Ozaukee County Wisconsin - Minutes - Aging & Long-Term Committee

Present: Supervisors Geracie, Egelhoff, Walerstein, Leach, Schlenvogt. Staff: Administrator Luedtke, County Administrator Meaux, ADRC Acting Director Ferrell, Veteran Service Officer Brown, and Deputy Clerk Henning.

Call to Order/Proper Notice/Adoption of Agenda: The meeting was called to order by Chairperson Geracie at 8:31 A.M. Deputy Clerk Henning assured the committee that the meeting was properly noticed.

Public Comments/Correspondence/Communications: No public comment, correspondence, or communications were received by the Committee.

Approve Minutes from the August 20 Meeting: Motion made by Supervisor Schlenvogt, seconded by Supervisor Leach to approve the minutes as presented. All members present voting Aye. Motion carried. (5-0)

Veteran’s Service Items:

Conference & Meeting Attendance Reports: No reports presented to the Committee.

Management / Financial Reports: Mr. Brown reported that the financials are still within budget; however, transportation issues are moving into "dire straits". When the time comes, Interfaith Caregivers will be utilized to assist with the transportation of veterans. An option would be to look for grave flags to be donated next year which would allow those dollars to be used for transporting the veterans. A deterrent of this option would be the uncertainty of donated flags for years to follow. The question was raised as to whether citizens could "volunteer" to transport the veterans. Mr. Brown indicated that essentially the volunteers would need to become employees of Ozaukee County due to auto insurance issues. Discussion on possibly using some dollars from the Aging & Disabilities Resources budget next year. Currently, all is contingent on the State’s budget being passed.

8:47 A.M. Mr. Brown excused.

Aging & Disabilities Resource Center Items:

Conference & Meeting Attendance Reports: No reports presented to the Committee.

Management/Financial Reports: Ms. Ferrell reported that the budget is well within range and there were no questions. Ms. Ferrell discussed the inclusion of ADRC with the Health & Human Services Department (HHSD). After referring with Brown, Manitowoc, Racine, Washington and Portage Counties, many of their concerns are the same as ours. The mission statements of the two departments are very different; the ADRC’s mission statement is that information and options are being provided to aid in their decisions; whereas, the HHSD mission statement is basically that they are working with specific individuals on specific services. The departments are coming from very different angles. There are definite stigmas for people coming to the HHSD. The ADRC is to be a warm and inviting environment so that people feel comfortable coming in. Unfortunately, in some cases, the people’s stigma about Social Services could prevent them from accessing the services of the ADRC. If the ADRC remains a separate identity from HHSD, that stigma would not be an issue. The ADRC anticipates that 80% of the clientele will be elderly. Ms. Ferrell stressed that over the course of the next few months, as we move into an ADRC, that the Committee have the time and energy into making the ADRC work. At this time, Ms. Ferrell does not anticipate the opening of the ADRC on November 1^st due to the timing of the signing of the State budget. Ms. Ferrell also indicated that if Family Care does not expand, ADRC will not expand. Ms. Ferrell is meeting with Carla Phillips and Michele Brandner this week to develop an alternate budget in the event the Governor does not sign the budget.

9:03 A.M. Ms. Ferrell excused.

Lasata Care Center Items:

Pathways Senior Living Project Update: Administrator Luedtke reported that a surveyor was measuring the Pathways property last week. If Family Care does not pass, the fate of Pathways remains to be seen. Regardless, the water and sewer projects need to be done. Administrator Luedtke has come to the conclusion that due to timing issues between the Cedarburg Planning Commission and the City Council for approvals; and bidding the project out that the water and sewer project will probably not be done until spring 2008.

2008 State Licensure Survey: The annual licensure survey was held from September 4-September 7. Overall, there were positive comments about the facility and the care offered at Lasata. Lasata received 6 citations related to health and quality of care; 3 citations related to cleanliness and the engineer issued 13 citations of the federal Life Safety Code. To summarize, all the citations, quality of care and life safety, were at minimum or minor levels of severity so there should not be any fines or penalties enforced. Lasata has 10 days to write a plan of correction for each citation and 30 days to fix all citations. The surveyors will return after 30 days to ensure compliance with all deficiencies.

Resolution on Certified Public Expenditures: Administrator Luedtke had drafted a resolution urging the State Legislature and Governor to reimburse County nursing homes for their Medicaid losses under the Certified Public Expenditures Program. This re-draft reduces the loss from $480,000 to $180,000 to reflect the budget loss projected for next year. Motion made by Supervisor Schlenvogt to take the Resolution directly to the County Board, seconded by Supervisor Leach. All members present voting Aye. Motion carried. (5-0).

Management / Financial Reports:

Conference & Meeting Attendance Reports: No reports presented to the Committee.

Monthly/Financials/Census/Department Report: Administrator Luedtke reported that Lasata’s year-to-date surplus is $181,123 and Lasata Height’s surplus is $139,865. Lasata Heights averaged 3 vacant apartments through August; 5 were budgeted. Lasata averaged 196.3 residents/day through August; 196 were budgeted.

Motion made by Supervisor Schlenvogt, seconded by Supervisor Leach to enter into closed session. Roll call vote taken, all members present voting aye. Motion carried. (5-0)

Closed Session – per WI State Stat. 19.85(1)(c) : Conduct interviews for the position of ADRC Director: 9:50 AM Closed Session. Present: Supervisors Geracie, Walterstein, Egelhoff, Leach and Schlenvogt; County Administrator Meaux, Benefit Manager Betty Klumb.

1:00 P.M. Supervisors Leach and Schlenvogt excused.

Next Meeting Date: Monday, October 15, 2007 at 8:30 A.M. at Lasata.

Adjournment: Motion made by Supervisor Walerstein, seconded by Supervisor Egelhoff to adjourn. All members present voting Aye. Motion carried (3-0). Meeting adjourned 3:30 PM.

