HomeMy WebLinkAboutLong Term Support Planning Committee 07-08-1999ST. CROIX COUNTY
NOTICE OF COMMITTEE MEETING
TO: Tom Dorsey, Chairman
St. Croix County Board
FROM: Ron Lockwood, SW Sup Board/
r \
Long Term Support Unit
DATE:
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COMMITTEE TITLE: Long Term Support Planning Committee
MEETING DATE: THURSDAY, JULY 8, 1999
MEETING TIME: 1:30 p.m.
Health & Human Services Complex, Board Room
MEETING LOCATION: New Richmond, WI 54017
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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) Family Care Districts
NEW BUSINESS:
1) Financial Report
2) Variance & Purchase Requests
3) Consider policy regarding purchase of generators for households with personfwho
require ventilator equipment and who may experience temporary electric service
disruptions caused by Y2K or electric storm, etc.
4) Status of county operated Home Health services.
5) Aging Unit Deport -Sandy Gehrmann
ANNOUNCEMENTS & CORRESPONDENCE:
POSSIBLE AGENDA ITEMS FOR NEXT MEETING:
ADJOURNMENT:
Copies to: County Clerk's Office
Committee Members
/its-com/notice
an additional CMO is needed to assure access to the Family Care benefit to all entitled persons
in the CMO's area within two years.
Potential conflicts of interest exist when the same entity determines eligibility for a benefit
with varying payment levels based on level of disability and also receives the payment as a
CMO. The federal government has indicated that it will not approve needed waivers under
such circumstances. Under the bill, a county, a tribe or band, a Family Care district or an
organization may not directly operate both a Resource Center and a CMO. The bill specifies a
number of options open to counties and tribes who wish to be involved in the operation of both
a Resource Center and a CMO. The bill authorizes a county department of social services,
human services, developmental disabilities services or community programs or an aging unit
authorized by the applicable county board of supervisors to apply to DHFS to operate a
Resource Center or a CMO.
The bill also authorizes the Secretary of DHFS, in order to facilitate the transition to the
Family Care benefit system, to grant a county limited waivers to certain COP and CIP statutes
and rules promulgated under those statutes. Counties are also authorized to create a risk
reserve under the Community Options program, within the currently allowed carry-over
provisions, to be used either to meet unexpected COP expenditures in a subsequent year or to
be transferred to a CMO risk reserve. In addition, the current limit of $500,000 on the amount
of COP funds that that have not been expended or carried over by counties is removed; the
purposes of these funds are expanded to allow DHFS to allocate funds to counties for planning
and implementation of Resource Centers and CMOs.
Family care district
To address the conflict of interest issues, the bill authorizes county boards of supervisors to
create, on a single county or multicounty basis, special purpose districts that are termed
Family Care districts. Under the bill, a Family Care district is a local unit of government,
separate and distinct from the state and a county, for which the primary purpose is to operate a
Resource Center or a Care Management Organization, but not both. The jurisdiction of the
Family Care district is the county or counties of the county board or boards of supervisors
who created the district. The Family Care district's board is appointed for three-year terms by
the county board of supervisors and must consist of 15 persons for a single county and, for a
multicounty Family Care district, an additional member for each county in excess of two.
Board members must be residents of the Family Care district's jurisdiction. At least one-
fourth of the members must be representative of the client group or groups whom it is the
Family Care district's primary propose to serve or those clients' family members, guardians or
other advocates. No member may be an elected or appointed official or an employe of the
county and no member may have a private financial interest in or profit from any contract or
other business of the Family Care district.
The bill authorizes a Family Care district to carry out the provisions of the bill related to the
Family Care benefit, Resource Centers and CMOs. In addition, the bill grants to a Family
Prepared by Department of Health and Family Services February, 1999 Page 5
Care district the powers, among others, to adopt bylaws and policies and procedures to
regulate its affairs; sue and be sued; negotiate and enter into leases and contracts; provide
services related to services available under the Family Care benefit, to older persons and
persons with disabilities, in addition to the services funded under the contract to operate a
Resource Center or CMO; employ agents, employes or special advisers, fix and regulate their
compensation and provide employe benefits; mortgage, pledge or otherwise encumber the
Family Care district's property or funds; create a risk reserve or special reserve, including as
DHFS requires by contract; accept aid; and make instruments necessary to exercise its powers.
