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December 5, 2017 CHILDREN S COMMUNITY OPTIONS PROGRAM ADVISORY COMMITTEE Douglas County Health and Human Services Department Wednesday, December 13, 2017, 2:00 p.m., Courthouse Room 207C, 1313 Belknap Street, Superior, Wisconsin If you are unable to attend, please call the County Clerk s Office (715-395-1569) prior to meeting. MEMBERS: Debora Carroll, Chair Susan Hendrickson, Vice Chair June Finsland Shari Pioro Paulette Alseth Mary Chialastri Kristina Lampi Kelly Schoen A G E N D A (Committee to maintain a two-hour meeting limit or take action to continue meeting beyond that time). 1. Roll call. 2. Approval of minutes from the September 13, 2017, meeting (attached). 3. Introductions. 4. Action items: a. Meeting dates/times; b. By-law revisions and application (attached); and c. Children s Community Options Program (CCOP) policy revision (attached). 5. Informational items: a. Updates: 1. CCOP (attached); 2. Membership; and 3. Program. b. 2017 approved CCOP manual (attached); and c. 2017 budget. 6. Future agenda items. 7. Adjournment. cc: Ann Doucette Susan Sandvick Douglas County Website Pat Schanen Erika Leif Shelley Nelson (Telegram) County Board Supervisors Samantha Roark Note: Attachments to agenda are available in County Clerk s Office for review or copying, and are also available on the county s website www.douglascountywi.org. Action may be taken on any item listed on the agenda. The County of Douglas complies with the Americans with Disabilities Act of 1990. If you are in need of any accommodation to participate in the public meeting process, please contact the Douglas County Clerk s Office at (715) 395-1341 by 4:00 p.m. on the day prior to the scheduled meeting. Douglas County will attempt to accommodate any request, depending on the amount of notice we receive. Posted: Courthouse, Government Center, Telegram copied 12-5-17 Name Date

CHILDREN S COMMUNITY OPTIONS PROGRAM ADVISORY COMMITTEE Douglas County Health and Human Services Department Wednesday, September 13, 2017, 2:00 p.m., Room 207C Douglas County Courthouse, 1313 Belknap Street, Superior, Wisconsin Meeting called to order by Vice Chair Susan Hendrickson. ROLL CALL: Present Susan Hendrickson, June Finsland, Paulette Alseth, Shari Pioro, Mary Chialastri (arrived at 2:11 p.m.). Absent Debora Carroll, Kristina Lampi, Patty Dodge, Wanda Woodhull, Carrie Lott. Others present Erika Leif, Samantha Roark, Shena Gerchman, Sandra Vidotto, Kaci Lundgren, Committee Clerk. APPROVAL OF MINUTES: Motion by Pioro, second Finsland, to approve minutes from the June 14, 2017, meeting. Motion carried. ACTION ITEMS: Children s Community Options Program (CCOP) Policy Review: Changes to policy reviewed. To change reimbursement language to reflect current MTM (Medicaid) rates. Section addressing advancement of money to be clarified with state. ACTION: Motion by Chialastri, second Pioro, to approve policy changes as presented. Motion carried. By-law Revisions: Changes reviewed. Wisconsin statutes to be verified regarding membership of County Board Supervisor; application for committee member appointment to be attached to by-laws. ACTION: Motion by Pioro, second Finsland, to approve by-law revisions in accordance with Wisconsin state statutes. Motion carried. Membership Updates: Kelly Schoen, parent of child in program, interested in joining committee. Leif to make contact with members of committee that have not been in attendance. ACTION: Motion by Chialastri, second Alseth, to approve Kelly Schoen as new member. Motion carried. INFORMATIONAL ITEMS: Program update: 32 in program; 30 on waitlist. Governor to implement removal of waitlist which will require additional assistance with caseloads; Shena Gerchman and Sandra Vidotto, new employees to support additional work, introduced. Budget: Currently under budget; CCOP match dollars do not show on budget report. Program Manual: In draft form waiting for review at state level. Page 1 of 2 Children s Community Options Program Advisory Committee 9/13/17

Waitlist Removal: Governor s proposal includes removal of CCOP waitlist. FUTURE AGENDA ITEMS: Program manual, budget, by-laws, meeting time, membership, policy. December 13, 2017, next meeting. ADJOURNMENT: Motion by Pioro, second Finsland, to adjourn. Motion carried. Meeting adjourned at 2:41 p.m. Submitted by, Kaci Jo Lundgren, Committee Clerk Page 2 of 2 Children s Community Options Program Advisory Committee 9/13/17

