Care, a Duluth area disability service provider, is raising its pay rates. Its staff work in St. Louis and Carlton counties.

“We really focus on providing supports for people who want to live independently,” Tender Loving Care Director of Operations Ryan Underwood said. “So we don’t own our own homes. We work with people to live in their own apartments and family homes, help them find jobs in the community, really just live with independence.”

Starting wages at Tender Loving Care will now be $16.

Underwood said early in the pandemic, like so many businesses, they had to make tough decisions. They even cut a program. But in that process, he said they’ve learned to do more with less.

“We’re in a position now where we could go and expand our upper part, our administration, back to what it was or we can reinvest in our workforce. And that’s what we’ve decided to do,” he said. “So take the cost savings we’ve realized, the efficiencies, and just give it back to the people providing the direct care.”

Because reimbursement rates are set by state and local government, it can take years for rates to catch up, making it tough to pay people more.

The agency typically has about 50-60 direct care staff. Underwood said hiring challenges haven’t hit them as hard as other businesses, but since announcing the wage increase, they have gotten in more than a dozen applications.

(Source: WDIO TV)

Looking at neurodivergent needs

For Bobby Hahn, having a high-functioning form of autism spectrum disorder is a double-edged sword. “My Asperger’s syndrome is an advantage for thinking analytically and problem solving. I can see things other people can’t. In terms of social interaction, it doesn’t help me. I’m awkward in conversation and I don’t pick up on signals. And I’m disorganized.”

Hahn is an incoming senior at the University of Minnesota. When he started applying for college, he referenced his Asperger’s in his admissions essay. He also posted a near-perfect math SAT score and musical extracurriculars. He was accepted by three of the four colleges where he applied.

The one college that didn’t offer the St. Paul student a spot happens to be the alma mater of his father, Rob Hahn.

“I e-mailed the admissions office to ask how they factored his autism in the decision, and they didn’t have an answer,” he said. “They say they take a holistic approach to admissions, but the back-and-forth showed me they just didn’t get it.”

That rejection set the father on a quest: to change how college admissions offices regard people who are “neurodivergent,” an umbrella term that includes people who are on the autism spectrum or have ADHD, dyslexia or other learning challenges.

“I want to create a shift, to get people thinking differently about people who think differently,” Rob Hahn said. “Schools are missing out on some of the brightest individuals who don’t fit in their neat little categories.”

The owner of a public relations business and an independent filmmaker, Rob is producing a self-funded documentary called “The Neurodiversity Challenge.” He’s hired a videographer to trail him as he travels the country, recording his visits with university provosts, higher education advocates and students. His aim is to persuade admissions offices to add an optional box that neurodivergent students can check to self-identify in their applications, adding that to the demographic data that colleges collect from incoming students about their race, ethnicity and gender.

He believes that simple change will not only help colleges acknowledge the value of neurodivergent students, but propel them to actively recruit students like his son.

“I’m arguing for another form of diversity that colleges should take into consideration when they’re building a class profile and thinking about the learning environment for everyone,” he said. “Neurodivergent students bring a unique perspective, and their talents strengthen institutions.”

(Source: Star Tribune)

Catholic schools provide training

Staff with Catholic schools across the Twin Cities metro area came together recently to prepare for the upcoming school year. But the training did not focus on academics. Instead, it was centered around mental health and wellness.

“When a child walks through a classroom, you can tell in the first few seconds what that child’s morning was like. It’s really unfortunate to think that that child maybe had a rough morning dealing with something and we’re going to have that child sit down and anticipate that they’re ready to learn. Well, we need to realize that not everybody is at that spot at every moment of the day,” said Brian Ragatz, president of Catholic Schools Center of Excellence (CSCOE).

The nonprofit created the mental health initiative “Peace of Mind” in the midst of the pandemic last year. The goal is to help not only students but also parents and school staff work through struggles and improve mental health and well-being both inside and outside of the classroom. 

CSCOE funds the initiative at no cost to schools. 

The pandemic has spurred more conversations around students’ mental health.

“Kids have been really impacted by this in so many different ways. They’ve had… highly increased anxiety; they’re worrying about their families; they’re worrying about their health; they’re being exposed to issues and questions that children usually don’t have to face like serious illness. They’ve lost people in their lives,” said Sarah Lilja, an elementary school counselor at Presentation of Mary School in Maplewood.

The area training was held at St. Peter’s Church in Mendota.

“I wanted to do this training so it’s not just my teachers who understand what social emotional learning (SEL) is. I have my administrative assistant from the office here, my advancement director, my custodian, because all of these adults touch children’s lives on a daily basis,” said Dawn Biren, principal at St. Dominic School in Northfield.

Biren said they spent last year focused just on the staff learning about SEL. Now they are ready to bring that support to their students. 

“Social emotional learning, a lot of Catholic schools we say we educate the whole child. Mind, body and spirit. This is a way of helping our children with the mind piece of it,” Biren said.

Teachers will get coaching throughout the entire school year as well as counseling support.

(Source: KARE-11)

More police claim PTSD

The wave of Minnesota police officers leaving the profession in the wake of George Floyd’s 2020 murder combined with a new state law making it easier to get state disability benefits for post-traumatic stress disorder is creating what the League of Minnesota Cities calls an unsustainable fiscal situation.

Law enforcement advocates say the League, which operates an insurance trust, is denying most workers’ compensation PTSD claims, forcing police officers and firefighters to either use their vacation time, take an unpaid leave of absence or apply for disability retirement.

The number of Minnesota police officers and firefighters applying for disability retirement tripled in the past fiscal year, with 79 percent of applicants saying they can’t do their jobs due to PTSD.

The Minnesota Public Employees Retirement Association administers several state retirement plans, including a police and fire fighter plan, which includes a disability benefit until age 55, when they’re eligible to retire. Employees who retire early due to a disability can get paid 60 percent of their salary tax-free until age 55. If they also get workers’ compensation, they can often make just as much as when they were working — and cities must continue to provide them health insurance until they’re 65.

Anne Finn, lobbyist for the League, said the cost of workers’ comp claims and health insurance for what’s known as a “duty disability retirement” has created a fiscally unsustainable situation for public employers, and, in turn, taxpayers.

Finn said duty disability benefit applications have been going up for years, but the law was changed in 2019 to make it easier for emergency responders to claim PTSD disability; now the presumption is if they have PTSD, it’s job related.

“The trends are really troubling,” Finn said.

A working group is tackling these issues and may seek changes at the legislature.

(Source: Minnesota Reformer)