Port Washington, Wisconsin

February 20, 2006

The Aging & Long-Term Committee met in Room A-200 of the Administration Center.

Present: Supervisors Erickson, Boesch, Stumpe and Barrow.   Staff: Aging Services Director Gilman, Lasata Director Luedtke, County Administrator Meaux and Clerk Marchese

Others Present: Bill Schanen from the Ozaukee Press and Dan Benson from the Milwaukee Journal/Sentinel

Call meeting to Order by Chairperson Erickson at 8:31 A.M.

Assurance that the Meeting has been Properly Noticed: (So noted by Clerk Marchese.)

Adoption of Revised Agenda: Motion made by Supervisor Boesch, seconded by Supervisor Stumpe, to approve the revised agenda. All members present voting aye. Motion carried (3-0).

Public Comments/Correspondence and Communications - None at this time.

Approval of Minutes: Motion made by Supervisor Stumpe, seconded by Supervisor Boesch, to approve the minutes of February 7 meeting. All members present voting aye. Motion carried (3-0).

8:35 A.M. – Supervisor Brooks and Ralph Luedtke now present.

Further discussion regarding the vacancy at the Fredonia Meal Site. Motion made by Supervisor Boesch, seconded by Supervisor Stumpe, to continue to keep all meal sites open and to fill any meal site manager vacancy as needed. All members present voting aye. Motion carried. (4-0).

Replacement of Meal Delivery Driver: Director Gilman explained that one of the three current drivers will be retiring soon. They are only part-time and work 25 hours every three weeks. Motion made by Supervisor Boesch, seconded by Supervisor Stumpe, to approve filling the Meal Delivery Driver vacancy. All members present voting aye. Motion carried. (4-0).

Carryover Request: Director Gilman explained the request for carryover was to cover the cost of furniture for an additional employee. Motion made by Supervisor Stumpe, seconded by Supervisor Boesch, to approve the request. All members present voting aye. Motion carried. (4-0).

Program/Annual Report: Director Gilman presented an update on the accounting procedure/programs used to obtain the financial information for the year-end reports.

Congregate/HDM report: - A copy of the home delivered meals and congregate meals reports were presented and discussed. Director Gilman explained the procedure they currently use for people that continually cancel their meal on the day of service. She also explained that they are not allowing any carry outs. Discussion regarding creating a policy for meal cancellations and to freeze unserved meals that could be distributed on Fridays.

Aging Service Department Role in LTC Reform - Director Gilman asked if this could be deferred until Human Services Director Haupt is present. There were no objections.

Status of Hiring Staff: - The Mequon-Thiensville site and the Clerk-Typist I positions have been filled.

Disaster Planning: - Director Gilman explained that her department is working with the Public Health and Emergency Management Departments to develop disaster plans. While the Department can work with those seniors that are clients of the department there is the larger number of vulnerable, frail seniors that are not known to the Department. An article on disaster planning was in the last Department newsletter and additional articles will continue to be placed in the newsletters.

9:03 A.M. – Human Services Director Haupt now present.

Review of Final Financial Statement for 2005: - Director Gilman handed out a revised financial report that included end of the year expenses. Discussion regarding "reserves". It was explained that there are two types of reserves. One is used for special/emergency needs and the other is for capital expense. The department is allowed to spend up to $25,000 for such needs, without committee approval, only once a year. She commented that these funds could be used to offset the cost of the meal delivery vehicle that was recently purchased. The Highway Department has agreed to sell the old van at their yearly-auction. Discussion regarding whether the van should be sold sooner, such as on e-bay, or wait until auction. County Administrator Meaux will discuss the selling of this vehicle with the Highway Commissioner.

Aging Service Department Role in LTC Reform: Director Haupt provided some background information on Long Term Care Reform. Ozaukee County is partnering with several counties and Community Care, an HMO, to plan for this reform. Community Care has received a grant from the state for a planning period of 18 months. He explained that somewhere between 5-10 years, family care will change and the hope is to provide better care with fewer funds. The goal is to eliminate the waiting list without additional money. One of the goals of this Long Term Care Reform is the establishment of an Aging & Disability Resource Center, which will affect the Aging Services Department. Mr. Haupt assured the Committee that the Aging and Human Services Departments are communicating and working together on this issue.

Brief discussion regarding the road trip to Pathway facilities. The feeling is that facilities of this sort may be the future that the citizens of the county and surrounding regions will be considering.

Lasata Care Center Items: -

2005 Annual Reports: A draft copy of the annual report was presented and Director Luedtke presented an overview of his report and financial. Director Luedtke reported that they received one-half million dollars more than anticipated by the state.

Assisted Living Project Update: A draft copy of a resolution, with revisions, for the March 1 board meeting was presented and discussed. Supervisor Brooks explained the appraisal would be performed today. It was agreed to meet on March 1 at 8:30 A.M. prior to the County Board meeting. Supervisor Erickson presented a brief outline that if WHEDA approves the request in February, and if all approvals are in order by April or May, construction would start in the fall of 2007.

9:30 A.M. - Supervisor Brooks excused.

The City of Cedarburg will be installing larger water and sewer lines on Wauwatosa Road starting in May and is asking for easement rights to install lines from the Retzlaff Farm south along Lasata Property. Mr. Luedtke has been in contact with the City and has discussed the possibility of granting the rights in place of the cost for improvement charges. Motion made by Supervisor Stumpe, seconded by Supervisor Boesch, to approve the easement, and to forward the request on to the Public Works Committee for approval. All members present voting aye. Motion carried. (3-0).

Management/Financial Report: -

Occupancy/Census Statistics for January - Mr. Luedtke explained that they had budgeted for at least two vacancies per month. Discussion regarding security deposit being charged as well as charging for half a month. Staff will be present at the Therapy monthly meetings at Columbia-St. Mary's-Ozaukee to discuss referring patients for rehab at Lasata.

Conference and Meeting Attendance: -

A report for attendance at a conference for Kathi Roberts and Sandy Szczerbinski at a NAP Day meeting in Milwaukee and a report for Veterans Service Officer Ken Brown at the SE Area CVSO Association meeting in Milwaukee.

Medicare D Update: -

Mr. Luedtke presented an update of Title XIX patients that families did not make a decision in a timely manner and Lasata is looking at a cost of $30,000 for drug reimbursement, but should be able to recover these cost as the federal government will reimburse the state. His staff will be working with Human Services and will be able to bill insurance companies and should be reimbursed. They must deliver medications to all patients or they will be fined by the state. The Pharmacist is working with the doctors of people that are applying to make sure that their drugs are covered.

Emergency Defibrillators: -

Mr. Luedtke informed committee members that since defibrillators have been installed in the Administration Center and Justice Center, employees are wondering why they have not been installed at Lasata. They currently have a "no code facility" policy and 911 is called for patients. The basic use would be for employees and visitors.

Out of 12 nursing homes that responded to a survey two do no CPR, but do have equipment on hand. Two are changing their emergency policy and will do residents and there are at least eight that have full CPR certified staff. The medical charts of the residents show that 192 said no and only 17 said yes to wanting CPR if needed. Discussion as to the cost of training staff, staff does not have to be CPR certified, what the liability is and what is the current procedure and policy. It was agreed to discuss this issue further at the next meeting.

Mr. Luedtke also updated the committee on a number of various items including: last debt payment for Lasata Heights will be made in March, federal legislation regarding deferment from 3 years to 5 years for those going on Title XIX, the ability to increase rent by 1.4% in April and then 2.8% starting in July until June of 2007 and that he has been nominated to be a member of the National Dietary Manager Board with two years all expenses paid with no cost to the County. Staff is working with the Sheriff's Department on proceeding with new ID cards with pictures for all employees and the security should be in place by the middle of March.

Motion made by Supervisor Boesch, seconded by Supervisor Stumpe, to adjourn. All members present voting aye. Motion carried. (3-0).

Meeting declared adjourned at10:23 A.M.

County Clerk

Table of Content

Port Washington, Wisconsin

February 15, 2006

The Aging & Long-Term Committee met in Room A-200 of the Administration Center, prior to the County Board session.

Present: Supervisors Erickson, Boesch, Stumpe, Walerstein. Staff: Lasata Director Luedtke, County Administrator Meaux and Clerk Marchese

Absent: Supervisor Herlache

Call meeting to Order by Chairperson Erickson at 8:45 A.M.

Assurance that the Meeting has been Properly Noticed: (So noted by Clerk Marchese.)

Adoption of Agenda: Motion made by Supervisor Boesch, seconded by Supervisor Walerstein, to adopt the agenda. All members present voting aye. Motion carried (4-0).

Public Comments/Correspondence and Communications - None at this time.

Authorize Real Estate Appraisal - Lasata Heights: Discussion regarding restrictions that might be on the title. Motion made by Supervisor Stumpe, seconded by Supervisor Boesch, to authorize an appraisal of Lasata Heights and to include a title search of the property. Mr. Luedtke indicated that the cost of the title search would be several hundred dollars and that there is money allocated in his budget to cover the cost. All members present voting aye. Motion carried (4-0).