BY-LAWS ARTICLE I NAME Douglas County Children s Community Options Program (CCOP) Advisory Committee ARTICLE II MISSION To provide support to families who have a child with severe disabilities. ARTICLE III PURPOSE 1. Assist in developing, reviewing, and approving the local CCOP plan and to monitor the program. 2. To develop informal supports and advocacy to families experiencing difficulties in meeting individual needs in the home environment. 3. To support the development of adequate services which can meet the needs of severely disabled children and their families. ARTICLE IV MEMBERSHIP 1. Composition: There is no set number of members for the committee; however, the majority of members must be parents of children with disabilities. Wis. Stat. 46.272 (4)(a)(1) Parents of children with disabilities, including, if possible, parents from families participating in CCOP. To the extent possible, parents must be representative of the various disability, racial, and ethnic groups in the service area. Representatives from (at least one person from this list must provide community social services to children who are eligible for CCOP). o County departments of divisions of human services, community programs, or developmental disabilities services o School districts o Local health departments Individuals in the service area who provide other social or educational services to children who have disabilities. 2. Appointments: Individuals interested in serving on the committee shall complete an application and submit it to the program supervisor. The supervisor of the program or committee members can propose new memberships. Committee members will vote on new memberships. 3. Terms: The term of the administrator of the program will be ongoing. Ongoing terms shall be five years. With committee majority, terms can be extended an additional two years. 4. Attendance: Regular attendance is expected. Persons unable to attend should call the program supervisor or another committee member. Members missing three consecutive, unexcused meetings will be contacted to identify any problems and determine if the member desires to continue to serve. Lack of response from the member shall result in a letter from the program supervisor informing them of the removal from the committee. Members may voluntarily withdraw with written notification to the program supervisor or chairperson. Members present constitute a majority to conduct business.

ARTICLE V MEETINGS Meetings will be held four times per year, approximately quarterly, with dates and times determined by by the committee; any changes will be posted. ARTICLE VI OFFICERS Shall consist of Chairperson and Vice-Chairperson, elected via nomination, seconding and affirmative voice vote of the majority. Terms shall be for three years. Duties Chairman shall preside over all meetings. Is his/her absence, the Vice-Chairperson shall preside. In the absence of both, the Administrator shall preside. Revised 01/2009 Revised 08/2017 Revised 11/2017

Human Services Division Suite 400 Phone 715-395-1304 Fax 715-395-1370 Suite 327 Health Division Suite 324 Phone 715-395-1304 Fax 715-395-1434 Douglas County Department of Health and Human Services 1316 N. 14 th Street Superior, WI 54880 Patricia A. Schanen Director Phone 715-395-1234 Fax 715-395-7371 Name: Address: City, State, Zip: Contact Number: Email: Children s Community Option Program Advisory Committee Member Application If approved for the committee, please specify whether you would like the agenda and supporting documents emailed or sent via postal mail. Please describe why you would like to be a member of the Children s Community Options Program Advisory Committee and what experiences you have had that you feel would benefit the Committee: Thank you for your interest in serving on the Children s Community Options Program Advisory Committee. Please return your application to: Aging and Disability Resource Center Erika Leif 1316 N 14 th Street, Suite 327 Superior, WI 54880 MISSION To promote the health, safety, and well-being of individuals and families

Phone: 715-395-1304 Health Division Suite 324 Fax 715-395-1434 Douglas County Department of Health and Human Services 1316 N. 14 th Street Superior, WI 54880 Patricia A. Schanen Director Human Services Division Suite 400 Fax 715-395-1370 Children s Community Options Program Policy Purpose: The Children s Community Options Program (CCOP) was created to enable parents of children with disabilities to care for their children in their own homes, rather than placing them in institutions or other out of home placements. Funding is intended to meet a family s unique needs due to a child s disability. Policy: Since the Children s Community Options Program is not an entitlement, funding will be prioritized annually by staff of the Department of Human Services. Funding will be afforded to families/children determined most in need using criteria included in the Children s Community Options manual and will be limited to the available funding. There is no assumption that funding will be available to a family who has received CCOP funding in the previous year. Priority will be given to families when one or more of the following considerations exist: Families in a crisis situation Families considering out-of-home placement for the child Families planning to bring a child home from an out-of-home placement Match dollars if FSP funding can be used to match other state and/or federal funding that would assist in providing a broader array of services to the child, examples might include Children s Long-Term Care Waivers Funds in the amount of $4,000 will be reserved from the CCOP annual allocation in order to meet the crisis needs of families on the waiting list. In determining whether a family is in urgent need and the extent of their need, the following factors will be considered: Possible out-of-home placement of the child Child is ready to be returned from an out-of-home placement Child has a one-time urgent developmental need that must be met in a time frame that will exceed the expected FSP wait list duration and cannot be met by another funding source The family s financial situation A family member is involved in the legal system and court-ordered services exist Extent of the family s current support system In-home health and safety concerns MISSION To promote the health, safety, and well-being of individuals and families

