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NOVEMBER 13, 2003
The following minutes have not yet been approved by the
Committee to which they pertain
Members Present:
- David Fagan, D.O.
- Mary Deluca
- Wanda Davies
- Sharon Gilman
- Ellen Zonka
- Katherine Smith
- Peter Duncan
- Cynthia Close
Members Absent: Margaret Sheldon, Myra Arendt, Rita Salamun, Jim
Schendel, Gail Bruss, Debbie Nowak
The Meeting was called to order at 9:00 by Dr. Fagan
Cindy Close was introduced to the Committee as a new member
representing Columbia St. Mary’s-Ozaukee Campus.
Motion by Katie Smith, seconded by Mary Deluca to accept the minutes of
September 11, 2003 as written. Motion approved by voice vote.
2003 SPENDING/STATISTICS – The Committee received the year to date
spending showing COP expenditures of $315,585 (89% in 83% of the year),
COP-Waiver expenditures of $918,497 (105% spent in 83% of the year, and
CIP II expenditures of $139,995 (111% spent in 83% of the year).
WAITING LIST UPDATE - Currently 16 Physically disabled persons, and
29 elderly persons are on the waiting list. In addition, 26 elderly
persons are waiting for CBRF funding. Discussion pointed out the elderly
persons on the waiting list are of various ages including 99 and 96 year
olds! One man who was 90 years old waiting for CBRF funding had to leave
the CBRF and enter a nursing home. He died 2 weeks later.
BUDGET FOR 2004 – The Committee reviewed the 2004 budget showing
nearly identical funds available in 2004 as in 2003. The $40,000 of County
Levy is projected to be in the budget for 2004 through the undesignated
fund balance rather than through New County Levy.
USE OF MA PERSONAL CARE IN CBRF: - Frank indicated a projected
revenue of $346,896 through Medical Assistance Personal Care funds to help
reduce CBRF costs in 2004. Social Services and the Public Health nurse
will use the MA-Personal Care Program to cover personal care to our
existing COP-Waiver clients in CBRF’s. There will be a reduction in
COP-Waiver payments to the facilities because of the additional MA
revenue. This will be gradually implemented throughout 2004. Dicussion of
the need for information packets for CBRF operators to clarify use of COP
and COP-Waiver funds for new residents. Frank will follow up.
UPDATE ON CIP II RELOCATION SLOTS – Social Services has received
approval for 3 CIP II relocation slots to be used for persons in nursing
homes who are waiting for funding. One individual has been relocated to a
CBRF. The other two are pending. These are additional funds over and above
our CIP II allocation
CBRF EXCEPTION REQUESTS - Three cases were presented to the
Committee requesting exception to the CBRF waiting list policy because of
a Court Ordered Protective Placement into a least restrictive setting.
There was much discussion on the nature of "least restrictive" and the
fairness issue of granting exceptions to allow these three to be funded
and jump over the 29 individuals on the waiting list! The question arose
as to the authority of the Long Term Support Planning Committee vs. Social
Services Committee in matters of policy on this issue. Dr. Fagan moved to
table action on the exception requests pending clarification of the
waiting list policy. Motion to table was seconded by Peter Duncan. Motion
approved by voice vote. Motion by Peter Duncan, seconded by Sharon Gilman
to bring the issue of CBRF waiting list exceptions to the Social Services
Committee. Motion approved by voice vote.
REQUEST TO REMAIN ON THE CBRF WAITING LIST - A man on the
physically disabled waiting list is waiting for CBRF funding. He will run
out of funds early in 2004. If he moved from the CBRF temporarily to a
family members home in Washington County, can he remain on Ozaukee’s
waiting list? Motion by Sharon, seconded by Wanda Davies to approve
remaining on Ozaukee’s waiting list provided the individual also applies
in Washington County for funding when the move occurs. Motion approved by
voice vote.
Next meeting scheduled for January 15, 2004 – The third Thursday of
January. The change is necessitated by the first Thursday of the month
being January 1st.
