MEETING MINUTES

MEETING:  WCC Steering Subcommittee

PURPOSE:  Planning

Meeting   Date

Location

Start Time

End Time

Call-In #

8/13/08

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 X

Pamela Eitland X

Kathy Gauger X

Melissa Gilbert X

Jerry Huber

Liz Janke X

Jeff McIntyre X

Gene Phillips X

Dean Ruppert X

Ron Schmidt

Jane Schmitz X

Brent Shoup

Paula Stansbury

Phil Wicktor X

Others Present

Barb Doubek

Tim Garrity

Bev Monahan

Maryellen Paudler

Items/Actions to Be Discussed

Time Line

Outcome/Notes

Welcome

-    Review minutes

-    Pepin County taking notes

9 – 9:05 AM

At 9:08 AM, Gene Phillips called the meeting to order. Minutes from the prior meeting were approved. 

Public Comment Period

9:05 – 9:15 AM

No public comment was provided.

MCO/County MOUs

-          Main Text (Follow-up)

-          Addendums

o   APS/Guardianships

o   MH/SA

o   Crisis Services

o   Case Record

o   Transitional Services

o   Nursing Home Relocations

o   Case Record Transfers

o   HIPAA Business Agreement

o   AFH Certification

9:15 – 10 AM

The discussion began with a review of the main body of the Memorandum of Understanding between the counties and WWC.  A few minor changes were noted.  Addendum I, regarding the certification of adult family homes, is being added.  The updated language requires WWC to collaborate with the county office of emergency management and public health in other emergency situations beyond a natural disaster, release of hazardous materials or national security incident.  The new draft also requires WWC to notify counties when an MCO member moves from one county to another.  Maryellen indicated that the current MOU requirements may change once the 2009 MCO contract is received. 

Addendum A, regarding Adult Protective Services and Guardianships, resulted in a lengthy discussion.  Item C under County responsibilities will be modified to state that APS intervention and protective services will be provided as required by state law (rather than  “immediately”).  Item F under County responsibilities created considerable discussion.  The primary issue related to who will be responsible for writing annual WATTs reviews for MCO consumers.  According to statutes, the county has the responsibility  to file a petition, but the question remained as to who will actually author the WATTs review.  Since the care managers for the MCO will have the day-to-day contact with these individuals, they will have more updated and current information and potentially could write the review more quickly than county staff; however, the MCO is unable to claim revenue for this activity.  Maryellen indicated the La Crosse County CMO currently does approximately 200 WATTs reviews for existing members but may not be able to continue this in the future.  Since MOU language needs to be finalized in advance of the October 1 enrollment date for La Crosse consumers, this issue needs to be resolved soon.  Therefore it was suggested that counties gather the following information and submit it to Melissa by August 19^th:

1)      The number of Waiver participants needing WATTs reviews.

2)      The actual time to complete the WATTs review report.

3)      Time to do reports and the total of those that are not Waiver participants.

4)      The form used by the county to develop these reports.

If the MCO was going to write reports, it would want to use a standard form.  After this information has been received, this matter will have to be reviewed and discussed at  the Steering meeting in September.

Addendum B, relating to Mental Health and Substance Abuse Services, required little change.  Wording will be added under Item II.A. to clarify that the MCO will arrange for Family Care-covered services in a member’s Individual Service Plan (not acute and primary services).

Addendum C, relating to Crisis Services, was written based on the current arrangement between La Crosse County and the CMO and will need to be revised for other counties since crisis services  vary from county to county.  Vernon and La Crosse counties are both HSF 34 certified but have different service delivery systems. Other counties use on-call systems to respond to crisis situations.  There may need to be at least two separate addendums to address different types of crisis systems.  Liz and Pam will take the lead in drafting alternate language.

