Loading...
HomeMy WebLinkAboutLong Term Support Planning 11-13-97ST. CROIX COUNTY NOTICE OF COMMITTEE MEETING TO: Robert Boche, Chairman St. Croix County Board FROM: Ron Lockwood, SW Supervisor Long Term Support Unit DATE: October 30, 1997 COMMITTEE TITLE: Long Term Support Planning Committee MEETING DATE: Thursday, November 13, 1997 MEETING TIME: 1:30 p.m. --- MEETING LOCATION: Health & Human Services Complex Board Room New Richmond, WI 54017 ----------------------------------- CALL TO ORDER: ROLL CALL: ADOPTION OF AGENDA: ACTION ON PREVIOUS MINUTES: DATE/LOCATION OF NEXT MEETING: AGENDA: (Agenda not necessarily presented in this order) UNFINISHED BUSINESS: 1. 1998 Plan and Budget for Long Term Support 2. Discussion regarding ideas generated at 10/14/97 community meeting on Long Term Care Redesign 3. St. Croix Disability Coalition position paper on LTC Redesign presented by Wanda Viellieux, Donna Fortin and other Coalition members. - NEW BUSINESS; 1. Financial Report 2. Variance & Purchase Requests 3. Report on Statewide LTC Advisory Committee --Ray Mealey 4. Aging Unit Report --Sandy Gehrmann S. Office of Strategic Finance Report by rent Sprague, Assistant Area Administrator for the Wisconsin Department of Health and Family Services 6. Consider setting further limits on supportive home care services purchased with COP and MA Waiver funds. RON LOCKWOOD SOCIAL WORK SUPERVISOR ANNOUNCEMENTS CORRESPONDENCE: POSSIBLE AGENDA ITEMS FOR NEXT MEETING: ADJOURNMENT: Copies to: County Clerk's Office Committee Members /lts-com/notice r St. Croix Disability Coalition Long Term Care Redesign THE ST. CROIX DISABILITY COALITION POSITION PAPER ON LONG TERM CARE REDESIGN PROPOSALS The St. Croix Disability Coalition is a group of consumers, professionals and parents in St. Croix, Pierce, Dunn and Polk counties. Among our goals is to advocate for the inclusion and integration of persons with disabilities into the mainstream of community life in housing, transportation, employment and social activities. We have a representative on the St. Croix County Long Term Support Committee and have had a focus group at which the Coordinator for St. Croix Long Term Support has discussed the issues with us. The St. Croix Disability Coalition has been very involved in tracking the work of the various state committees and recommendations prior to the spring Long Term Care Redesign Proposal by the Wisconsin Department of Human Services. Membership in the Coalition includes three Full Citizenship Initiative Coordinators spanning 6 counties; St. Croix/Pierce, Dunn/Pepin, and Chippewa/Eau Claire. All of the members are active in state-wide organizations and have access to timely information regarding state-wide issues. When the proposal by the Department of Human Services was announced, the St. Croix Disability Coalition decided that it was important to communicate a position reflecting the needs of an area in Wisconsin where the system attitudes, dollars and services seem to be remarkably different from the urban southern part of the state, while the needs of the differently abled person remain the same. The following is the result of our considerable efforts. The working group is made up of parents, professionals, and consumers. The St. Croix Disability Coalition believes the following: That Community is essential to human life. Community establishes values, benefits and responsibilities. Community provides an individual with a sense of belonging and value, while individuals, in turn, provide a community value. A sense of security is provided to individuals who belong to a community. That quality of life rests in consumer control of service opportunities. That choice and control over all services is designed by the consumer with incentives for fiscal responsibility that does not sacrifice quality of services. Respects and values the inherent worth of each individual and each family unit. That desire and motivation are the key elements to quality of life and individual goal achievement. That technology is not about boxes, wires, gadgets and such. It is about ideas, communication and the extension of life opportunities. When we speak of the development and use of technology the really valid measure is outcome. C� St. Croix Disability Coalition Long Term Care Redesign That the present system is non responsive to our needs in rural northern Wisconsin and we must continue to creatively organize and present our views. That the present system is based on ease of delivery and a narrow range of services which does not take into account rural distances and incomes. That we, as consumers, professionals and parents must continue to educate ourselves and direct the system to provide for our needs, rather than continue at our individual and childreds risk. That the Long Term Care Redesign for the State of Wisconsin will include: Transportation: The long distances required to access services makes the current cost of transportation out of reach for a family with a member requiring special vehicles to transport them. An increase in the provision of scheduled service by trained personnel with accessible vehicles is essential. It is necessary to revise the allocation of funding for disabled and elderly transportation to rural northern areas of the state under a new formula which matches funding for urban areas and takes into account the number of miles needed to cover rural areas and the limited county community aids for rural counties . More affordable, accessible transportation systems are necessary for consumers who are not Medical Assistance eligible. Presently, transportation for all basic needs is limited by income and lack of public transportation in rural counties. Consumer directed long term support plans: All consumers will be given the opportunity to choose their individual community