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HomeMy WebLinkAboutLong Term Support Planning Committee 09-21-95ST. CROIX COUNTY NOTICE OF COMMITTEE MEETING TO: Robert Boche, Chairman St. Croix County Board FROM: Ron Lockwood, SW Supervisor Long Term Support Unit DATE: SeptemJ�er 11, 1995 ------------------------------------------------------------------- ------------------------------------------------------------------ COMMITTEE TITLE: Long Term Support Planning Committee MEETING DATE: Thursday, September 21, 1995 MEETING TIME : l: 30 p .m. Board Room - St. Croix Co. Health & Human Services Complex MEETING LOCATION• 1445 N. 4th Street, 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) 1996 Plan & Budget for LTS Programs. (see enclosure) NEW BUSINESS: 1) Financial Report 2) Variance and Purchase requests 3) Waiting list report 4) Consider endorsing Partnership Program project application Center for Independent Living of Western Wisconsin, Inc. 5) Medicaid Block Grant Issue Paper from Coalition of WI Aging 6) Legislative proposal to create single division within State submitted by the Groups(see enclosure) DHSS to administer both institutional and home and community -based long term care programs. ANNOUNCEMENTS & CORRESPONDENCE: POSSIBLE AGENDA ITEMS FOR NEXT MEETING: ADJOURNMENT: Copies to: County Clerk's Office Committee Members /lts-com/notice YVcsconsin SURVIVAL COALITION Coalitioii of Wiscoiisiii Agi»g Croups MEDICAID DLUUN GRANT ISSUE PAPER 1. The Survival Coalition and organizations representing the aging community believe that a Medicaid state block grant will undermine the delivery of cost- effective home- and community -based health care to all Wisconsin citizens. o Slock grants will perpetuate the inequalities that now exist between institutional and home- and community -based Medicaid expenditures. According to the National Association for Home Care, inpatient hospital and nursing home care represent 27.4% and 25% of total Medicaid payments respectively. In Wisconsin, according to the Legislation Fiscal Bureau's January 1995 paper on the Medical Assistance program, the percentages are 13.9% and 36.4% respectively. In fiscal year 1994, Wisconsin spent $828.7 million for nursing homes and $315.7 million for inpatient hospital services for a total of $1.14 billion for institutional care. This compares to less than $100 million for home- and community -based long-term care. � A Families USA May 1995 study states that Wisconsin will have a 32% reduction in Medicaid funds by 2002 with a block grant formula. This reduction could cut 35,100 Wisconsin citizens from long-term care services. The proposed decrease of $180 billion over seven years is simply too drastic and will result in the lack of health care for too many low-income families, especially given proposals to cut taxes which will primarily benefit wealthier persons. o Wisconsin's three choices to address these Medicaid reductions will be to: a. reduce services, ,_ bo restrict eligibility; or c4 raise taxes. 2. The entitlement of current Medicaid services must remain for all eligible Wisconsin citizens. The priority of funding must be shifted to home- and based services services as opposed to institutionalization. o Home- and community -based care has been proven to be a cost-effective alternative to institutional care. The U.S. General Accounting Office's August 1994 report, Medicaid Long -Term Care: Successful State Efforts to Expand Home Services While Limiting Costs, tells how Washington, Oregon, and Wisconsin have achieved significant Medicaid savings. On a per -beneficiary basis, home- and community -based care is considerably less expensive than nursing facility care." o A Medicaid block grant with a cap on the amount of funding for a state eliminates the entitlement nature of the program. If the cap is too low and/or if there is a recession, needy, low-income citizens (including people who are elderly, have disabilities, and children) would not receive health care. With block granting, Medicaid would no longer be a "safety net" for these people. o Medicaid entitlement should not be eliminated until there is a national health care program for all persons. 3. Wisconsin has a national and internationally renowned home- and community - based care delivery system. o The Community Options Program and its Medicaid waiver programs have been studied and duplicated in the United States and abroad. Wisconsin has the capacity to further reduce Medicaid costs while serving more citizens, whether delivered through managed care or fee for service, through its home- and community -based system. This system includes home health care and personal care with the Medicaid waiver programs. o Demographics, (i.e., the rapidly growing elderly population), and the high costs of institutional care provide an opportunity to shift the focus from high cost institutional care to less expensive and more desirable home- and community -based care. The result: more people receive services for the same or less money. For example, in 1993 the average monthly cost of nursing home care in Wisconsin was $2,166 compared to $1,609 for community care. Wisconsin provides long-term care to 20,000 more people in institutions than in the community (35,000 in Medicaid paid nursing homes vs. 15,000 in COP). 