PrairieCare, Medica in dispute
Brooklyn Park-based PrairieCare dropped out of Medica’s provider network recently, claiming the insurer limits mental health care for children and teens without justification and beyond the norm at other health plans. But Medica has disputed that claim, saying that PrairieCare patients staying longer at the hospital and requiring readmission at higher rates than those treated by other health care providers. The dispute means that Medica subscribers won’t have access to PrairieCare facilities at in-network prices.
PrairieCare is a private company that employs about 400 people. It has six locations in the Twin Cities metro area and one in Rochester. Owned by two child psychiatrists, the mental health provider does not release financial information. Medica is one of the state’s largest health insurers, with about $125 million in operating income on $3.5 billion in revenue during 2014. It employs about 1,300 people.
“I mainly worry about parents whose kids are in an emergency situation having higher out-of-pocket costs, and not knowing that’s the case,” Sue Abderholden, executive director of the National Alliance of Mental Illness Minnesota, said to the Star Tribune. The contract dispute went public in September after Prairie-Care sent letters to patients notifying them of the potential change in its network status. Last year, about 360 children and adolescents with Medica coverage obtained inpatient and partial-inpatient care at PrairieCare.
In the near term, PrairieCare will continue to serve admitted Medica patients under the in-network contract until they complete treatment, said Tom Lehman, government relations manager for PrairieCare.
In a statement, Medica said its network of providers still includes “full-capability systems” such as Allina and Fairview that will meet the treatment needs of subscribers. When needed, Medica will make out-of-network exceptions for PrairieCare services. (Source: Star Tribune)
Fight over access lawsuits goes to Congress
Congressman Ted Poe (R-Texas) introduced a bill that he said will improve the Americans with Disabilities Act (ADA) by protecting small business owners from lawsuits over access. A number of the lawsuits have been in Minnesota.
“The ADA is a vital law that is meant to make American businesses more accessible to the disabled. But the integrity of this important law is being threatened,” said Poe. “Most of these business owners believe that they are in compliance with the ADA and have even passed local and state inspections. However…certain attorneys and their pool of serial plaintiffs troll for minor, easily correctable ADA infractions so they can file a lawsuit and make some cash.”
The ADA Education and Reform Act of 2015 would ensure small businesses to have the opportunity to fix access violations. The bill has the support of several business groups.
Poe said that the bill will only be able to prevent a lawsuit by giving the business an allotted amount of time to fix the infraction, but it does not deal with any lawsuit that is already been filed.
Poe and other members of Congress met recently with Amy Rowland, owner of the Bulldog Northeast bar and grill in Minneapolis. Rowland is one of many business owners who was sued by Paul Hansmeier on behalf of a group of people with disabilities. Hansmeier has filed more than 100 lawsuits in Minnesota.
After spending $15,000 in legal fees on a preliminary hearing and facing tens of thousands more for future court dates, Rowland settled her case for $8,000.(Source: Talk Radio News, Star Tribune)
St. Louis River trail restored
The Grassy Point Trail along the St. Louis River has had its share of vandalism and damage due to high water levels. Now a group of Duluth area residents is working to improve the trail and improve its accessibility. Dwight Morrison, from the Wheels on Trails Organization, said even when the trail was functioning, it wasn’t very
wheelchair- or scooter-friendly. That is changing.
With the city’s push to improve the prospects for the St. Louis River Corridor, Morrison said the Grassy Point project was something he could get behind. It makes sense, he said, with the 25th anniversary of the Americans with Disabilities Act this year.
Improvements include rails along the boardwalk to prevent wheelchairs from drifting off and going into the river. Trail boards are being replaced. Workers are also switching out some boards for more width. Turnaround areas are available so no one has to put a chair in reverse.
In the next few years, a loop along the river edge will lengthen the trail and allow people with any type of disability to enjoy nature and take in this unique spot, Morrison said. The people working on the project come from Trillium and Udac. Both agencies serve people with disabilities. It’s a multiyear project that gets its funding through a grant from the Duluth Superior Area Community Fund.