8:47 A.M. - Supervisor Barrow now present.

Supervisor Erickson presented an update of informational meetings with the City of Cedarburg officials, Lowell Levy and Stroebel Group Inc. They appear very receptive and will work with the County as much as possible.

Motion made by Supervisor Stumpe, seconded by Supervisor Walerstein, to adjourn. All members present voting aye. Motion carried (4-0).

Meeting declared adjourned at 8:56 A.M.

County Clerk

Table of Content

Port Washington, Wisconsin

February 7, 2006

The Aging & Long-Term Committee met in Room A-200 of the Administration Center.

Present: Supervisors Erickson, Boesch, Stumpe, Walerstein, Herlache, Brooks and Egelhoff. Staff: Aging Services Director Gilman, Lasata Director Luedtke, County Administrator Meaux and Clerk Marchese

Others Present: Human Services Director Bob Haupt and Staff Frank Peterson, Veteran Service Officer Ken Brown, Assistant Corporation Counsel Rhonda Gorden, Brian Cloch, Chris Block and James Keledjian of Pathway Senior Living, LLC

Call meeting to Order by Chairperson Erickson at 9:30 A.M.

Assurance that the Meeting has been Properly Noticed: (So noted by Clerk Marchese.)

Adoption of Agenda: Chairperson Erickson asked to amend the agenda by moving the presentation from Pathway Senior Living before the communication. There were no objections.

Public Comments/Correspondence and Communications - None at this time.

Approval of Minutes: Motion made by Supervisor Walerstein, seconded by Supervisor Stumpe, to approve the minutes of January 19 meeting. All members present voting aye. The motion was declared adopted (5-0).

A brief review of the presentation from Pathway Senior Living, LLC made at the January 19 meeting was presented and further details were discussed in regards to the presentation that will be made at the February 15 County Board meeting and the tour scheduled for February 17.

The Chairperson then asked all but the committee members to leave for five minutes so the committee could discuss a communication.

Supervisor Erickson explained that each firm that had been interviewed for this project; but was not selected, was mailed a letter back on December 22. A letter was received from SunStarr Real Estate Group expressing their disappointment in what action the Committee took. Supervisor Erickson stated that she prefers not to respond to the letter and is asking the Committee members if they agree with her decision. There were no objections.

Motion made by Supervisor Stumpe, seconded by Supervisor Walerstein, that the Committee convene into Closed Session, per Section19.85 (1)(e) of the Wisconsin Statutes, for deliberating, negotiating, where the investment of public funds and competitive or bargaining reasons require a closed session. All members present voting aye. The motion was declared adopted (5-0).

Present at this time: Supervisors Erickson, Boesch, Stumpe, Walerstein, Herlache, Brooks and Egelhoff, Lasata Director Luedtke, Assistant Corporation Counsel Gorden, County Administrator Meaux, Brian Cloch, Chris Block and Jim Keledjian of Pathway Senior Living and Clerk Marchese.

Discussion than proceeded to deliberate, negotiate the joint venture of a partnership between Ozaukee County and Pathway Senior Living.

Meeting declared adjourned at12:15 P.M.

Mary S. Marchese

County Clerk

Table of Content

Port Washington, Wisconsin

January 19, 2006

The Aging & Long-Term Committee met in Room A200 of the Administration Center.

Present: Supervisors Erickson, Walerstein, Herlache and Richart, Aging Services Director Sharon Gilman, Lasata Director Ralph Luedtke, County Administrator Tom Meaux and Clerk Marchese

Excused: Supervisors Boesch and Stumpe.

Call meeting to Order by Chairperson Erickson at 8:35 A.M.

Assurance that the Meeting has been Properly Noticed: (So noted by Clerk Marchese.)

Adoption of Agenda: Motion made by Supervisor Walerstein, seconded by Supervisor Herlache, to adopt the agenda as revised. All members present voting aye. The motion was declared adopted (3-0).

Public Comments/Correspondence and Communications - None at this time.

Approval of Minutes: Motion made by Supervisor Herlache, seconded by Supervisor Walerstein, to approve the minutes of December 19 meeting. All members present voting aye. The motion was declared adopted (3-0).

Replacement of elderly meal site manager position in Mequon/Thiensville and Cedarburg - Director Gilman explained that the manager for Mequon/Thiensville sites was a probationary employee and was not performing the duties and responsibilities of the job. The Cedarburg manager has resigned to take a job in the Human Services Department. Both positions are budgeted for in this year's budget. Motion made by Supervisor Walerstein, seconded by Supervisor Herlache, to approve the request to fill both vacancies. All members present voting aye. The motion was declared adopted (3-0).

Management and Financial Reports - Director Gilman explained the procedure for preparation of the annual report and the delays she is experiencing in obtaining the statistical data that is needed. Final federal allocations for 2006 will be received in March or April. Based on legislation passed by Congress she estimates that there will be a 1% federal cut across the board. The financial report for 2005 will not be final until February as expenses/income figures are still being calculated.

She also provided a brief update of Medicare Part D program and problems that have occurred and how they have been handled, status report of hiring of part-time position of Information and Assistance Specialist, Elder Care and Work initiative, donation received for Home Delivered Meal Program, the monthly congregate meals; and calls received from numerous volunteers after an article appeared in the Milwaukee Journal.

Supervisor Erickson asked if Director Gilman could prepare a monthly report of attendance at each meal site for presentation at each committee meeting.

At this time, Director Gilman presented some background information on out-of-county transportation services. Her department had been using G&G Enterprises for approximately 150 trips out-of-county at a cost of $30.00/hour. Because of the problems the county has encountered with that firm, she contacted Johnson Bus Service and they will assume this service at a cost of $35.00/hour. These services are not available to the general public; but only available to elderly and disabled residents that meet certain qualifications.

8:55 A.M. - Supervisor Egelhoff, Lasata Heights Director Diane Nelson, Dan Benson of the Milwaukee Journal and Ron Yokes, member of Health and Human Services Board now present.

Lasata Items/Director Reports -

Supervisor Erickson ask that Item a - Assisted Living Public/Private Partnership goals/objectives presentation be moved to the end of the meeting. There were no objections.

Occupancy/Census Statistics - Director Luedtke reviewed the report as handed out. Final statistics for Lasata for the end of 2005 which is used for the development of the annual report. At the end of the year, they had a census of 196 residents which is about 23 patient days below budget. The report shows the percentage of pay source to the difference of what was budgeted and that private pay census is much lower than Medicaid.

Comparison versus past years - the level of care for intermediate care level is down about 5% so skilled care or intensive skilled care takes more cost and staffing issues. Discussion regarding residents in the intermediate care category being contacted by Social Workers about looking into the Nursing Home Relocation program in the community. One or two are interested in pursuing the issue, and several have already been moved from nursing homes. This would mean an increase in the number of skilled care.

Discharges and admissions were down compared to other years with 91% admissions were county residents with 9% being non-county with relatives. He also explained the results of a comparison back 15 years to current.

Lasata Heights currently has 3 empty apartments. Since open house and advertising, four people have signed agreements for admittance, they all have taken advantage of the $500.00 a month credit but were not aware of the promotion. The offer of the winter rent credit has not drawn any new interest.

Donations are about the same every year with several church groups and women organizations donating and what some of the donations are designated for.

Management Report and Financial Reports - Director Luedtke reviewed the preliminary monthly report which currently shows a surplus of $387,000, but without the levy, would have a balance of $100,000-$150,000 surplus, with receipt of $699,000 IGT payment which is $300,000-$400,000 more than anticipated and would show $200,000-$300,000 loss.

Lasata Heights final payment will be made this year and will plan a small event as well as Lasata being 40 years in October (first resident was admitted).

Lasata Heights preliminary numbers currently showing a surplus $100,000 without the levy. He explained that originally the loan payment was included in the expense portion of the budget, but since has been changed by Finance.

9:12 A.M. - Supervisor Brooks and Rhonda Gorden, Assistant Corporation Counsel now present.

Comments were made about the procedure that St. Mary's-Ozaukee has been following regarding notifying clients about rehab being offered at Lasata. They end up calling the Office on Aging, and are being told that if they are placed in another home for rehab, they should file an application with Lasata in case they decide to transfer at a later date. This way, if there is not an opening at the present time, they will be placed on the list when and if a vacancy does occur. Ralph will do another follow-up with the Hospital in regards to this issue.

At this time, Supervisor Erickson explained the public/private partnership and development of Lasata Campus which is to finalize the Committee's goals and objectives are in answers to questions followed by discussion.

9:18 A.M. - Brian Cloch, Chris Block and James Keledjian of Pathway Senior Living and Bill Schanen of the Ozaukee Press now present.

