June 27, 2016
Dear Member,
On behalf of the LeadingAge Minnesota Board of Directors, I am pleased to provide you with this comprehensive report summarizing the 2016 Legislative Session. We have designed this summary as a reference tool for you to use to better understand the new provisions in Minnesota law that affect providers of older adult services.
While this Legislative Report covers the outcome of the session, we know that as state agencies begin to interpret these new laws, there will be additional information on implementation that you need to know. Therefore, we will once again make available an expanded version of this report online with links to complete bill language, related state agency bulletins, and other tools and resources for implementation. This members-only benefit will be available at shortly.
As always, we are available to assist you with any questions or technical assistance you may need—don’t hesitate to give us a call.
Along with the LeadingAge Minnesota staff, I want to thank you for your advocacy this year and encourage you to continue this engagement into the 2016 campaign season. We are counting on you and your staff to engage current legislators and candidates in discussions about the important issues surrounding the field of older adult services.While the next legislative session is months away, we have already begun our work on enhancing our advocacy strategy for the 2016 session and beyond.
We are grateful for the opportunity to represent you and your missions of service at the State Capitol.
Sincerely,
Gayle M. Kvenvold
President and Chief Executive Officer
Table of Contents
Overview: 2016 Session / Page 5Media Relations / Page 8
General / Page 12
All Payer Claims Database / Page 13
Assault Motivated by Bias (Age) / Page 14
CARE Act / Page 15
Dispense of a 90-day Prescription / Page 16
Dual Training (PIPELINE) Grants / Page 17
Electronic Monitoring Workgroup / Page 19
Health Information Technology (HIT) / Page 20
Loan Forgiveness Promotion / Page 21
Long Term Care Ombudsman Final Rule / Page 23
Medical Cannabis / Page 24
Quality of Care Complaints / Page 25
Temporary Health Care Dwellings / Page 26
Housing/HCBS / Page 29
Anti-Spousal Impoverishment / Page 30
Deletion of Obsolete Home Care Language / Page 31
Disability Waivers DHS Website Update Requirements / Page 32
Exclusions from Home Care Licensure Requirements / Page 34
Group Residential Housing / Page 35
Home Care Advisory Council Changes / Page 36
Immediate Temporary Suspension of Home Care License / Page 37
MnCHOICES Assessment / Page 38
Olmstead Plan / Page 39
Care Centers / Page 41
Moratorium Exceptions Process Funding
Nursing Facility Consolidation Program Update / Page 42
Page 43
Nursing Facility Recodification / Page 44
Pharmacy Collection of Controlled Substances and Other Drugs / Page 45
Scholarship Program Update / Page 46
Technical Correction to Value Based Reimbursement / Page 47
2017 Session Outlook / Page 49
Our Process / Page 53
Overview: 2016 Session
The tone of the 2016 session was beginning to form even before lawmakers returned to St. Paul on March 8 and could be described using one phrase: low-expectation setting. During the interim, lawmakers in both bodies and in both parties were telling their constituents, as well as the media, not to expect much coming out of the short, 12-week session.
Legislative leaders said their work would be laser focused on three major issues considered to be unfinished from last session: transportation, taxes and bonding. The tone of the legislature, paired with a shortened time-frame, made 2016 an uphill battle for many organizations to pass their priorities.
Leading up to the 2016 session, LeadingAge Minnesota began laying the groundwork for our three legislative priorities: secure a 5% rate increase for Home and Community Based Services (HCBS), build the pipeline of professional caregivers through a career promotion campaign and protect the new nursing home reimbursement system. This groundwork occurred through members inviting their lawmakers into their communities to educate them about the importance of HCBS settings, highlight the hard work of our caregivers and showcase the benefits of the new payment system.
The February Budget Forecast was released just days before the Legislature convened, projecting a $900 million surplus for the FY16-17 biennium. Although the forecast revealed a positive projection, this number was $306 million less than the budget projection made in November. The reduction was attributed to lower than projected sales and income tax and a slower growing economy. It was the largest reduction swing since 2007-2008. As a result of the decreased surplus, Senate Majority Leader Tom Bakk urged caution to groups seeking large investments and said “everything got a little harder” with this budget forecast.
It soon became clear with the decreased February forecast that there would not be funding in the education budget to support this workforce package. Nevertheless, our proposal did meet all committee deadlines which enabled LeadingAge Minnesota staff to present our workforce challenges and potential solutions in front of the Higher Education committees in the House and the Senate. This is the first time that long term care issues have been before these committees and provided an opportunity to educate lawmakers about the needs of our aging population.
