New Minnesota health commissioner makes fight vs. elder abuse a high priority

Gov. Mark Dayton has appointed former Health Commissioner Jan Malcolm to lead the state Health Department, following highly publicized breakdowns in senior home regulation that led to the resignation of the agency's previous leader.

Malcolm, a veteran health care executive with a national reputation in health policy, led the department under Gov. Jesse Ventura from 1999 to 2003.

"Jan Malcolm brings exceptional experience in public and nonprofit health management to the Minnesota Department of Health," Dayton said during a Tuesday morning news conference.

Malcolm will succeed Dr. Ed Ehlinger, who resigned last month, in running a 1,400-person agency that leads the state's public health efforts, including tracking disease outbreaks, promoting immunization and regulating certain health facilities.

The appointment comes less than three months after a five-part Star Tribune series chronicled breakdowns in the agency's handling of elder abuse allegations. 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 Health Department lacks the staff and forensic expertise to investigate them.

At a news conference Tuesday morning, Malcolm pledged to "work hard to fix and repair the systems that have broken down" at the Health Department office that investigates maltreatment in senior homes, known as the Office of Health Facility Complaints (OHFC). She also made a rare apology to seniors and their families for the breakdowns at the state agency she now heads.

"First and foremost, I am so sorry for the pain, the trauma, and all the difficulties that have been caused … and about what is being experienced by some of our most vulnerable citizens and where the system has not kept pace," Malcolm said. "I am so sorry for the anguish they have suffered."

After the series was published, Dayton convened a work group of senior advocates and families of abuse victims to review the state's oversight of senior facilities and make recommendations for the 2018 Legislature.

On Monday, that work group issued a lengthy report recommending a series of broad reforms. These include tougher criminal sanctions against abusers, greater access to state investigations for abuse victims and their families, and increased oversight of the lightly regulated assisted-living industry. The group also called for protections against arbitrary evictions from senior facilities, and enshrining the right of seniors to place cameras inside rooms to monitor the quality of care, among other recommendations.

Both the work group's report and Malcolm's appointment were applauded across party lines.

Sen. Jim Abeler, R-Anoka, chairman of the Senate Human Services Reform Finance and Policy Committee, said Malcolm's experience working with adults with disabilities gives her an understanding of the challenges faced by vulnerable seniors. Malcolm served as president of the Courage Kenny Foundation, the philanthropic arm of the Courage Kenny Rehabilitation Institute.

"She has a really good heart," Abeler said. "She understands the elder abuse issue very well, and will be able to push where things have to be pushed to get a resolution to this crisis."

One of Malcolm's immediate challenges will be modernizing the Health Department's antiquated system for receiving and investigating complaints of elder abuse. In interviews last month, former and current employees at the agency described an office so overwhelmed by backlogged cases that workers dumped dozens of maltreatment complaints into recycling bins without reading them, according to a Star Tribune report. Others said unread complaint forms piled up into stacks 2 feet high and went unexamined for months.

The bureaucratic bottlenecks have resulted in excruciating waits for justice across Minnesota. In many cases, elderly victims of abuse have been forced to wait a year or longer for state investigators to complete their cases.

The delays undermine efforts by police and county prosecutors to hold perpetrators accountable, the Star Tribune found.

State health officials have acknowledged that they failed to react quickly enough to a surge in abuse allegations, which have risen sevenfold since 2010. At a legislative hearing last week, the agency said it is still sorting through more than 2,300 maltreatment cases that have never been reviewed by state regulators. While the much-larger Department of Human Services has stepped in to help, the backlog may not be completely eliminated until December, staff officials said last week.

"A big part of our backlog problem, besides the growing numbers of cases, is this very antiquated system" for handling abuse complaints, Malcolm said.

Lawmakers have been scrambling to come up with some solutions before the Legislature convenes.

Sen. Karin Housley, R-St. Mary's Point, chairwoman of the Senate Aging and Long-Term Care Policy Committee, said she plans to introduce multiple bills this session advancing elder care reform. The bills would make abuse reports and investigations more readily available to victims and their families, and strengthen the rights of older residents in senior care facilities. Housley is also in talks with senior advocates and providers about developing standards of care for the state's nearly 1,200 assisted-living facilities, which are less regulated than nursing homes.

"Elderly and vulnerable Minnesotans and their families have suffered for too long due to bureaucratic backlogs and inaction," said Housley. "We're going to get them answers, accountability, and action this session."

Malcolm, a graduate of Dartmouth College, most recently served as vice president for public affairs at Allina Health, the large hospital and clinic system. She has been an adjunct faculty member at the University of Minnesota School of Public Health and a senior program officer of the Robert Wood Johnson Foundation.

Chris Serres • 612-673-4308 Twitter: @chrisserres