Discussion of when does the current Lasata become functionally obsolete to the point were it should be rebuilt. Director Luedtke feels that realistically in 10 years and Lasata will be 50 years old and where rooms have double beds are no longer desired and you no longer see 200 bed nursing homes. New nursing homes that are being built today are smaller, having a kitchenette, day room and laundry facility, it makes it easier for the residents as well as for the staff and other features not available today.

Discussion regarding reasons 1 and 2 for building this partnership - it is felt that they will become obsolete; if in 10-15 years Lasata is not functional anymore, and if the plan does not include rebuilding.

Reasons 3, 4 and 5 are perfect if the county decides not to rebuild and priorities will have to change.

If the decision is made to fully develop the site, where and how will the new Lasata campus be built, this now will become the issue. Various options were presented and discussed.

It was suggested to amend 1.e. to move the word "sell" to the end of issues as a consideration.

The Committee too a break so representatives of Pathway Senior Living could set up for presentation.

10:01 A.M. - Corporation Counsel Dennis Kenealy and Frank Peterson of the Human Services Department now present.

Motion made by Supervisor Walerstein, seconded by Supervisor Herlache, that the Committee convene into Closed Session, per Section19.85 (1)(e) of the Wisconsin Statutes, for deliberating, negotiating, where the investment of public funds and competitive or bargaining reasons require a closed session. All members present voting aye. The motion was declared adopted (4-0).

Present at this time: Supervisors Erickson, Walerstein, Herlache, Brooks and Richart, Aging Services Director Sharon Gilman, Lasata Director Ralph Luedtke, Corporation Counsel Dennis Kenealy, Frank Peterson from Human Services Department, Brian Cloch, Chris Block and Jim Keledjian of Pathway Senior Living, County Administrator Tom Meaux and Clerk Marchese.

Discussion than proceeded to deliberate, negotiate the joint venture of a partnership between Ozaukee County and Pathway Senior Living.

Motion made by Supervisor Brooks, seconded by Supervisor Walerstein, to adjourn the meeting.

Meeting declared adjourned at 12:55 P.M.

Mary S. Marchese

County Clerk

Table of Content

Port Washington, Wisconsin

December 19, 2005

The Aging & Long-Term Committee met in Room A200 of the Administration Center.

Present: Supervisors Maryann Erickson, Bob Walerstein, Dan Herlache, Clarence Boesch, Rick Nelson , Aging Services Director Sharon Gilman, Lasata Care Center Administrator Ralph Luedtke, Social Work Supervisor Frank Peterson, and County Administrator Tom Meaux.

Excused: Supervisor Warren Stumpe

1. Call meeting to Order by Chairperson Maryann Erickson at 8:30 A.M.

2. Assurance that the Meeting has been Properly Noticed/Adoption of Agenda-(So noted by County Administrator Tom Meaux)

Chairperson Erickson asked that the issue of Temporary Housing for Hardship Case at Lasata Heights be moved up on the agenda. Supervisor Nelson reported that he had received a call about a 46 year old man with a disability who was in need of temporary housing, food assistance, and a job. Supervisor Nelson contacted Ralph Luedtke and Sheriff Straub about possible use of the jail or Lasata Heights. Sheriff Straub said that the jail could not be used. Admittance to Lasata Care Center would not be appropriate and there was question as to whether or not state statutes would allow placement at Lasata Heights. After discussions between Ralph Luedtke and Bob Haupt it was determined that this individual had family supports in the area and this would not be an appropriate placement. The consensus of this committee was to leave the current policy in place – one must be 62 years or older to be eligible for housing at Lasata Heights. Supervisor Nelson left the meeting at 8:50 AM.

3. Public Comments/Correspondence and Communications made or presented:  There were none.

4. Approval of Minutes. Motion made by Supervisor Boesch, seconded by Supervisor Walerstein, to approve the minutes of November 21 as mailed.  Motion carried (4-0)

5. Department of Aging Items/Director Reports:

a. Sharon reported on the staffing changes that have occurred in the department.  Dawn Woda, Account Clerk, has transferred to the Public Health Department.  Some of her accounting duties have been transferred to Carla Phillips in the Finance Department who has worked with aging programs in the past. Tara Tremain, current Clerk-Typist in the department, has agreed to working 40 hrs/week and assuming the remaining duties of the Account Clerk. There still remains a need for additional assistance in the department. Motion made by Supervisor Walerstein, seconded by Supervisor Boesch to hire a Clerk-Typist for 18.75 hrs/week. Motion carried (4-0). Chairperson Erickson requested that the committee report to the County Board indicate the savings that are achieved by the above actions and how many persons could be taken off of the department’s waiting list, utilizing these savings.

b. The Committee discussed the undesignated/reserve funds and whether they should be used to cover the cost of the van purchased in 2006 or kept for possible use as a match for the development of an Aging and Disability Resource Center.  Consideration will be given to these items during the next budget cycle.  

c. 2005 anticipated expenditures – Sharon reviewed a report that had been prepared

on the estimated expenditures and revenues for 2005.

d. Management and Financial Reports – discussed with the above items.

6. Lasata Items/Director Reports.

a. Write-off uncollectible accounts:  Ralph reviewed the uncollectible accounts amounting to $14,416.90. An explanation was given to the committee. Motion made by Supervisor Boesch, seconded by Supervisor Herlache to approve the write-offs. Motion carried (4-0).

b. Update of Public/Private Partnerships regarding Assisted Living:  Chairperson Erickson reported that the committee has heard from all interested parties at this point. Chairperson Erickson, along with County Board Chair Brooks and County Administrator Meaux met with representatives from Pathway Senior Living who have indicated they are willing to work within the current system in order to build the facilities. They are also considering hiring a lobbyist to work with the state and they are also ready to work with the City of Cedarburg. Chairperson Erickson was requesting that the committee approve the continuation of work with Pathways. The chairperson suggested the following timetable:

January 19 – presentation by Pathway to interested parties
February 7 – special meeting of the committee for a formal presentation by Pathway
February 15 – presentation by Pathway to County Board of Supervisors
February 17 – County charter buses so County Board of Supervisors can visit

Pathway facilities in Illinois.  March 1 – possible vote by County Board of Supervisors to continue with project.  Question was raised by the committee about a public/private partnership instead of the county pursuing this on their own. The committee also expressed concern that they be involved in every aspect of this project. It was suggested that County Administrator Meaux write a thank you note to the other contractors thanking them for their efforts. Motion made by Supervisor Herlache, seconded by Supervisor Walerstein to pursue the above schedule. Motion carried (4-0). It was suggested that our state legislators be invited to the 2/7 presentation and Cedarburg officials to the 2/15 session.

c. Financial Reports:  The estimated surplus at Lasata Heights is $250,000. There has been no concrete interest in renting apartments and there will be 5 vacant apartments in January.  The estimated deficit at Lasata Care Center will use $287,000 of the tax levy and possibly some ($50,000) of the reserve.

d. Occupancy/Census Statistics:  Thru November there were 196 residents at Lasata. .

f. Management Report:  The pharmacy changes are working well. The pharmacist whose position is being eliminated will work through February to cover for the other pharmacist’s vacation.   The annual Christmas party was held on 12/11 and was well received.  IGT – Was approved 97-0 in the Assembly and will now go to the Senate. It would allow for all 2.1 Million to go to county nursing homes.  Security update – The doors to the building, except for the main entrance, will now be locked on a 24 hour basis. A new security system is in the process of being ordered.  Quality assurance for food – a format has been put together to have the food tested every couple of weeks and residents and clients are being interviewed about the quality of the food.   Meeting with Columbia St. Mary’s – Supervisor Stumpe and Ralph Luedtke met with several staff at the Ozaukee campus. Supervisor Stumpe expressed the committee’s concerns about Medicare discharges from the hospital and whether or not patients were given Lasata’s name. Hospital staff assured the Supervisor that all nursing homes were given fair treatment. Kathy Rismeyer has been invited to a meeting of the hospital case managers and therapy staff to talk about Lasata. Kathy will also call the case managers by 9 AM to inform them of the number of open beds.

7. Review of Veteran’s Service Department Financials:  Review completed.

8. Items for Committee Report:  Funds available for the aging services department waiting list.  The 2/17 bus trip to Pathway facilities.

9. Future Agenda Items/Adjournment:  Draft of department annual reports for suggestions.

Supervisor Boesch moved to adjourn the meeting. Supervisor Walerstein seconded the motion. The meeting was adjourned at 10:40 AM.

Table of Content

November 21, 2005

The Aging & Long-Term Committee met in Room A200 of the Administration Center.

Present: Supervisors Maryann Erickson, Bob Walerstein, Dan Herlache, Warren Stumpe, Clarence Boesch, Aging Services Director Sharon Gilman, Lasata Care Center Administrator Ralph Luedtke, Social Work Supervisor Frank Peterson, and County Administrator Tom Meaux.