4. Other related block grant issues: o Will spousal impoverishment protections be lost? o Will nursing home regulations and consumer protections be eliminated? o Will low-income older persons, children and people with disabilities be forced to compete against each other for needed health care? What happens to the losers? Reference materials: 1. U.S. General Accounting Office Report, August 1994 ,. Lewin - VHI Study Kaiser Foundation Report, March 1995 4. ASAP Chart/Families USA, May 1995 5. Legislative Fiscal Bureau Information Paper, January 1995 Contacts for more information: Tom Frazier, Coalition of Wisconsin Aging Groups, (608) 257-0023 Chris Thomas -Cramer, Wisconsin Council on Developmental Disabilities, (608) 266-0979 LONG TERM SUPPORT COMMITTEE M Members present: James Craig, Charles Dow, Vern Dull, Honorine Gedatus, Lee Kellaher, Ray Mealey, Charles Murphy, Lee Steinberger, Robert Stephens, Marguerite Sumner, Glenda Zielski Members excused: Myrtle Munns Members absent: Lynn Erkkila Staff present: Ron Lockwood Meeting called to order by Chair Ray Mealey at 1:30 p.m. Roll call: Eleven present, one excused and one absent. Quorum present. Agenda Changes: Additional items were suggested for the agenda as follows: 1) Whether the Health and Human Services Department should be allowed to advertise; 2) Request to have a CSLA evaluation report at November meetings 3) Conference on Effecting Change; 4)Elder Abuse program information. Motion to adopt agenda with suggested additions by Robert Stephens, second by Lee Steinberger. Motion carried. Motion to approve minutes as mailed by Lee Kellaher, second by Marguerite Sumner. Motion carried. Chair Ray Mealey set the date and time for next meeting to be Thursday, November 16, 1995 at 1:30 p.m. at the Human Services Complex in New Richmond in the Board Room unless otherwise indicated on the meeting notice. The CSLA Advisory Committee will present their annual program evaluation report at that time. Unfinished Business: Ron Lockwood presented the 1996 budget for the Long Term Support Unit. Major budget cuts were necessary to comply with the Finance Committee directive to freeze county dollars going to the Human Services Department at the 1994 funding level. This demonstrates a lack of support and confidence in the Human Services Department by the leadership of the county board. To accomplish a balanced budget for Long Term Support while employee wages increased by 3%, maintenance costs increased by 22% and contracted service cost rose by 3% it was necessary to make major cuts in certain program areas. One position in St. Croix Industries which will be vacant due to retirement will be terminated. Cooperative Community Programs/Adapted Living, Inc> was pressured to make substantial cuts in its charges for residential support services so that its costs were more in line with the other residential service providers currently under contract with the county. Limited funds LTS Committee Minutes 9/21/95 Page Two also made it necessary to channel supportive home care dollars through the Home and Community Based MA Waiver program so that federal resources could be leveraged and services could be targeted to those most in need. Motion by Robert Stephens, second by Lee Kellaher that the LTS Committee Chair send a letter to the Human Services Department Board advising that $25,000 should be maintained in the General Relief Fund for 1996 and that the administration receptionist position be reviewed for true costs. Motion carried. New Business: 1) The financial report for January to July 1995 activities showed most programs well within budget limits. The Home and Community Waiver COP-W is running at about $68,000 above budge" and so it will be necessary to use COP dollars to finance the required 40% match of $27,200. Federal dollars pay 60% of expenditures above the fully funded levels as long as the average daily rates do not exceed $40.00. The average daily rate is currently at $22.70. 2) Variance and purchase requests. None were requested. 3) Waiting list report: COP 33 and CIP-2/COP-W 34. 4) The Independent Living Center Partnership Program will be discussed at the November meeting. 5) Because of limited time the Medicaid Block Grant issue paper will also be discussed at November meeting. 6) Legislative proposal for long term care discussion will be on the November agenda. 7) It was agreed that the CSLA Evaluation Committee would report on their findings at the November meeting. 8) The recent Corporation Counsel opinion on advertising was reviewed and discussed. Motion by Glenda Zielski, second by Charles Dow to send a letter to the Human Services Board that the LTS Committee would like to see advertising of Human Services Department services in all telephone directories in St. Croix County for the purpose of informing the public regarding availability of Human Services Department services. Motion carried. 9) Motion to adjourn at 3:30 p.m. by Lee Steinberger, second by Honorine Gedatus. Motion carried. by: Ron LocKwood Alcohol / Drug Abuse 246-8209 Child Protection 246-8285 CSP 246-8400 Economic Support 246-8257 Family & Children's Services 246-8285 Home Health 246-8279 Long -Term Support Early Intervention 246-8250 Mental Health 246-8287 Nursing Home 246-6991 Public Health Family Planning WIC 246-8263 St. Croix Industries 246-8299 FAX 246-8225 Information / Other Departments 715/246-6991 TDD 246-6325 1445 N. Fourth Street New Richmond, Wisconsin 54017 October 3, 1995 LuVerne Burke, Chair Health & Human Services Board 1330 Eighth Avenue Baldwin, Wisconsin 54002 Dear Mr. Chairman: The Long Term Support Committee directed me to send you a letter regarding the following items: General Relief, the administrative receptionist position and advertising services. The Committee recommends that at least $25,000.00 be budgeted for General Relief during 1996 to help the people who have nowhere to go. It was also recommended that the administrative receptionist position be reviewed for true costs. As Chair of the Long Term Support Committee I requested and received a memo from Corporation Counsel Gregg Timmerman indicating the Human Service Department can inform the public as to the availability of county provided services through advertising in local media. The Committee would like to see advertising of Human Services Department services in all telephone directories in St. Croix County. The Committee would appreciate your consideration of these matters. S ierely, R Me ley T Chair, LTS Committee h-iu�itF1�1 cc: Members, HHSD Board John Borup