Lisa M. Henning

Deputy County Clerk

Table of Content

August 20, 2007

Port Washington, WI

The Aging and Long Term Care Committee met in room A-200 of the Administration Center

Committee Members Present: Chairperson Geracie, Supervisor Egelhoff, Supervisor Leach, Supervisor Schlenvogt

Others Present: Veteran’s Service Officer Ken Brown, Interim Aging and Disability Resource Center Director Mary Ferrell, Information and Assistance Ginger Ayres, Nursing Home Administrator Ralph Luedtke, Assistant Administrator Michael Fogel County Administrator Thomas Meaux and Assistant County Administrator Jason Dzwinel

Absent: Supervisor Walerstein (excused)

Call to Order: Meeting called to order at 8:30 AM by Chairperson Geracie.

Public Comments/Correspondence/Communications – No public comment, correspondence, or communications were received by the Committee.

Approve minutes from the June 18 meeting – Motion made by Supervisor Leach to approve the minutes as presented, seconded by Supervisor Egelhoff. Motion carried (3-0).

Supervisor Schlenvogt Joined the Meeting – 8:33 AM

Veterans Service

a. Discussion and/or Action Items

i. Preliminary 2008 Budget Review – Ken Brown explained that to meet the 2008 Budget directive the two program areas that could be reduced would be the budgeted mileage paid veterans transport and flags for the veteran graves throughout the county. The demand for neither has decreased in 2007. Supervisor Egelhoff inquired about the number of veterans transported by the Veterans Service Department, Ken Brown explained that is it generally about 250-300 a year. Ken Brown further explained that the only area that he requested an increase was the mileage that will be paid to his part time drivers to account for increased fuel and maintenance costs, and a small increase in his conference and meetings account planning due to the fact that his professional conference will be held outside of Southeastern Wisconsin in 2008.

ii. Conference and Meeting Reports – Motion made by Supervisor Egehoff to approve the reports, seconded by Supervisor Schenvogt. Motion carried (4-0)

iii. Management and Financial Reports – The Committee reviewed the reports, Ken noted that his overall budget is on balance year to date.

Aging & Disability Resource Center Items

b. Discussion and/or Action Items

i. ADRC Application Update – Mary Ferrell reported that the State of Wisconsin has indicated that the County’s ADRC application will receive approval. The State has indicated that that the level of the Ozaukee County application was so high that they are considering using it as best practice for other Counties considering the application process. Discussion on the addition of an Economic Support worker, the State will not approve the grant, without the removal of the funding request for the position. Staff will remove the proposed funding from the application. The State also requested that the ADRC implement the 1-800 numbers so that it could be included in the 2008 phone books. The Department had developed a request to implement the number, if it can still be included in the 2008 printing Mary will move the process ahead. The cost is $5.00/month and $.03/minute. The Department could secure the number and not promote until the State grant funds become available. Supervisor Schlenvogt inquired about the level of public use of the 800 number, in light of the current Departmental phone numbers. Staff could advertise the 800 as secondary to the current local and metro phone numbers. Committee consensus was to postpone approval until the State approves the ADRC application.

ii. Discussion Regarding ADRC Departmental Structure – Mary Ferrell discussed the inclusion of the ADRC within the Human Services Department, staff has had preliminary discussions on potential collaboration. Tom Meaux explained that this issue was studied as a part of the creation of the Ozaukee County Human Services department in 2005, at the time the decision was made to leave the Aging Department stand alone, however, since the initial report the implementation of Family Care and the creation of ADRCs has changed the potential for efficiencies. Motion made by Supervisor Egelhoff to direct staff to prepare a report for the Aging and Long Term Care and Human Services Committees on the potential for the inclusion of the ADRC in the Human Services Department, seconded by Supervisor Schlenvogt. Motion carried, (4-0). Administrator Meaux presented the list of candidates for the ADRC Director position, and requested that the Committee provide their input into the selection of the candidate. Chairperson Geracie and Supervisor Egelhoff will attend the interview, the meeting will be posted as public meetings so that all interested Committee Members may attend.

iii. Preliminary 2008 Proposed Budget Review – Mary Ferrell explained that all budget assumptions are predicated on the receipt of the ADRC grant funding. Further explaining that, the Economic Support position will be removed from the Information and Assistance cost center and additional grant funded administrative support time will be included per State directive. Discussion on State and Federal funding sources included in the ADRC budget, outside printing and contracted services. Committee discussion on the availability of the State funding – staff reported that program funding is dependant on the biennial State budget and the expansion of Family Care. It is likely that if the Family Care expansion is not approved the ADRC funds will not be received, alternatively the implementation dates will be rescheduled until later in the biennium as a cost saving measure by the State of Wisconsin. The budget assumes a fourth ADRC newsletter to be funded through the ADRC grant funds to meet the State prescribed marketing requirements. Discussion of Congregate meals, the budget assumes a five percent increase as a pass on from the Sheriff Department’s contracted food service. Discussion on the use of Title-IIIb and Title-IIIe funding to provide part-time case management to clients who will not qualify for Family Care due to the functional and/or financial thresholds – the budget assumes the creation of a part-time position to fund services to elderly clients who require services, but may not qualify for Family Care or other State/County services to avoid higher acuity and cost level care.

c. Management and Financial Reports

i. Conference and Meetings Attendance Reports – No reports presented to the Committee

ii. Management and Financial Reports – Mary Ferrell reported that the 2007 Budget is within expectations

Lasata Care Center Items

d. Discussion and/or Action Items

i. Pathways Update – Administrator Luedtke reported that the planning continues for the water and sewer upgrades at the Lasata Campus. Pathways has begun the process for the development of a certified survey map (CSM) that will create the lot for the Pathways facility. Supervisor Egelhoff inquired about the completion of the water and sewer project. Administrator Luedtke reported that staff is waiting for preliminary CSM survey lines so that the project might be coordinated to support Pathways.

