AGING AND LONG TERM CARE COMMITTEE

Monday, September 10, 2007

Administrative Center – Room 3220

9:00 a.m.

MEMBERS PRESENT:  Roger Plesha, Jim Ehrsam, Ann Fisher, Ray Ebert, Jason Gillett, Lyell Montgomery (exc @10:03) 

MEMBERS EXCUSED:  Jerry Sebranek and Sharon Hampson    

MEMBERS ABSENT:  None   

GUESTS & STAFF:  Pam Semb, Noreen Kuroski, Pete Eide, Jim Gausmann, Mary Hennen, Jim Speropulos, Michael Edwin, Cheryl Stephen

CALL TO ORDER/ROLL CALL

Roger Plesha, Committee Chair, called the meeting to order at 9:00 a.m. 

APPROVAL OF MINUTES

MOTION by Ehrsam/Fisher to approve minutes of July 9, 2007.  Motion carried unanimously; Sebranek and Hampson excused.  

CONSENT AGENDA

MOTION by Ehrsam/Gillett to receive and place on file the following consent agenda items:

• Commission on Aging Minutes of July 3 and August 9, 2007
• Commission on Aging Advisory Minutes of June 6, 2007
• Ripples & Waves – Lakeview Newsletters

Motion carried unanimously; Sebranek and Hampson excused.

PUBLIC COMMENT

None requested.

FUTURE VA HEALTH PLANS FOR LA CROSSE COUNTY

Jim Gausmann distributed a written report.  He noted the following:

·        Decline in number of Veterans in La Crosse County; now under 10,000.  But at the same time, 25% increase in compensation and pension from 2004 to 2006 (from $11.4 million to $13.9 million).

·        Medical expenditures totaled $12.1 million in 2006.

·        2007 Fall school enrollments:  WTC w/268 veterans and 89 spouses/children, UW-La Crosse w/199 veterans and 39 spouses/children , and Viterbo w/63 veterans.

·        Tomah VA Medical Center plans to expand services in La Crosse County for mental health services; currently looking for space in the Village Shopping Center area; this will free up clinic space and hopefully provide compensation examinations in La Crosse vs. Veterans having to travel to Tomah.

2006 VETERANS AFFAIRS STATISTICS

Copies of “Compensation and Pension Dollars” were distributed as provided by the State.  Information for each county showed:  (1) number of Veterans, (2) increase or decrease as compared to 2004, (3) compensation/pension dollars for 2004 and 2006, (4) per capita compensation & pension and (5) % change.

UPDATE ON STRAP GRANT

Noreen Kuroski gave a verbal update.  The STRAP grant is for Supplemental Transportation for Rural Assistance Program.  The grant is due by the end of the week.  She has met with Town of Holland and they unanimously agreed to support and provide $3,000 for local match of providing Shared Ride services.  Within the next few days, she will also be meeting with the Towns of Onalaska and Hamilton regarding similar proposal.

HILLVIEW SATISFACTION SURVEY

Pete Eide distributed copies of two satisfaction surveys that were solicited to the residents and/or to the family or guardian.  He was well pleased with the results and with the comments; most questions were 90% or above as being satisfied with Hillview’s services.

HILLVIEW ASSISTED LIVING FEASIBILITY STUDY

Michael Edwin, of WIPFLi CPAs and Consultants, reviewed the distributed 24-page report regarding “Hillview Health Care Center Assisted Living Market Study”.  A more detailed report is available upon request.  Highlights of the overview as follows: 

• The study conducted secondary market research to assess the community needs for additional RCAC (residential care apartment complex) and dementia-care CBRF (community based residential facility) beds for the service area for development on Hillview campus.
• Also assessed the private pay and affordable market needs as supported by the Family Care Program (CMO/new MCO) already in the county.
• Trends were given for payor type, level of care, admissions and discharges for years 2003-2007.
• WI trends in long-term care:  nursing homes are downsizing, more senior campus settings, more continuum of care services, focusing on rehabilitation and short-term stays, more growth in RCAC and demential care.
• Information given on short and long range population trends; for the next 5-8 years, flat or smaller population growth for those 75+, but starting 2015, growth will be more significant.
• Currently in the service area, 12 RCACs with total of 410 units of which 339 were comparable/competitive; most were full with waiting lists, but indicated those waiting lists getting smaller and in some cases harder to fill vacancies.
• Currently in the service area, there were 8 CBRFs with total of 152 beds of which 73 were comparable/competitive; most were full with waiting lists but also noted filling vacancies were becoming more problematic.  Patients were mostly on Family Care, suggesting private pay was primarily in the RCACs.
• Currently in the service area, 3 CBRFs were dementia-specific and 3 were mixed dementia-care and frail elderly for total of 118 beds of which 67 were comparable/competitive; and most were full.
• Conclusion:  Need for more dementia-care CBRF beds focusing on high acuity, lower functioning residents.  Less of a need for short term RCAC units.  With the expansion of Family Care into an 8-10 county district, CMO/MCO will need more vendors for assisted living and at home programs.  By 2015, senior population boom will occur and will have greater need for more RCAC units.  Hillview might consider the dementia-care CBRF as a higher priority option than the RCAC option.
• Hillview might consider conducting a financial analysis of the private pay RCAC and dementia-care option before proceeding as well as architectural assessments and master site planning

• Hillview might consider converting some of the existing Carroll Heights units to RCAC to contract with the CMO/MCO for Family Care in those units.

