MEETING MINUTES

MEETING:  WCC Steering Subcommittee

PURPOSE:  Planning

Meeting   Date

Location

Start Time

End Time

Call-In #

1/9/08

La Crosse County Health and Human Services (Basement Auditorium) –

300 N. 4^th St.

La Crosse

9 AM

12 N

Facilitator/Lead

Materials/Preparation Required

Gene Phillips

Members/Attendance (x = present; italics = alternate)

Todd Bowen X

Carroll Carlson

Pamela Eitland X

Mary Faherty

Kathy Gauger X

Melissa Gilbert X

Ginny Graves

Connie Herman

Jerry Huber X

Liz Janke

Gene Phillips X

Dean Ruppert X

Jane Schmitz X

Ray Seiler

Paula Stansbury

Phil Wicktor X

Others Present

Joan Benson

Pat Killeen

Maryellen Paudler

Items/Actions to Be Discussed

Time Line

Outcome/Notes

Welcome

-          Review minutes

-          La Crosse taking minutes

9 – 9:05 AM

 Gene called the meeting to order.  Minutes were approved.

Public Comment Period

9:05 – 9:15 AM

 No public comment was provided.

ADRC Updates

9:15 – 9:30 AM

Representatives from the Aging and Disability Resource Center of Western Wisconsin counties (Jackson, La Crosse, Monroe, Vernon) will meet Thursday with Department of Health and Family Services staff to try to resolve remaining issues regarding the joint application submitted August 1.  The Steering members involved will stress that they intend to meet all state expectations but that the state needs to grant flexibility in how those expectations are met.  Pending the outcome of that meeting, the ADRC-WW planners will meet again on January 22 to discuss how to proceed.

Planners for the ADRC of Buffalo, Clark and Pepin Counties will meet again Monday.  That workgroup has written a job description for the director and is working on a budget.  Assignments for the various application sections are being issued.

Trempealeau County Social Services has begun contracting with the county’s Senior Services Department for an AIRS-certified staff member to cover noon hours in the ADRC to help maximize collaboration between the two agencies.  Since this person does not have a four-year degree, DHFS will need to approve the arrangement.

Follow-up on Meeting with DHFS Secretary Kevin Hayden

9:30 –  9:45 AM

Jerry provided an overview of Tuesday evening’s meeting with DHFS Secretary Kevin Hayden, Deputy Secretary Karen Timberlake and Long-Term Care Division Administrator Sinikka Santala.  Secretary Hayden expressed a desire to give consortia flexibility but also noted that department resources dictate limits to that flexibility.

Issues discussed included ADRC staffing concerns, Economic Support needs (including the proposed ES Liaison position), WRS law, the state’s $30 million MA cut and IT needs.

Pam E. stressed that inflexibility on the state level could dismantle the four-county ADRC-WW model and this would cause problems for Vernon County, which could not afford to operate an independent ADRC and therefore would lose access to the regional Managed Care Organization.  DHFS officials expressed a better understanding of local ADRC issues after the meeting and voiced confidence that remaining issues could be resolved.

Frustration also was voiced regarding the length of time it has taken DHFS staff to render opinions on the ES proposal.  The DHFS response noted concerns about setting precedent without adequate review by various sections within the department.  Nevertheless, Secretary Hayden also talked about the need for his staff to respond promptly to consortia inquiries.

In regard to the timing of WRS eligibility, Deputy Secretary Timberlake asked whether non-legislative options had been explored.  Concerns about these alternative options then were discussed.  She will follow up with Melissa on this issue.

When asked about the impact of the $30 million cut DHFS must make to the Medicaid program to help balance the state budget, Secretary Hayden noted there may be some modest benefit reductions but that administrative reductions would account for most of that amount.  Administrator Santala said Family Care would not be impacted by the MA reduction.

Finally, Secretary Hayden said the state remains interested in the idea of creating a uniform IT/business system for MCOs but that no decision has been made on how  or whether to pursue this idea.  He noted that the WCC would not be the biggest beneficiary since local systems must be implemented before any statewide system will be ready and that the state is cognizant of the need to provide for interface capability between any state-sponsored product and local systems.

Follow-up on WRS Participation

9:45 – 10 AM

Legislation providing a second window for WRS participation is in drafting.  During a La Crosse County Legislative Committee meeting Monday, Speaker Mike Huebsch said he thought the bill could pass both houses yet this year and that only non-controversial bills will get to the governor’s desk.  Melissa is still working to identify primary authors who will make the bill a priority during the short spring legislative session.

Other options remain contracting back to counties for care management initially or delaying implementation until 2009.  Preference was to begin enrollment in 2008 and pursue legislation as the first option.

Transition Team Issues

-          RFP/Pre-Certification Status

-          Client Info Request

-          Implementation Timeline

10 – 10:45 AM

Several CMO staff and Steering members met with DHFS reps in December to discuss remaining RFP requirements.  DHFS provided positive feedback about the meeting but needs more written narrative.  In order to produce a revised business plan, CMO fiscal staff need updated data on waiver clients.  Consensus was info could be sent within a week once the request is made.

The WCC also needs to project a realistic implementation timeframe for business plan calculations.  Several factors impact enrollment dates, including the length of the certification process and the hiring of key start-up staff.  If an MCO director is hired first and then expected to hire the other key positions, implementation likely will be delayed at least two to three months, which effectively would delay enrollment for all counties, except perhaps for La Crosse, until 2009.  Based on a basic start-up task list, September would appear to be the soonest clients could be transferred to the MCO.  Since the regional rate will not “kick in” until non-La Crosse counties begin enrollment, it may make sense to speed up the transition if possible.

Sentiment was that the Information Technology Director, Human Resources Director and Chief Financial Officer should be hired as soon as possible rather than waiting for the Chief Executive Officer to hire those individuals.  Any further delay will cause additional complications locally as counties plan for reorganization; exacerbate planning fatigue; prolong uncertainty for staff; and result in frustration for consumers, providers and county boards.

Jerry provided an overview of the recruitment results for the four key MCO exec positions.  There appear to be sufficient quality applicants for the CEO, HR Director and IT Director positions but not for the CFO.  This position probably needs to be re-advertised with a higher salary range.  The Implementation Council will need to decide on a process for participating in candidate interviews and selection.

Prioritize Implementation Council Agenda Items

10:45 – 11:10 AM

Priority agenda items for the Implementation Council include the executive hiring process, implementation timeframe, selection of the final member and picking a name for the organization.  Other items that may need to be included on a regular basis include time for questions and answers and the role of Steering members.

Andy Phillips will attend the January 22 Council meeting to present draft bylaws and discuss articles of incorporation, indemnification and other issues.  He also may be able to furnish some materials on open meetings, public records, etc.

Discuss Future Role of Steering Subcommittee

11:10 – 11:55 AM

Consensus was that Steering members should continue to attend Implementation Council meetings as a resource at least until the Council/future Board elects officers and a CEO is hired.  To help cut down on meeting days, the second Steering meeting of the month will be moved from fourth Wednesdays to 9 AM – 12 N on fourth Tuesdays (preceding the monthly Council meeting).

Wrap-Up/Other

11:55 AM – 12 N

Steering will still meet on the fourth Wednesday this month since a large group meeting is scheduled for that afternoon.  This will serve as the final full consortium meeting, with communication continuing through a newsletter, the website and other means.

Action Items

Resource

Action

Due Date

Pam, Gene, Pat, Melissa, others

Contact lawmakers regarding support for WRS legislation

ASAP