1. Call meeting to Order by Chairperson Maryann Erickson at 8:30 A.M.

2. Assurance that the Meeting has been Properly Noticed/Adoption of Agenda-(So noted by County Administrator Tom Meaux)

3. Public Comments/Correspondence and Communications made or presented:  There were none. 

4. Approval of Minutes. Motion made by Supervisor Herlache, seconded by Supervisor Walerstein, to approve the minutes of October 17 as mailed.  Motion carried (5-0)

5. Department of Aging Items/Director Reports:

a. Chairperson Maryann Erickson opened the public hearing on the Draft S.85.21 Application for Elderly and Disabled Transportation at 8:32 AM. Sharon reviewed the application. There were no comments from the public. Chairperson Erickson closed the hearing at 8:35 AM.

b. Motion made by Supervisor Stumpe, seconded by Supervisor Walerstein, to approve the Draft S.85.21 Application for Elderly and Disabled Transportation. Motion carried (5-0)

c. Report on Undesignated/Reserve Funds – the committee requested that this matter be brought to the attention of the Commission on Aging for their recommendations as to how these funds might best be utilized; with the understanding that traditionally these funds are not used to offset operating expenditures.

d. Review of Elderly Nutrition Forms – Sharon reviewed the forms that are mandated by the state/federal governments to be used for the Congregate Meal Program. Supervisor Stumpe suggested changes to the form.

e. Management and Financial Reports:  Sharon reported on the need for volunteers for the Home Delivered Meal Program –a shortage of volunteers is creating problems in our delivery system. The suggestion was made to pay for an ad in the News Graphic.

The financial report was reviewed.

6. Lasata Items/Director Reports.

a. Approval of IGT Resolution:  Ralph reviewed a resolution that has been drafted in regard to IGT. The resolution is in response to AB 802, which would require that the State of Wisconsin more equitably share Federal IGT funds with local governments that operate nursing homes. Motion made by Supervisor Stumpe, seconded by Supervisor Walerstein, to approve the IGT Resolution. Motion carried (5-0).

b. Transfer of Funds:  Ralph requested that $24,660 be transferred from the Administration Medicaid Assessment Account to the Capital Outlay in order to purchase a new 4-wheel drive pickup truck with snowplow. The current truck needs to be replaced and was budgeted for 2006; however the Purchasing Agent has located a truck that meets the specifications but must be purchased quickly. Motion made by Supervisor Stumpe, seconded by Supervisor Walerstein, to approve the transfer. Motion carried (5-0).

c. Update of Public/Private Partnerships regarding Assisted Living

1) Presentation from SunStarr Real Estate Group – Scott Stevlingson, COO of SunStarr Real Estate presented information on the development of an RCAC (Residential Care Apartment Complex) on the Lasata grounds. SunStarr has developed a similar project on 107^th Street in Milwaukee. It is a 62 unit building;  12 are independent living and 50 are RCAC. The complex at Lasata would be very similar to that one.

2) Presentation from Hoffman/Revere – this group was not able to attend the meeting but did send a letter. They are interested in developing a study first prior to any project. The committee does not feel another study is necessary.

3) Draft of needs assessment for State of Wisconsin – this document has been drafted. Motion made by Supervisor Stumpe, seconded by Supervisor Boesch, to approve this draft and send to the State. Motion carried (5-0)

d. Lasata Heights Vacancy Action Plan:  Lasata Heights held an open house recently; invitations were sent to all people on the waiting list. There are 3 different size apartments available; 45 people attended the open house and several people showed interest in leasing a unit. Lasata Heights is offering several incentives to those wanting to lease an apartment and will have another open house in the spring. Questions were raised by supervisors about complaints that they have been hearing about the quality of the food and they recommended that someone in administration periodically have one of the meals that are prepared for the residents of Lasata Heights.

e. Financial Report:  At the present time there is a surplus of $282,000 for Lasata Heights and $319,503 for Lasata with a levy of $240,000. Lasata may not need a transfer of $350,000 from reserves.

f. Occupancy/Census Statistics: Thru October there were 196 residents at Lasata. As of November 1 Lasata was not accepting any Title XIX applicants or Medicare recipients unless they were going to be private pay. However, if the census falls below 94% Lasata is in danger of losing Title XIX funding. Therefore, they have started accepting these applicants in order to not fall below the 94% limit. The lack of private pay patients may be due to an expansion of Cedar Springs and Newcastle. Heritage is also adding more Medicare beds. The average for Title XIX beds in nursing homes is 72%.  Supervisor Stumpe volunteered to work with Lasata Administrator Luedtke on communicating with St. Mary’s Hospital Ozaukee in regard to their discharges.

g. Medicare Part D:  The new pharmacy distribution system won’t be in place until Feb. 3 – at that time one full-time pharmacist position will be eliminated. A Medicare Part D program was held on November 9 and 130 people attended. Lasata residents on Title XIX have been receiving information on the prescription drug plan that they have been assigned to by the Medicare program. Family members are responsible for making this information available to Lasata. Without this information Lasata could lose approximately $30 - $40,000 in revenue per month. Lasata will be contacting all families who have not reported this information.  Administration Leudtke reported on an arbitration decision recently received. The decision was that an employee who Lasata believed voluntarily resigned should be reinstated with no back pay.

Supervisor Walerstein moved to adjourn the meeting. Supervisor Boesch seconded the motion. The meeting was adjourned at 11:40 AM.

Table of Content

Port Washington, Wisconsin
October 17, 2005

The Aging & Long-Term Committee met in the Auditorium of the Administration Center.

Present: Supervisors Maryann Erickson, Bob Walerstein, Dan Herlache, Warren Stumpe, Clarence Boesch, Rob Brooks, Aging Services Director Sharon Gilman, Lasata Care Center Administrator Ralph Luedtke, Social Work Supervisor Frank Peterson, Lasata Care Center Assistant Administrator Rosalie Kraus, Lasata Heights Manager Diane Nelson, and County Administrator Tom Meaux.

1. Call meeting to Order by Chairperson Maryann Erickson at 8:30 A.M.

2. Assurance that the Meeting has been Properly Noticed/Adoption of Agenda-(So noted by Aging Services Director Gilman)

3. Public Comments/Correspondence and Communications made or presented:  There were none.

4. Approval of Minutes. Motion made by Supervisor Walerstein, seconded by Supervisor Stumpe, to approve the minutes of August 15 and September 26 as mailed.  Motion carried (5-0)

5. Aging Services Department Reports.  Sharon reported on the educational programs that are being held this month and next In regard to Medicare Part D and the Financial Planning Seminar on Thursday, November 3. It was suggested that information on the Medicare Part D Presentation be placed on the municipal cable stations.  Expenditures are in line with the budget.

6. Lasata Items/Director Reports.

a. Management and Financial Reports:  Ralph reported that that the financials are in good shape. There is a surplus of funds for Lasata and Lasata Heights through September. It was anticipated that Lasata would need tax levy at this point but tax levy is not yet needed.

b. Occupancy/Census Statistics:  Lasata is attempting to increase the Medicare census. At the present time, 80% of the waiting list is Title XIX funded.

c. 2006 Budget Update:  Lasata Heights will not receive any tax levy in 2006, Lasata will receive $300,000.  Discussion ensued on the need for Lasata to receive tax levy. 

d. Medicare Part D: Staff is receiving information and training and is working with the Aging Services Department on providing training for families/residents. This program will place a burden on staff in terms of billing insurance companies, etc.

e. Capital Outlay/Construction Progress:  Remodeling of the medication rooms is in progress. Since there are funds available in the budget the project will be finished this year. The nurse call system on the west side is also being improved. One company bid the project and will complete all of the work this year and will wait until January 2006 for the rest of his payment.

Chairperson Erickson called a break at 8:55 AM.

Chairperson Erickson resumed the meeting at 9:00 AM.

New Horizon Properties presented their proposal for assisted living on the Lasata Campus. This would be a stand alone facility near the corner of Bridge and Wauwatosa. It would be built in two phases – first would be a 20 unit CBRF (Community Based Residential Facility) and the second would be a 20 unit RCAC (Residential Care Apartment Complex). It would be a single story building – 28,000 square feet.

The CBRF rooms would be 325 square feet with a private bath and roll-in shower. The RCAC rooms would be 400 square feet with bath and convenience kitchen.

Construction cost would be $1.6 million per side. Site work cost of $150,000 would be borne by the county. Once the facility was constructed New Horizons would lease it to a qualified operator with the county’s approval. Payments to the county for lease of the land would be approximately $48,000/year although New Horizons would request that some of the lease payment be put back into the project to subsidize room cost for some residents.

New Horizons is working with two non-profit entities in terms of financing and will know more about this in November. They are looking for 4% or lower financing rate.

If all negotiations were complete, construction could begin in Spring 2006 with occupancy slated for October 1, 2006.

New Horizons was asked if they were interested in purchasing Lasata. Any decision on that would be made by Sandmar Properties.

Chairperson Erickson declared a break in the meeting at 10:00 AM.

Chairperson Erickson resumed the meeting at 10:05 AM.