Minutes Respectfully Submitted,
Frank Peterson
Long Term Support Planning Committee Liaison
Table of Contents
SEPTEMBER 11, 2003
Members Present: Margaret Sheldon, Peter Duncan, Myra Arendt,
Mary Deluca, Ginger Ayres, for Sharon Gilman, Katie Smith, and Ellen Zonka
Members Absent: David Fagan, Wanda Davies, Rita Salamun, Glenda Madlom,
Jim Schendel,
Gail Bruss, Debbie Nowak, Anne Lulloff
The Meeting was called to order at 9:05 by Frank Peterson, acting
Chairperson
INCREASED FUNDS – Frank explained the percentage of Federal funds
increased by 3% to 60.71% for 2003. This change in the federal rate means
an increase of $51,454 in funds for 2003 and an increase of $32,390 for
2004. The federal rate is reduced in July 2004 back to the 2002 level.
Because of the increase for 2003, we will not use the $40,000 of County
Levy in 2003. The $40,000 will be carried over and used in 2004.
2003 SPENDING/STATISTICS – The committee received the year to date
spending showing COP expenditures of $232,479 (72% in 66% of year),
COP-Waiver expenditures of $697,417 (80% spent in 66% of year) and CIP II
expenditures of $102,304 (81% spent in 66% of the year).
WAITING LIST UPDATE – There currently are 15 physically disabled
persons under 65 on the waiting list, plus 23 elderly persons 65 and older
waiting for services at home. The CBRF waiting list has 32 elderly
individuals. Waiting times are two years for physically disabled, one year
for elderly in the community, and three plus years for CBRF funding.
BUDGET FOR 2004 – The same amount of State and Federal funds are
anticipated for 2004. Aging Services is facing a reduction of County levy
that pays for lifeline and homemaker services. 20 people will lose
funding. (Note: the funds were restored in the County Budget adopted
11/5/03). Aging Services will need to reduce the number of times the
Senior Facts Newsletters will be printed in 2004. Social Services will
have the Community Aids funds reduced in 2004. These funds assist persons
while on the LTS Waiting List.
USE OF RELOCATION FUNDS IN CBRF’S – The Committee was presented
with a request to seek CIP II Relocation slots. The State is making
available to Counties on a first come, first serve basis. These funds can
only be used by someone in a nursing home for more than 90 days. We may
have as many as 15 potentially eligible persons. The Committee was asked
to grant an exception to our CBRF Cap if it is necessary in order to use
the CIP II relocation slots. Motion by Ellen Zonka to record CIP II
relocation funds separately from our 40% CBRF cap as long as Social
Services seeks the least restrictive alternative that meets the
individuals needs (community placement or Adult Family Home in addition to
a CBRF). Seconded by Katie Smith. Motion approved by voice vote.
APPROVAL OF MINUTES - Minutes of the July 10, 2003 meeting were
approved as written.
COMMITTEE MEMBERSHIP CHANGES - Margaret Sheldon, representing the
elderly, was approved as a Committee Member by the County Board. Cindy
Close, St. Mary’s Hospital Ozaukee was also presented to the County Board
as a Committee member.
FUNDING REQUEST - A resident in a Washington County nursing home
requests to come to a CBRF in Ozaukee County. Washington County is asking
Ozaukee County to follow-up and seek CIP II relocation funds for her and
place her in the Ozaukee County CBRF. The Committee discussion centered on
concerns that this individual should not be given preference over our
residents on the waiting list who should have chance to seek CIP II
relocation funds. Information will be relayed back to Washington County.
Minutes Respectfully Submitted,
Frank Peterson
Long Term Support Planning Committee Liaison
Table of Contents
JULY 10, 2003
The following minutes have not yet been approved by the
Committee to which they pertain
Members Present: Dr. David Fagan Jill Compton for Debbie Nowak
Wanda Davies Sharon Gilman
Rita Salamun Peter Duncan
Mary DeLuca Jim Schendel
Glenda Madlom Gail Bruss
Members Absent: Anne Lulloff, Ellen Zonka, Myra Arendt, Katherine Smith
Guests: Margaret Scheldon, proposed committee member; Jody Lorenz –
Public Health Dept. student
The meeting was called to order at 9:08 a.m. by Dr. Fagan
APPROVAL OF MINUTES – Minutes of May 8, 2003 meeting were approved
at written.
2003 SPENDING/STATISTICS – The Committee reviewed the year to day
spending showing COP expenditures of $170,563 (53% spent in 46% of year),
COP-Waiver expenditures of $517,743 (63% spent in 46% of the year), and
CIP II expenditures of $75,163 (60% spent of 46% of year). Discussion of
the $40,000 County levy in the 2003 budget. At this time it is unclear if
these funds continue to be available for 2003. Committee feels strongly
the 40,000 of County levy should remain in the budget for 2003 as well as
2004. Because of the need demonstrated by the waiting list and the fact
that county funds serve as local match bringing in more federal funds.
