Health Care Center Committee Meeting Minutes

DATE: July 26, 2005

PRESENT: Linda Borleske, Larry Volz, Joan Fordham, Lowell Haugen, Judith Stoeckmann, Joan Wheeler, Al Dippel, Art Carlson, Jeanne Leeck, Gene Wiegand, Trish Vandre, Cindy Bodendein, Diane Keylock, Bill Orth, Kathy Schauf

ABSENT: Tommy Bychinski, John Earl and Paul Endres

Called to order at 6:00 p.m. by Linda Borleske. The open meeting law requirements were met.
Motion by Carlson, second by Volz to adopt the agenda.
Motion carried.
Motion by Fordham, second by Dippel to approve the minutes.
Motion carried.
Presentations - Trish Vandre gave a presentation of Medicare Part D which is the new federal prescription drug program which will be available for all Medicare beneficiaries. Enrollment begins November 15 with coverage beginning January 1, 2006. Wisconsin SeniorCare hopefully will be available through mid-2007. Those who receive Rx through Medicaid will be required to enroll in Part D effective 1/06. Retirement plan coverage may be discontinued with the start of Part D. Multiple private companies will administer Part D with many different plans and benefits. The program is very complicated, not every plan will cover all prescription drugs, income and asset tests are necessary to be eligible for subsidy, and very high out-of-pocket cost sharing if not eligible for subsidy. Standard coverage may include monthly premium of $35 - 38; annual deductible of $250; Copay of 25% of retail drug costs between $250 and $2250 ($500 out of pocket) then the "Doughnut Hole" - pay 100% of retail drug costs until out-of-pocket equals $3600; 5% or a $2/$5 copay for additional prescriptions for the rest of the year. Impacts include - Even if people enroll in plan which suits their needs at the right time, will pay high out-of-pocket costs part of year; new Rx costs may have to be fully paid by consumer if isn't covered in plan they choose; increased spells of illness; less available disposable income; exhaustion of assets; increased despondence and depression; housing issues; transportation issues; current system is not adequate to provide the assistance which will be necessary.
Questions for future speakers. Borleske would like presenters to discuss how they addressed the gaps in service which they found. After identifying needs what is the next step? Gene added that we need to identify which gaps we can play a roll in filling. Also suggested was the Dane County study and what structure they have adopted to continually assess the needs of the population. A summary of what a resident needs on discharge was also requested. Jeanne indicated we look at toileting ability, mobility, medication management and safety as major items. Wheeler requested financial estimates of cost to provide services to people on the waiting lists. Most accurate estimates would be to look at people on the waiting list and see what the cost would be of providing services they need. Taking tax levy money (such as that amount which would be available if the HCC were to be privatized) and applying it to only specific programs or people would result in the county loosing federal money. Need to go down the waiting list in order and with specific guidelines.
Wheeler also asked about the process for getting more information about the HCC to those individuals interested in taking over the management/purchasing the facility. Individual she has been in contact with who purchased Eau Claire County Home and a brokerage firm in Milwaukee are both interested. Gene indicated we could provide the Keefe study and budget - all is public information. Tours are premature. Fordham asked if it would be appropriate for them to write to this committee stating their parameters, expressing their interest, and what information they need. Would be appropriate but with a release so we can check out their credentials also. Would be just an exchange of information. Trish stated that talking with a county administrator rather than a person interested in buying the facility would provide more valid information. Jeanne indicated a supervisor from Jackson County has expressed an interest in providing information to our committee on their experience.

Fordham expressed concern about guaranteeing that the nursing home remain in this county. Also suggested that costs are both monetary and the effect the decision will have on the population. Have to look at both. Inspections are more rigorous in the nursing home than in the community settings. Fordham felt this committee needs to be responsive to the questions posed by other county board members. The committee needs the support and trust of the full board to pass any proposal that is presented.

Gaalswyck sent questions in e-mail to the committee in which he asked about cost effectiveness of community placement vs. Nursing homes. Sue Hebel has presented this information at a previous meeting so it is available. With the pending nursing home initiative, funding will not follow the resident if it is deemed less expensive to maintain the person in the nursing home rather than community placement. Gaalswyk also made reference to ICF/MR being empty. Jeanne indicated the initiative is to close the ICF/MR, however cannot close without a place for residents to go. Currently funding hasn't been following them closely enough to place the more costly residents. One option may be to have some "centers" for residents who can't go into the community. For the DD person, they are not putting caps on the funding for them to be placed into the community whereas in the nursing home situation they are, so far.
Development of information needs and future plans.
Committee would like to hear from Dane County and their study and strategies used to resolve identified issues.

Jackson County representative regarding their experiences

Representative from state or state associations - Perhaps Chuck Wilhelm from the Department of Health and Family Services.

Possible Representative of Wisconsin Partnership Program, or Family Care Program in Richland Co.

Brian Schoeneck of WAHSA.

Stoeckmann requested a copy of the March 03 issue of Wisconsin Counties magazine. Also, copy of the study referred to in that issue entitled "Redesigning Wisconsin Human/Social Services Delivery System".
Future meetings. Next meetings will be on August 10, August 24, September 14, September 28, October 11, and October 24 all at 6:00 p.m.
Motion by Stoeckmann, second by Carlson to adjourn.
Motion carried.

Respectfully Submitted By: Joan Fordham, Secretary