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Legislators face fork in the road on elder abuse reform

House Photography file photo
House Photography file photo

The myriad horror stories from Minnesota elder care facilities unveiled in a newspaper expose last year demanded state government do something to protect seniors from harassment and unnatural death. The problem is, that government is divided on what to do: institute decisive reform now or wait and study the issue further before committing.

A consumer workgroup ordered by Gov. Mark Dayton in November found Minnesota to be the only state that does not have a licensing system for assisted living facilities. Instituting licensing for them, and a certification system for providing memory care to people with dementia, are strongly recommended by the working group.

Rep. Liz Olson (DFL-Duluth) sponsors HF3468, directly informed by the work group, which would take direct, abrupt action to address the problem. It would require the licensure of assisted living facilities and the certification of those providing dementia care. It would also allow families to place cameras in the rooms of elderly loved ones to monitor their care. 

Olson was heartened by the support of Republican lawmakers for the bill: Senate President Michelle Fischbach (R-Paynesville) joined Dayton in announcing the new proposals. In the House, Rep. Rod Hamilton (R-Mountain Lake), Rep. Jon Poston (R-Lake Shore), Rep. Tim O'Driscoll (R-Sartell), Rep. Jason Rarick (R-Pine City), Rep. Mark Uglem (R-Champlin) and Rep. Joe McDonald (R-Delano) are co-sponsors along with a host of DFLers.

However, that bipartisan support does not appear to be enough.

Olson’s bill never received a hearing by the House Health and Human Services Reform Committee. When Olson offered it as an amendment to another bill, it was voted down along party lines.

In an interview, Olson said she perceived a dismissal not just of her bill itself but of the entire issue of elder abuse.

“That this need isn’t as urgent as everybody else in the public is telling us, is what I heard,” she said.

As to the criticism her bill is weighted toward elder care consumers as opposed to the industry, Olson says that’s the very idea of the proposal.

“People keep saying, ‘Your bill was the consumer bill,” she said. “You’re right. It was written by the people most impacted by this issue, the front line. On the opposite side, you see that [Rep. Debra] Kiel’s bill (HF3308) was written by industry, I mean, it’s an industry-friendly bill.”

Rep. Debra Kiel (R-Crookston), chair of the House Subcommittee on Aging and Long-Term Care, advocates a slower, more deliberative approach – forming working groups to study the problem, and making sure the elder care industry is there when discussions turn to policy reforms that would impact their business.

Kiel’s bill would set up a work group to study the idea of licensing assisted living facilities, and another to study a certification process for dementia care. A third group would study the idea of creating an “assisted living report card” that consumers could use when trying to decide where to live.

Kiel, too, has a personal connection to the elder crisis.

After her grandmother was heartbroken over the death of her grandfather, Kiel vowed to always be there for her. Decades later, her grandmother began to display signs of dementia and Kiel put her in a nursing home. Eventually, the grandmother’s lucidity declined so much that she forgot Kiel was her granddaughter, instead confusing her for a great aunt. Kiel helped her grandmother until she died.

As to why Kiel opted for simply studying assisted living licensure and memory care certification rather than actually implementing them, she said there weren’t enough voices heard during the process.

“I … understand that the laws we create could create a bigger problem for us taking care of vulnerable adults,” she said.

Olson’s bill – which Kiel referred to as “the consumer bill” — did not have enough input from the assisted living facilities and nursing homes themselves, she said. Kiel compared Olson’s bill to recent buffer law legislation: government rulemaking that she believes doesn’t fully take into account the impacts on the people being regulated.

However, Kiel highlighted the fact her own proposal would require the working groups to put forward a proposal for legislation by next January.

In response to criticism that her bill works too slowly, Kiel said the top priority should be making sure two state agencies – the Office of Health Facility Complaints and the Minnesota Adult Abuse Reporting Center – work smoothly to field complaints of abuse and post substantiated claims online.

“Those are first steps, certainly not the last,” Kiel said. 

 

The future

Working groups alone won’t solve the problem, Olson said.

“We’re really good at putting together task forces,” she said. “I’ve seen a lot of task forces come up with really wonderful recommendations that never get enacted (into law).”

The Senate companion (SF3088) was a bright spot for Olson, since it includes much of the licensure teeth in her standalone bill.  However, any hopes it would be included in the omnibus budget bill were dashed, as the language was nowhere to be found in the Senate’s version. Instead, the potential language to be adopted in the conference report was mostly that of Kiel’s House bill.

Licensure is definitely still an eventual goal, Kiel said.

“We have to make sure we give clear guidelines to both … the OHFC and (elder care) facilities themselves,” she said, adding providers are already preparing to educate their staff on internal reform.

 


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