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Inside Mirrors: A poem on life after stroke — p. 6
Volume 12, Number 4
Legislative Update — Page 3
SOURCES
April 10, 2001
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“To the press alone, chequered as it is with abuses, the world is indebted for all the triumphs which have been gained by reason and humanity over error and oppression...” Thomas Jefferson
RESOURCES
April 10, 2001
UNLIMITED MR/RC WAIVERS AVAILABLE WINDOW OF OPPORTUNITY SHORT by Jeff Nygaard
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he Minnesota Department of Human Services (DHS) announced on March 23rd that they will allow all Minnesota counties to offer an “unlimited number of MR/ RC waiver allocations” from now until June 30th, 2001 to families and consumers who are on the waiting list for services.
Wound Clinic To Reopen by Nathan Halvorson
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fter a three-month reassesment process, Abbott Northwestern Hospital has decided to reopen the Wound Clinic which they had closed December 31st, 2000. The Wound Clinic, housed in the Minimally Invasive Care Center (MICC), plans to reopen on June 1, 2001, at which time patients with complex, chronic, or nonhealing wounds may return and receive care. As reported in the January 10th ACCESS PRESS, the financial struggles that caused the clinic’s closing were rooted in four major areas which had to be addressed before the clinic could operate on stable terms: an inconsistent standard model for care; no database to track client’s wound history and care history; poor reimbursement levels, and the high-cost of real estate. Since the closing of the clinic was announced in December, a restructuring group has been working to develop a plan to address all of these issues. ACCESS PRESS was informed in mid-March that the group has come up with a satisfactory plan, leading Abbott Northwestern to announce that the wound clinic would re-open. Members of the program
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development group included Wound Clinicians Jan Chevrette and Jennifer Todd, Wound Clinic Doctors Peter Alden and Eric Irwin, Director Pat Boeckman (formerly Hartwig), and Abbott Northwestern office coordinator Linda Ruiz. The clinic will reopen with new systems and guidelines in place to standardize methods of care for patients and will also include clear methods for tracking a person’s progress while receiving care at the clinic. These changes will reduce confusion and stress for patients and clinicians. They will also improve the clinic’s ability to accurately file reimbursement claims, another change necessary for the clinic’s survival. Walt Kune, Director of Ambulatory Services for Abbott Northwestern Hospital, said “clinicians will now be able to file exact documentation that assures proper reimbursement for services from both Medicare and private insurers.” Clinician Jennifer Todd pointed to another improvement in the clinic’s reimbursement system. Due to certain changes outside of the clinic, Todd says “we can bill for some things now that we
weren’t able to before, like the actual application of a unnaboot. Before the clinic closed, we could only bill an insurer for the supplies, but now we can bill for the actual procedure.” Educating a patient about their wound is another service “that will be newly reimbursable when the clinic reopens,” says clinician Jan Chevrette. For financial reasons, the clinic has decided to cut some services which previously garnered low reimbursement rates from insurers. Kune notes that services like bandaging, for example, “require minimal care and can be easily treated at a primary physician’s office or even at a patient’s home.” The clinic expects to com-municate with primary phy-sicians for the on-going care of these chronic wounds and admits that “for a patient to come in time after time for re-bandaging just isn’t a good use of our resources if the clinic is to stay open.” The team confronted the problem of high-cost real estate at the Abbott Northwestern hospital by relocating the clinic to a building directly across the street from the main hospital, at 2800 Chicago Avenue. As a tenant of Clinic - cont. on p. 9
In their alert to members, Arc Minnesota called the offer a “tremendous opportunity” for people with mental retardation and related conditions (MR/RC) and advised advocates and parents to “jump on this once-in-a-lifetime opportunity.” In order to take advantage of this opportunity, individuals must contact their county worker by May 1st to set the process in motion. For the final allocations to be approved, individuals must be screened and “in service” by June 30th, 2001. “In service” means that persons must be receiving case management with at least one other service. Approved waiver services are numerous, and may include such things as: respite care; personal care assistancechoice; day training and habilitation; home modifications; consumer directed community supports; environmental modifications; housing access coordination; assistive technology; care giver training and education; caregiver living expenses; supported employment,or; supported living services. Advocates stress that eligible citizens will not need to “have it all together” by June 30th, but simply must have a case manager and one of the other services in place. In other words, it will be possible for people to start with one waivered service and then add others after June 30th as staff become available or
needs change. In addition, DHS has assured counties that adequate funds will be available to implement whatever service plans are ultimately put in place by consumers and county case workers.
This short “window” of opportunity offered by DHS is designed to help those 4,400 Minnesotans who continue to wait for waivered services. Some counties are proactively reaching out to people on the waiting list to let them know that they need to re-establish contact immediately in order to get “in the system.” Hennepin County, for example, will offer 45 different informational sessions in the month of April alone. However, the short time-frame puts a lot of pressure on county workers, and will likely result in some systems responding slowly or incompletely. For this reason, Arc Minnesota stresses that you should take the initiative and not wait for your county to contact you. If you are in need of waivered services, Arc urges you to call your County case manager immediately and request one of these new waiver slots. If your case manager has not heard of this opportunity, Arc suggests that you ask him/her to call the DHS Regional Support Specialist. (See list on page 9.) If you continue to have problems, call your local Arc chapter or Arc MN. (Arc MN can be reached at 1800-582-5256). Remember you only have until May 1st to get this arranged and you must have one service in place by June 30th. Stunned and Overjoyed News of the DHS announcement flew through the community with great speed.
Paul Fleissner, Director of Adult and Family Services for Olmsted County, reports that “people were just stunned, overjoyed” upon hearing the news. In the days following the announcement, this reporter heard the news described as “unbelievable” and “almost too good to be true.” Reactions to the response were no doubt enhanced by the memory of the recent scare brought on by the Governor’s budget proposal for the next biennium. As reported in the February 10th ACCESS PRESS, that proposal was to take $44 million in unspent funds and fold them back into the state’s general revenues, thus making them unavailable for the waiver program. While there are significant sums of money that have been allocated under the 1999 law that remain unspent, advocates and county workers are well aware that these unspent funds are not the result of a decrease in the demand for these services. The continued existence of a waiting list confirms this. Rather, the surplus results from a set of problems in matching the needs with appropriate providers, chief among them the critical lack of workers who provide home care services. The unlimited waiver announcement by the DHS is intended to assure that already-allocated waiver funds will be kept in the system while individuals attempt to create service plans that are achievable and that work best for them. Legislation has been introduced to assure that, in the future, funds that have been allocated for the purpose of reducing the waiting list must be spent for
Waivers - cont. on p. 8
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