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Kandiyohi County frustrated by rule change for care agencies

WILLMAR -- A change in a state rule handed down by the Department of Human Services is causing headaches for counties and the businesses they contract with to provide services for physically disabled individuals who are under 65 years of age.

Kandiyohi County Family Service administrators had been warning the state department since 2002 of the problems the change would cause once it was implemented this year. County officials made numerous attempts to get answers from the state about the change or the possibility of getting a waiver, but most of the calls were not returned, said Tami Goldenstein, family services supervisor.

The situation demonstrates a "lack of cooperation and acceptance that the state screwed up on this," said Commissioner Harlan Madsen during the County Board meeting Tuesday. "Extreme frustration," is how Madsen described the county's response to the state's action.

The change pertains to the provider qualifications and licensing of businesses that provide independent living services to physically disabled individuals under age 65, who may be at risk of going to a nursing home.

There are 12 individuals in Kandiyohi County that currently receive the service and the county has contracts with home care agencies and businesses to provide the care.

In the past, people providing that direct-care service did not need to be Medicare-certified, but could be supervised by their company's senior independent living services division, which must be a Medicare-certified, licensed health care provider.

The rule change requires the independent living service providers to have supervision under their own certification and license. The process to become certified is very lengthy and complicated, said Kleindl.

The other option is for Kandiyohi County to become the "provider of record" for the providers.

The county does not want the liability of providing supervision to direct-care workers who are employees of a business, said Family Services Director Larry Kleindl. And besides, he said, the county is not Medicare-certified.

At the urging of Kandiyohi County, the state has agreed to research the possibility of waivers, but in the meantime the rule stands as it is.

The commissioners agreed to notify the providers that the contracts would be terminated in 60 days, with the understanding that if the state changes its position, the contracts could be reinstated. The home care agencies are looking at options for ways to meet the new state rule, including sub-contracting for the service.

Kleindl said the goal is to come up with a solution that will have little or no effect to the clients.

The sale of Juhl Enterprises, which includes the GlenOaks living and senior care facilities in New London, will mean a change of contract for services with Kandiyohi County.

Larry Juhl appeared before the County Board to discuss the changes to his family-owned business, which has been sold to Living Services Foundation, LLC. The sale was completed earlier this month.

Juhl said the sale will be "good for the community, good for the staff, good for the patients and residents and good for my family."

As one of the few for-profit nursing homes in the state, Juhl said he was a "dinosaur in the business." As a nonprofit entity, Living Services Foundation will save an estimated $100,000 in taxes every year, said Juhl.

Juhl said he is "very comfortable I'm doing the right thing" for the community, staff and residents of GlenOaks.

Carolyn Lange

A reporter for more than 30 years, Carolyn Lange covers regional news with the West Central Tribune.

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