MEETING MINUTES

MEETING MINUTES
MEETING: WCC Steering Subcommittee
PURPOSE: Planning
Meeting Date	Location					Start Time		End Time		Call-In #
4/22/08	La Crosse County Care Management Organization (Vernon Room) – 1407 Saint Andrew 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			Melissa Gilbert X				Ginny Graves		Connie Herman
Jerry Huber			Liz Janke X				Gene Phillips X		Dean Ruppert X
Ron Schmidt			Jane Schmitz X				Paula Stansbury X		Phil Wicktor X
Others Present
Ron Carney			Carl Kallberg				Bev Monahan
Items/Actions to Be Discussed				Time Line	Outcome/Notes
Welcome - Review minutes - Buffalo taking notes				9 – 9:05 AM	Minutes were reviewed and accepted.
Public Comment Period				9:05 – 9:15 AM	No public comments were provided.
ADRC Updates				9:15 – 9:30 AM	The Aging and Disability Resource Center of Buffalo, Clark and Pepin Counties is in the process of completing its application. One obstacle is determining the appropriate amount of MA match dollars to put in the budget. Janice Smith at DFHS told Phil at the Long-Term Care Conference that if the ADRC of Buffalo, Clark and Pepin Counties does not earn the 23.6% MA match, the State will cover the shortfall. Phil is waiting for this commitment in writing before actually budgeting the 23.6%. Providing adequate staff coverage within the budgeted amounts remains a significant challenge. The ADRC-BCP workgroup meets for the final time tomorrow, with the goal of submitting the completed application to the State by May 1. Discussion ensued regarding Disability Benefit Specialist salaries. In the ADRC of Western Wisconsin (Jackson, La Crosse, Monroe, Vernon), DBS’ will start at the same rate as certified social workers but will not advance as far on the salary grid due to the lack of certification. The Elderly Benefit Specialist works in a different department (aging), so the DBS and EBS salaries are not directly comparable. Concerns exist regarding the possibility of economic support workers posting into DBS positions, which provide a higher rate of pay. This could cause problems for counties due to the time and cost involved in training new ES workers to become proficient. Shared positions in the multiple county ADRC will be posted on May1 if no La Crosse County union members bid into those jobs. The ADRC-WW Advisory Board is still in need of three members. Two reps for frail elders and one for adults with developmental disabilities still need to be appointed. The Advisory Board will consist of 11 members and meet at least every other month in the beginning. The counties have had trouble recruiting board members from the elderly population, especially since the state is mandating that 51% of the members represent the elderly population. The Aging Units are vocal about ADRC quality but are not focused on the makeup of the board. The ADRC-WW waitlist policy has been submitted to the state, but no response has been received yet.
Update on MCO CEO Hiring Process				9:30 – 9:45 AM	A second round of interviews for the Executive Director position has been scheduled for this Friday with three candidates. There will be two panels again, one comprised primarily of board members and one comprised of CMO management staff. All WWC board members are invited to attend. WWC HR Director Bev Monahan was introduced. Her presence will help facilitate ramp-up, as the La Crosse County Personnel Department has had to handle all additional workload related to MCO personnel activity.
Discuss Website Revisions				9:45 – 10 AM	Melissa has been working on updating the WCC website. She is working on revising the facts for the frequently asked questions. Melissa also is looking for info for the ADRC page to keep people updated on the three ADRCs. In addition, she is attempting to keep the schedule up-to-date so that people can stay aware of meetings that are occurring. We want to keep the public aware of what is going on, and this is one avenue to make sure that communication is occurring. Consensus was the implementation timeline should be posted on the website. This might be especially helpful since a previous memo from the state listed the wrong dates. The provider community may want the numbers listed on the enrollment plan to assist in planning for future services. A disclaimer noting that these numbers estimates should accompany the timeline. The website will continue to be a work in progress. If you notice any errors or see changes that should be made, please let Melissa know.
Update on Transition Issues				10 – 10:15 AM	Many different issues have come forward, including the following: Transportation issues: will the MCO contract on its own or work on joint contracts with the counties to increase economies of scale? Melissa will ask Chris Sander and Nancy Schmidt from La Crosse County to attend the next Steering meeting and discuss transportation contract issues. DHFS has been indicating that no answers are forthcoming any time soon regarding a number of issues related to responsibility for Adult Family Home certification, corporate guardianship payment, etc., in the future, which will make it difficult to budget. What is the MCO’s obligation and what will be the counties’ obligation? Jerry will share a list of transition issues with other directors. The proposed Economic Support Liaison position also remains in limbo due to lack of State commitment/funding. Concerns arose about continuity in regard to Family Care expansion due to Secretary Hayden leaving. Deputy Secretary, Karen Timberlake, who is replacing him, spoke at the Long-Term Care Conference and stated she remains committed to Family Care but has a lot to learn and wants to visit each of the counties to listen and discuss concerns. A number of MOUs need to be developed between the MCO and the counties. In addition to the enrollment plan, the state requires agreements on IMD discharge planning and disaster planning. In addition, it may be advantageous to develop a number of other MOUs in relation to record transfer, after-hours coverage, etc. La Crosse County is seeking legal advice on the transfer of records, and the state also has released draft guidance. Since new transition issues continue to arise, Steering may need to use the guidance available to address issues as best as possible and then move onto other issues with the realization that things may change. Items should be prioritized, with special attention given to the most time-consuming issues.
Review MCO Certification Process - MOUs - Provider Network Meetings				10:15 – 10:45 AM	Provider network meetings are being scheduled with each county to help facilitate certification. CMO/MCO staff need to ascertain gaps in provider coverage, differences in rates and other information in order to prepare for implementation in each county.
Human Resources Workplan				10:45 – 11 AM	Bev discussed the human resources workplan. The hope is still to complete the union contract and extend the first wave of job offers by the end of June. There may be a number of areas where the counties and MCO need to come to agreement in regard to benefit liability so that county employees don’t lose vacation, sick time, etc., and neither the counties nor the MCO assume complete financial responsibility. Each county has different contract provisions, and these issues need to be resolved prior to the offers being made. Each county handles these types of issues differently. Related workplan items include selection of a health plan and worker’s comp and unemployment insurance. Personnel policies also need to be written, although La Crosse County’s policies may be used as a starting place and revised as needed and time allows. Questions remain regarding the hiring process and applicable legal requirements. We want to create as smooth of a process as possible for employees.
Review WWC Agenda				11 – 11:20 AM	Melissa distributed a resolution to participate in the Wisconsin Retirement System. The Western Wisconsin Cares board will vote on this today.
Wrap-Up				11:20 – 11:30 AM	Melissa discussed the the MCO certification kick-off meeting on Thursday and distributed handouts on the certification process. DHFS would like all requirements to be met 45 days prior to the start date but has some flexibility. Pam followed up on the letter to nursing homes by Gundersen Lutheran asking that GL be listed as the first medical facility of choice. A memo has since come out rescinding this agreement. Jerry brought up Mississippi Valley Health Services (Lakeview) collaboration. The MCO has not committed to becoming a member, resulting in concerns about the potential financial impact on the counties who are partners to the agreement.
Action Items
Resource		Action									Due Date
Melissa		Add MCO enrollment plan to website
Melissa		Add transportation contracts and case file transfers to next agenda									Next mtg.
Melissa		Distribute copies of state memos on file transfers and transition issues									Next mtg.