With respect to the 5% rate HCBS increase, there was bipartisan support throughout session with 82 House authors and 34 Senate authors signed on in support of the bill. LeadingAge Minnesota continued to put the pressure on lawmakers with weekly emails and calls urging them to find the money needed to make this important investment. This message was well-received and supported by lawmakers, with several making comments during committee meetings about the number of grassroots messages they had received. However, despite this support, the Legislature failed to support a rate increase for HCBS this session.
While we were disappointed that HCBS did not receive a rate increase, our messaging and commitment to reform and quality opened the door for waiver reform in upcoming legislative sessions. This sentiment was shared by several lawmakers, including bill author Senator Kent Eken (DFL-Twin Valley) who stated, “I am extremely disappointed that we could not include an increase to the hardworking caregivers working in home and community-based services. There is a workforce crisis in these settings, and I hope to bring back reform to these providers next year.”
Elderly Waiver (EW) Reform work is well underway and began even before the end of the 2016 session with the creation of a joint working group. The working group, composed of members from LeadingAge Minnesota and its partner in the Long Term Care Imperative, is tasked with developing a proposal to reform payment and housing policy for EW clients in time for the 2017 legislative session
Legislative Advocacy
LeadingAge Minnesota was once more joined by our Contract Lobbyist Judy Cook and her team at Cook Girard. LeadingAge Minnesota continues to coordinate advocacy activities at the Capitol with our partners in the Long Term Care Imperative. The Long Term Care Imperative welcomed back Todd Rapp and his team at Himle Rapp and Company, Inc. to assist with public relations and advocacy. Todd Rapp engaged Swim Creative to begin phase two of our FaceAging MN campaign, which is designed to raise awareness and grow the conversation around the challenges facing our aging population.
During session, our team worked together with committee chairs, committee members and staff, provided information at meetings, and testified in several different committees, including a few committees outside of our typical Health and Human Services jurisdiction.
Coalition Work
LeadingAge Minnesota continued to be a member of the Best Life Alliance, formally known as the 5% Campaign. The Best Life Alliance is a broad coalition of advocates for people with disabilities and aging Minnesotans. Through our participation in the Best Life Alliance, LeadingAge Minnesota coordinated grassroots activity such as calls, emails and letters to lawmakers.
Grassroots Advocacy
With the short legislative session, LeadingAge Minnesota’s grassroots advocacy began during the interim – starting as far back as the beginning of September. During this time, LeadingAge Minnesota members hosted 70 lawmaker tours at their communities and sent nearly 1,000 testimonial postcards. These tours and postcards laid the foundation for Elderly Waiver Reform, educated lawmakers on the difference between nursing homes and Home and Community-Based Services options, showcased the importance of the new value-based reimbursement system for nursing homes, and provided the opportunity for lawmakers to hear directly from older adults and their caregivers.
Here are some quotes highlighting the impact these tours had on lawmakers:
Representative Torkelson: “We need to come back in 2017 and reform the Elderly Waiver system like we did with the nursing homes so that it is tied to the true cost of care.”
A caregiver shared with Representative Norton: “As a single mother, this increase [from the new payment system] meant the world to me and my family – thank you.”
A family member explaining what Adult Day Services mean to her family to Representative Youakim, “My husband was diagnosed with early onset Alzheimer’s. Without the partnership of Adult Day Services, I honestly do not know where my husband and I would be. These services, as the disease progresses, are a life-saver.”
“We now have the ability to compensate our workforce at a competitive wage so that we can recruit and retain talented individuals,” saidRob LaHammer to Speaker Kurt Daudt.
“We need more home and community-based services like this in Minnesota in order to continue to serve our growing aging population. As lawmakers we need to make sure that the reimbursement rates at the state allow seniors of any income to live in these types of settings,” said Representative Dave Baker.
Our grassroots advocacy continued with weekly calls and emails from LeadingAge Minnesota members through our Engage network. Over the short twelve-week session, we sent more than 2,600 emails to lawmakers and made hundreds of personal phone calls. Our goal is to continue this strong grassroots advocacy into the campaign season.
Capitol News Update
We again hosted Capitol News Update this year with a slightly different twist. Instead of a live interactive webinar, we sent brief recorded YouTube updates so that members could watch whenever convenient. These broadcasts were open to all LeadingAge Minnesota members and designed to inform our members of our weekly advocacy activities, including meetings with legislators, developments in hearings and key decisions made by lawmakers. We also provided updates on our grassroots advocacy.
Day at the Capitol
Even with the Capitol under construction, we were still able to host our very popular Day at the Capitol. We had nearly 150 members from across the state attend our annual lobby day. After receiving an update on the dynamics of the State Capitol this session, a preview of the upcoming elections, a briefing on our 2016 legislative agenda and tips on how to share our message, the group met with their lawmakers. The day allowed legislators to visit directly with our members and hear their stories.
