Health care meeting allows providers to voice concerns

Article by: Dean Bloemke, President of Welcome Home Management Company

This past Wednesday morning, I had the opportunity to attend a long term care leadership round table sponsored by Guardian Pharmacy of St. Cloud.  Representatives of a number of federal offices were there along with a number of state level senators and representatives from both sides of the aisle were in attendance.  The roundtable discussion was reported in the St. Cloud Times in their Thursday edition.  A copy of the article may be viewed at    http://www.sctimes.com/apps/pbcs.dll/article?AID=/201209052032/NEWS01/309050044

I had the chance to tell those in attendance our story about health care costs under the new Affordable Health Care Plan also known as Obama Care.  In our company, if we choose to pay the penalty, our costs will increase by $170,000 according to an estimate prepared by our insurance agency.  If we choose to provide the insurance, our costs increase by $220,000.   The problem is, that there is not an adequate payment alternative to offset these increased costs.

Elderly Waiver, upon anywhere from 20% to over 50% of our client base depends, has had a decrease of 15 – 20% over the past three years.   This puts operating margins at risk, especially in these tough economic times.

Other providers mentioned that they were in the 5^th year of a pay freeze.

Rep. Steve Gottwalt, (R) mentioned in his remarks that long term care and assisted living are first in line to receive new funding when the revenues from increased tax collections derived from an increasing economy permit.

Other items mentioned were that Equalization should be repealed (Rep Gottwalt); that Electronic Funding & Implementation time schedules need to be extended (Rene Doyle of Michele Bachman’s office), that liability for readmission is causing a problem for nursing homes;  and also tort reform, and National Background Checks (Darwin Schwantes – Talahi Care Center) mentioned.

A question was asked about the difference between metro and rural economics of Assisted Living.  There was a long discussion regarding how rural assisted living has stayed close to providing the service in very nice properties and a relatively low cost.  That on average, each EW client in an AL property was saving the state on average of $1500 to $2500 per month for each client.

All legislators or their representatives were invited to take a tour of a rural senior living community and to become familiar with the economics of rural senior living.

Legislators or representatives of their office in attendance were:  Lisa Fobbe of Sen. Franken’s office; Rep. Steve Gottwalt; Renee Doyle of Congresswoman Bachmann’s office; Rep. King Banaian; Adam Schiff of Sen.  Klobuchar’s office; Sen. Michelle Fishbach; Rep. Tim O’Driscoll; Sen John Pederson, and Jeff Howe, House Candidate.

Providers in attendance were Darwin Schwantes of Talahi Care Center;  Deanna Johnson of Carefree Living AL in St. Cloud; Tami Rakke of Carefree Living, Deb REitmeier of Annandale Care Center, Phil Lord of Belgreade Nursing Home; and Jim Birchem of Eldercare in Little Falls.

Interested parties attending were Jeff Drown of Lyon Contracting and Brian Musech of Granite City Real Estate.

Trace Roller and Mark Boe of Guardian Pharmacy of St. Cloud were our hosts.

 

HHS Bill Passes House and Senate, Awaits Governor Dayton’s Signature

News from Aging Services of Minnesota yesterday regarding the Health and Human Services Bill comes with some interesting notes.

According to Aging Services of Minnesota, the Health and Human Services Conference Committee bill passed both the House and Senate floors and now awaits Governor Dayton’s signature. In a year where there has been very little money available, lawmakers have placed a priority on senior care in funding and policy. Many of Aging Services and the Long-Term Care Imperative’s agenda items are included in the Conference Committee bill.

• The 1.67% Contingent Cut for waiver providers will not occur as originally scheduled on July 1, 2012.  This provision is important so that senior care providers do not see additional cuts on top of the double-digit cuts they have received in recent years. Although the hope is that the Level of Care waiver will be approved and the contingent cut will not be necessary, the contingent cut would occur on July 1, 2013 under this bill, and the cost of shifting the cut ($21M) is almost all that the bill spends in the second biennium;

• Changes to the mandatory transitional consultation process to include provisions that require DHS to develop protocols for hospitals and health-care homes to identify at-risk older adults to determine when to refer them to mandatory consultation. It further requires hospital discharge planners to refer people to the mandatory consultation prior to discharge; allows “responsible parties” to be able to make the call on behalf of the prospective resident; permits people in emergency situations to move prior to making the call and makes the following exemptions: people seeking lease-only arrangements, people who have previously received a long-term care assessment, people entering hospice, and, people that have used financial planning services and created a long-term care plan in the last 12 months.  DHS estimated that the requirement that hospital discharge planners provide referrals for consultation would produce $350 thousand in annual savings.