Motion by Sharon Gilman, seconded by Jim Schendel to use the $40,000 of
County levy to serve persons on the waiting list in 2003. Motion approved
by voice vote.
WAITING LIST UPDATE – 18 physically disabled persons, 27 elderly in
the community, and 29 elderly needing CBRF care are on the waiting list.
The waiting list continues to grow.
BUDGET FOR 2004 – The Committee reviewed a proposed 2004 budget
that removed the County levy for 2004. After significant discussion,
motion by Jim Schendel, seconded by Wanda Davies to return the $40,000 of
County levy to the 2004 budget. Motion approved by a voice vote. Frank
will write a letter on behalf of the Committee requesting the County levy
remain in the 2003 and 2004 budgets and the reasons why as discussed by
the Committee.
MESSAGE TO VENDORS - Frank submitted two draft letters seeking no
rate increases in 2004 from contracted service providers and CBRF owners.
Discussion that the County agencies: Social Services, Aging Services, and
Community Programs may contract with the same service providers. The three
agencies will discuss the possibility of a joint letter.
CBRF RATES FOR 2004 - The committee discussed maximum monthly rates
for CBRF care in 2004. Motion by Peter Duncan, seconded by Rita Salamun to
keep CBRF maximum monthly payments the same for 2004 as they are in 2003.
Current rates are 2,785 for Class A facilities and $3,203 for Class C
facilities. Motion approved by voice vote.
CBRF EXCEPTION REQUEST – Discussion of 98 year old woman who has
been in a local CBRF for four years. She is believed to have enough funds
to remain in the CBRF for one year longer. Her assets are not quite down
to the level that she can go on the CBRF Waiting List. When she goes on
the Waiting List, she will need to wait for approximately three years.
Appeal by the CBRF to prioritize her case situation so she does not need
to leave the facility. No action taken by the Committee. It is recognized
a number of persons on the waiting list are in a similar predicament and
need to leave the CBRF and reside in a nursing home.
The meeting was adjourned at 10:07 AM.
Minutes Respectfully Submitted,
Frank Peterson
Long Term Support Planning Committee Liaison
Table of Contents
MINUTES MAY 8, 2003
The following minutes have not yet been approved by the
Committee to which they pertain
Members Present: Dr. David Fagan Ellen Zonka Wanda Davies Katherine
Smith Peter Duncan Sharon Gilman Mrya Arendt Jim Schendel
Members Absent: Mary DeLuca, Anne Lulloff, Debbie Nowak, Gail Bruss,
Glenda Madlom, Rita Salamun
Guests: Gus Wirth, County Board Chairman, Carolyn Lien, Assistant Area
Administrator, Southeast Region, Division of Supportive Living.
The meeting was called to order at 9:00 AM by Dr. Fagan.
APPROVAL OF MINUTES – Motion by Wanda Davies, seconded by Katherine
Smith to approve the minutes as written.
INTRODUCTION OF CAROLYN LIEN FROM THE STATE REGIONAL OFFICE –
Discussion of the planned reduction of State employees eliminating all the
Assistant Area Administrator positions in all the regions of the State. We
would lose the link Carolyn Lien provides between the State Offices in
Madison and the County departments managing the human services programs.
RECONCILIATION OF 2002 SPENDING– The final tally of 2002 spending
shows that in addition to the available COP, COP-Waiver and CIP II funds,
$37,000 of the $40,000 County Levy was used to bring in additional Federal
funds.
2003 SPENDING – The Committee reviewed the year to date spending
showing COP expenditures of $127,042 (39% spent in 33% of the year),
COP-Waiver expenditures of $314,830 (38% in 33% of the year) and CIP
expenditures of $32,865 (26% in 33% of year). All of the $40,000 County
levy allocation is projected to be spent by years end. Discussion of State
budget decisions that will impact our Long Term Support funds. If Medical
Assistance reduces covered services, the pressure will fall to LTS funds
to cover instead of M.A.
WAITING LIST UPDATE - The current list contains 20 physically
disabled individuals, 19 Elderly needing care in home settings and 28
Elderly need CBRF care. Anticipated waiting list times are two years for
the physically disabled, one year for the elderly needing care at home and
three years for elderly needing CBRF funding.
WAITING LIST POLICY ISSUE - The committee received the revised
Waiting List Policy developed at the March 13, 2003 meeting. Discussion on
opening up the Waiting List to non-residents of Ozaukee County. No action
taken. Non-residents are not eligible for the Waiting List.