Addendum G, relating to the Transfer of County Waiver Consumer Information to WWC, has been updated to reflect a few clarifications regarding the information to be transferred.  One year of Adult Family Home and Employment plans were added if this information is applicable to the situation.  The DDE 919 form was also added.  Include high cost durable medical equipment  as well as any placement history, especially where there has been a fair amount of movement, and rationale for the change of placements.  Otherwise the document remains much the way it was.  Maryellen also  circulated the WWC Transition Face Sheet. 

Addendum H, the HIPPA Business Associate Agreement, has been revised to reflect that WWC and the counties may or may not be contracted service providers for each other.

Discussion ensued as to who will be responsible for the 822 forms or the PASSAR forms for those individuals who are developmentally disabled or on psychotropic meds and enter a nursing home.  This is not a major issue but the issue of responsibility still needs to be clarified.

Follow-up on County/MCO Transition Process and Timelines

10 – 10:45 AM

Melissa noted she is working on a revised timeline grid to help counties in preparing for Family Care implementation.

Pam noted that directors are invited to attend training on the new state system replacing the Medicaid Management Information System on September 9^th in Madison.  She will forward information to Melissa to share with the group.

ADRC/Options Counseling Updates

10:45 – 11:15 AM

Vernon County will begin their options counseling the last week of August.  Jackson county staff will be assisting Vernon County in this process due to staffing constraints.

Trempealeau County has scheduled training with DHS in September.  It may be possible for staff from other counties to attend this as well.

The ADRC of Buffalo, Clark and Pepin Counties stressed in a phone conference with the State that adequate training must be provided.

A common concern involves the accuracy and consistency of information being shared with consumers so that they are able to make informed decisions about service options without feeling pressured.  Pam noted she needs the handbooks the MCO is currently using to share with consumers during option counseling. In addition, IRIS is one area where more staff training is needed.  

Employee Transition Process

11:15 – 11:45 AM

Tim discussed the method used in La Crosse County to transition employees from the CMO to the MCO.  Of the 99 union employees who received a job offer, 97 accepted the transfer to the MCO.  Staff received about two weeks to meet with Tim or Bev to discuss any questions about the offer and to accept or decline the offer.  A similar process is expected to occur in other counties. 

In order to begin extending job offers in waiver counties, the MCO still needs updated information on the following:

1) names and positions of individuals who should receive job offers (in other words, those  with current jobs that will be eliminated);

2) how your county plans to address vacation  balances, that is a) to pay out per normal procedure via the union contract or the county personnel policy or  b) transfer the amount of payout to WWC so the employee retains vacation balances in the new organization or c)  pay out some and transfer some per employee’s request; and

3) your county’s current policy on sick leave and how your county plans to address the sick leave balances (e.g. will the county be willing to help fund sick leave liability for employees who transfer to the MCO)?

It was noted that according to the transition agreement and MOU between the professional unit and clerical and paraprofessional units of AFSCME and the MCO, provisions from the existing union contracts in the counties can be waived to address these issues.  

Wrap-Up

11:45 AM – 12 N

A question arose regarding the location of the satellite offices for the MCO.  Tim indicated that the Tomah office will be located on Warren Street.  Potential sites have been identified in Alma, Whitehall and Neillsville, but nothing has been decided.

A question arose regarding community relocations.  Will these individuals be able to enroll automatically in the MCO, or will they need to go on a waiting list first?

The next Steering Subcommittee meeting is scheduled for 9 AM on September 10 at the MCO in La Crosse.

Action Items

Resource

Action

Due Date

Melissa

Send electronic copies of all MOU and addendum documents, including the case record face sheet, to Steering members.

ASAP

Melissa

Send copies of the initial and final transition plan spreadsheets to counties.

ASAP

Melissa

Send an e-mail request to counties for information on the number of Watts review cases, average timeframes for completing reviews for waiver and non-waiver clients and formats used for reports.

ASAP

Counties

Provide info requested on Watts reviews

August 19, 2008

Counties

Provide requested employee info to MCO

ASAP

Liz/Pam

Draft crisis services addendum

Next meeting

Maryellen/Melissa

E-mail APS form used by CMO/MCO to counties

Next meeting