A total of 369 Morrison County residents under age 65 have received waiver services through Social Services so far in 2021.
Social Services Adult Services Supervisor Jeff Bowman gave the Board of Commissioners an update on the programs for which he is responsible during Tuesday’s meeting. In order to be eligible for services, residents must meet eligibility and financial guidelines. That includes completing an annual assessment.
There are a total of four waivers available for people age 65 and younger. One is for those with developmental disabilities and serves 166 people within Morrison County. The total budget for the waiver in 2021 is $14.673 million, with $8.228 million paid out through the end of June.
With that, the revenue taken in from the program has increased in recent years. The total amount in 2020 was $352,762, and it was at $190,378 through June 30 this year.
“You can see that the numbers continue to increase over the years based upon the amount of case management work our case managers are doing,” Bowman said. “We are very much working to support our clients as best as we can to fill the gaps.”
The other three programs — community alternative care (CAC), community access for disability inclusion (CADI) and brain injury (BI) — are combined into one fiscal budget.
CAC serves clients who Bowman described as “very medically fragile.” These include residents who require increased medical assistance, such as on-site nursing. CADI waivers are a bit less specific and include folks who need mental health or physical services. Brain injury services are available to those who meet eligibility due to a brain injury.
In all, Morrison County serves 203 clients who qualify for those waivers. That is comprised mainly of CADI waivers, which makes up 198 of those clients. There are three who receive CAC waivers and two for brain injuries.
In 2020, 165 adults and 31 children were served with those three waivers. Through June 30, there were 181 adults and 22 children in 2021.
“If we were to look back over the years, Morrison County’s involvement with kids getting this higher level of service that go beyond state planned services have greatly increased over the years to avoid having to go to that more restrictive hospital setting of service,” Bowman said.
Morrison County’s allocated budget for 2021 is $12.944 million, which is actually down from $15.441 million the previous year. Bowman said this is due, in part, to there being greater restrictions on services due to COVID-19 and an inability for people to access service providers because of staffing shortages.
“Each year Morrison County is allocated a certain number of slots for our waivers,” Bowman said. “As you can see, over the past several years, we continue to receive more and more allocations. At this time, the state is being very generous with being able to provide resources to meet the needs of our individuals. There was a time, many years ago, where we were not given allocations every year. When we get an increased allocation, our budget, in turn, increases as well.”
So far in 2021, the county has been authorized to use $7.689 million of those funds, with $1.330 million paid out, as of June 30.
When residents receive services under the developmental disability waiver, the county bills the waiver itself for its case management in 50-minute increments of time spent. The revenue is on pace to exceed what was budgeted.
“The reason for that is, our case managers are doing their best to provide services that are not being provided by providers at this time,” Bowman said. “They’re going above and beyond what normally would be expected.”
Regardless of what waiver those residents are receiving services through, Bowman said COVID has “signficantly impacted” the ability to provide services due to a lack of providers. He said Social Services is working diligently with its providers and its families to find alternatives, which includes utilizing community resources, family members and churches, for example.
Morrison County Public Health Nursing Supervisor Cindy Nienaber said her department oversees waiver services for residents over age 65. These include the alternative care, elderly waiver and essential community support.
“Those three waivers all require that somebody meets nursing facility level of care,” Nienaber said. “That does not mean that they have to go to a nursing home. It simply means that, based on our assessment and the guidelines from the state, without services they are at risk to end up in the nursing home. The goal of these programs is to keep people out of the nursing home.”
In order to meet requirements, they must also meet financial criteria.
Nienaber said to receive the elderly waiver, clients have to be equivalent to reciving medical assistance. Alternative care, she said, is a little less restrictive but also has fewer services available. These clients have to meet income guidelines and may have to pay a portion of their services.
In 2020, there was a $142,841 budgeted revenue for these programs, and Public Health ended up bringing in $149,778. As of June 30 this year, the revenue was at $73,008 compared to a total projection of $127,639.
In terms of expenses, the total for 2020 was $141,623 compared to a budgeted amount of $139,305. Through the first six months of 2021, expenses sat at $76,753, with $182,919 budged.
“When we made this budget last year, we anticipated that we might be able to go into homes and see people face-to-face,” Nienaber said. “That increases our cost, because then we have drive time and travel expense. Because we’re still not doing these visits, for the most part, face-to-face, we’re saving money on that expense. We should be at more, like, $90,000 for expenses and we’re only at $76,000.”
County Commissioner Jeffrey Jelinski said, though the dollar amounts for these programs may look high, they are vitally important to those who need them.
“First of all, it’s pretty big numbers that we’re talking about here; dollar values,” Jelinski said. “From the outside looking in, one could maybe suggest that, ‘Whoa. There’s an awful lot of welfare money,’ maybe. However, I would like to be very clear and point out, there is not one person that wants to be on one of these waivers.
“This is a big deal,” he continued. “For what happens and for what you go through and for what every one of your clients are dealing with — big stuff. Truly, thank you for that.”
Board of Commissioners Briefs:
In other business Tuesday, the Morrison County Board of Commissioners:
• Proclaimed October as Domestic Violence Awareness Month in Morrison County;
• Approved the Lake Sullivan Lake Improvement District’s (LID) 2022 work plan and budget with a $100 per parcel levy;
• Approved the Lake Shamineau LID’s 2022 work plan and budget with a $905 per parcel levy;
• Acknowledged the importance of cybersecurity and offered their support for a national effort toward awareness;
• Approved a request to replace a public health nursing position for Family Home Visiting, which includes providing reflective supervision for the nurses as required under the evidence based program;
• Approved a request from Public Works Director Steve Backowski to appoint a county employee to carry out the duties required by the noxious weed law;
• Accepted a motion to install Region 5/Visit Little Falls welcome and wayfinding signs at Belle Prairie Park; and
• Appointed Commissioner Greg Blaine to the Region 5 Development Commission for a new three-year term, beginning in 2022.
The next meeting of the Board of Commissioners is a planning session at 8:30 a.m. Tuesday, Oct. 12, in the Board Room at the Morrison County Government Center.