APPROVAL OF COP HIGH COST FUND REQUESTS - Request for video
magnifier for an 80 year old woman with significant vision loss due to
macular degeneration. New glasses have not solved her vision problems. The
video magnifier would allow the woman to use her hands to clip coupons, or
write a note. The Badger Association is working with her and sees the
magnifier as appropriate. She has tried several models as well. Motion by
Jim Schendel, seconded by Wanda Davies to approve up to $1,200 of the COP
High Cost funds be used to purchase magnifier. Motion approved by voice
vote. The remaining cost of the $2,435 total cost will be covered by
COP-Waiver funds.
Second request is for COP High Cost funds to cover a new wheelchair for
a young disabled man in his 40’s who is in a nursing home. He is scheduled
to leave the nursing home and move in with his parents in Grafton when the
decubiti on his buttocks is taken care of. It has been determined that his
present wheelchair is not fitting properly and causing the decubiti to not
heal. It’s been recommended he receive a new wheelchair. However, because
he is in the nursing home, MA will not pay for a new wheelchair for him.
Discussion about options such as use of a new cushion (Roho cushion) with
the existing wheelchair, to the nursing home responsibility to pay for the
wheelchair. The Case manager will pursue the issue of MA paying or issuing
a denial. The individual was recently hospitalized so he is back in the
nursing home under Medicare. No final decision made at this time.
CBRF EXCEPTION REQUEST - 76 year old man is in Court under a
Guardianship/Protective Placement petition. He has been living at home,
however has no short term memory. He was hospitalized at VA and could not
be discharged home because of the serious safety risk. Discharge to CBRF
was recommended. Frank Peterson polled three members of the LTS Planning
Committee and received tentative approval to place him in a CBRF. Motion
by Katherine Smith, seconded by Sharon Gilman to grant an exception to the
CBRF Waiting List and CBRF funding limit to allow funding of this man at
New Perspectives Inc. Motion approved by voice vote.
The meeting was adjourned at 10:35 AM.
Minutes Respectfully Submitted,
Frank Peterson
Long Term Support Planning Committee Liaison
Table of Contents
MINUTES MARCH 13, 2003
The
following minutes have not yet been approved by the Committee to which
they pertain
Members Present:
Dr. David Fagan
Jill Compton for Debbie Nowak
Wanda
Davies
Ellen Zonka
Peter
Duncan
Myra Arendt
Mary
DeLuca
Jim Schendel
Anne
Lulloff
Members Absent: Gail Bruss, Sharon Gilman,
Katherine Smith, Glenda Madlom, Rita Salamun
APPROVAL OF MINUTES
– Motion by Wanda Davies,
seconded by Ellen Zonka to approve the minutes of January 9, 2003 as
written. Motion approved.
FINAL
2002 SPENDING
– The Committee reviewed COP spending
showing $346,858 (100%) spent in 100% of the year. COP-Waiver shows
$1,234,587 (154%) spent in 100% of the year. The overspending will use all
of the $40,000 County Levy and all of the remaining $140,066 as the local
match for additional Waiver funds. The CIP II spending shows
$187,059 (92%) spent in 100% of the year.
2003 FUNDS AND COMMUNITY PROGRAMS COP
ALLOCATION
– Comparison of the 2002 and 2003 funding shows a slight decline
overall in 2003 funds due to lack of any carryover from 2002 in 2003.
Because of the decline in funds, less COP dollars are available to split
between Social Services and Community Programs. Last year, Community
Programs COP allocation was increased by $40,000 because of the COP
carryover from 2001 into 2002. Frank recommends the two departments “split
the difference”. Community Programs would see $20,000 less in their
allocation and Social Services will have $20,000 less to apply to Waiver
as the local match. The percentage split remains the same: Social
Services 52.5%; Community Programs 47.5%. The issue will be taken to
the two agency directors for a decision. Other options may be
explored to increase revenue, such as Community Programs’ participation in
the M.A. Personal Care Program.
COP PLAN UPDATE FOR 2003
– Motion made by Jim Schendel to approve the COP Plan Update
as amended. Seconded by Wanda Davies.
Motion approved.
HARBOR CLUB REQUEST FOR STATE VARIANCE
FOR CBRF’S LARGER THAN 20 BEDS
- Peter Duncan discussed his client who is under a Guardianship/Protective
Placement. Harbor Club appears to be the only facility able to meet
his complex medical needs. Because Harbor Club/Harbor Cove is a
total of 70 beds, State approval is needed to use COP and Waiver funding.