ii. 2007 Capital Outlay Projects – Administrator Luedtke reported that the window replacement and roof repair projects are currently underway at Lasata Heights and are projected to be under budget. Both projects should be completed this year.

iii. Preliminary 2008 Proposed Budget Review –

Lasata Heights - Administrator Luedtke reported that the budgeted occupancy in 2008 will be assumed at 57 residents as compared to 55 in 2007. Discussion on the part-time status of the Lasata Heights Manager - currently, the incumbent is working beyond the weekly scheduled hours to meet the demands of the residents and families interested in living at the facility. The staff is working with the ADRC to make sure the acuity levels of the residents are appropriate for independent living environment. These factors cause staff to work beyond the budgeted hours, however, the Manager prefers the current 30hrs/weekly schedule. Apartments are updated as necessary when they become vacant. The Heights is budgeted at a $173,000 surplus in 2008. Utilities and architectural services for planning for 2009 renovations account for the increase of about $20,000 in purchased services.

Lasata Care Center – Administrator Luedtke reported that the budgeted occupancy is 97.5 percent, Medicaid accounting for 73 percent and private pay at 21 percent. The census mix is aggressive, but realistic. Medicaid is anticipated to increase 2.5 percent, and the budget assumes the increase, private pay rates will increase 6 percent. The budgeted deficit is expected to increase from $300,000 in 2007 to $479,000, the committee will be asked to decide how to address the expected deficit. The implementation of ‘culture change’ has begun in the dining services, and will continue in the 2008 budget. Additional Medicaid revenue is anticipated from the State as a new coding/claiming system will be implemented. The State Medicaid bed tax increased from $75 to $100/day accounting for a $90,000 expense increase, utility rates continue to increase, health insurance increases account for $161,000 as more employees opt for the County benefit plans, and the 2007 salaries did not include a budget for a nighttime and weekend differential – the 2008 budget makes this correction with a corresponding expenditure increase of $300,000. Intergovernmental Transfer monies are expected to remain at the 2007 levels, however, more than $500,000 below the 2005 levels, this accounts for much of the overall Lasata deficit. To meet the Executive Committee Budget directive Lasata would be required to take a few courses of actions:

Assume the revenue from the sale of the Pathways land as a one-time revenue

Increase Lasata Heights rents $400/month – this course of action is likely to have a significant impact on occupancy levels

Increase the Private Pay rates $35/month – this course of action would likely impact the number of private pay residents and may increase the number of Medicaid residents

Increase the employee contribution to the Wisconsin Retirement System – this would require negotiations with the union and may result in the loss of current nursing staff

Increase the employee health insurance contribution to 22 percent - this would require negotiations with the union and may result in the loss of current nursing staff

Eliminate 27 positions – this would result in Lasata not meeting the required State staffing levels and increase liability for State fines

Seek increase in Intergovernmental Transfer funds from the State of Wisconsin to fully reimburse County Medicaid losses.

Motion made by Supervisor Schlenvogt to direct staff to develop a resolution to urge the State Legislature and Governor to fully reimburse County nursing homes for their Medicaid losses under the Intergovernmental Transfer Program, seconded by Supervisor Leach. Motion carried, (4-0).

e. Management and Financial Reports

i. Conference and Meeting Attendance Reports - No reports presented to the Committee

ii. Management and Financial Reports - Administrator Luedtke reported that Lasata Heights year to date surplus is $152,000, Lasata’s year-to-date deficit is $144,000 deficit

Motion made by Supervisor Leach to adjourn, seconded by Supervisor Egelhoff. Motion carried.

Meeting adjourned at 11:35 AM

Table of Content

Port Washington, Wisconsin

June 18, 2007

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

Present: Supervisors Egelhoff, Walerstein, Leach, Schlenvogt. Staff: Administrator Luedtke, County Administrator Meaux, ADRC Acting Director Ferrell, Program Assistant Ayres, Veteran Service Officer Brown, Finance Director Lamb and Deputy Clerk Henning.

Absent: Supervisor Geracie

Call to Order/Proper Notice/Adoption of Agenda: The meeting was called to order by Vice Chairperson Walerstein at 8:30 A.M. Deputy Clerk Henning assured the committee that the meeting was properly noticed.

Public Comments/Correspondence/Communications: None.

Approve Minutes from the May 21 Meeting: Motion made by Supervisor Egelhoff, seconded by Supervisor Leach to approve the minutes as presented. All members present voting Aye. Motion carried. (4-0)

Veteran’s Service Items:

Conference & Meeting Attendance Reports: Mr. Brown attended the Southeast Area County Veterans Service Officer meeting in Lake Geneva on May 17. Mr. Brown also attended the National Association of County Veterans Service Officers (NACVSO) Conference from June 3-8. This was a great opportunity to meet CVSOs from around the country, compare notes and discuss "challenges" here and in other states. Mr. Brown attended Veterans Committee Hearings in Madison on June 13. The hearings were in regard to Veterans Property Tax Relief. Included were meetings with Chairs of Assembly and Senate of Chairs of Veterans Committees regarding proposed changes to Veterans Property Tax Relief and Wisconsin GI Bill Education Component.

Management / Financial Reports: Mr. Brown reported that the budget is well within the expenditure limits. He expressed a concern with the travel/training expenses as the demand for transporting veterans has been high this year. Typically there is a slow down the months of July and August. Currently there are three drivers and 236 veterans to be transported; mainly back and forth to the VA Hospital for doctor appointments.

8:47 A.M. Mr. Brown excused.

Aging & Disabilities Resource Center Items:

Aging & Disability Resource Center (ADRC) Update: Ms. Ayres indicated that she is in the process of writing the ADRC application. Ms. Ayres is meeting with Long Term Coordinator Michelle Pike of the Human Services Department to coordinate needs from both departments. ADRC Acting Director Ferrell is meeting with Carla Philips of the Finance department to look over the budget for that part of the application. The deadline to get the application to the State is the end of July.