Discussion followed, in particular on the next step.  General agreement to look at the financials.  Hillview staff will bring more informationand options to the October meeting.

RESOLUTION RE AUTHORIZATION ACCEPT BIDS TO REMODEL FOR A COMMUNITY BASED RESIDENTIAL FACILITY WITHIN LAKEVIEW HEALTH CENTER

MOTION by Plesha/Ehrsam to approve the resolution which approves the low bid from Market & Johnson in amount of $273,310 for remodeling a portion of the A-Wing at Lakeview Health Center for a community based residential facility, plus additional costs of $19,132 for architectural and engineering fees and a contingency amount of $25,558; total project not to exceed $318,000.  Funds will be borrowed from the General Fund for a 20-year term at 5% interest.  Motion carried unanimously; Sebranek and Hampson excused.  Other bids were:  Voss & Sons Construction @$278,370, R.J. Sullivan Inc. @$283,063, and Olympic Builders General Contracts Inc. @$289,800.

RESOLUTION RE SUPPORTING CHANGE FOR RETURNING FEDERAL FUNDS FROM CERTIFIED PUBLIC EXPENDITURES OF COUNTY NURSING HOMES

MOTION by Ehrsam/Gillett to approve the resolution which supports returning all Federal funds received from the Certified Public Expenditures of county nursing homes be returned to the county nursing homes in order to bring direct tax relief to the citizens of La Crosse County.  Motion carried unanimously; Sebranek and Hampson excused.

DISCUSSION ON RELOCATION COSTS OF LAKEVIEW RESIDENTS

A 1-page report was sent with the agenda as provided by Pam Semb.  Based on relocation of 7 FDD residents and 57 nursing home residents, cost to relocate elsewhere would range from $4.6 to 5 million.  Current Lakeview tax levy is $2.3 million.

STATE BUDGET UPDATE

Pete noted nothing new to report.  There are two proposals – 2% or 5% rate increases.  On positive side, Medicare approved a 5.5% increase.

LAKEVIEW COLLABORATION UPDATE

Pam distributed an informational sheet showing that as of September 7^th, nine (9) counties have either approved resolutions or sent letters of intent regarding their participation in the Lakeview Collaboration.  Including their membership fee of $5,000 plus daily rate charges, the additional revenue for Lakeview is estimated at $785,220.  Jackson County has not made a commitment. They were notified by the Lakeview social work department; noting no more acceptance of clients and need to start discharge planning for those currently at Lakeview.  Steve O’Malley noted next steps will be approval of contractual agreements and by-laws; the new board will be an advisory body that will set long-term goals and direction.  Supervisor Ehrsam suggested make-up of the new board using a weighted vote.  

UPDATE ON 2008 BUDGETS FOR AGING UNIT, VETERANS, HILLVIEW AND LAKEVIEW

Steve O’Malley noted his prepared budget for 2008 is in print and will be handed by the end of the month.  A 2-page tax levy summary will be handed out at tonight’s County Board meeting.  Aging Unit and Veterans Service will provide same level of services with few budget changes; their budget increases relate to wages and benefits.  Same for Hillview but Hillview is not on the tax levy.  Lakeview has tax levy decrease of $149,000; also need to review and adopt a capital improvement plan for Lakeview.

ITEMS FOR FUTURE AGENDAS

Per Supervisor Ebert, two items as requested at the July meeting:

• Per Supervisor Sebranek – RSVP volunteer driver hours for providing home delivered meals from the nutrition sites.
• Per Supervisor Montgomery – Review vendor relations with Aging Dept., including policies and practices, collaboration efforts and consistency.

JOINT MEETING

Joint meeting with Health & Human Services Board on September 10^th from 5:00-6:00 p.m.

NEXT MEETING

Wednesday, October 10^th at 9:00 a.m.  (Moved from Monday to Wednesday due to WCA Conference.)

ADJOURNMENT

MOTION by Ehrsam/Fisher to adjourn the meeting.  Motion carried unanimously; Sebranek, Hampson  and Montgomery excused.  The meeting adjourned at 10:26 a.m.   

Disclaimer:  The above minutes may be approved, amended or corrected at the next committee meeting.

Cheryl Stephen, Recorder