MDH clears backlog of elder and vulnerable adult maltreatment complaints

Passing a significant milestone in the drive to improve performance, the Minnesota Department of Health (MDH) Office of Health Facility Complaints (OHFC) announced Wednesday it has cleared the backlog of maltreatment cases for elders, vulnerable adults and their families from 2017 and continues to successfully complete initial reviews for all reports within two days. The initial review screens for cases requiring rapid response due to heightened risk to vulnerable adults.

When the MDH and the Minnesota Department of Human Services (DHS) inter-agency team started its work in January 2018, they faced a backlog of 2,321 reports awaiting triage and 826 triaged cases awaiting investigation. The backlog had built up over time as the nearly 400 reports coming into OHFC each week from elder care facilities around the state outpaced state investigators’ ability to respond.

Minnesota Commissioner of Health Jan Malcolm praised the contributions of DHS as well as the efforts of OHFC staff and managers for implementing a broad set of improvements that allowed MDH to clear the backlog and greatly improve overall performance.

“Due to hard work and an aggressive quality improvement process, we are in a much better place to serve Minnesota’s elders and families,” said Malcolm. “We continue to work hard to improve our efficiency in handling complaints and completing investigations, while at the same time working with partners on long-term reforms that can reduce the rate of maltreatment incidents in long-term care facilities around the state.”

MDH posted the last of the investigations from the backlog this week, after having completed triage review of all reports in February.

“Elimination of the backlog is an important milestone in our efforts to protect vulnerable Minnesotans,” said DHS Commissioner Emily Piper. “This is an excellent example of the positive results that can occur when we marshal our expertise and work together toward a common goal. I am proud the employees of the Minnesota Department of Human Services could be part of that effort. Much work remains, including needed legislation that will put safeguards in place to make sure Minnesotans are treated with dignity as they grow older and can no longer care for themselves.”

Success depended in part on eliminating cumbersome paper-based processes and inefficient manual hand-offs between workers. The team relied Minnesota IT Services (MNIT) to facilitate the development of the new solution.

“I’m proud of the hard work of the Minnesota IT Services team, in collaboration with OHFC, to move quickly to put in place an efficient, effective technology solution that addresses previous practical challenges,” said MNIT Commissioner Johanna Clyborne. “This is our mission: to work in partnership with agencies, sharing expertise and data to create and leverage solutions to better serve all Minnesotans."

MDH implemented a number of changes that helped reduce the backlog and improve OHFC performance, including:

• Working closely with a MNIT technical team, OHFC implemented a new electronic document management system for receiving, handling and investigating elder abuse complaints. OHFC staff no longer rely on paper documents as part of the complaint process, thereby increasing efficiency.

• The inter-agency team implemented changes to help ensure better standardized work for intake, triage and investigations. This includes documented processes and performance metrics enabling better management of workflow and team performance.

• OHFC continues to refine improved standard work processes in multiple areas, using OHFC and DHS Office of Inspector General subject matter experts.

• OHFC implemented new processes to allow in-office follow-ups by investigators, thereby reducing travel time that staff had spent previously as part of mandatory on-site follow-ups regardless of severity of the deficiency.

• The inter-agency team streamlined and improved the internal case review process.

Work is ongoing to develop a long-term electronic case management system. MDH is also continuing the conversations and needed collaborations with consumer advocacy groups, DHS, industry and legislators to develop a broader consensus on the best ways to prevent elder abuse in long-term care settings.

Governor Dayton proposed a package of reforms in March 2018 reflecting the recommendations from a large coalition of consumer and seniors’ advocacy organizations. Governor Dayton’s proposed reforms included assisted living licensure and dementia care certification, giving family members the ability to enforce the rights of their loved ones, and clarifying the rights of residents and clients to use electronic monitoring devices for their own safety and protection.