The group of people working on it this month said if the trail becomes more accessible, the increased use might keep vandals out. (Source: Duluth News-Tribune)
Youth league makes accommodations
Gloria and David Nathanson’s lawsuit against the Spring Lake Park Panther Youth Football Association has been settled. It’ll establish a disability access fund, provide $3,000 toward their son Dov’s college fund and cover about $5,000 in legal fees. The family sued the youth football organization after running into resistance to their requests to accommodate Dov Nathanson, a deaf fourth grader.
But the family recently moved to White Bear Lake, where their son is able to get what they couldn’t get in Spring Lake Park: sign-language interpreters and someone beating a drum to correspond with the cadence of a quarterback’s calls.
The Nathansons and Spring Lake Park group disagree about the issue. The youth group contends that disability access laws don’t apply to a nonprofit association run by volunteers. Costs were cited as a hardship.
They also claimed that the drum alerted opponents to plays. But the Nathansons said accommodations should be made. They and a local Lions Club paid for interpretation after the Fridley school district quit providing an interpreter.
The Nathansons and two of their four children are deaf. David Nathanson has been allowed to be an assistant coach at White Bear Lake. Coaches and fans there said the accommodations have gone smoothly. The Lions Club there has also helped pay for interpreters. (Source: Minnesota Public Radio, Star Tribune)
Teen will be sent to autism treatment facility
A Waseca teen who was accused of planning to kill his family and attack his school will spend time at an autism treatment facility in Georgia. In September John LaDue, 18, had pleaded guilty to possessing an explosive device. Waseca County officials have agreed that LaDue should be sent to the Devereux Autism Treatment Facility in Kennesaw, Georgia. It is a secure facility that helps people 21 and other who have severe emotional and behavioral disorders.
LaDue received a 10-year stayed sentence. He will not have to serve that sentence if he completes treatment and
undergoes supervision in a halfway house. He will be on probation for 10 years and could go to prison if he violates the probation. If all goes as hoped for, he will transition from the halfway house back into the community.
“Tragedy was avoided and hopefully this will be a tale of hope for similar situated individuals with this disorder,” said Waseca County Public Defender Dawn Johnson said In 2014 LaDue was accused of planning to kill his family and start a fire in rural Waseca to distract first responders from the school. LaDue planned to go to the Waseca Junior/Senior High School. His plan called for setting off bombs during lunch, killing the school resource officer, starting fires and then shooting students and staff. A 180-page journal found at the teen’s home outlined the attack in great detail. Authorities, who searched the locker and LaDue’s bedroom, said they confiscated chemicals, several guns, ammunition and a few completed explosives.
He was charged with six counts of possessing explosive devices. As part of the plea agreement, five counts will be dismissed. LaDue pleaded guilty to a single felony count of possessing an explosive device after nearly a year-and-a-half of legal battles over what should happen to him. (Source: KSTP-TV)
Fort Snelling’s housing opens
Veterans, including many with disabilities, have moved into refurbished barracks and stables at Fort Snelling. The Upper Post Veterans Community held an open house in October to show off accommodations for 58 military veterans.
The apartments are furnished and have been a big hit with new residents. Residents began moving in several months ago. The housing is next to Historic Fort Snelling, a state living history museum. Some residents enjoy the space as a safe place to live and pursue hobbies such as art. Other appreciate secure housing where they can live with therapy dogs.
The refurnished buildings have community and technology rooms, as well as a community center. The development is part of a larger initiative aimed at ending homelessness among the state’s military veterans. At the opening ceremony Minneapolis VA Health Care System
Executive Director Patrick Kelly was among those whose spoke on the need to provide housing for veterans. The $17.2 million project was developed by CommonBond Communities, with assistance from a wide range of donors. The Minnesota Twins provided the technology room and also invited the live-in veterans to a game this fall. (Source: Pioneer Press)
Concussions sideline popular “Radio Free Current” DJ
A key disc jockey has resigned from 89.3 FM, the Current. David Campbell, who hosted “The Local Show” and “Radio Free Current” stepped down in mid-October. While dissatisfaction with his work was a factor, Campbell also said he is dealing with health issues.