CCOP Policy 2 A determination that a family on the CCOP waiting list is in crisis will be made through one of the following: Social worker meets with the family as part of the annual re-assessment Family notifies the social worker that the family has an urgent need related to their child s disability or the family s circumstances. All families on the CCOP waiting list receive a letter annually informing them where they are at on the waitlist and to inform us whether their circumstances have changed including any health or safety concerns. Documentation from a medical provider (e.g. physician, occupational therapist, speech therapist, physical therapist, etc.) regarding how expenditures meet the child or family s unique needs due to the child s disability may be required for purchases. Expenses for mileage, meals, transportation and lodging will be limited to local county policy. Mileage will be reimbursed at the same rate as MTM, the state of Wisconsin s Non-Emergency Transportation Manager. Receipts for meals must include the number of people who were included on the bill, who they were (e.g. eligible child, parent(s), number of siblings under 18), and the meal purchased (e.g. breakfast, lunch, dinner). Alcoholic beverages are not reimbursed. Bona fide itemized receipts will be required for all purchases. Please note, reimbursement for any medical and/or dental services will be limited to the portion not covered by the family s health insurance or other health related resources such as Medicaid or BadgerCare, excluding co-payments and/or deductibles. Service Categories: Services that are available through CCOP are defined broadly to create flexibility to identify the supports that best address the unique needs of each child and family. The CCOP program guide outlines CCOP-allowable services, most of which are also allowable under the CLTS Waiver Program with the exception of dental and medical care (non-ma eligible children only), health screening and accessibility (non-ma eligible children only), housing counseling (utilities only), recreation/alternative activities, specialized clothing and specialized diet/nutrition. The CCOP program guide should be referenced for descriptions of these services. Other: As outlined in the CCOP procedures guide, advance payment to the family for approved goods and services is allowed. Advance payments must be reconciled to actual costs prior to the end of the contract year. Families are encouraged to allow the Social Worker to facilitate purchases through the Department of Human Services. Direct purchasing allows us to avoid sales tax; and in some instances, it will allow families to take advantage of State rates. It may also eliminate the need for large advances or the subsequent paperwork required to document receipts. EL 6/3/15 EL 8/31/17 EL 12/4/17

DEPARTMENT OF HEALTH SERVICES Division of Medicaid Services F-02230 (10/2017) STATE OF WISCONSIN Wis. Stat. 46.272 COUNTY AGENCY CHILDREN S COMMUNITY OPTION PROGRAM (CCOP) ANNUAL PLAN UPDATE The County Agency Community Options Program (CCOP) Annual Plan Update form must be submitted to the Department of Health Services, Division of Medicaid Services, Bureau of Children s Long Term Support Services, for review and approval by the deadline date established by DHS. DHS will review and approve or disapprove each county s CCOP Plan. Please complete the step-by-step CCOP Annual Plan Update for 2018 calendar year (CY), according to the instructions detailed below: A. County Agency Contact Information Please provide your County Agency CCOP Coordinator s contact information, as indicated below: County Agency Douglas County Name of CCOP Coordinator Samatha Roark Isenhart CCOP Coordinator Phone Number 715-395-1316 CCOP Coordinator Fax Number 715-395-7371 CCOP Coordinator Email samantha.roark@douglascountywi.org CCOP Coordinator Street Address 1316 N 14 th Street Suite 327 Mailing Address same State WI Date the Annual Plan Update was Approved by the County CCOP Advisory Committee* ZIP Code 54880 (MM/DD/YYYY) B. County CCOP Administration For each numbered item below, please check the box, to indicate a change or update to the CCOP Five-Year Plan has occurred, and provide brief summary of the change. 1. County CCOP Operations Describe any changes to your county s operations from your CCOP Five-Year Plan, including the following activities: Access Intake Assessments Brief summary: No change 2. Updated estimated number of families that will be assessed and served Provide an updated estimate of the number of families that will be assessed and served utilizing CCOP funds during calendar year 60. Brief summary: Douglas County estimates that 60 children will be served in 2018 through CCOP. 3. Outreach procedures changes for children with disabilities Describe any changes to your county s outreach procedures to ensure families are aware of the CCOP funds, and their availability to children with physical, emotional and developmental disabilities. Brief summary: No changes 4. Other County CCOP Plan Changes Describe any other changes to your county s CCOP Five-Year Plan, including updates to the county s program operations, outreach efforts, assessment to determine family needs, or monitoring protocols. Brief summary: Two additional staff have been trained to provide CCOP services. Page 1 of 3