ADRC Letter of Support: Ms. Ayres will draft a letter of support for the committee to adopt at the July 16 meeting. This letter will show this Committee’s support to include with the ADRC application. This draft will be included with the packet for the July 16 meeting.

Review/Approve ADRC Positions:

ADRC Director - County Administrator Meaux explained that since Ms. Gilman retired, Ms. Ferrell was appointed the interim director of the department, but the intent now, as part of the ADRC, is to go through a recruitment process for a director level position. Included in the packet was a draft of the job description. Motion made by Supervisor Leach, seconded by Supervisor Egelhoff to approve the job description for Director – Aging and Disability Resource Center. All members present voting Aye. Motion carried. (4-0)

Disability Benefit Specialist & Information & Assistance Specialist – As part of the ADRC development, there will be more requests/inquiries for service from the public. The thinking in this process is that the staff will have to be increased in order to meet these demands. Therefore, a request is being made to fill these positions effective November 1, 2007. These positions are funded through the grant so there is no local tax levy. Ms. Ayres indicated that the Disability Benefit Specialist position is a required position as part of the ADRC. Motion made by Supervisor Leach, seconded by Supervisor Egelhoff to recommend approval for the positions of Disability Benefit Specialist and Information & Assistance Specialist. All members present voting Aye. Motion carried. (4-0)

Conference & Meeting Attendance Reports: None.

Management/Financial Reports: Ms. Ferrell reported that the budget is doing well and there were no questions.

9:23 A.M. Ms. Ayres & Ms. Ferrell excused.

Lasata Care Center Items:

Pathways Senior Living / Family Care/ Partnership Agreement: Administrator Luedtke included a packet of information showing the differences between nursing homes (NH), Community Based Residential Facility (CBRF) and a Residential Care Apartment Complex (RCAC). Mr. Luedtke did contact Pathways after the County Board vote regarding the implementation of Family Care. Pathways will start the process right away by contacting the City of Cedarburg on what needs to be done for the Planning Commission meetings. Mr. Luedtke has been in contact with Public Works Director Dreblow regarding the water/sewer lines and the parking lot. The parking lot will be done by the Highway Department and the water/sewer work will be put out on bid.

Decertify 2 Beds at Lasata: When the building was built, Rooms 266 and 267 were originally designed as an ICU type setup. Room 266 was originally designed as a 3 bed room and was turned into a 2 bed room when part of the room was converted to a medication room to alleviate continual State survey deficiencies. These rooms are located behind the nursing station and are very inconvenient for residents and family to get in and out of. They are not very private and are very noisy due to their location. These rooms are usually vacant and are used only in emergency situations. This room would be better utilized for storage of medical equipment and/or redesigned as a place for families to gather when their resident is "terminal". Procedure for downsizing requires the Administrator to send a request to the State Office of Quality Assurance with at least 45 days notice of the date wanted to reduce our license capacity. The effective date has to be on the first date of a calendar quarter in the fiscal year; the earliest date of reduced licensure would be October 1, 2007. Once beds are decertified they cannot be retrieved. Motion made by Supervisor Egelhoff, seconded by Supervisor Leach to decertify 2 beds at Lasata Nursing Home. All members present voting Aye. Motion carried. (4-0)

Lasata Internal Audit: County Finance Director Lamb conducted an internal audit of Lasata Nursing Home and drafted a report with his findings and recommendations. This report was included in the packet for the Committee’s review along with Mr. Luedtke’s response to the audit recommendations.

Lasata Heights Tenant Survey: Mr. Luedtke informed the committee that the residents of Lasata Heights are given a survey on a yearly basis to determine their likes and dislikes and how well they like living at the Heights. Overall, the response is very positive. The survey was included in the packet.

Management / Financial Reports:

Conference & Meeting Attendance Reports: Gail Wilson attended the Wisconsin Association of Homes and Services for the Aging (WAHSA) Conference in Wisconsin Dells on May 3-4. Topics covered were resident centered care in regards to dining and set up as well as communicating, managing and motivating staff. Report was accepted.

Monthly/Financials/Census/Department Report: Mr. Luedtke reported that Lasata Heights is averaging 3 vacant apartments. There have been 10 permanent discharges this year due to various reasons. In the month of May there were 23 inquiries for admission and tours were given to 11 prospective tenants. The Cedarburg Lions Club donated new patio furniture for the east side patio and the Cedarburg Garden Club completed planting the flower bed. Lasata Care Center averaged 195.9 residents per day; Medicaid census is 76%, Medicare – 5% and Private pay is 19%. Master Gardeners have complete gardens and the soil is in. Construction of a gazebo has begun and will be placed in the central area of the gardens. Through word of mouth, almost $3,500 in donations has been received for this project. Lasata Heights had a surplus of $120,321 through May and Lasata Care Center had a surplus of $82,920. Mr. Luedtke noted that the Union contract has not yet been settled, therefore the Lasata Care Center surplus does not reflect the anticipated 2 – 2.5% wage increase. The "Dining by Choice" program is being implemented in stages and has proven to be very efficient. The roof and window project for Lasata Heights are currently out on bid. The Mr. Luedtke will have the budget ready for the committee’s review at the August meeting.

Next Meeting Date: Monday, July 16, 2007 at 8:30 A.M.

Adjournment: Motion made by Supervisor Leach, seconded by Supervisor Schlenvogt to adjourn. All members present voting Aye. Motion carried (4-0). Meeting adjourned 10:30 AM.

Lisa M. Henning

Deputy County Clerk

Table of Content

Port Washington, Wisconsin

May 21, 2007

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

Present: Supervisors Geracie, Egelhoff, Walerstein, Leach. Staff: Administrator Luedtke, Assistant Administrator Fogel, County Administrator Meaux, ADRC Acting Director Ferrell, Program Assistant Ayres, Veteran Service Officer Brown, Damon Anderson, Michelle Finet and Deputy Clerk Henning.

