MDH Clarifies Temporary Staffing Issue

In October, LeadingAge Minnesota met with the Minnesota Department of Health (MDH) to discuss a number of issues related to home care and received an important clarification on the interpretation of the statutory home care language regarding temporary staff.

Temporary Staffing Several months ago, MDH told an Aging Services member that a health care agency must essentially keep a full personnel file on any temporary staff that works for them to meet the requirements of state law. MDH has clarified its interpretation and will now accept what has been the standard of practice when health care providers use temporary staff -- the contract with the temp agency guarantees it will ensure temporary staff meet all the requirements under the appropriate home care license and personnel records will be available to the home care agency upon request.

Processing of Applications and MDH Review of Policies and Procedures MDH said the notice to current home care agencies regarding the expiration of their license goes out 75-90 days before the expiration date. Occasionally there has been a problem with the MDH database. If a home care agency hasn’t received the notice two months before their license expires, the provider should contact MDH. MDH is trying to improve communications with new and renewing applicants by distributing a letter to notify providers when their application has been received. The 90 day clock for the MDH review period begins when the provider receives a letter indicating the application is complete.

MDH is revising the new and renewal application form to clarify language that has been confusing, and is also making changes to its website. Providers have asked MDH to post a number of documents on the website, such as the policy/procedure checklist and the TAG number crosswalk. Aging Services has also requested an improved search tool for home care surveys.

In terms of materials that must be submitted for an application, MDH encouraged providers to try to submit all required materials in one envelop (e.g., application, check). If additional information is required, MDH requested the information be sent via email. If it is not possible to send documents via email, MDH said providers should fax the materials and contact the appropriate staff person to let them know the materials were faxed.

MDH continues to see problems with policies and procedures submitted by new applicants based on templates from consultants or other resources. The provider associations who participated in the meeting agreed that home care agencies need to modify sample policies and procedures to fit their own organization. However, the association representatives raised concerns about the policy and procedure checklist that MDH uses in its review of new applications. In particular, some items on the checklist are simply not appropriate to include in a provider’s internal policies and procedures. To respond to these concerns, MDH will send the checklist to Aging Services and the provider associations for their review and comments.

Additional updates provided by MDH: Survey Forms: The survey forms have now been revised and should be posted soon on the MDH website. Aging Services advises members to carefully review these forms to help prepare for a future survey.

Bill of Rights: MDH is reviewing the different versions of the home care bill of rights as well as client rights under 245D in preparation for a legislative report due by Feb. 15, 2014. MDH will meet with the Ombudsman for Long Term Care as part of this process, and send more information to Aging Services and other provider associations as it is available. This streamlining project could eliminate the assisted living bill of rights addendums, which provider associations have supported, with the compromise possibly being to require more than 10 days’ notice of the termination of services by non-assisted living providers.

Guide to Home Care Services: Given the new information that must be included in staff orientation under state law, MDH has concluded that it is impossible to develop a guide to cover the orientation requirements. Many of the orientation requirements are provider specific, such as handling of emergencies and review of the home care agency’s policies and procedures. The Aging Services’ Home Care Cabinet will discuss and identify tools we should develop to help providers meet some of the orientation requirements at its November meeting.

Online Provider Directory: There may be a short delay in updating the online provider directory when a provider converts from the old license categories to Basic or Comprehensive. In addition, because of programming issues, a Medicare-certified home health agency’s listing on the online directory may continue to list a Class A license even after the agency has converted to a Comprehensive license. This issue may not be corrected until July 1, 2015.

MDH Staffing: Four more surveyors are expected to be hired by mid-December. Four to six additional positions will be posted in early 2015, with the intent to have those additional staff hired by March 2015 for a total of 30 surveyors and administrative staff. Surveyor training materials have been updated and MDH has resumed its weekly nurse calls to promote consistency. MDH reported that all current surveyors are certified on investigator techniques by CLEAR (Council on Licensure, Enforcement and Regulation). Aging Services offered assistance in training surveyors on topics like Fair Housing and landlord-tenant law, and will follow up with MDH regarding recommended resources.

New and Renewal Applications: MDH has received 50 new applications for licensure and 27 temporary licenses have been issued, 17 of which are Comprehensive providers. As of Oct. 22, at least 325 home care agencies have converted to the new license when they renewed, with 310 converting to the Comprehensive license.

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