On the second point, we believe this is a step in the right direction.  Although not what providers had hoped for, this change in the mandatory consultation should help.  We still believe that consumers want good information to make informed decisions.

Roman Bloemke, Director of Operations at Welcome Home states: “I really believe that information is powerful for consumers.  And while I applaud lawmakers for taking a step in the right direction, I hope that we can move the discussion to an earlier point in life.  As consumers, if we know about our options earlier in life, we can begin to plan for our future.”

As the session progresses, we’ll continue to pass along information as it becomes available.  We also want to say thank you to Aging Services of Minnesota for being a great resource for providers and getting our concerns across to lawmakers.

Mandatory Consultation – 4 months later, how’s it going?

Roman Bloemke, Director of Operations at Welcome Home was quoted in a story recently published on the Assisted Living Federation of America’s news releases.

The story takes a look at Minnesota’s new requirement regarding mandatory consultation since it was implemented October 2011.

While we are for education and information, we believe that this requirement is at the wrong stage in life.

Consumers should have this knowledge when they are in the early 40′s and 50′s. If done at that time, something similar to the “55 Alive” program where drivers get a discounted insurance rates after taking a class, would seem to be more of an appropriate time.

As we age, we all want to know what our options are. If we learn information early enough in our lives, we can begin planning for our future.

What are your thoughts?

Noticing signs of Alzheimer’s in friends or family at the holidays

The holidays offer busy and remote families an opportunity to gather and spend time with loved ones who they see only occasionally during the year.  While visiting, you may notice changes in a relative that raise questions about their health. 

It’s often difficult to know the difference between typical age-related changes and the first signs of Alzheimer’s disease. Some people may recognize these changes in themselves before anyone else notices. Other times, friends and family will be the first to observe changes in the person’s memory, behavior or abilities. They may be easier to notice in a person who you don’t see very frequently.

Thomas Landing team walks to find an end to Alzheimer’s

What an honor to walk with so many people committed to find and end to Alzheimer’s on Saturday, September 10, 2011.

The walk started at 9:30am on a beautiful, sunny day.  Walkers of all ages helped raise over $31,000.00 from the Rice Lake area. There were many different ways money was raised such as raffle tickets towards vacations and savings bonds, rummage sales and carnivals or just plain asking for a donation. There even was a football raffled off with all the Green Bay Super Bowl Champions signatures on it.

I would like to thank all the staff and family members who participate in the walk. I especially would like to thank Gloria  Widiker, Thomas Landing’s Memory Care Coordinator , for being our team leader to help us get organized and raise our share of the money. One of our residents was at the walk and helped direct traffic so people would know where to register.  Also thank you Vera L.

With support from everyone we can find a way to end Alzheimer’s Disease.

PS: There is still time to donate to the Walk to End Alzheimer’s.  The Legends at Heritage Place team will be participating in their event on September 24th, along Lake George in St. Cloud, MN.  Their donation page can be found along the right hand side of this blog, or by following this link.

Sue Jutz, Director of Resident Services - Thomas Landing

Commissioner Jesson Responds to Imperative Letter on Mandatory Consultation

In late August, the Long-Term Care Imperative wrote DHS Commissioner Lucinda Jesson regarding Aging Services of Minnesota’s concerns with the mandatory consultation/LTC Options Counseling law. They raised a number of concerns including personal autonomy, privacy, provisions for emergencies and short stays, surrogate decision-makers, and other issues (see Aging Services of Minnesota’s letter for details).

In her response, Commissioner Jesson says, “We understand that this initiative needs to strike a delicate balance between its intent to provide information to all persons seeking to sign a lease with a housing-with-services setting and not being intrusive into peoples’ lives.” Her letter goes on to state clearly that clients can refuse or decline the counseling and goes on to say “there is no penalty, nor intent, to bar anyone from receiving services or signing a lease.” However, Aging Services notes that we expect that there will be penalties for providers who execute leases without obtaining the clients’ verification code. Click here to read Jesson’s entire response.

One of the Imperative’s concerns is the ongoing capacity of Senior LinkAge Line^R to be able to respond to consumer calls within one business day–which is the current policy. Jesson states that the Minnesota Board on Aging will continue to monitor response time.

The letter includes no new information regarding whether Senior LinkAge Line^R will require any verification of identity for someone calling on behalf of a prospective tenant. Nor has the definition of subsidized housing, which has an exemption from the consultation requirement, been determined.