However, a Family Care district may neither issue bonds nor levy a tax or assessment.
Under the bill, a Family Care district must appoint a director, who must manage the Family
Care district's property, business and employes. The Family Care district must also develop
and implement a personnel structure and other employment Policies. However, with respect to
the hiring of employes who formerly were county employes to perform the same or
substantially similar functions that they previously performed, the Family Care district must
observe a number of requirements designed to assure that these employes' wages, benefits,
hours, years of service pensions, and collective bargaining rights are preserved.
Numerous laws that apply to counties, special purpose districts and other local units of
government apply to the Family Care district, including, among others, exemption from sales,
income and property taxes, inclusion in unemployment compensation, worker's compensation
and public employe occupational safety and health laws, open records and meetings, municipal
employment relation laws, code of ethics, and participation in the state retirement and health
benefits. Under the bill, obligations and debts of a Family Care district are not the obligations
or debts of the county that created the Family Care district. A Family Care district may be
dissolved by joint action of the Family Care district board and the county board or boards of
supervisors that created the district, subject to performance of its contractual obligations and if
first approved by the Secretary of DHFS. If the Family Care district was created by more than
Lonepcounty, the county boards of supervisors must agree on the apportioning of the district's
ty before dissolution takes place.
Pre -admission screening and requirements of care facilities
The bill requires the Secretary of DHFS to certify to each county, nursing home, community -
based residential facility, adult family home and residential care apartment complex the date on
which a Resource Center that serves the area of the county, home, facility or complex is first
available, with respect to specific groups of eligible individuals or for specified facilities, to
provide a functional and financial screen. Within a time period prescribed by DHFS by rule, if
the certification has taken place, each affected nursing home, community -based residential
facility, adult family home and residential care apartment complex must inform prospective
residents of the facility about the services of a Resource Center, the Family Care benefit and
the availability of a functional and financial screen to determine eligibility. Also, these
facilities and hospitals must refer to the Resource Center persons who seek admission and who
are aged at least 65 years or have a physical disability unless the person has received a screen
Prepared by Department of Health and Family Services February, 1999 Page 6
ST. CROIX COUNTY DEPARTMENT OF HEALTH
AND HUMAN SERVICES / HEALTH CENTER
1445 N. Fourth Street
New Richmond, Wisconsin 54017 - 1063
Alcohol / Drug Abuse
246-8209
Child Protection
246-8285
LONG TERM SUPPORT PLANNING COMMITTEE
MEETING MINUTES
Economic Support
246-8257
JULY 8, 1999
Family & Children's
MEMBERS
Services
246-8285
PRESENT:
Bruce Bayer, Robert Boche, Keith Gregerson, Fern Johnson,
_
Ray Mealey, John Mortensen, Robert Palewicz, Richard
Home Health
246-829
Peterson, Francis Schaffner, Marguerite Sumner, Wanda
Viellieux
Long -Term Clinical
Services / CSP
246-8400
MEMBERS
EXCUSED:
James Craig, Glenda Zielski
Long -Term Support
Early Intervention
246-8250
MEMBERS
Mental Health
ABSENT:
none
246-8287
STAFF
Nursing6 91ne 246
PRESENT:
Ron Lockwood, Social Work Supervisor; Sandra Gehrmann,
Aging Department Director
Public Health
Family Planning
WIC
CALL TO ORDER:
Meeting called to order by chair Ray Mealey at 1 :30pm
246-8263
St. Croix Industries
ROLL CALL:
Eleven present and two excused.
246-8299
FAX
ADOPT AGENDA:
Ron Lockwood requested two items be added to today's
246-8225
agenda; modify the pre -admission screen policy; and consider .
246-8220
modifying the waiting list priority list. Robert Boche requested
Information
a change in order of business with regard to policy on
Other Departments
generator purchases as he needed to be excused from the
715/246-6991
TDD
meeting early. A motion was made by Keith Gregerson to
246-8325
adopt today's agenda with the above additions and change;
second by Marguerite Sumner. Carried unanimously.