Absent: Supervisor Schlenvogt

Call to Order/Proper Notice/Adoption of Agenda: The meeting was called to order by Chairperson Geracie at 8:31 A.M. Deputy Clerk Henning assured the committee that the meeting was properly noticed. Motion made by Supervisor Egelhoff , seconded by Supervisor Walerstein to adopt the agenda. All members present voting Aye. Motion carried. (4-0)

Public Comments/Correspondence/Communications: Ms. Ayres informed the Committee of the new Ozaukee County Wanderer Registry. The Aging & Disability Resource Center, in cooperation with the Ozaukee County Sheriff’s Department and all Police Departments in Ozaukee County have created this Registry in hopes of helping older people found wandering and not knowing who they are and where they are. Ms. Ayres handed out the Policies and Procedures for the Ozaukee County Wanderer Registry. Supervisor Walerstein distributed copies of "The Wisconsin Taxpayer Alliance" referring the Committee to an article on nursing homes.

8:40 A.M. Bill Schanen, Ozaukee Press, now present.

Approve Minutes from the April 23 Meeting: Motion made by Supervisor Walerstein, seconded by Supervisor Leach to approve the minutes as presented. All members present voting Aye. Motion carried. (4-0)

Veteran’s Service Items:

Veteran’s Memorial Update: Everything is in place. Maintenance is planting flowers in the central garden area. The re-dedication is scheduled for Sunday, May 27th at 2:00 PM.

Mr. Bob Shappell, Chairperson of the Veterans Memorial Fundraising Committee and the Post Commander of the Cedarburg American Legion Post 288 will be chairing the re-dedication.

Conference & Meeting Attendance Reports: Mr. Brown attended a meeting of the Southeast Area County Veteran’s Service Officers in Lake Geneva. Mr. Brown also reported that the National Convention will be held in Milwaukee starting June 2nd. Mr. Brown has helped organize a golf outing to be held at Mee-Kwon Golf Course on June 3rd. Mr. Brown noted that the Parks Department was excellent in cooperation with the planning of the aforementioned outing.

Management / Financial Reports: Mr. Brown reported that the budget is well within the expenditure limits. He expressed a growing concern with the relief fund.

County Administrator Meaux presented Mr. Brown with a certificate citing his 10 years of service to Ozaukee County.

8:50 A.M. Mr. Brown excused.

Aging & Disabilities Resource Center Items:

ADRC Update: Ms. Ayres distributed an ADRC Readiness Checklist which is intended to help in planning for the development of and evaluating readiness to begin operation as an Aging & Disability Resource Center (ADRC). The readiness criteria included in the checklist reflect the requirements found in the standard contract between an ADRC and the Wisconsin Department of Health & Family Services (DHFS). The services described in the contract are to be available to all of the populations served by the ADRC by the end of their first year in operation. Ms. Ayres and Ms. Ferrell met with the Twelve County Coalition sub-committee for ADRC last month. The entire meeting was a presentation and question/answer session with Michelle Goggins, Racine County ADRC Director. Ms. Ayres and Ms. Ferrell learned that the enrollees for ADRC have to be found eligible for Family Care two months before they are actually beginning Family Care. Example: If Family Care begins January 1st, enrollment would need to begin November 1st. Current staffing is a concern if enrollment is to begin November 1st. The 60-day lag time is in the beginning only, once the program is fully functional, the 60-day lag time will decrease to a 30 day wait time.

Conference & Meeting Attendance Reports: Ms. Ferrell attended the Wisconsin Area Nutrition Directors Conference in Stevens Point on May 4th and 5th and the Senior Farmers Market Nutrition Program in Stevens Point on May 9th.

Management/Financial Reports: The budget is doing well and there were no questions.

9:00 A.M. Ms. Ayres & Ms. Ferrell excused.

Lasata Care Center Items:

Pathways Senior Living / Family Care/ Partnership Agreement: Ozaukee County is considering selling 3.5 acres where the current parking lot is in order to relocate parking. Visitors of Lasata and family members of residents are very happy with the proposed parking plan.

9:00 A.M. Human Services Director Haupt now present.

An issue came up with Pathways Senior Living last week. Pathways wanted Ozaukee County to sign a Letter of Agreement so they could proceed with an application to the Federal Government certifying that there are sufficient Medicaid beds in Ozaukee County. Corporation Counsel Kenealy advised against signing a Letter of Agreement as there is not yet a contract in place nor County Board approval. Corporation Counsel Kenealy did approve signing a Letter of Intent only, which is helpful in showing good faith. Motion made by Supervisor Egelhoff, seconded by Supervisor Leach to support the signing of a Letter of Intent. All members present voting Aye. Motion carried (4-0).

9:20 A.M. Mr. Haupt excused.

No Lift Policy and Procedures: Mr. Anderson explained that in an effort to address employee health and safety and to mitigate current and future Worker Compensation Claims, the Department of Administration sought assistance from the College of Health Sciences at the University of Wisconsin, Milwaukee. Mr. Anderson then introduced Michelle Finet, a doctoral student at the aforementioned college. Ms. Finet has been working with the County on Ergonomics. Ms. Finet proposes a "Zero Lifting Program" for Lasata due to the many ergonomic risk factors and physically demanding work involved with caring for nursing home residents. Ms. Finet indicated that the majority of the injuries at Lasata the last three years were ergonomically preventable. If the policy is instituted, the nursing staff at Lasata feels the 15 lifts currently in inventory are sufficient. Also, extensive training with the staff as to how to properly use the lifts would be necessary. Lasata budgets for 3 or 4 new lifts per year. Ms. Finet also indicated that the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH) support these programs because these types of injuries are preventable.

9:45 A.M. Mr. Anderson excused.

