U.S. Rep. Pete Stauber (R-8th District) visited with directors of local adult care programs and area state legislators Monday to hear how the programs have been impacted by the COVID-19 pandemic and what Congress can do to help.

Stauber hosted the listening session, titled “Caring for Our Aging Community,” outdoors at the All Veterans Memorial in Park Rapids.

Regarding issues affecting the Developmental Achievement Center (DAC) and senior services,

Stauber said he relates to these concerns because his son, Isaac, has a “severe and profound” disability, and because of the “devastating” effects of COVID-19 restrictions on his parents, who are in their 80s.

DAC needs support

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Laura Johnson, executive director of the Hubbard County DAC, told Stauber about the financial toll the COVID-19 pandemic has taken on services for adults – like the permanent closure of Headwaters Adult Day Services, which served 27 people.

“We’re only paid when our clients attend,” said Johnson, “and that’s either through Medicaid waivers or county waivers. Obviously, no clients – no revenue.”

Meanwhile, she said, the DAC has fixed costs – building rent, mortgage, transportation, health insurance. Plus, it self-pays the unemployment benefits of furloughed or laid-off workers.

“We’re not under unemployment insurance,” she said. “We have to pay it all back. Where am I going to come up with that money?”

A $329,000 award from the Paycheck Protection Program covered about 10 weeks of DAC payroll, she said. But this did not replace lost revenue. Johnson said their June billings were projected to total $96,000, but they actually billed $7,000. At the same time, new rules required them to staff clients at a 1:1 or 1:2 ratio.

“I can’t even cover the costs of my payroll for that amount of billing,” she said.

Johnson appealed for funding to help the DAC cover its costs and pay unemployment.

‘End-run’ around DHS

State Sen. Paul Utke (R–Dist. 2) criticized Minnesota Department of Human Services Commissioner Jodi Harpstead for not applying for a waiver to allow organizations like the DAC to receive retainer fees – aid that some 35 other states have received under the federal Coronavirus Aid, Relief and Economic Security (CARES) Act.

“I don’t buy Jodi Harpstead’s (claim) that they couldn’t do it,” said Johnson.

Utke, who serves as vice chair of the Senate Human Services Reform Finance and Policy Committee, claimed Harpstead “dances around” questions about why her department has not applied for the waiver.

Utke also estimated the state has about $600 million in CARES Act funds “sitting in the checkbook,” which could help struggling DACs, “but for some reason, they just will not do that.”

Johnson noted that the DAC’s three thrift stores were developed to provide employment for DAC clients, and one of them – Bearly Used – is as heavily shopped as any store in downtown Park Rapids.

This “provides good revenue and good employment,” she said. “But do you know what? DHS doesn’t value it as employment, because it’s owned by the DAC.”

Johnson challenged this reasoning. “Right now, in an economy where there aren’t very many jobs, who’s going to hire my clients?” she said. “To say that we don’t continue to provide a value, or to say that we take away people’s rights – they’re not looking at the programs.”

Utke clarified that DHS guidance is toward offering clients “individualized employment” at outside businesses.

Johnson said DAC staff have worked hard to develop programs that offer options for everybody. “That’s expensive,” she said. “But we’re not here to make money.”

Johnson said the state authorized DAC to bill for remote services, but her staff may spend 20 hours preparing for remote services only to bill three hours.

“We’ve been doing remote services, both for senior and disabled clients, this whole time, but we haven’t billed for any of that,” she said. “We’ve done that because we care about the people we serve.”

Lawmakers respond

Stauber said the care of people with developmental disabilities “is about taking care of the most vulnerable, and who we are judged as a society,” and asked, “What would you like to see me do?”

Utke asked if it is possible to “end-run the system” and go around Harpstead.

Stauber said he would work with legislators to encourage the state to spend its CARES Act funds appropriately.

State Rep. Steve Green said bills to disburse CARES Act money would only provide temporary relief. “The fact is, we have to open up the state, and then the money’s got to flow,” he said. “Our deficit continues to grow.”

Green complained that it’s “business as usual as far as politics in Minnesota,” adding, “If there’s ever a time when we should be working together and looking at just the necessities to move forward, it can’t be more than this.”

Stauber talked about “the red line in the sand” of liability protections. He said Republican leaders in Congress are pushing for laws shielding businesses that have followed CDC guidelines from lawsuits for COVID-19 related damages, but Democratic leaders are opposed.

“If your facility has been given guidelines, if you’ve followed them and somebody gets COVID – if there’s not liability (protection), trial lawyers are going to love this,” he said. “We have to protect the small businessmen and -women of this country.”

Utke said a state liability bill didn’t make it through the last Legislative session, partly because of scheduling, but added that the trial lawyers’ lobby “was crazy on it. So, it would be nice if it came from the federal end of it.”

Senior living issues

Stauber also asked Ashley Ylitalo, director of Knute Nelson Crystal Brook, how he feels senior living has been impacted by COVID-19.

“I would say our No. 1 concern, early on, was social isolation for the residents, who were used to seeing their families all the time or going out and about,” said Ylitalo. “That, of course, changed with COVID.”

While good steps have been taken to relieve these issues, he said the senior apartment building’s occupancy has declined from about 90 to 70 percent, with 60 of 88 apartments currently occupied.

Besides deaths, Ylitalo said some people chose to move out, or were moved by their loved ones. He said he expects it to take Crystal Brook 18 months to rebound fully from these setbacks.

Char Christenson, a Hubbard County commissioner who also serves on the Heritage Community board, reported that the 64-bed Heritage Living Center had a recent census of 56 occupants, many of them on short-term hospital rehab.

“We just redid our budget in the middle of the year for 48 beds,” she said. “People are waiting to move in, but they don’t want to move in because of the restrictions.”

Echoing Ylitalo, she said residents have moved out because of the restrictions, and Heritage also anticipates an 18-month recovery period.

County commissioner and Heritage board member David De La Hunt added that Heritage received federal aid for COVID-19 impacts, “but when you couple that with the drop in the census and the extra COVID expenses … that money from the feds will only cover about half of the cash-flow shortage we’re probably going to be facing. We’re talking about hundreds of thousands of dollars.”

Christenson voiced frustration about Gov. Tim Walz’s lack of guidance for long-term care facilities before mid-May, but she applauded local facilities’ staff for taking the initiative to protect staff and residents.

Regarding the suffering of elderly residents who haven’t been allowed to leave care facilities since mid-March, she said, “People have died alone without their families, and that is not right. I don’t care what is going on; people should not have to die alone.”

Christenson cited increases in rates of suicide, addiction and out-of-home placement. “This is not how they’re meant to live,” she said. “There’s way more things to think about here than just COVID, and no one seems to be talking about them,” she said.

Utke agreed, “I truly believe half of the people dying in long-term care are dying of loneliness. We’re social creatures.”

Calling for a more commonsense approach, he said, “We could do this smartly and safely, but we’ve just gone so far overboard, all the way across. To me, it’s inhumane.”