Aging Services remains opposed to the new law. While the law will take effect on Oct.1, 2011, Aging Services is actively lobbying our Legislature on this issue. Because the proposal never received a public hearing of any kind prior to its passage, many lawmakers are unfamiliar with this law. As we talk with lawmakers over the interim, it is clear that once lawmakers understand that the requirement to obtain a verification code prior to moving into housing-with-services establishment applies to anyone, regardless of payor source, there is growing opposition to the law. We urge you to discuss this issue with your legislator prior to the 2012 Legislative Session.

Article from: Aging Services of Minnesota which Welcome Home Management is a member.

A Walk to End Alzheimer’s

Today, as many as 5.4 million Americans are living with Alzheimer’s. In addition, 10 million baby boomers are aging, increasing their risk for developing this fatal disease. Now is the time to end this epidemic!

But there is something we can do to stop this devastating disease. We can walk together to end this disease. That’s why we are participating in the Alzheimer’s Association Walk to End Alzheimer’s™.

The Alzheimer’s Association^®, the leading voluntary organization in Alzheimer research, care and support, is dedicated to finding prevention methods, treatments and an eventual cure for the disease.

This year, two of our communities are participating in area events.  The Legends at Heritage Place team will be participating in their event on September 24th, along Lake George in St. Cloud, MN.  The Thomas Landing team will participate in the Rice Lake, WI event on September 10th starting at the Moose Lake Lodge.

We know we can do this with your support. Would you please consider making a donation? Visit either communities online fundraising headquarters for Thomas Landing or The Legends at Heritage Place to learn more and make a donation.

Walk to End Alzheimer’s™ “The You Factor”

Thank you in advance for your time, generosity and for supporting our team members as they support this cause.

Mixed Results, Mixed Messages for Seniors: One-Time Relief for Some, Long-Term Challenges for All, More Government Intrusion in Personal Decisions

New mandatory transition counseling inserts government appointed counselors into seniors’ personal housing choices

The Legislature and Governor Dayton sent mixed messages in the details of their HHS budget agreement. While the agreement does not cut nursing home rates in this biennium and provides a small amount of relief for a small number of nursing homes, it also repeals a critical payment reform measure adopted in 2007 that in practical terms will cut $133 million in promised payments to nursing homes starting in 2013.
The budget also includes significant cuts to cost-saving home and community-based services, while creating a new layer of government bureaucracy by making counseling with a government employee mandatory for all seniors seeking home and community-based care services, including seniors seeking care with their own private resources.

Minnesota Leaders Agree to Budget Framework

Two weeks into the state government shutdown – the longest in history – Governor Dayton and Republican legislative leadership struck a deal outlining a framework for a budget agreement.  Governor Dayton announced in a speech yesterday that he was willing to accept the Republican’s June 30 budget offer, with some conditions, in order to get the government working again. Dayton said he was “willing to agree to something I do not agree with” to end the shutdown. Dayton, Speaker Kurt Zellers & Senate Majority Leader Amy Koch emerged from a 3 hour meeting to announce they had agreed to a framework based on that budget offer.

Agreement Closes $1.4 Billion Gap with Funding Shifts, Tobacco Bonds

The framework includes a $2.1 billion in savings from a shift in school aid payments and $700 million in one-time revenue from the issuance of tobacco bonds, but no tax increases.  Dayton’s additional conditions were a $500 million bonding bill, removal of some controversial policy provisions the GOP proposed earlier in negotiations and removal of a proposed 15% state workforce cut.  This agreement closes the remaining $1.4 billion difference between the two sides. Click Here to view Dayton’s letter to Zellers and Koch outlining the proposal.

Many details still need to be worked out on the budget deal. Finance Chairs and Commissioners will join the discussions starting today with Health and Human Services.  No date is set for the special session yet, but Dayton said the shutdown will be over in a matter of days.  Meetings are expected to occur around the clock for the next few days to hammer out the remaining details.

Dayton to agree to June 30th GOP offer?

In what some may call a surprising move, Governor Mark Dayton has tenatively agreed to the GOP budget plan that was introduced on June 30th.

Gov. Dayton stated: ”Despite my serious reservations about your plan, I have concluded that continuing the state government shutdown would be even more destructive for too many Minnesotans,” Dayton wrote to legislative leaders. “Therefore I am willing to agree to something I do not agree with – your proposal — in order to spare our citizens and our state from further damage.”

While nothing is final yet, we are very interested to see how this potential agreement plays out for older adults and older adult service providers across the state.

Star Tribune article with the letter Gov. Dayton sent to GOP leaders this morning.