living, employment, social, recreational and health care plans within the funding allocated to them. Plans will include mileage to and from medical and support services. Funding for such long term support plans will remain with the consumer, when that individual chooses to terminate provision of services with specific programs/agencies. A single point of entry. Using the present systems which have been developed through the counties, families and individuals who travel long distances in rural northern Wisconsin will be able to access quality services in one setting and with one agency. Satellite intake offices will be located throughout the county, with at least two per county. Intake procedures will include a variety of communication modes (braille, audio tape) and a full range of options will be presented to the consumer. First Step and First Call for Help will continue to be utilitzed for publicity purposes. Funding through current programs such as Community Options, Community Integration Program, Community Aids, Birth to Three and the Family Support Program as well as Medicare and Medical Assistance will continue to be accessed for this care. Mileage or low cost transportation for rural families and individuals will be included in any health care plan. 7 St. Croix Disability Coalition Long Term Care Redesign Consistent and measurable performance criteria for the provision of services in long term care plans will be implemented. In the beginning monitoring will occur annually until counties and consumers are satisfied that services are being provided in a timely and humane manner. Application for Home Health Care licenses will be required. Agencies which do not comply with agreed upon performance standards will not be re- issued licenses. Monitoring for quality of service will be the responsiblity of a separate agency not administering or providing for services. Funding for independent advocacy organizations will be provided to individuals and families with easy access in alternative communication modes and funding for mileage to appointments provided. County Long Term Care Support Committees, made up of consumers, professionals and parents will continue to monitor long term health/home care plans. Mileage for attendance at meetings will be provided for members. Health Care: Consumer managed, holistic approach to individual health needs from medicine to assistive medical technology. All citizens will be able to receive/purchase health care coverage at an affordable rate which will be portable from job to job and from state to state. It will include the following basic features: No exclusions for congenital defects or pre-existing conditions. Absolute guarantee of consumer's choice of providers which does not restrict client to specific clinic or network of providers or to a particular state or locality. Easy access/self-referral to specialists and for second opinions. Basic health care including pediatric and geriatric services, prenatal and well child care, immunizations, mammography and PAP tests, dental care, mental health services and prescriptions. Home health care, Durable Medical Equipment and medical supplies which enable people to remain in their homes and communities and function as independently as possible. Reimbursement rates to give incentives for rural health care providers. Coverage to include pain management and "experimental" treatments/drugs. Funding for alternative health care practices, such as chiropractic, massage therapy and homeopathic practioners will be provided. Funding for acute health care will be separate from long term support care, however it will be taken into consideration in individual cases. Rehabilitation Technology will be more easily accessed with medical and vocational evaluations to promote as much individual independence as possible in personal and employment environments. 8 St. Croix Disability Coalition Long Term Care Redesign Vocational Training will continue to provide education, work modification and placement within regular or home environments, full employment with regular benefits, and career advancement opportunities. Accessible housing information, supportive services and funding opportunities for individual home buying and building with barrier free energy efficient options will be offered in individual service plans. F Independent Living Centers will provide advocacy services for individual independent continuum plans from point of referral to consumer termination of services. Advocacy services will include legal rights specialists. - - - - Community support: Community support will be designed and developed with peers and community leadership, including community integration opportunities and health and safety monitors. Family Services: Services which strengthen the family unit, empower them to care for a member with special needs and enable that individual to retain his/her unique and integral position with that family, including, but not limited to, • Individual, Marriage and Family Counseling • Respite and Day Care • Case Management •, Home Health Care and other supportive services • Housing modifications • Assistive technology • Access to legal and advocacy services • Flexible employment options for caregivers which expand on the Family Leave Law Education/Transition Planning: All parents will have free access to information regarding their children's rights to an education in the least restrictive environment, transition plans and be provided with resources for the above. Length of school bus rides in compliance with state laws will be monitored. Medical Assistance and School services: Parent's health insurance coverage should not be accessed by schools for services mandated by I.D.E.A. in lieu of Medical Assistance. G] Ideas generated from 10/14/97 community meeting to