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Friday, May 18, 2018

Significant progress and improvement reported in state office investigating elder abuse complaints

The Minnesota Department of Health (MDH) and the Minnesota Department of Human Services (DHS) this week provided an update on the progress of the inter-agency partnership to improve the performance of the program that investigates reports of elder abuse and maltreatment.

Minnesota Commissioner of Health Jan Malcolm praised the contributions of DHS as well as the efforts of MDH's Office of Health Facility Complaints (OHFC) staff and managers for implementing a broad set of improvements, ranging from new electronic tools to stronger communication and oversight.

The MDH/DHS partnership formed in late 2017 to address the significant performance shortfalls documented in OHFC. When the inter-agency team started its work in early January 2018, there was a backlog of 2,321 reports awaiting triage and 826 triaged cases awaiting investigation. By the end of February, the team had completed triage review of all reports in the 2017 triage backlog and greatly reduced the investigation backlog. In the latest progress report posted on the Office of Health Facility Complaints Quality Improvement Project website this week, that investigation backlog had been reduced to 122.

Among the other accomplishments to report:

  • All maltreatment reports now have an initial review within two days to screen for imminent and continued risk to vulnerable adults.
  • 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 supervision of staff performing intake, triage and investigations. This includes documented processes and performance metrics that help monitor staff work output, enabling supervisors to more effectively manage the performance of individual staff and teams.
  • The team created a public dashboard to document the status and progress of our effort. This dashboard is updated weekly and posted on the Office of Health Facility Complaints Quality Improvement Project website.
  • 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 is working with OHFC supervisors to streamline and document the supervisory reviews of investigations. Standards for supervisory review step did not exist previously, making the process inconsistent and inefficient.
  • The team facilitated weekly human resources training for supervisors and mentoring on effectively supervising a paperless process.
  • OHFC is streamlining and improving the quality and clarity of the letters it sends to complainants and families.
  • OHFC implemented an interim technology solution and electronic fax technology, eliminating antiquated paper-based systems and improving efficiency and accountability.
  • The inter-agency team is working with Minnesota Information Technology Services to develop a long-term technology solution and to document business practices.
  • Using a request for information process, MDH solicited stakeholder feedback on specifications and functions of a new electronic case management systemto replace the antiquated system currently in use. The department received 20 responses that will help ensure a modern, highly functioning case management system is put in place.
  • The inter-agency team reorganized the OHFC workspace to better support paperless processes and effective performance management.

"These accomplishments are encouraging steps in a larger process to ensure an effective and timely response to every complaint we receive," Commissioner Malcolm said. "We look forward to continuing to improve our regulatory oversight. We also reiterate the need for the Legislature to come to the table to address larger issues of reforming the long-term care industry to ensure the dignity and safety for all our seniors."

Governor Dayton proposed a package of reforms in March 2018 that dovetailed with the recommendations of the Office of the Legislative Auditor and the recommendations of the group convened by AARP. His proposal strengthens the state's regulatory system while also tackling the broader issue of elder abuse. The reforms focus on prevention, quality improvement, greater accountability for care providers and stronger protections for seniors.


Tuesday, May 8, 2018

Ten Minnesota illnesses linked to national E. coli outbreak associated with romaine lettuce

Health officials say do not eat romaine unless certain it is not from Yuma region

The Minnesota Department of Health (MDH) is working with the Minnesota Department of Agriculture (MDA), the Centers for Diseases Control and Prevention (CDC), the U.S. Food and Drug Administration (FDA), and public health agencies in other states to investigate an outbreak of E. coli O157 infections associated with eating romaine lettuce.

Information on the national outbreak can be found on CDC's and FDA's websites: CDC: E. coli and FDA Investigating Multistate Outbreak of E. coli O157:H7 Infections Likely Linked to Romaine Lettuce from Yuma Growing Region.

Ten cases of E. coli O157 infection in Minnesota residents have recently been identified and linked to the multi-state outbreak. Illness onset dates range from April 20 through May 2. The cases are from both metro and greater Minnesota counties; 90 percent are female. Three cases were hospitalized, and two developed hemolytic uremic syndrome (HUS), a potentially fatal complication that can include kidney failure and other severe problems.

All of the Minnesota cases interviewed by public health investigators reported exposure to romaine lettuce. Reported exposure locations include restaurants, grocery stores, and residential facilities. MDH is working with MDA to further investigate these exposures.

"Do not eat, buy, or sell romaine lettuce unless you can confirm it is not from the Yuma growing region," said Kirk Smith, manager of the Foodborne, Waterborne, Vectorborne, and Zoonotic Diseases section. "The Yuma growing region includes part of western Arizona and extends into the Imperial Valley of southeastern California, but does not include Salinas Valley or other growing regions in California." Product from the Yuma growing region should no longer be on sale; however, individuals should check their refrigerators for romaine lettuce that may have been grown in the Yuma region.

Symptoms of illness caused by E. coli O157 typically include stomach cramps and diarrhea, often with bloody stools, but only a low-grade or no fever. People typically become ill two to five days after exposure, but this period can range from one to eight days. Most people recover in five to 10 days. However, E. coliO157 infections sometimes lead to HUS. Those most at risk of developing complications from E. coli O157 include children younger than 10, the elderly, and those with weakened immune systems.

Diarrhea associated with E. coli O157 infections should not be treated with antibiotics, as this practice might promote the development of HUS. Anyone who believes they may have developed an E. coli O157 infection should contact their health care provider.

Approximately 135 cases of E. coli O157 are reported each year in Minnesota. More information on E. coli O157 and how to prevent it can be found on the MDH E. coli website.



Tuesday, April 24, 2018

Regional trail in Burnsville closed until further notice

The Minnesota River Greenway in Burnsville has been temporarily closed due to spring flooding.
The paved regional trail along the Minnesota River will close beginning Wednesday, April 25, from the Minnesota Riverfront Park Trailhead at the Interstate 35W bridge to the Minnesota Department of Natural Resources boat landing under the Cedar Avenue bridge.
The Minnesota River Greenway was designed and engineered with spring flooding in mind.
The closure will last until flood waters recede and any necessary trail cleanup is complete. For updates and more information, visit and search Minnesota River Greenway.