Resident Smoking Policy Review: Informational only - policy was included in the packet. Mr. Luedtke explained that every two or three years the Committee reviews the policy to ensure a safe environment for the residents and employees of Lasata Care Center. Staff members would like to see the policy changed to the effect that all new residents would not be allowed to smoke on the property and the current residents who smoke would have to be "grandfathered" in to allow them to continue to be able to smoke. Lasata Heights - new admits would not be allowed to smoke anywhere on the property, and current tenants would be grandfathered whereby they and their guests would be allowed to smoke in their apartment but not on their patios, any common areas in the building, walking trails or recreational areas.

Management / Financial Reports:

1^st Quarter Statistics: Mr. Luedtke reviewed the statistical reports included in the packet; electric costs are right on budget. The daily resident usage rate is down slightly due mainly to the conversion of lights. The natural gas cost is above budget due to increased rates and the winter season increases gas usage. Water/sewer rates have increased slightly. A graph was included showing the trend of nursing homes and assisted living facilities. Over the last 10 years, the number of nursing homes in Wisconsin has decreased from 472 to 425 and the assisted living facilities have increased from 1448 to 2634; nursing home residents decreased from 52,000 to 40,000 and assisted living residents increased from 20,000 to 35,000. An update on the Capital Outlay was included in the packet.

Conference & Meeting Attendance Reports: All reports were accepted.

Monthly/Financials/Census/Department Report: Mr. Luedtke reported that Lasata Heights had a surplus of $93,923 and Lasata Care Center had a surplus of $160,062. Mr. Luedtke noted that the Union contract has not yet been settled, therefore the Lasata Care Center surplus does not reflect the anticipated 2 – 2.5% wage increase. A CPE (Certified Public Expenditure) check in the amount of $278,000 was received in April. Correspondence was received from a family regarding the excellent care given to their mother by the entire staff of Lasata Care Center.

Motion made by Supervisor Egelhoff, seconded by Supervisor Leach to enter into closed session. Roll call vote taken, all members present voting aye. Motion carried. (4-0)

Closed Session – per WI State Stat. 19.85 (1)(c): Discussion of Union Contract Negotiations and Section 19.85 (1)(g): Discussion of Legal Claims/Possible Litigation: 10:35 AM Closed session. Present: Supervisors Geracie, Walerstein, Egelhoff, and Leach; County Administrator Meaux, Administrator Luedtke and Assistant Administrator Fogel.

Next Meeting Date: Monday, June 18, 2007 at 8:30 A.M.

Adjournment: Motion made by Supervisor Egelhoff, seconded by Supervisor Walerstein to adjourn. All members present voting Aye. Motion carried (4-0). Meeting adjourned 11:15 AM.

Lisa M. Henning

Deputy County Clerk

Table of Content

Port Washington, Wisconsin

April, 23, 2007

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

Present: Supervisors Stern, Egelhoff, Schlenvogt and Walerstein. Staff: Administrator Luedtke, County Administrator Meaux, ADRC Acting Director Ferrell, Program Assistant Ayres, Veterans Service Officer Brown, County Clerk Winkelhorst and Deputy County Clerk Henning.

Call to Order/Proper Notice/Adoption of Agenda: The meeting was called to order by Vice -Chairperson Stern at 8:00 A.M. Ms. Henning assured the committee that the meeting was properly noticed. Motion made by Supervisor Egelhoff, seconded by Supervisor Schlenvogt to adopt the agenda as mailed. All members present voting Aye. Motion carried. (4-0)

Public Comments/Correspondence/Communications: There was no public comment or correspondence.

Approve Minutes from the February 19 Meeting: Motion made by Supervisor Walerstein, seconded by Supervisor Egelhoff to approve the minutes as presented. All members present voting Aye. Motion carried. (4-0)

Veteran’s Service Items:

Veteran’s Memorial Update: Mr. Brown stated that a re-dedication is scheduled for Sunday, May 27th at 2:00 PM. The base work is done, waiting for Hilgendorf to re-assemble and complete finishing touches.

Budget Review: Mr. Brown explained that a grant was approved from the State in the amount of $13,000. Flag holders at Veteran’s graves were $14.50 last year, increased to $18.00 this year due to being made of bronze. Approximately 80 holders are used each year. Bronze holds up to the elements where as if plastic or aluminum holders were to be used, the holders would need to be replaced about every five years.

Conference & Meeting Attendance Reports: Mr. Brown attended a meeting with Representative Terry Musser, Chairperson of the Assembly Committee. A number of issues were ironed out with the Wisconsin Department of Veteran Affairs.

Grafton will be hosting the American Legion National Commander, Paul A. Morin, at a dinner this evening. This is the first time a national commander has visited an Ozaukee County Legion Hall. Mr. Morin will be presenting six Ozaukee County legionnaires with honorary awards.

Aging & Disabilities Resource Center Items:

ADRC Update: Ms. Ayres gave a brief history - two to three years ago the State offered grants for pilot ADRC, for which Ozaukee County applied but was not accepted. Some of the original employees who worked on the grant have left Ozaukee County; therefore our in-house ADRC work group has been revised. Ms. Ayres and Long Term Coordinator Pike have created a new Power Point presentation combining the ADRC and CMO presentations which is more user-friendly.

Conference & Meeting Attendance Reports: Ms. Ayres reported that she, Ms. Ferrell and Ms. Pike attended the ADRC conference in Madison last week and indicated that they gained a lot from the conference regarding INA workers. ADRC offered excellent workshops. Information and Assistance Specialist Braby attended a caregiver conference in Chicago. Ms. Ayres also informed the Committee that the Ozaukee County Senior Conference will be held on Thursday, June 14 at the Grafton High School.

Management/Financial Reports: The budget is doing well and there were no questions.