In the coming months, LeadingAge Minnesota will continue to focus on maintaining and increasing the understanding of our issues by key legislators, legislative leadership, the Administration and the general public, as well as continuing our Face Aging MN campaign to generate broader public supportfor how the State of Minnesota cares for its growing aging population. We will also turn our attention to the elections, and will be providing tools to help members educate candidates about the challenges we face serving a growing aging population.
Media Relations
With the late start of the legislative session in 2016, LeadingAge Minnesota took full advantage of the extended interim to build awareness and secure ongoing support for our efforts to reform how Minnesota cares for its aging citizens. As part of our grassroots advocacy, we engaged our members in a proactive media relations strategy to spread the word of Senior Care Reimbursement Reform as well as lay the groundwork for the need to similarly reform waivered services for home and community-based services.
We encouraged our members to invite the local press to their site during the lawmaker visit, write thank you letters to lawmakers for their support of Senior Care Reform, and to submit letters to the editor publicly acknowledging the support of their local lawmakers, demonstrate how the increased funding for care centers will be used to improve the quality of lives for seniors and those who provide them with care, and call on lawmakers to join us as we set out to reform waivered services.
The more than 50 visits that took place prior to the start of the 2016 legislative session in February generated many local news stories, and included such headlines as:
- Nursing Homes Get Millions in Funds (Fergus Falls Journal, June 22):
- New Legislation Allows Nursing Homes to Offer More Competitive Pay (Waseca County News, Oct. 20)
- New Year, More Money for Nursing Homes (Rochester Post Bulletin, Jan. 1)
- Nursing Homes See First Big Pay Raise in Years (Ely Timberjay, June 26)
These stories were then cross-promoted via the LeadingAge Minnesota social media channels (Facebook, Twitter) as well as by individual lawmakers.
As we approached the start of the 2016 legislative session, we continued to receive positive media coverage based on lawmaker visits and noticed more mentions of the need to support reform of waivered services that help lower income Minnesotans age in their homes and communities.
Running parallel to our Association’s media relations strategy, was Phase 2 of the Face Aging MN campaign. Face Aging MN, a public information campaign conducted in collaboration with our partner in the Long Term Care Imperative, sparked a conversation on aging in its first phase that helped us raise awareness of the state’s fast growing aging demographics on long term services and supports and secure support from lawmakers to ensure access to quality senior care from experienced caregivers.
The goal for second phase of Face Aging MN was to turn awareness raised during the initial phase of the campaign into action – action that helps us create a smarter and better way of supporting seniors in all the places they choose to live and raise up the career of caregiver as one of the most sought after and honored professions in our state.
Elements of the Phase 2 campaign included:
Advertisements in the state’s daily newspapers, including geographic targeting in key legislative districts and in counties with a high population of aging Minnesotans.
Digital media ads that capitalize on the growing trend of social media as a key source of information for our targeted audience.
Billboards in 18 locations across the state, again targeted at key legislative districts in counties with a higher population of aging Minnesotans.
Sponsorship of MPR Programming during periods of high listenership for two of our target audiences – lawmakers and influential stakeholders.
A new, vibrant web site that showcases stories of Senior Care Reimbursement Reform and the caregiving profession, and provides consumers with aging readiness information.
A community relations toolkit members can use to host Face Aging MN meetings with key stakeholders, residents, families and lawmakers to generate more support for the collective action we need to ensure issues related to seniors and their caregivers remain at the forefront of the state policy agenda.
One goal of the campaign was to drive more traffic to the Face Aging MN web site to get people engaged in our campaign to change the way we see aging from a burden we manage to a responsibility we embrace.
Throughout the legislative session, the Face Aging MN campaign’s steady flow of advertisements, radio sponsoring, social media posts and digital media advertisements kept the question focused on how do we shift thoughts on aging from “a burden we manage” to a responsibility we embrace.
“Minnesotans want what we want -- to live well as they age, to grow old in the community they call home, and to be supported by committed, talented and amazing caregivers should they need that help. If we can bring them alongside us in our quest to make our vision of aging well a reality, we will achieve the reforms needed to ensure the services and supports are available to them as they age,” said Gayle Kvenvold, President and CEO, LeadingAge Minnesota when she introduced phase two of the Face Aging MN campaign to members and caregivers at the Institute in February.
In addition to Face Aging MN, LeadingAge Minnesota was also a partner in the Best Life Alliance. The Best Life Alliance, formerly known as The 5% Campaign, is a group of organizations serving seniors and people with disabilities that came together to advocate for a five percent rate increase for home and community-based services at the State Capitol. The Best Life Alliance implemented a dual earned media and social medial strategy heavily focused on sharing stories about the need for increase funding to provide a wage increase to caregivers in these settings.