discuss Long Term Care Redesign for St Croix County. Issues/ Concerns: • Should be more than one managed care organization so people have some choices. • Concern that all resources will be channeled to only those most in need. • Need incentives in system to provide prevention services. • What about children services? Will those services be carved out? • Why don't the waiver programs pay for care in an apartment which is attached to a nursing home. Some older persons would like to live there because medical support services are so accessible, • Should be prohibition against county self referring to its own nursing home when the county nursing home is not the person's preference or is not the best qualified facility. Goals: • Acute medical care and long term care should be better integrated. • Should have task force to look at long term care issues from an area -wide perspective. • Should host visit by Secretary Leann to NW Wisconsin. • Need measurable objectives for long term care services. • Direct care givers need to be better compensated for their work. County Role: • Need for a strong partnership between county government and private sector. • - State should not impose unfunded mandates on counties. • Establish a task force to come back with recommendations for the county after a few months of consideration. Task Force would be a cross section of providers and consumers. ST CROIX COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES LONG TERM SUPPORT PLANNING COMMITTEE NOVEMBER 13, 1997 MINUTES MEMBERS PRESENT: Bruce Bayer, Loraine Darnauer, Keith Gregerson, Fern Johnson, Lee Kellaher, Ray Mealey, John Mortensen, Marguerite Sumner, Wanda Viellieux, Larry Weisenburger, Glenda Zielski MEMBERS EXCUSED: James Craig, Robert Palewicz, Joan Richie MEMBERS ABSENT: STAFF PRESENT: Ron Lockwood, Social Work Supervisor Michele Johnson, LTS Clerk III GUEST(S): Donna Fortin, St. Croix Disability Coalition Meeting called to order by Chair Ray Mealey at 1:30pm Roll Call taken with 11 present; 2 excused; 1 absent. Quorum present. Motion by John Mortensen; second by Marguerite Sumner to adopt agenda as presented. Motion carried. Motion by Lee Kellaher; second by Bruce Bayer to accept minutes as written. Motion carried. Date & Location of next meeting wili be February 12, 1998 at 1:30pm. T he meeting will be held in the Board Room of the Health & Human Services Complex in New Richmond. UNFINISHED BUSINESS: 1998 PLAN AND Budget for Long Term Support. Ron Lockwood reported that the 1998 budget has been approved as submitted. The increase in funds for in -home community waiver programs has been approved to start 1/1/98. This will allow us to remove 20 persons from the CIP2/COPW waiting list and 12 from the CIP1 B waiting list. Discussion continued regarding block grants, budget, budget freezes, etc. Ron LTS Committee Meeting page 2 Thursday, November 13, 1997 Lockwood reported that a "round table" group including persons from all human services departments has been meeting to discuss many inter -departmental issues. Long Term Care Redesign Community Meeting 10/14/97. Ron Lockwood handed out an outline of ideas generated at this meeting. St. Croix Disability Coalition position paper on LTC Redesign presented by Donna Fortin. Coalition members grouped together to write the proposal. Ms. Fortin explained a history and purpose of the coalition. She indicated some of the points in this proposal; saying that this is the best the coalition would like to see. This proposal is written for presentation to Secretary Joseph Leean. NEW BUSINESS: Financial Report: All budgets are within limits. Waiting list discussed. A change will be made in the format of the report to indicate that the 20 persons on the CIP2 and COPW list are the same persons. This will be updated on the next report. Variance & Purchase Requests: There were none. Statewide LTC Advisory Committee report — Ray Mealey will be attending on November 20'. There has been no new information. He will keep this committee informed. Aging Unit Report — Sandy Gehrmann reported on the Office on Aging activities. Information on How to Stop Medicare Fraud was handed out. Ms. Gehrmann discussed the enormous amounts of money that is being spent on fraudulent claims. A volunteer committee is being formed to help deal with some of these issues. Anyone interested in volunteering should contact the Office on Aging Supportive Home Care Guidelines/Limits: Ron Lockwood presented to the committee a proposal for setting guidelines for waiver participants to receive supportive home care services. The guidelines came about as the amount requested by participants is increasing, the providers are increasing, and the costs for these services is increasing. LTS Committee Meeting Thursday, November 13, 1997 page 3 A written proposal for Supportive Home Care Limits to be effective 1/1/98 presented as follows: Limits for all Supportive Home Care services purchased through the Community Options Program and the Medical Assistance Home and Community Based Waiver Programs. 1.) Yard work will be provided only when no member of the household is capable of performing this task. 2.) House cleaning services will be limited to a maximum annual cost of $3,000. 3.) Snow removal will not be provided. Variances to the above policy as with all county determined COP/CIP related policies are obtained in the following manner: Requests must be submitted to the Long Term Support Planning Committee for approval or denial. Policy to be effective January 1, 1998 for new program participants or at the first annual review after January 1, 1998 for current participants. Motion made by Lany Weisenburger second by Bruce Bayer to approve the requested limits as submitted. Carried unanimously. Meeting adjourned at 3:15pm Submitted by Michele JohrTon, LTS Clerk III