Lasata Care Center Items:

Pathways Senior Living Project Update: Mr. Luedtke reported that the boundary lines need to be determined so work can proceed with the water/sewer lines and the parking lot. Pathways would like to start working with the City of Cedarburg as soon as next month to obtain the necessary zoning permits. At this point, everything is contingent on the ADRC and Family Care being implemented in the County. Conference call was then placed to Bob Helle at Pathways Senior Living Center to give the Committee an update as to the status of the partnership and where things are headed. Mr. Helle has met with the Zoning Administrator in Cedarburg and due to the existence of Lasata Heights, there is no need for a zoning change, but a Conditional Use Permit will be needed which will require a public hearing. Mr. Helle would like to start the zoning process now and needs to be ready for a WHEDA tax credit application on or about February 1, 2008. A response on those credits should be received by mid-April, and at that point construction documents would be started and construction would begin fall 2008. The Cedarburg Planning Commission will have to approve the location of the new parking lot.

5-Year Capital Improvement Plan: Mr. Luedtke presented the 5-year plan for budget purposes. Lasata Care Center needs more staff compared to 5 years ago to care for increased resident acuity. Lasata also needs to upgrade its physical plant to meet State and Federal standards. Discussion of remodeling Lasata Heights apartments. Plunkett/Raysich Architects have been contracted to assist with renovations of both facilities.

http://www.co.ozaukee.wi.us/Administration/Ozaukee%20County%20CIP%202008-2012%20-%20Final%20Draft.pdf’

9:15 AM - Supervisor Walerstein excused.

Motion made by Supervisor Schlenvogt, seconded by Supervisor Egelhoff to approve the 5-Year Capital Improvement Plan. All members present voting Aye. Motion carried (3-0)

Conference & Meeting Attendance Reports: Mr. Luedtke and Assistant Administrator Fogel attended a Nursing Home Association meeting on February 28 and March 1 in Madison. State legislators were there and the Nursing Home Association could lobby on the budget issues. A staff member from the National Nursing Home Association was there talking about what is happening in Washington DC. There was also a representative from the State Bureau of Quality Assurance discussing what is happening in Madison and how the budget is going to work. Mr. Luedtke also attended the Annual Wisconsin County Home Conference the end of March.

Monthly Financials/Census/Department Report: Mr. Luedtke reported that Lasata Heights had a surplus of $66,970 and Lasata Care Center had a surplus of $10,200. Mr. Luedtke wrote a letter to our Senators and Representatives regarding SB 40, 2007-2009 budget and stated his concerns regarding the proposal to raise the nursing home bed tax from $75/month to $101/month and then to $124/month. He also stressed concern with the Certified Expenditure Program (CPE), formerly known as Intergovernmental Transfer Program (IGT). By Statute, the State budget uses $37.1 million of federal funds to pay back County Homes for their losses. In fiscal 2005/06, County Home Medicaid losses were $142.9 million, yet only $37.1 million was received to offset these losses.

Next Meeting Date: Monday, May 21 at 8:30 AM

Adjournment: Motion made by Supervisor Schlenvogt, seconded by Supervisor Egelhoff to adjourn. All members present voting Aye. Motion carried (4-0)

Meeting adjourned 9:30 AM.

Lisa M. Henning

Deputy County Clerk

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Cedarburg, Wisconsin

February 19, 2007

Aging and Long Term Care Committee met at Lasata Care Center.

Present: Supervisors: Erickson, Stern, Egelhoff, Schlenvogt, and Supervisor Walerstein arriving at 8:20 AM, County Administrator Tom Meaux; Ralph Luedtke, Lasata Care Center; Mary Farrell and Ginger Ayres, Aging and Disability Center; Ken Brown, Veterans Service Office; and Joanne Prom, Recording Secretary.

Call to Order/Proper Notice/Adoption of Agenda

The meeting was called to order by Chairperson Erickson at 8:00 AM. Mr. Luedtke assured that the meeting was properly noticed. The Agenda was adopted and there were no Public Comments.

Approval of Minutes: The minutes for the meeting held January 15th were approved as submitted.

Veterans Service

Request to Carryover 2006 Funds – Veterans Relief Fund After discussion the Veterans Relief Funds will be carried over from the 2006 budget to the 2007 budget.

Management/Financial Report

The General Fund for Veterans Service was reviewed through January 31, 2007. No problems are anticipated with obtaining grants.

The Conference and Meeting Attendance reports were accepted.

Ken Brown was excused.

Aging & Disability Resource Center

Approval of Resolution to Seek Funding for an Enhanced ARDC A power point presentation was given by Ginger Ayres to the Committee for review and will also be used for a presentation to the County Board on February 21, 2007. The presentation centered on the changes that will be made for access to and funding for community based services. The funds under the Community Options Program and Medicaid Waiver have never been sufficient to serve all who qualify and are in need of services. The proposed Family Care system will be giving people a better choice, access and quality services and will create a cost effective care system for the future. The presentation pointed out that the redesigned system will be made up of two separate and distinct entities. The Care Management Organization will oversee and direct publicly funded benefits for qualified individuals. The power point focused on the Aging and Disability Resource Center which will assist families and individuals seeking information and help, provide counseling on long term care options, and be the single entry point for publicly funded services. Also presented was a timeline for Ozaukee County to move into this redesigned system and an estimate of projected expenditures and revenue.

Motion by Supervisor Walerstein seconded by Supervisor Egelhoff to approve a Resolution to Seek Funding and Technical Assistance to Expand the Ozaukee County Adult and Disability Resource Center. Motion carried (5-0).

Supervisor Walerstein excused for 10 minutes.

Request to Carryover 2006 Funds There is a surplus of Program Income generated by the Home Delivered Meals program. The funds have to be carried over and spent within 60 days of January 1, 2007. Motion made by Supervisor Schlenvogt seconded by Supervisor Egelhoff to amend the Budget to include these funds. Motion carried (4-0), Supervisor Walerstein returned and voted aye, motion was unanimous (5-0).

Management/Financial Report The Budget was discussed with some changes to be made.

Mary Farrell and Ginger Ayres were excused.

Lasata Care Center

Discussion and/or Action Items

Pathways Senior Living Project Update The Committee will tour a new Pathway facility in Bartlett, Illinois immediately after this meeting ends.

