6/13/2013 2:49:00 PM HHS Director describes strain on federal program
by DENISE MARTIN
The County Board heard last week that for the first time in a very long time, there’s a “waiting list” (seven names as of last week) of residents hoping to be approved for special needs Medicaid monies. Chisago County has two population sets that it manages Medicaid for; who have suffered traumatic brain injury or are developmentally delayed. Disabled individuals receive federal funds which are administered through counties as “community care alternatives.”
The sets of populations are called “aggregates.” Chisago County has about $23 million budgeted annually for this. The county has a policy for prioritizing who is in greatest need of these services. Commissioners were asked last week to “reaffirm” the policy because it’s been quite a long time since there’s been a waiting list, and commissioners may get complaint calls, according to Nancy Dahlin Health & Human Services Director. She wanted the County Board to refresh itself with the waiting list process. The process for apportioning the yearly funds means each applicant makes a case, or their guardian or representative does, for receiving funds. Dahlin said people may complain because they were on the “waiting list” longer than somebody who might get funding before them.
Dahlin said the term “waiting list” may not be the most ideal description, as this isn’t really a first come first served process. How staff manages the aggregates is “quite important” so that Medicaid funding is directed to those who have the most serious needs, while trying to not overspend. Dahlin said top priority is clients facing “imminent institutionalization.” Any cases above-and-beyond the approximately $23 million the county gets could become a local tax levy liability, she continued. With the aging population and federal budgeting issues there is a projection of local support becoming an issue as early as 2015.
“But we haven’t had to have that conversation yet,” she told the Board. “We knew this was coming,” Dahlin continued, explaining that staff is monitoring clients frequently to make sure the covered services are absolutely needed and that “we maximize use of the aggregates” funding formula. In other matters: The County Board approved 4-1 contributing to a study for the next phase of transit “alternatives analysis” for communities in the Rush Line Corridor. Rush Line Task Force member-counties are funding the work.
Ramsey County has the largest share at $239,000 and Chisago County (based on a formula) is putting in $15,000. Commissioner Lora Walker was the lone no vote.
~ Sheriff’s law enforcement service contracts were adopted 5-0 for Shafer and Taylors Falls. Shafer is buying 20 hours per week hourly patrol and services, Taylors Falls is buying 80 hours per week, for the April to November period and the hours decrease to 40 per week in winter. The county also leases an office in Taylors Falls Municipal Bldg for $18.70 per square foot under the contract.
~ A Government Center parking lot that is deteriorating will be replaced for approximately $92,000. The costs are shared with Soil & Water Conservation District which is leveraging state grants to do parking lot stormwater projects. Paving is more like $60,000. New lighting is about $8,600. Commissioner Mike Robinson was the no vote.
~ A contract was approved with Bolton & Menk for preliminary design work for Old Towne Road (or County Road 24.) Reconstruction is planned in 2016. There’s $1.9 million in federal funding set aside for a two mile stretch between Stinson, south to Chisago Blvd. On a 1 to 100 scale the “rating” for the pavement is 38.
~ The county has a 20 percent share in the new Heartland bus approved unanimously for purchase. Total for the bus is $74,000 approximately.