Home Care Provider Advisory Council Meeting Minutes
June 8, 2015
Attendance
Members present: Cheryl Hennen, Amy Nelson, Suzan Sinna, Jean Peters
MDH representatives present: Lari Anne Mazzitello, Cindy Vargas, Alice Sanders, Jeri Cummins
Brief Introductions
Forwarded to next meeting: Due to construction and traffic conditions, no council was present
at the beginning of the meeting.
Location of HCPAC Information on Website (Cindy Vargas)
Cindy Vargas discussed that all information including meeting dates, times, locations, and
minutes can be found on the Home Care website at:
http://www.health.state.mn.us/divs/fpc/homecare/advcouncil/index.html.
Comprehensive Surveys (Alice Sanders & Jeri Cummins)
Alice Sanders and Jeri Cummins updated the community on trends in surveys. Since January
2015, the Home Care and Assisted Living Program (HCALP) conducts an average of 10 surveys
per week. Most surveys are for basic and comprehensive licenses. Temporary licensed
providers are averaging fewer citations than permanent license holders. The range of
deficiencies per survey is 0 - 31. Common citations include:
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Lack of two-stage Tuberculosis (TB) screenings
Missing information in service plan documentation
Client assessments not performed or performed by unlicensed staff
Improper bed rail usage
Medication management plans and treatment plans not used or not clearly defined
Lack of proper documentation of training and demonstration of competency by
licensed staff when tasks are delegated to unlicensed staff. Registered nurses (RN) are
eligible to train, certify competency, or delegate tasks to unlicensed personnel
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according to state statutes. Certified nursing assistants (CNA) and licensed practical
nurses (LPN) are not eligible.
The main citation on surveys for basic license holders is that providers are providing services
outside of the scope of the license. A common example is hands-on assistance with mobility.
Survey Results are Now Emailed (Alice Sanders)
Survey results for all HCALP surveys are now being emailed to providers in addition to mailing
hard copies of the results. At the time of surveys, HCALP is confirming email addresses. They
are in transition to eliminate mailing hard copies and only email survey results to providers.
Innovation Variance (Carol Insley)
Carol Insley is requesting an innovation variance for Granite House. Granite House is a nonprofit organization that plans to serve clients with severe brain injury in a long-term care
environment. They are planning on a 4, perhaps 5, bed capacity. They are requesting a
variance because Granite House will provide care for their son, and guardians of clients cannot
be owners, managers, or board of directors for the same provider. They would like to retain
guardian rights as well as be able to serves as owners, managers, or board members for Granite
House. They are working on discharge policies and procedures for Granite House and
understand that they would not be able to give preferential treatment to their son if he no
longer met the minimum criteria for care. They plan to be ready in Fall 2015 or Spring 2016 for
bidding and constructing the facility. MDH is looking to the council for recommendations and
ideas on this variance request. Council should give direction to the provider regarding criteria
for which the council would consider a variance including:
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Whether they should be a for-profit or non-profit entity
Discharge criteria for clients
Any conflicts of interest
How the client’s parents could manage guardianship versus management duties
MDH Communication to Providers (Cindy Vargas)
The Minnesota Department of Health (MDH) sends communication inserts to providers in
monthly renewal letter mailing. They are updated regularly as important topics change.
Provider Application Process (Cindy Vargas)
HCALP is inviting some home care applicants to meet (in-person or via teleconference) as a part
of the license application review. The assessment meetings do not extend the length of the
processing time, which remains at 30-60 days after MDH receives a completed application. The
purpose of the meetings is to assess applicants’ knowledge of home care laws (as required by
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statute), to provide education, and answer applicants’ questions. Applicants are invited to a
meeting if their application materials raise questions about their knowledge of home care laws.
Not all applicants are invited for a meeting. Approximately 53 new licenses have been issued
since the new home care statutes became effective in January 2014.
Updates (Cindy Vargas)
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MDH proposed a unified Bill of Rights to the legislature. It is tabled for this year and will
be brought back next year.
Statutes were amended for dementia language.
HCALP identified some key changes in statutory wording that need to be modified.
The Minnesota Adult Abuse Reporting Center (MAARC) will be the statewide reporting
point for adult abuse previously referred to county Common Entry Points (CEP).
Methods of communicating changes to the public include HCP Advisory Council
meetings, GovDelivery.com email notifications, MDH letter inserts, and other tools.
The Home Care Laws & Rules statute book is available online at the Minnesota
Bookstore for $21.00.
Ombudsman Report (Cheryl Hennen)
Cheryl Hennen recommended signing up for the MAARC briefing or streaming it online on June
25, 2015. She reported that all training sites in the metro area were full. A vulnerable adult
policy is needed. She acknowledged that defining a risk assessment is difficult in situations
where you only provide services about 3 hours per week. It is also difficult to write a plan in
situations of self-abuse or self-harm. She indicated that care plans are not being revised over
time. Initial assessments and care plans are great, but later plans lack incorporating known
risks. She requested a template to help keep care plans updated. A common problem is that
known risks are not transferred into care plans. A question was asked if risk assessments must
be performed by an RN. In answer, Ms. Hennen stated that while statutes do not specifically
address risk assessments, they do mandate that assessments in general must be performed by
a licensed RN.
Next Meeting
The next meeting is scheduled for Monday, September 14, 2015, 3:00 pm – 5:00 pm. It will be
held at the Wilder Foundation in Auditorium C/D.
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