Management/Financial Report

Financial Report: No monthly financial report is available.

The draft of the Annual reports for Lasata Heights and Lasata Care Center were presented. Goals include continued retention and recruitment of qualified nurses.

Contract Negotiations with the Labor Association will be held with a Mediator in March or April.

The Automatic Funds Transfer for room and board with the Billing Office and the County Treasurer were successfully completed for 23 residents.

A Master Gardeners program will be coordinated at Lasata with improved raised gardens for handicapped residents and they will also re-design outdoor gardens and landscape areas.

A report on the Lasata Donation fund was presented.

The Medicare Census for January was at budget numbers of 10 residents per day mostly because of the certification of the 1East wing.

A Family complaint was reported to the State regarding a resident who was physically aggressive towards other residents. This resulted in a State Class B Violation and the possibility of a civil forfeiture to the State at a later date.

Conference & Meeting Attendance report was approved.

Motion by Supervisor Schlenvogt seconded by Supervisor Egelhoff to adjourn at 10:10 AM. Motion carried (5-0).

Respectfully submitted,

Joanne M. Prom

Recording Secretary

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Cedarburg, Wisconsin

January 15, 2007

Aging and Long Term Care Committee met at Lasata Care Center.

Present: Supervisors: Stern, Walerstein, Egelhoff; Schlenvogt, Erickson arrived at 8:15 AM, County Administrator Tom Meaux; Ralph Luedtke and Mike Fogel, Lasata Care Center; Mary Farrell and Ginger Ayres, Aging and Disability Center; Ken Brown, Veterans Service Office; Bob Haupt, Human Services; and Joanne Prom, Recording Secretary.

Call to Order/Proper Notice/Adoption of Agenda

The meeting was called to order by Acting Chairperson Stern at 8:00 AM. Mr. Luedtke assured that the meeting was properly noticed. The Agenda was adopted and there were no Public Comments.

Approval of Minutes: The minutes for the meeting held December 18, 2006 were approved as submitted.

Veterans Service

Budget Review A review of the budget shows a surplus of funds that will be carried over to the Veterans Relief Fund.

Conference and Meeting Attendance The Meeting Attendance Report for December 11, 2006 was approved.

County Veterans Memorial Update The funds needed to restore the memorial have been received and the dedication will be planned near Memorial Day, since many veterans are involved in local observances on Memorial Day.

Youth Government Day is being planned for March 7, 2007 is sponsored by the Ozaukee County Council of the Wisconsin American Legion with all five area high schools invited to participate with 15 representatives.

Department of Aging and Disability Center

ADRC Update Ginger Ayres updated the committee on the work of the ADRC workgroup, which is a sub-committee of the Family Care consortium. The workgroup is doing the following: preparing a powerpoint that will explain the role of ADRCs; gathering job descriptions; considering services that could be shared; reviewing recommended actions (resolutions, steering committees). To become a Family Care ADRC, the Ozaukee County ADRC has most of the I&A services in place for elderly and physically disabled; Beacon software, certified functional screeners, ability to do short term case management, prevention programs, resource database. We would need to address such things as I&A for DD and MH persons, a Disability Benefit Specialist, toll free phone, building signage, emergency response, space, and need for increased staff. Bob Haupt reported that the Family Care consortium has passed a governance model with the HMOs doing fiscal duties and the counties arranged in clusters. Probably the state will not fund all counties/clusters at the same time and he would like Ozaukee County to move on this soon. He feels that Waukesha and Washington Counties are not ready/willing to work with us at this time but Sheboygan County might be. We would be looking at delivery of integrated services for funded clients. The ADRC has to be in operation three months before these services by the HMOs begin. The committee agrees that we should work toward this end soon and directed Tom Meaux to contact the county administrator in Sheboygan County to discuss a partnership.

Transfer of Funds The Transfer of Funds requested was approved by the Committee.

Management/Financial Report Mary Farrell discussed the Special Revenue Fund Aging Services budget showing an undesignated balance of $54,841.

Mary Farrell, Ginger Ayres and Bob Haupt were excused.

Lasata Care Center

Pathways Senior Living Project Update The tour planned for today was postponed due to the weather.

Carryover of 2006 Funds to 2007 Amended Budget Motion by Supervisor Stern seconded by Supervisor Egelhoff to approve the transfer of $25,000 from the 2006 Capital Outlay Fund to the 2007 Capital Outlay Fund. Motion carried (5-0).

Accounting Services Coordinator The part-time Account Clerk in the Business office will retire in March, and the Accounting Services Supervisor has requested to be transferred to that position. Approval is needed to fill the non-union Accounting Services Supervisor position. Motion by Supervisor Walerstein seconded by Supervisor Stern to approve the hiring of an Accounting Services Supervisor. Motion carried (5-0).

Management/Financial Report

Financial Report: No report is available as of this date.

Resident Satisfaction Surveys: The resident satisfaction survey was presented by Ralph Luedtke. The Social Services Department sends out a survey to residents when they are discharged home after rehabilitation or to families of deceased residents. Of the 53 surveys sent out, 78% were returned with the overall response and comments being positive.

Supplemental Payment Program (IGT): A review of the funds received for Medicaid (T19) losses for the years 1993/94 to 2006/2007 were discussed. It was noted that not until 2002 did Lasata Care Center need a tax levy for support when the funds were not adequate to care for T19 residents.

Conference Meeting Attendance Reports: None

Pathways Senior Living Update The Committee had a discussion and review of the Pathway Senior Living plans for the Assisted Living Facility Project. As of now the plans are for development in 2008 and opening in early 2009.

The next meeting will be held February 19^th at the Administration Center

Motion by Supervisor Egelhoff seconded by Supervisor Stern to adjourn at 10:20 AM. Motion carried (5-0).

Respectfully submitted,

Joanne M. Prom

Recording Secretary

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