Just days after taking the helm as Minnesota’s acting health commissioner, Dan Pollock is pledging to make deep reforms to the state’s troubled system for handling allegations of abuse and neglect in senior care facilities.
In an interview Thursday, Pollock said efforts to protect seniors — by accelerating investigations of abuse and reducing the huge backlog of uninvestigated complaints — will be his “first, second and third priority” in his new role as state health chief. He said these efforts will include shifting the agency away from its longtime reliance on a cumbersome, paper-based system for handling elder abuse complaints, which has bogged down state investigators and frustrated families.
Pollock took the helm of the state Health Department on Tuesday after the previous health commissioner, Dr. Ed Ehlinger, abruptly resigned following published reports that suggested his agency was not doing enough to protect vulnerable seniors from abuse and neglect.
“We have heard the message. This needs to be resolved,” Pollock said, in his first interview since becoming acting commissioner of the 1,400-person department. “Families want the investigations to happen in a timely way — and the only way that’s going to be possible is by doing this restructuring.”
The new health chief will be getting help from an unlikely source: Minnesota’s human services commissioner, Emily Piper, who oversees the largest agency in state government.
Under an unusual partnership formalized this week, Piper has agreed to share her agency’s staff and technical expertise in responding to maltreatment complaints at senior facilities. In effect, Piper’s much-larger agency, the Department of Human Services (DHS), will take the lead over efforts to redesign the Health Department’s systems for investigating allegations of maltreatment, and top administrators at both agencies have already begun drawing up plans for reducing the immense backlog of abuse cases.
Speaking at a news conference Thursday, Gov. Mark Dayton highlighted the urgency of the issue, noting that many of the recently published reports of abuse are “not only immoral, they are illegal.” He said that bringing in DHS should help accelerate investigations, in part because Piper already has experience in reducing backlogged maltreatment cases.
“DHS has really transformed their oversight … and there’s really an excellent system there,” Dayton said.
A five-part Star Tribune series published last month chronicled multiple breakdowns in the state’s system for investigating maltreatment at senior care facilities that serve about 85,000 Minnesotans. The series documented that hundreds of residents at senior care centers across Minnesota are beaten, sexually assaulted or robbed each year. Yet the vast majority of these incidents are never resolved, and the perpetrators go unpunished, in part because the state health agency lacks the resources to investigate them. Even when cases are investigated, they often drag on for months, undermining criminal prosecutions.
The Star Tribune report also highlighted the secrecy that surrounds elder abuse investigations. Even in cases of serious abuse, involving physical or sexual assaults, families are often told that state investigations are confidential and that they are not entitled to even basic details.
One of Pollock’s most immediate challenges will be catching up with a dramatic surge in the volume of abuse and neglect complaints. The number of maltreatment allegations received by the agency’s Office of Health Facility Complaints has swelled from about 4,000 in 2010 to more than 25,000 in 2016. Much of this increase stems from the 2015 launch of a new state hot line that has made it easier for people to report abuse. Yet last year, the agency investigated only 3 percent of these allegations on site, depriving families and facilities of information that could be used to improve care and safety.
The problem of backlogged cases is a familiar one to Piper and her agency.
In 2014, the DHS Office of Inspector General, which investigates reports of maltreatment in about 8,900 state-licensed facilities, had fallen deeply behind. At the time, the agency was only completing about 14 percent of its maltreatment investigations within the 60-day time frame mandated under state law. Through a series of process improvements, the agency sped up its turnaround time on investigations. Today, nearly 90 percent of its maltreatment investigations are completed on time.
“That’s the kind of gain we’d like to see” at the Department of Health, Piper said in an interview. “We will be able to move expeditiously because we are now moving in a coordinated way.”
To accomplish that feat, agency officials acknowledged they have to move away from a reliance on an archaic, paper-based system for processing abuse complaints. Even when complaints are sent electronically by other agencies, staff must still create a special paper file. In interviews, former employees at the agency said paper complaint records are stacked up to 2 feet high in staff cubicles, and sometimes go missing or are permanently lost, further frustrating families who report abuse.
“When you’re confronted with something that was as distressing as some of the allegations we saw, speed and timing and outside perspective should be brought to bear as quickly as possible,” Pollock said. “DHS had this experience, so it was a no brainer to get them going.”
Pollock said staff from his agency and DHS are now meeting daily to craft ways to improve the state’s maltreatment investigation system. This includes establishing new metrics for the timeliness of complaint investigations.