Pathway Senior Living representatives presented their proposal for assisted living on the Lasata Campus. Their proposal would redevelop the entire Lasata campus. There are three phases to their proposal. Phase 1 would construct an 80 unit assisted living facility. This unit would require a new reimbursement program from the state of WI. The RCAC would rent for approximately $2700-2800. The second phase would be an independent living rental facility – single story 2-unit buildings with individual garages, a total of 50 units. The cottages would rent from $700-900 with an income qualification of $15,000 to $32,000. The third phase would be a potential acquisition of Lasata Heights. The building would then be rehabbed with new kitchens, updated baths, and all major systems replaced or repaired. With WHEDA funding the rents would be from $500 – 800.

Pathway would also be looking for a long-term lease on the land, 99 years with a minimum of 40 years. The tax credits would expire after 15 years but the project would then be resyndicated for another 15 years. The project would stay low-income for 40 years.

Question was raised about Pathway purchasing Lasata – they would not be interested since they don’t believe a private operator could operate the nursing home and provide the same quality.

Chairperson Erickson thanked both groups for their presentations and called a break at 11 AM.

Chairperson resumed the meeting at 11:05 AM. Supervisor Herlache moved to go into closed session per WI State Statutes Sec. 19.85 (1) (e), deliberating, negotiating, where the investment of public funds and competitive or bargaining reasons require a closed session. Motion seconded by Supervisor Brooks. Roll call vote was taken: Supervisor Boesch, Aye; Supervisor Walerstein, Aye; Supervisor Herlache, Aye; Supervisor Erickson, Aye; Supervisor Stumpe, Aye.

Discussion ensued regarding the investing of public funds and the potential county financial commitment and return and what the County may be able to commit to under either scenario or subsequent proposals.

Supervisor Walerstein moved to reconvene to open session at 11:55 AM. Supervisor Stumpe seconded the motion and the motion was approved.

Supervisor Walerstein moved to adjourn the meeting. Supervisor Herlache seconded the motion. The meeting was adjourned at 11:55 AM.

Table of Content

PRESENT: Karen Broman, Margie Fuhr, Joan Groh, Kathy Geracie, Gladys Huber, Clarence Boesch, Ed Adams, Maryann Erickson, Warren Stumpe, Dan Herlache, and Robert Walerstein.

Others present: Sharon Gilman, Mary Ferrell, Tom Meaux, Ginger Ayres.

Chairman Maryann Erickson called the meeting to order at 9:00 AM

Assurance that the Meeting has been Properly Noticed

Sharon indicated that the meeting had been properly noticed.

Adoption of Agenda

Chairman Erickson opened the hearing and asked that those speaking give their name and address. 12 people were in attendance for the public hearing. Their comments related to the consolidation of the Cedarburg/Grafton and Belgium/Fredonia meal sites. 4 persons spoke against the consolidation of the Cedarburg/Grafton sites; 6 persons spoke against the consolidation of the Belgium/Fredonia sites and 2 people spoke against moving the Fredonia site.

Changes in 2006 County Plan for Senior Citizens

The Commission reviewed the draft county plan. Discussion centered on the consolidation of the four meal sites. Chairman Erickson summarized the comments of the review of the Congregate Meal Program.

Kathy Geracie spoke to the concerns about the meal sites and the need to consider all the services that are offered to seniors. Kathy reported on her meetings with the administration of the city of Cedarburg.

Several Commission/Committee members commented on the proposed consolidation plan and requested that a policy be drafted that addresses the issue of when a meal site should close (number of meals served).

Sharon reported that one bid was submitted to provide the food for the Congregate and Home Delivered Meal Programs. The bid from the Ozaukee County Sheriff’s Department was:

Congregate Meals $3.19

Home Delivered (prepackaged with disposables) $3.19

Breakfast meal $2.85

Frozen Meal (no cold bag) $1.13

Warren Stumpe left the meeting at this time.

On a motion by Ed Adams and a second by Karen Broman, the minutes of August 22nd were approved.

Discussion of Establishing an Aging Resource Center

Discussion was held on the location of a center, a possible name change, and the need for an 800 phone number.

Discussion of Conference on the Challenge of an Aging Society

Those members who attended this conference discussed the need to be prepared for an influx of seniors as the baby boomers begin to turn 60.

Reports

The following reports were distributed in the packet:

Congregate/Home Delivered Meals Program – Mary Ferrell reviewed the statistics for the meal programs. Discussion was held on the need to establish criteria for the closing of meal sites. The Committee asked Brad Peele to check with other counties about their policies.

Information & Assistance: Ginger clarified what is meant by "answering the phone" and what the responsibilities are for this position. She went through the process of taking the phone call to evaluating the situation, making a home visit if necessary and working with the client.

Ed Adams left the meeting at 11:10 AM.

Department Financial Report: Financial report is within budget parameters.

Coalition of Wisconsin Aging Groups: Meeting will be held the week of October 3 in Kenosha. CWAG is holding a fundraiser in November and the Southeastern WI Area Agency on Aging is sponsoring a table.

Area Agency Board/Advisory Council: The Area Agency Board has approved a slate of officers. The Elder Issues Conference is scheduled for Thursday, November 3 – nominations for the Pearl Award are due to the AAA. Margie commented that there is one scholarship still available for the Senior Statesmanship Program.

Brad commented that Sharon presented "A House in Order" at the August meeting of the Advisory Council.

Topics for Next Meeting

Approve County Plan

Respectfully submitted,

Sharon Gilman, Director

Aging Services

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August 15, 2005

Aging and Long-Term Committee met in Room A-200 at the Administration Center.

Present: Supervisors: Erickson, Boesch, Stumpe, Walerstein, Herlache and Geracie, Ralph Luedtke, Sharon Gilman, Dawn Woda, Marge Fuhr, Tom Meaux and Clerk Marchese.

Call to Order: Meeting Called to Order by Chairperson Erickson at 10:50 A.M. following the Commission on Aging meeting.

Proper Notice/Adoption of Agenda: Assurance that the meeting has been properly noticed - so noted by Clerk Marchese.

Public Comment/Correspondence and Communications: - at this time, Supervisor Erickson mentioned that she has asked Supervisor Geracie and Sharon to reschedule the monthly Commission on Aging meetings on a different day in order for the Commission and Committees to have enough time to discuss all items on the agenda.

Approval of Minutes: Motion made by Supervisor Stumpe, seconded by Supervisor Boesch, to approve minutes of July 18 meeting as mailed. Vote was taken. Motion carried unanimously.

Department of Aging Items/Director Reports - Action Items:

Approval of 2005 final federal/state allocations - Supervisor Erickson mentioned that Sharon had explained at the Commission meeting that there were no changes in the state dollars previously approved but there are changes in the federal allocation. By statute, federal dollars are allocated to individual programs and cannot be transferred to other programs, except in the case of Congregate and Home Delivered Meal allocations. A percentage of the federal funding for Congregate Meals can be transferred to Home Delivered Meals. Motion made by Supervisor Stumpe, seconded by Supervisor Herlache, to approve and accept the final allocation of funds. Vote was taken. Motion carried unanimously.

At this time, the Chairperson deviated from the agenda to take action on the Veterans' Service Officer's 2006 proposed budget and current budget before continuing with the Aging Department budget:

Mr. Brown presented an overview of his budget request for 2006 followed with a report of his current budget. This and all budgets will be discussed further at the department head's meeting with the County Administrator in the next couple of weeks.

The Chairperson resumed the agenda to discuss the proposed budget for the Aging Department.

2006 Budget:

Budget No. 1 included all of the items discussed at last month's Commission meeting such as new van for home delivered meals, full-time Information & Assistance Specialist position and removing all the individuals from the waiting list for assistance. This came to a 45% increase in the tax levy. The Commission decided this was too high, and asked that two other budgets be prepared for presentation to the committee.

Budget No. 2 in the amount of $937,936, included the consolidation of several meal sites, the cost of a van, a part-time Information & Assistance Specialist position and $10,000 to remove nine individuals from the waiting list for home care which came to a 30.5% increase in the tax levy. This is the budget preferred by the Commission.

Budget No. 3 does not include $10,000 to remove people from the waiting list, $14,000 which is half of the cost for a replacement van for home delivered meals and $15,000 which is half the cost of home delivered meals for a total increase in the tax levy of 18% or an increase of 6.6% in the total budget.

At this time, Mrs. Fuhr commented that the Commission prioritized the items, looked at all avenues on each item and cut as they felt necessary to where they feel comfortable with presenting budget number two and not budget number three.

It is recommended that Sharon should submit budget number 2, in the amount of $937,936 for approval.

Approximately 11:30 A.M. - Supervisor Geracie and Dawn Woda were excused.

Challenge of an Aging Society Conference/Aging Resource Center:

Sharon passed around a calendar and financial information from the Centralia Center, a combined senior center/aging resource center in Wisconsin Rapids. This was a joint effort between the City and the County. As far as she knows, there is not another center like this in the state. Sharon and Supervisor Erickson explained that the City of Wisconsin Rapids took a vacant store and remodeled the building. Wood County leases space for their Aging Resource Center; the City relocated their Senior Center to the space and leases other space to an adult day care center. The vacant store is attached to a mall where other services such as an eye center, hearing aide specialist, and physical therapist are located. This situation is much the same as the one in Grafton with the old K-Mart Store.