PREVIOUS
MINUTES ACTION:
Motion by John Mortensen to accept the previous meeting
minutes as written; second by Wanda Viellieux. Carried
unanimously.
NEXT MEETING:
Thursday, August 12' at 1 :30pm. Human Services complex in
New Richmond; 74 Board Room.
NEW BUSINESS:
Consideration of new policy regarding purchase of generators due to possible Y2K
electrical service disruptions. This discussion is related to request for variance by
family with multiple
handicapped child who is requesting a generator be purchased for
the family so that there will be no interruption in electrical service to this ventilator
dependent child. There was much discussion with many other options and issues
LTS Planning Committee Meeting
July 8, 1999
noted by several committees members. Issues and options that were discussed included:
1. Liability for county with regards to maintenance, costs after purchases,
operation of the generator, periodic testing.
2. There is a battery backup unit on this child's ventilator with time so as to allow
the family to get the child to a facility that can provide power needed.
3. Arrangements could be made prior to December 31, 1999 to have the child at a
facility that will be able to provide power.
After a lengthy discussion, a motion was made by John Mortensen to deny this request for a
variance to purchase a generator through a county program; but that this committee would give the
family a list of other options that would be available to them. Motion second by Wanda Viellieux.
Carried unanimously. Chair Ray Mealey indicated he would draft a denial letter and include on it the
options that were discussed at this meeting.
Robert Boche submitted handout with regard to steps taken by St. Croix County for Y2K
preparations. The report indicates that St. Croix County is up to date on testing and preparing the
different aspects of the possible Y2K disturbances.
UNFINISHED BUSINESS:
Proposed Family Care: Sandy Gehrmann from the Department on Aging provided a promotional
videotape on Family Care.
Family Care Districts: Ron Lockwood shared a descriptive report
Some items to be noted:
• Districts will eliminate conflict of interest between CMO and Resource Center;
(Resource Center determines amount of dollars to be available for care while the CMO delivers
the services)
• Currently Waiver Programs run on a cost -based system (reimbursement as costs occur)
• New system will be risk -based (a lump dollar amount will be available for a person for specified
amount of time
• CMO will be allocated fixed dollar amount per month per person served regardless of costs
incurred.
Discussion and questions on Family Care Districts and Family Care itself, however, there are not any
clear answers yet. Information will be shared with this committee, as it becomes available.
NEW BUSINESS:
Financial Report: Expense levels are in line with budget limits for this period of time.
Waiting list increasing due to application process taking longer; families have
been asked to apply for Medical Assistance first because if they
don't qualify for MA, they don't qualify for a waiver program.
Status of County operated Home Health Service: The county board voted to close the St. Croix
County Home Health Department. The department is already in the process of taking steps to
close. The date for closure will be 11 /1 /99. There was some discussion of implications this will
have on residents.
LTS Planning Committee Meeting
July 8, 1999
COP Pre -admission Screen Policy: Ron Lockwood informed the committee of the current
requirement in the policy for CBRF admission to require a pre -admission screening in order to be
eligible for COP. He would like a statement in this policy that if Alzheimer's or related dementia, the
pre-screening is not required. Motion by Marguerite Sumner: Second by Fern Johnson; no further
discussion. Carried unanimously.
Waiting List Priority Level: Ron Lockwood explained the priority list for waiting and that it would be
financially advantageous to St. Croix County for the persons that are currently in IMD slots
(Institution for Mental Diseases) to be a priority for the waiver program waiting list. Motion by
Richard Peterson, second by Bruce Bayer. Carried unanimously.
Aging Unit Report: Sandra Gehrmann, Director of Department on Aging reported that they are ready
for the fair, July 22-25. The Golf Benefit is doing well and they are getting the sponsors needed.
The Benefit specialist is getting increasingly more legal issues coming up and is asking for some
legal advice. An attempt will be made at getting area attorney's to sign up for pro-bono work.
Motion to adjourn by Keith Gregerson; second by John Mortensen, carried unanimously.
Minutes submitted by
Michele M Johnson, LTS Program Specialist