DEPARTMENT OF HEALTH SERVICES Division of Medicaid Services F-02230 (10/2017) STATE OF WISCONSIN Wis. Stat. 46.272 5. County CCOP Risk Reserve Escrow Accounts Include a description of your county s CCOP interest-bearing risk reserve escrow accounts, including the terms, any revenues or disbursements issued for administrative or staff costs. The total amount of the county s CCOP risk reserve, including interest, may not exceed 15 percent of the county's most recent allocation. Attach a current statement of your county s risk reserve account, to verify the account s balance. Describe any plans for improvement or expansion of your county s current CCOP operations with the risk reserve funds. Counties with a risk reserve balance exceeding the 15 percent maximum must describe how they plan to come into compliance with statutory risk reserve limits. Brief summary: Douglas County does not have a CCOP interest-bearing risk reserve escrow account. 6. County CCOP Advisory Committee State law requires that the county CCOP Advisory Committee consist of following defined members; Wis. Stat. 46.272(4)(a): Parents of children with disabilities, including, if possible, parents from families participating in CCOP. To the maximum extent possible, parents must be representative of the various disability, racial, and ethnic groups in the service area. Representatives from the following list (at least one person from this list must represent community, human, social services departments delivering services to CCOP participants): o County departments or divisions of human services, community programs, or developmental disabilities services o County departments of social services o School districts o Local health departments Individuals in the service area who provide other social or educational services to children who have disabilities. Please provide a brief summary of any changes to your county s CCOP Advisory Committee since the last plan approval, including a description of the following details: Role of the county s CCOP Advisory Committee and its members Frequency of the CCOP Advisory Committee meetings Information about the activities of the Advisory Committee If you have attached separate documentation or materials that provides this information, please indicate Attached in the box below. Brief summary: Attached Complete the county s CCOP Advisory Committee Membership Roster, listed on page 4, item 8. 7. CCOP Annual Plan Update Submission The County CCOP Coordinator must submit the completed CCOP Annual Plan Update form to the Department of Health Services (DHS) by the established date. Please submit this completed CCOP Annual Plan Update and any supporting documentation via email to the BCLTSS at: DHSCCOP@dhs.wisconsin.gov. Please include the following information in the subject line of your email message: CCOP Annual Plan Update for <INSERT YOUR COUNTY S NAME> If you have questions regarding the development of your county s CCOP Annual Plan, contact your assigned Children s Services Specialist. Page 2 of 3

DEPARTMENT OF HEALTH SERVICES Division of Medicaid Services F-02230 (10/2017) STATE OF WISCONSIN Wis. Stat. 46.272 8. County Children s Community Options Program Advisory Committee Membership Roster Complete the County CCOP Advisory Committee Roster below. Identify the CCOP Advisory Committee Chairperson and include each member s name, affiliation, address, phone number, and email address. You may attach your local County CCOP Advisory Committee roster, if it contains all the information listed below. Name Affiliation Complete Address, Phone, Email Deb Carrol Chairperson 7 Royalton Rd. Superior, WI 54880 715-392-6093 Shari Pioro Health Care Provider 5808 Cumming Ave. Superior, WI 54880 715-392-7626 June Finsland Parent 901 N 21 st St. Superior, WI 54880 715-392-4263 Mary Chialastri Public Health, Birth to Three 1316 N 14 th St. Suite 400 Superior, WI 54880 715-395-1616 Paulette Alseth Parent 5927 E County Road B. South Range, WI 54874 715-817-0119 Kelly Schoen Parent 2119 Ogden Ave. Superior, WI 54880 715-969-9636 Kristina Lampi Parent E6 Linden Courts. Superior, WI 54880 715-460-9525 Carrie Lott Parent 3282 S. Cty Rd A. Superior, WI 54880 218-428-8931 Wanda Woodhull Parent 5533 S Westline Rd. Poplar, WI 54864 715-364-2529 Patty Dodge Advocate/Educator 3626 Hammond Ave. Superior, WI 54880 Sue Hendrickson County Board Supervisor 5112 South Stone Rd. South Range, WI 54874 715-398-7213 *Your county s CCOP annual plan must be reviewed and receive preliminary approval by your local CCOP Advisory Committee. Following the local CCOP Advisory Committee s approval of the county s plan, please submit the final plan and any attachments to the CLTS inbox at DHSCCOP@dhs.wisconsin.gov. Page 3 of 3