The County will be meeting with the Village of Grafton this week and the question will be raised at this time. They will also mention that the County is looking to combine the congregate meal sites for Cedarburg and Grafton and this could be the central location.

Further discussion regarding funding, what facilities might be available in the area and that this could be a joint effort in fund raising efforts of the seniors, the County and the Village.

Management and Financial Reports: Review of the budget shows that the Aging Department is currently $127,000 under budget and does not for see any problem with any account, except for the home delivered meals, but overall, will be under budget for the balance of 2005.

Approximately 11:50 A.M. - Sharon Gilman was excused.

Department of Lasata Items/Director Reports - Action Items:

New Mission Statements:

Three revised mission statements for Lasata Care Center were presented to the committee for discussion. Motion made by Supervisor Walerstein, seconded by Supervisor Stumpe, to accept version three which reads: "Lasata Care Center is dedicated to providing for the social, spiritual and medical needs of our residents, preserving their dignity and individuality, and adhering to their personal health care choices." Vote was taken. Motion carried unanimously.

Three revised mission statements for Lasata Heights were also discussed by the committee. Motion made by Supervisor Stumpe, seconded by Supervisor Walerstein, to accept version three which reads: "Lasata Heights is committee to offering services that allow our tenants to maintain an independent lifestyle of their choice." Vote was taken. Motion carried unanimously.

The 2006 budget for Lasata was presented. Discussion regarding the 1.4% bed tax that the Governor has vetoed and how it affects both budgets.

There was discussion regarding the length of stay for Medicare patients, how many of these have returned home compared to passing away, the policy of removing individuals from the waiting list, increase rate of private pay residents, the possibility of increasing the number of available private pay rooms and the anticipated available amount of IGT funds.

An update from a recent meeting with the county's Purchasing Agent, there is a good possibility that the pharmacy will be able to take over supplying medication to the Sheriff's Department. The base plan is to have a new pharmacy system which will be implemented this later this year, going a way from filling pills every day to once a month. This means the laying off a Pharmacist, taking less tech time and savings of supplies and expenses.

A proposed budget was presented for the take over and provide medication for the Jail, there is a need to keep that Pharmacist on board, increase pharmacy technician time by 8 hours and will increase the supply for the cost of drugs to $158,000, which would be the cost charged back to the Sheriff's Department, this would offset the cost to his budget. This would be a better deal for them than to stay with their current outside service; this would be a wash for the Lasata budget. If the decision is made that they stay with their current service, revenue would go down by about $158,000, expenses of $158,000would go away, but would have to budget $15,000 for pharmacy back-up to cover the Pharmacist time-off, by law need to bring in an outside consultant to cover the day.

There was discussion regarding alternatives if Lasata would go to an outside source for purchasing medication, if it would be cheaper. Ralph explained that because they are a member of a nursing home facility purchasing group, they are able to purchase mediation, from the same sources as an outside service, but at a cost reduction of 7-8% compared to their discount of 1-1/2%.

As part of this discussion, it was asked if this service could be beneficial to the County if it could be offered to our employees and their families. Ralph explained that although it may sound good, they would not be able to compete with a pharmacy that has hundreds of thousands of clients and give our insurance company a decent rate.

The overall projected loss is anticipated at $586,813.00 for 2006, which is $50,000.00 less than this year with the difference being made up from reserves. He is estimating a balance of $777,000.00 in reserves at the end of 2006, if this budget was approved as presented.

The final payment for Lasata Heights' indebtedness will be made in 2006. This annual savings will not be seen until 2007.

He is recommending an increase of $14.00 per month. (this includes $10.00 for rent and $4.00 for meals of which 15 meals are included in their rent). They are budgeting with the idea of having 1 or 2 apartments available every month, as in previous years. For every $10.00 a month increase, it is another $7,200.00 in revenue, if the rent would be increased to $24.00, this would generate more revenue. Did not increase parking, housekeeping services and raising the meals of $.25 meal. Energy costs have been locked in for natural gas until October of 2007 (renewed every 2 years), electricity and water are furnished by Cedarburg Light and Water for an increase of 5-8%.

The big expenses for Lasata Heights are: several capital outlay projects including $14,000.00 this year and $110,000.00 for next year. Discussion regarding the amount budgeted for the repair work of the driveway. There is also an $8,000.00 increase in buildings repairs and maintenance which is included in purchased services.

The consensus of the committee members is to try to come in with a zero levy.

Review of Medicaid Divestment Practices: Nothing new to report at this time.

Public/Private Partnership-Assisted Living: Supervisor Erickson presented a brief follow-up of meetings that have taken place with two corporations that have shown interest, there is a third party now showing some interest but have not scheduled a meeting with them. Tax Credit System/federal level was explained and it appears that only these companies are able to apply for a grant once a year in January. All business contacts will be kept confidential at this time, but will be brought to the committee, in close session, for a formal presentation before going to the full County Board.

Management and Financial Reports for Lasata and Lasata Heights:

Ralph explained the current surplus of $963,000 for Lasata, but the real surplus is about $300,000 after the last payroll figures, utilities and the principal on current debt for July are actually deducted.

Lasata Heights is currently showing a surplus of $226,000 but the real surplus is about $27,000 after the last payroll figures, utilities and the principal on current debt for July are actually deducted.

Occupancy/Census Statistics – Lasata and Lasata Heights: Ralph explained the handout and stated that about 26% of the residents have been discharged back to a home or their apartments after a short term stay for rehab; but has now gone up to 50%.

Conference and Meeting Attendance Reports: Four attendance sheets for Lasata employees were signed by Supervisor Erickson.

Motion made by Supervisor Stumpe, seconded by Supervisor Boesch, to adjourn. Vote was taken. Motion carried unanimously (4-0).

Meeting declared adjourned at 12:52 P.M.

__________________________________

County Clerk

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Port Washington, Wisconsin

July 18, 2005

Aging and Long-Term Committee met in Room A-200 at the Administration Center.

Present: Supervisors: Erickson, Boesch and Walerstein, Ralph Luedtke, Sharon Gilman, Tom Meaux and Clerk Marchese

Absent: Supervisors Herlache and Stumpe.

Call to Order: Meeting Called to Order by Chairperson Erickson at 10:58 A.M. following the Commission on Aging meeting.

Proper Notice/Adoption of Agenda: Assurance that the Meeting has been Properly Noticed - so noted by Clerk Marchese.

Public Comments/Correspondence and Communications: - none

Approval of Minutes: Motion made by Supervisor Walerstein, seconded by Supervisor Boesch to approve minutes of June 20 and July 6, as mailed. Motion carried (3-0).

Challenge of an Aging Society: Supervisor Erickson presented a summary of a conference she attended with Supervisor Herlache, Sharon, Marge Fuhr and Jan Braby. Obtained informational material and ideas in terms of an Aging Resource Center. Also discussed the Task Force on the Aging of Dane County executive summary report, the conclusions they came to and the problems they anticipate will be the same as Ozaukee County.

Aging Resources Center Guidelines: Sharon explained that the copy of the guidelines was in the packet and she was interested in considering whether or not to start looking into officially calling the department an Aging Resource Center even though there will not be additional funding. Sharon will detail what is already being done, what additional things need to be done and any additional cost.

Supervisor Erickson explained that the City of Wisconsin Rapids took a vacant store and remodeled the building. Wood County leases space for their Aging Resource Center; the City relocated their Senior Center to the space and leases other space to an adult day care center. The vacant store is attached to a mall where other services such as an eye center, hearing aide specialist, and physical therapist are located. This situation is much the same as the one in Grafton with the old K-Mart Store. Look into putting together a team to see if there is a possibility of obtaining private donations and working with a municipality. Tom Meaux mentioned that the County will be having a series of meetings with the Village of Grafton in August and he will raise this question at that time.

Medicare Part D Implementation: was briefly discussed and was explained at the Commission on Aging meeting earlier.

Management and Financial Report: The attendance at the Congregate Meal Sites has been declining at some sites. Reservations are made the day before thus eliminating most of the concerns about ordering too much food. Sharon explained that a paid driver picks up the food at the jail and delivers it in bulk to all of the meal sites. The food for the home delivered program is then packaged at the site. In the southern part of the county home delivered meals are delivered by volunteers but the northern part of the county is being delivered by the paid driver after he leaves the Port Washington site. The cost of delivery is about $15 – 20,000. Also discussed how Maple Crest meal site is working out and using that as a model program, but their numbers have gone down slightly from 2004. Discussion if there was a possibility of having the home delivered meals packaged at the jail, if this would make it easier for the managers and the meal sites would not need a kitchen. The main concern would be if the temperature of the food would remain at the necessary level.