Campbell played hockey in his youth and sustained several concussions. He said those have resulted in learning disabilities and attention-deficit disorder in his adult years. He said it has become more difficult to keep up with his work, but that his requests to be reassigned couldn’t be worked out. Campbell had been at the station, which is part of Minnesota Public Radio, since 2007. He has also been a member of a local band.
Campbell is one of two Twin Cities media personalities to speak out about concussions and their effects.
KMSP-TV Meteorologist Ian Leonard sustained a concussions playing soccer several months ago. He has returned to his on-air duties after taking a medical leave, but has had to take a number of measures to deal with aftereffects from the head injury.
Leonard is a longtime supporter and volunteer with Special Olympics Minnesota and its Polar Plunge events.
Large malpractice verdict announced
One of the largest medical malpractice verdicts in recent Minnesota history was awarded this fall to a former auto mechanic who suffered spinal cord damage and paralysis in a 2012 surgery.
Large malpractice verdict announced. His attorney argued that an anesthesiologist left him dangerously dehydrated before surgery to repair a perforated bowel at North Memorial Medical Center in Robbinsdale.
“Joe Lakoskey wants nothing more than to have his life and ability to walk back,” Brandon Thompson, an attorney with the Robins Kaplan firm, said in a statement. “This verdict will provide him with the resources he needs to live as independent a life as possible.” Lakoskey, 51, went to North Memorial with flu-like symptoms. He received fluids for dehydration while doctors found his injury and recommended surgery.
The problem, his attorneys argued, was halting treatment of dehydration while starting him on anesthesia an hour before surgery—a double whammy that caused his blood pressure to drop and his spinal cord to receive inadequate blood flow. Attorneys for Anesthesiology P.A., the private practice that provides anesthesia services at the hospital, denied that was the cause of the injury.
Lakoskey had to sell his mechanic business. Intensive therapy through the Courage Center’s ABLE program helped him gain strength and mobility in his legs — to the point he could use a walker to cross a 50-foot platform in a couple of minutes. But then grant and insurance funding ran out. Now he hopes money from the lawsuit will allow him to replace his broken-down wheelchair and resume therapy. (Source: Star Tribune)
Alcoholism is disability, is lawsuit claim
A fired Minnesota State Lottery official is claiming discrimination based on her alcoholism ad is arguing that alcoholism should be seen as a disability.
Johnene Canfield, who was the lottery’s director of operations, was fired earlier this year. She had been in a December 2014 auto accident, which resulted in driving while intoxicated charges.
This fall Canfield sued the state and her former boss for firing her. She is claiming that state lottery executives knew she has a disability as a result of her alcoholism. Yet her boss drank with her at conferences and other events.
While alcohol dependency isn’t spelled out specifically in the Americans with Disabilities Act or in state disability law, the courts and regulatory agencies have interpreted chemical dependency as qualification for disability status. It is mentioned in U.S. Justice Department rules related to the ADA.
Canfield began working for the state lottery in 1989 and rose through the ranks to become operations director. The lawsuit states she began having issues with alcoholism in 2011 and was suspended in 2012 for being drunk at an out-of-state conference. She was banned from drinking on future trips.
After the 2014 accident she sought and received treatment but was terminated instead of being reinstated. (Source: Star Tribune)
People lose low-cost Internet service
About 14,000 low-income Twin Cities households risk losing their low-cost Internet service in early November. The pending end of an old Sprint data network means the end of a service provided by the St. Paul nonprofit PCs for People.
The service taps into WiMAX wireless technology, which Sprint is dropping. PCs for People officials contend that Sprint is required to put in a substitute service but that hasn’t happened. PCs for People works with two national technology-focused nonprofits, Mobile Citizen and Mobile Beacon, to help make Internet service available in the Twin Cities. The two nonprofits are continuing to have talks with Sprint. In the meantime, PCs for People is directing its clients to other services.
Twin Cities customers are worried. Melanie Manson, a PCs for People client with disabilities who lives in the western suburbs, said she wouldn’t want to go back to dial-up service. But she cannot afford other Internet providers available. “Being disabled is isolating, and this helps me feel less isolated,” Manson told the Pioneer Press. “I really felt like I was part of society.” She has been unable to find a new service she can afford.