Motion by Wanda Davies, second by Mary DeLuca to submit the Variance
Request concerning Harbor Club to the State. Motion approved.
CHANGES TO THE WAITING LIST POLICY
- Discussion of changes to
the Waiting List Policy. Motion by Jim Schendel, seconded by Anne
Lulloff to approve the Waiting List Policy as amended. Motion
approved.
CBRF EXEPTION REQUESTS
- Discussion of three pending cases that may need to come before the
Committee. All three are pending in Court with Protective Placements into
CBRF’s that may be ordered. Discussion of interim Committee approval if
necessary by polling some of the members prior to next meetings. No
further action taken today.
Minutes Respectfully Submitted,
Frank Peterson
Long Term Support Planning Committee Liaison
Table of Contents
January 9, 2003
Members Present:
- Wanda Davies
- Jill Compton for Debbie Nowak
- Ellen Zonka
- Sharon Gilman
- Myra Arendt
- Mary DeLuca
- Gail Bruss
- Peter Duncan
Members Absent: Dr. David Fagan, Anne Lulloff, Katherine Smith, Glenda
Madlom, Jim Schendel,
Rita Salamun
APPROVAL OF MINUTES – Motion by Peter Duncan, seconded by Wanda
Davies to approve the minutes as written. Motion carried.
LTS PLANNING COMMITTEE MEMBERSHIP – Discussion of the need for an
elderly consumer or other person to replace Arnold Gundersen on the
Committee. Frank indicates several elderly participants in the program
have declined for health reasons. Suggestion by Wanda Davies to consider
someone she knows. This may be pursued if a consumer is not found. Another
option is the family member of an elderly consumer.
UPDATE OF 2002 SPENDING - The Committee reviewed COP spending
showing $358,242 (95%) in 100% of the year. Some 2002 bills are still
outstanding and haven’t been counted. COP-Waiver shows $1,242,605 (150%)
spent in 100% of the year. The overspending will use all of the $40,000
County Levy and all available $110,000 of COP funds as the local match for
additional Federal funds. The CIP II spending shows $123,144 (108%) spent
in 100% of the year.
WAITING LIST UPDATE – The current waiting list has 15 Physically
Disabled persons, 9 Elderly persons needing services at home and 29
Elderly needing CBRF funding. There are 20 Developmentally Disabled
persons not funded with LTS dollars waiting for COP funds. 123
total Developmentally Disabled persons waiting for COP funds.
CBRF QUALITY CARE POLICY – The Committee reviewed the policy needed
for the CBRF contracts in 2003. These criteria will be used by Social
Services to answer the question of quality care in each CBRF. Motion by
Wanda Davies, seconded by Gail Bruss to approve the CBRF Quality Care
Policy. Motion approved.
HIPAA REQUIREMENTS FOR SOCIAL SERVICES AND POSSIBLY CONTRACTED SERVICE
PROVIDERS – The Committee received general information on the Federal
HIPAA law. The privacy portion is be in place by April 2003. The
electronic billing for Medical Assistance is to be in place by October
2003. The Committee will hear more as time goes on.
COP PLAN UPDATE FOR 2003 – The Committee reviewed a draft of the
COP Update. Suggested additions and comments will be incorporated into the
Cop Plan Update due to the State February 28, 2003.
CBRF PERCENTAGE FOR 2003 – Motion by Mary DeLuca, seconded by Myra
Arendt that the percentage of COP, COP-Waiver, and CIP II funds allocated
to CBRF can remain at 40% for 2003. Motion approved by voice vote.
CBRF EXCEPTION REQUEST - Peter Duncan discussed the need for an
elderly man with vascular dementia –wheelchair bound diabetic. Need to
monitor blood sugar levels and change insulin dosage multiple times per
day. Guardianship and Protective Placement hearing will occur soon. Issue
discussed of least restrictive alternative and the Court’s need to
consider CBRF placement. Motion by Mary DeLuca seconded by Wanda Davies to
approve an exception to allow CBRF funding if that is the least
restrictive alternative as ordered by the Court and an appropriate CBRF is
found that is willing to accept him.
The meeting was adjourned at 10:50 A.M.
Minutes Respectfully Submitted,
Frank Peterson
Long Term Support Planning Committee Liaison
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