Minnesota shoring up long-term care, hospitals amid ongoing COVID-19 surge

Gov. Tim Walz wants to provide $50 million in federal money to help long-term care facilities hire and retain staff in the midst of the state's ongoing surge of COVID-19 cases.

Walz announced the funding proposal Monday along with a new plan for how the Minnesota National Guard will support long-term care facilities that are short of staff.

Meanwhile, U.S. Sen. Amy Klobuchar announced that a team of doctors, nurses and respiratory therapists from the Department of Defense is scheduled to start working Thursday — Thanksgiving Day — at Hennepin Healthcare's HCMC in Minneapolis.

"Our hospitals are getting help, but they're still going to be way overworked," Klobuchar said during a news conference across the street from the hospital. She urged Minnesotans to help by getting vaccinated — either initial shots for those who haven't yet been immunized or boosters for those who qualify.

"You have to do it for your family. And you have to do it for those doctors and nurses," Klobuchar said. "When people are gathered for Thanksgiving, you have to understand that there are doctors and nurses that are going to be working double shifts on that day."

Walz announced last week that the federal government would send 22-person medical teams to HCMC as well as CentraCare, which is based in St. Cloud.

The governor has submitted to a legislative committee his proposal to use $50 million in federal American Rescue Plan funding for emergency grants to long-term care facilities. The state Department of Human Services (DHS) would distribute the grants in December, Walz said in a news release Monday, with 90% of the funding used for workforce retention and hiring.

On Monday, Walz also announced new skilled-nursing response teams from the Minnesota National Guard that nursing homes facing severe staff shortages can request for up to three weeks at a time. Over the next seven days, 400 National Guard members will start training as certified nursing assistants and temporary nursing aides.

"There are 23,000 open long-term caregiver positions across Minnesota. A crisis of this scope requires bold solutions, and we know we cannot fix this problem alone," Gayle Kvenvold, president and chief of LeadingAge Minnesota, a trade group for long-term care providers, said in a news release announcing the developments.

Patti Cullen, president and chief executive of Care Providers of Minnesota, another trade group, added: "We are facing unprecedented, record-level workforce shortages in long-term care communities across our state."

On Monday, Klobuchar toured HCMC's emergency department, where five patients were on ventilators in the ER because beds were not available. That's an unusually high number, doctors said, adding that at least one of the patients on a ventilator was sick with COVID-19.

By week's end, the hospital intends to launch a new 10-bed holding unit for those awaiting an inpatient bed. It won't be staffed by the medical team from the Department of Defense, but the federal health care workers will help free up others to staff the holding area.

The hospitals' current staffing crunch means HCMC at times has been declining five to 50 patient transfers per day because the emergency room is just too full, said Dr. Dan Hoody, the interim chief medical officer at Hennepin Healthcare. When small rural hospitals are trying to send patients to the metro for complex care needs, the delays can have consequences for patients, Hoody said.

"We are not at capacity. Most days, we're over-capacity," Jennifer DeCubellis, the chief executive of Hennepin Healthcare, said during the news conference with Klobuchar. "Hospitals are taking on more care than they're staffed to provide. We are stretching our team members to an extreme."

The developments Monday came as Minnesota's pandemic indicators showed small signs of improvement, although not enough to signal a turnaround from recent trends of more COVID-19 cases and hospitalizations.

The Minnesota Department of Health announced Monday another 4,718 cases of COVID-19 and 37 deaths connected to the pandemic. The latest case tally brings the rolling seven-day average to 5,573 new cases per day, which is down slightly from last week, according to a Star Tribune analysis.

The Health Department's most recent data show 1,373 patients with COVID-19 were being treated in hospitals on Friday, down from 1,414 patients the previous day.

Counts for new cases and hospitalizations in recent weeks have been approaching the highs from 2020. At one point last November, the state was reporting an average of more than 7,000 new cases per day; statewide hospitalizations peaked in late November at 1,864.

The latest figures released Monday on "breakthrough" infections — meaning COVID-19 cases in people who previously were vaccinated — show that vaccines continue to be highly effective, but the protection wanes over time.

Throughout the pandemic, roughly 84,000 Minnesotans have suffered breakthrough infections, which is less than 3% of all state residents who have been fully vaccinated. However, more than 11,000 of those cases were identified with the most recent batch of data, which the Health Department updates every Monday.

COVID-19 vaccines are highly effective, doctors say, but they can't stop all infections. They add that while some are hospitalized with and die from breakthrough infections, the chance of serious illness from COVID-19 is much lower in those who've been vaccinated.

"If more Minnesotans were vaccinated right now, I can unequivocally state we would not be in as dire a situation as we are today," Hoody said. "Getting vaccinated, getting your booster, will make a real difference for everyone in the weeks and months to come."

Walz's announcement included funding for long-term care facilities facing unexpectedly high costs associated with COVID-19. DHS is expediting Medicaid reimbursement payments, he said, to eligible nursing homes that experience staff shortages beginning in January 2022 and continuing for up to six months.

The moves are the latest in a series of measures designed to help long-term care providers that suffered the worst of the pandemic before widespread vaccination brought protection. The governor announced in October that the National Guard would help relieve a staffing bottleneck in long-term care that prevented Minnesota hospitals from discharging patients to transitional care units and nursing homes.

Since the beginning of November, nearly 50 members of the Guard have supported transition care units at sites in Shakopee, Brainerd and St. Paul. More than 70 service members since mid-October have been working at community-based testing centers across the state.