PCs for People estimates that about 36,000 children and 16,800 adults will be affected by the change. (Source: Pioneer Press)
Nursing home to close soon
Inability to attract enough residents and ongoing financial losses are forcing north . Closing of St. Olaf Care Center will take place later this month.
The nursing home opened in 1964. Closing means displacement of about 50 people, including several younger residents with disabilities. The church is considering converting part of the facility into assisted living in the future.
St. Olaf will continue to operate North Oaks of Emerson, a smaller, 48-unit assisted living facility in the area. Church officials said that the nursing home was long a destination for people with disabilities and senior citizens being discharged from metro area hospitals. But in recent years more people opted to go to newer, suburban facilities. Another change is that more people receive services in their homes.
Minnesota has seen many changes in its skilled nursing facility industry. More people are opting to live at home with support, or to move to assisted living centers. About 70 nursing homes in the state have closed since 2000. The number of beds has declined by about one-third, from 43,000 to 29,600 statewide. The 2015 Minnesota Legislature made changes in how nursing homes are reimbursed for care but that may be too late for some facilities. (Source: Star Tribune)
Metro Mobility drivers file lawsuit
Three drivers of Metro Mobility buses have filed a legal complaint alleging wage theft against the suburban para-transit service provider. The complaint is against First Transit Inc., a company that provides rides for disabled and elderly people in the southern and eastern suburbs.
Kent Thompson of Blaine, Majic Martin of Mounds View, and Mark Stang of White Bear Lake, claim that First Transit Inc. has denied them payment for time worked. Attorney Shawn Wanta, who represents the three, said that class-action status will be sought. Wanta estimates that there could be more than 500 people in the class.
The legal action is what is called a “pocket filing.” Under state law, a civil case starts when a complaint is served, instead of a more common court filing. The complaint was served on the defendants October 26. The court it will be heard in hasn’t been determined.
The complaint states that drivers spend time before their paid shift finding their bus and preparing it for service. At the end of the workday, drivers are required to drive to a fuel station, inspect their vehicles, complete post-trip reports, count and reconcile fares, and report any incidents.
Metro Mobility buses provided more than 1.7 million rides to people with disabilities throughout the Twin Cities in 2014. First Transit, the U.S. subsidiary of Ohio-based FirstGroup America, has been operating Metro Mobility East for several years. The Metropolitan Council, the regional government for the Twin Cities, recently renewed the contract through August 2020.
In June, First Transit won a new five-year contract with Metropolitan Council to provide service in the southern suburbs, replacing the West St. Paul nonprofit group DARTS. DARTS itself has been roiled by litigation and allegations about management and condition of vehicles.
FirstGroup had not filed a response to the lawsuit as of Access Press deadline. (Source: Star Tribune)
Group home residents are rescued
Three residents of a Roseville group home were rescued from a burning building October 22 thanks to the quick reaction of their caretakers. Just days before, Brenda Spaggins and Nasu Mboma, caretakers with Wingspan Life Resources, practiced a fire drill with the residents. They didn’t know they’d need to put their plan into action so quickly.
The caretakers’ first thoughts were their clients— George, 86, Christopher, 46, and Guy, 61. Two of the men cannot walk.
“I became fire mom, just carried him out,” said Spaggins, a supervisor who worked at the home for six years. “I got them both together. I got Guy out of his room, got him to the living room and took him out the door and then picked up George, put him in his wheelchair and pushed them out.”
“We were out of the house less than two minutes I can say,” said Mboma.
Firefighters arrived to the sight of heavy smoke and flames shooting up the back of the home and the caretakers and three residents watching from the road. “They did exactly what they were trained to do and what their drilling told them to do,” said Sam Baker, fire inspector with the Roseville Fire Department.
Within 20 minutes, the flames were out, leaving behind heavy damage to a majority of the home. Baker says the fire started on the deck of the house, possibly from an unattended cigarette. The cause has not officially been determined. (Source: KARE 11 News)