Management and Financial Reports: Sharon reminded the committee that funding is on a reimbursable basis so reports will always be a month behind and right now, net is higher than projected and presently under budget for the year.

11:18 A.M - Supervisor Geracie now present.

Increase in Medicare Certified Beds: Ralph explained how many units they already have certified, problems currently have with staffing, what happens if a patient is hospitalized until they are able to return to their room; that approximately $160,000 net could be generated if another heavy care unit is certified, then staffing would not have to be increased. Applications can only be submitted once a year in January. Motion made by Supervisor Erickson, seconded by Supervisor Walerstein, instruct Ralph to apply in January to have another unit approved as Medicare certified. The vote was taken. Motion carried (3-0).

Review of Medicaid Divestment Practices: Nothing new to report.

Public/Private Partnership-Assisted Living: Follow up of approval given at last meeting to go forward with project. A copy of the letter that was sent and a list of business that were contacted were handed out at this time. Family Tree was inadvertently omitted but since received a letter. Several calls have been received in support of this program and from a business in Illinois wishing to start a program in Wisconsin. All business contacts will be kept confidential at this time.

Tour of Manitowoc County Facility: A report of the visit was presented and they explained how rooms/offices were designed and named after a famous landmark for the clients to associate with, private rooms with private bath compared to most places having double occupancy and sharing a bath. How they economized to save on expenses and delivery of services.

Management and Financial Reports: The budget of Lasata Heights was discussed and mentioned that the last loan payment will be made in March of 2006, but there are many improvements that need to be made but could be held off until 2007 with an estimated cost of $100,000 and work would be done in two or three stages.

The Lasata Care Center budget was then discussed and Ralph feels that he will be able to come in with the same budget figures for 2006 as he had in 2005, not have to ask for additional staff and not have to use any reserves.

Discussion if the pharmacy would be able to provide services for the County Jail. New distribution system will be in place and running by September 1 after which they will be able to have a better idea if this proposal would work and make a decision how the prescriptions would be delivered and submitting the same budget as the Sheriff to committees. The hours of the Pharmacist will be determined if this program works or not. They might be able to reduce some expenses if proposed legislation is approved so unused prescription packaged medication of a deceased patient could be returned to the pharmacy and reissued to a patient that might be coming in the later in the month and proper credit being applied.

Occupancy/Census Statistics – Lasata and Lasata Heights: Ralph explained the handout and stated that about 26% of the residents have been discharged back to a home or their apartments after a short term stay for rehab; but has now gone up to 50%.

Brief discussion on Assisted living and Ralph explained that it takes about two to three years to have a facility completely full.

Frank Peterson was now present and explained the MA personal program and having two nurses transferred from the Public Health Department to the Human Services Department as of August 1 and will have an additional four Home Health Aides (now known as CNA’s). Will be able to double the number of individuals being served from 20 to 40 and cost will be increasing as well. This means that they will be able to remove more homebound and disabled from the waiting list sooner. Frank will present a monthly update for the committee.

Conference and Meeting Attendance Reports: Attendance sheets for Ken Brown and Office on Aging were signed by Supervisor Erickson.

Items for Committee Report. Suggested items for the Board report are: moving forward with private participation for assisted living, suggestions and ideas on their part, if they build and we rent or if we provide the land and they build, remodel an existing facility and be open to any suggestions proposed.

Further discussion regarding grant money to cover hours worked by employees with the new Medicare Part D because of the number of individuals involved and trying to educate them as much as possible within a short period of time. Some alternatives were discussed.

Motion made by Supervisor Boesch, seconded by Supervisor Walerstein, to adjourn. Vote taken. Motion carried. (3-0).

Meeting declared adjourned at 12:18 P.M.

__________________________________

County Clerk

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Port Washington, Wisconsin

July 6, 2005

The Aging & Long-Term Care Committee met in Room A-209 of the Administration Center, prior to the County Board session.

Present: Supervisors Erickson, Boesch, Herlache and Walerstein (participated by phone), Tom Meaux and Clerk Marchese.

Absent: Supervisor Stumpe.

1 - Call meeting to Order by Chairperson Erickson at 8:30 A.M.

2 - Assurance that the Meeting has been Properly Noticed/Adoption of Agenda - So Noted by Clerk Marchese. Motion made by Supervisor Herlache, seconded by Supervisor Boesch, to adopt the agenda as presented. Vote taken. Motion carried unanimously.

3 - Resolution No. 05-26 - Assisted Living Public-Private Partnership at Lasata. Motion made by Supervisor Walerstein, seconded by Supervisor Boesch, to approve the resolution. Discussion regarding if the rate would be set by the private sector or as set by the county.

It was agreed that the County first needs to determine if there is an interest by the private sector.

4 - Discussion regarding "new construction". Would this be the private sector or county's responsibility and if this would be converting current apartments. At this time, the Corporation Counsel provided his opinion of the resolution and what procedure the committee can take.

8:37 A.M. - Supervisors Leider, Brooks and Stumpe now present.

It was stated that this is only a request to explore the prospect of entering into an assisted living partnership. The vote was then taken on approval of the resolution. Motion carried unanimously.

5 - Motion made by Supervisor Stumpe, seconded by Supervisor Herlache to adjourn.

Meeting Adjourned 8:55 AM

_________________________________

County Clerk

Table of Content

Cedarburg, Wisconsin

June 20, 2005

Aging & Long-Term Committee met in the Board Room at Lasata Care Center.

Present: Supervisors: Maryann Erickson, Clarence Boesch, Dan Herlache, Warren Stumpe, Bob Walerstein, Kathryn Geracie, County Administrator Tom Meaux, Lasata Care Center Administrator Ralph Luedtke, Aging Services Director Sharon Gilman, Veterans Service Officer Ken Brown, Maureen Tryggestad of Social Services, Marge Fuhr and Gladys Huber of the Commission on Aging, Joanne Prom of Lasata Care Center.

1. Meeting Called to Order by Chairperson Erickson at 10:45 AM and introductions were done by all present.

2. Assurance that the Meeting has been Properly Noticed/Adoption of Agenda – so noted.

3. Public Comments/Correspondence and Communications - none

4. Approval of Minutes: Motion made by Supervisor Herlache, seconded by Supervisor Walerstein to approve the minutes as mailed. Motion carried (5-0).

Veterans Service Officer Brown requested that Agenda Item #9c: Veterans Office organization matrix be moved up on the Agenda. So allowed by Chairperson Erickson. He explained the basic benefit structure as mandated by the Federal and State Government in conjunction with the Department of Veterans Affairs.

5. Tour of Lasata Complex: Committee members and interested visitors toured Lasata Heights.

6 & 7. Discussion of Wisconsin Nursing Home conversion demo project: This program sponsored by the Wisconsin Department of Health and Family Services (DHFS) and the Wisconsin Housing and Economic Development Authority (WHEDA) is intended to replace nursing home beds with assisted living alternatives, which would be CIP-II/Cop-Waiver slots so they would be available for the elderly or physically handicapped.

Ralph attended a meeting in Madison and presented a summary of the information. Maureen Tryggestad of Social Services also presented a report regarding monthly costs at assisted living facilities in Ozaukee County. Motion by Supervisor Stumpe seconded by B. Walerstein to not get involved with this program. Motion carried (3-2).

The discussion continued regarding adding assisted living facilities and looking into continuing or updating the study done by Keefe & Associates about six years ago. The possibility of partnering with a private company was brought up by Tom Meaux.

12:00 Noon Supervisor Stumpe excused.

Motion by Supervisor Walerstein seconded by D. Herlache to ask staff to prepare a PFI and to consult with the Corporation Counsel with regard to a partnership with a private company. Motion carried (4-0).

8. Review of Medicaid divestment practices: The financial impact to the County and what can be done to encourage the Federal and State governments to close divestment loopholes was discussed. Discussion on this item will be on-going.

9. Director Reports:

a. Aging Services Department report presented by Sharon: Aging and Disability Resource Center funding to government agencies is extremely limited. Foundations are prone to funding 501.c3 agencies. The majority of funding to government agencies is from state and federal sources and at the present time there are no state/federal funds available.

She also commented on the Conference she attended regarding Elder Care & Work: Finding the Balance. The Conference was very informative; the most difficult part will be finding staff time to implement the techniques learned A presentation on Medicare Part D (Prescription drugs) was given on Friday, June 17 to persons providing services to the elderly.

b. Lasata Reports presented by Ralph: The census at the Care Center has been averaging 196 residents per day right and the Heights currently has one vacant apartment with an average of 1.2 vacant apartments for the year. The Care Center had 49 new admissions with 48 County residents and one Out of County with a relative. Both the Care Center and the Heights revenues are above budget and expenses are below budget.

The State Joint Finance Committee has recommended a Medicaid rate increase of 1.4% for July 2005 and 2006, and will include no increase in the nursing home bed-tax.

The Cedarburg Light & Water Utility Company has obtained funding through the State Public Benefits program again for low-income (our Medicaid residents) citizens and we are expected to receive a credit of $20,000 on the electric bills this summer.

Results of the Lasata Heights Tenant Satisfaction survey was given to the members. The only issue of concern was the menu and variety of food. This is being addressed by the Dietary Supervisor and the Heights Manager.

12:45 PM - Supervisors Walerstein and Boesch were excused.

Budgets for 2006 are due by August 19, 2005, so they will be presented to the Aging & Long-Term committee at the August 15th meeting.

The meeting ended at 12:50 PM, due to lack of a quorum. No further action was taken.

__________________________________________________

Joanne M. Prom, Secretary – Lasata Care Center

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Port Washington, Wisconsin

May 16, 2005

The Aging & Long-Term Committee met in Room A-200 of the Administration Center.

Present: Supervisors Maryann Erickson, Bob Walerstein, Dan Herlache, Rob Brooks, Aging Services Director Sharon Gilman, Veterans Service Officer Ken Brown, Lasata Care Center Administrator Ralph Luedtke, Lasata Heights Manager Diane Nelson, Finance Director Andy Lamb, County Administrator Tom Meaux and County Clerk Mary Marchese.

Absent: Supervisors Boesch and Stumpe.

1. Call meeting to Order by Chairperson Erickson at 8:35 A.M., and introductions were done by all members present.

2. Assurance that the Meeting has been Properly Noticed/Adoption of Agenda - (So noted by Clerk Marchese.)

3.- Public Comments/Correspondence and Communications made or presented:

Andy Lamb made a presentation of the Financial Statements followed by an explanation of what format the Administrative Committee would like to see presented by departments each month and to make any significant statements in writing on the bottom of the financial report regarding their budgets.

Supervisor Erickson commented that she would like to see a monthly Year-To-Date report and the column showing the percentage of the budget balance instead of a Year-To-Budget report. The Finance Department has created such a report for Lasata and Ralph will include this in his information for next month's meeting.

4. Approval of Minutes. Motion made by Supervisor Herlache, seconded by Supervisor Walerstein, to approve the minutes as mailed. Motion carried (3-0).

5. There were no action items for the Aging and Veterans' Service Departments.

Lasata Action Items:

a. Request to fill vacant Nursing Supervisor position:

Ralph explained some of the duties of this managerial position, that no one from within applied and that this position pays an additional $4.00 an hour more than the Nursing position.

Motion made by Supervisor Walerstein, seconded by Supervisor Brooks, to approve filling the position. Motion carried (3-0).

Request to attend an Out-of-State Convention:

Ralph explained that this request is for the Pharmacy Director to go to Orlando, Florida. She is only asking for reimbursement for the registration fee and for the room. She is not asking for air fare.

Discussion regarding how information is currently updated every month.

Motion made by Supervisor Brooks, seconded by Supervisor Herlache, to approve the request. Motion carried (3-0).

7 a. Aging Services Department Reports:

Sharon presented an overview of the Aging Services Department, the services they provide and handed out a booklet of all these services For most programs, the staff cannot ask what a participant’s income is and cannot deny services based on their income, but they can request donations for services provided. They collaborate with Human Services, Veterans Service and Lasata. Aging Services does the intake and assessment for all older people and if eligible a person would be placed on the department’s waiting list for services or would be placed on the Adult Services Unit (in the Human Services Department) waiting list. Aging Services has limited funding to assist individuals on a temporary basis.

Sharon did review the powers and duties of the Commission on Aging. They are the policy making Board that oversees the department and the activities of the department. She explained the three-year County Plan, which she develops and is then approved by the Commission. The plan tells the state what services the county will provide for older adults and the budget to provide these services. It was suggested that the Commission meet prior to this committee (this will be discussed at their meeting next week) as well as having the Long-Term Support Planning Committee meet in the afternoon of the day in which the Committee meets in July (they currently meet every other month. An orientation has been scheduled for Wednesday afternoon, June 1.)

Supervisor Brooks presented an example of why two or three committees should meet jointly in order to have better communication and take less time for all committees to take action on items

With the receipt of federal funding, much of the Aging Department staff's time this summer and fall will be involved in educating and helping older adults on Medicare decide whether or not they will participate in Medicare Part D. (Medicare Prescription Drugs Program). A decision has to be made no later than May 15, 2006.

Sharon mentioned that her department did not receive the Aging and Disability Resource Center (ADRC) grant that they applied for and presented some background information as to why this grant was not received.

It was suggested to check if this grant will be available again next year and if not, what other options or sources of funding might be available.

Sharon did a quick review of her budgets, explained what state and federal programs/agencies her department works with and answered questions regarding timely receipt of revenue funds.

Her department is the fiscal agent for a Senior conference, held jointly with other agencies throughout the county, which will be held at the Grafton High School, on June 14. This event generates income as venders with booths are charged $150.00, major sponsors of the conference donate $500.00 and session sponsors donate $200.00.

b. Lasata Reports:

Ralph presented an overview of Lasata Care Center and explained the policy used in accepting residents from within the county as well as from outside the county, rates established for these residents, how Medicare and IGT pay scale factors in the revenue part of the budget and turn over of residents. How applicants may not qualify to be placed on the waiting list and how the closing of Mequon Care Center affect them and how the vacancies varies from day to day.

Family members are billed up front for the difference between a single room and a double room of $15.00/day up front for the first month. If they do not pay, a fee of 1% is added to the bill and the individual is moved to a double room. This procedure has not been an issue.

Discussion regarding possible uses of Lasata's Pharmacy and changes made in daily/weekly distribution of medication to residents and possibly becoming a centralized pharmacy and the possibility of developing an out sourcing in cooperation with the Sheriff's Department, Social Services Department and the possibility of county employees using these services as well. Currently the department consist of 2 full-time and 2 part-time employees. The staff could be reduced to only one full-time employee somewhere in the future.

He discussed his budgets, explained what state and federal programs/agencies they work with, and like Aging, revenue fluctuates on a monthly basis throughout the year.

10:05 A.M. - Frank Peterson of Human Resources Department now present to discuss Long-Term issues.

The committee would like to tour the facilities Manitowoc County facilities at a future date.

Mission statement will be discussed at a future meeting.

Diane presented an overview of Lasata Heights and explained the policy used in accepting residents from within the county as well as from outside the county and if resident's spouse would be allowed to be placed on the waiting list for Lasata. How many applicants are not qualified to be placed on the waiting list and how the closing of Mequon Care Center may have affect them.

She discussed her budget, explained what state and federal programs/agencies she works with, and like Aging, revenue fluctuates on a monthly basis throughout the year.

Discussion followed if the county should keep the Heights as is or change over to assisted living quarters.

The Committee would like to tour both Lasata and Lasata Heights, open this tour to all County Supervisors.

c. Veterans Service Office:

Ken explained the services provided by his office: how federal programs are updated weekly, involved with rewriting state funding issues (AB210), Federal and State do not pay for services (these services are funded by the interest collected on loans), what some of the qualifications are for these programs, the number of veterans assisted each year.

He explained that his department receives two grants every year and this money is used for improvising services, salaries and equipment for his office. He does receive a grant for transportation and excess funds are used to replace flags at the Justice Center. He does have funds for veterans relief for food, shelter and bus fare. He has requested an update for one of two computers in his office.

His has an interoffice relationship with Aging and Human Services Departments that if a veteran contacts one of them, they will be referred to his office.

10:41 A.M. - Ken excused.

Presentation from Long-Term Support:

Frank explained services provided for the elderly, young physically disable, adult protection and elderly abuse, structure of committee, CIP mandatory and recommended regulations, waiting list for available funding/services, COP state money is administered, how funding is shifted to LTS fro IGT money, placing of residents when Mequon Care Center closed and place in less restricted facilities.

Long-Term Support Planning reports to 2 Committees (check). Will be having an orientation on Wednesday, June 1 at 1 p.m.

Family members are invoiced for services provided to a client while on waiting list, which is a potential of two years or longer.

There is a Challenge of an Aging Society conference June 27 and 28 in Wisconsin Rapids that is recommended for all members to attend.

8. Asset Divestment also called "voluntary impoverishment".

Divestments affects nursing homes as well as other departments. At times, the client is the person getting hurt the most because their choice has been taken away from them. Joint Finance is trying to change the state law as the penalty is to generous at the present time.

It was stressed that they can not ask the individual what their financial status is.

11:21 A.M. - Supervisor Walerstein excused.

Discussion regarding concentrating on monthly disbursements and see if any other county would join the effort of having proposed changes to close loop holes in the state laws changed and to contact Representative Gielow.

Topics for future meetings:

Funding Mechanism - including general fund, special revenue, primary payment. Work on a 3-5 year plan, what are laws and where do they come from.

10. The next Committee meeting will be held on Monday, June 20 at 8:30 A.M. at Lasata.

11. Motion made by Supervisor Brooks, seconded by Supervisor Herlache, that the meeting be adjourned. Vote taken. Motion carried (3-0).

County Clerk

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