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FINANCE COMMITTEE
REPORT (Misc. #00092) May 4, 2000
BY: Finance Committee, Sue Ann Douglas, Chairperson
IN RE: DEPARTMENT OF HUMAN sERvins/mEDICAL CARE FACILITY-
APPLICATION AND ACCEPTANCE OF THE NURSING HOME QUALITY INCENTIVE
GRANT
To: The Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
The Finance Committee, having reviewed the above referenced
resolution on April 13, 2000, reports with the recommendation that
the resolution be adopted with an amendment to add a BE IT FURTHER
RESOLVED paragraph as follows:
BE IT FURTHER RESOLVED that grant approval is contingent upon
Corporation Counsel's approval as required by the Board of
Commissioners' Grant Application, Acceptance and Reimbursement
Agreement Procedures.
Chairperson, on behalf of the Finance Committee, I move
acceptance of the foregoing report.
FINANCE COMMITTEE VOTE:
Motion carried unanimously on a roll call vote with Friedman-Appel
and Douglas absent.
ernment Committee
May 4, 2000
Miscellaneous Resolution # 00092 _
BY: Shelley G. Taub, Chairperson, General Government Committee
RE: Department of Human Services/Medical Care Facility — Application and Acceptance of the
Nursing Home Quality Incentive Grant
TO: Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS, the Michigan Department of Consumer and Industry Services has made funding
available in the amount of $24,960.00 through its Nursing Home Quality Incentive Grant program, for the
period October 1, 1999, through September 30, 2000; and
WHEREAS, this grant is funded by 50% state funds and 50% federal funds with no local match
required; and
WHEREAS, the Oakland County Medical Care Facility will utilize these funds to improve resident
nutritional status and expand the Eden Alternative process already started; and
WHEREAS, no new staff are requested; and
WHEREAS, additional county funding is not required.
NOW THEREFORE BE IT RESOLVED THAT the Oakland County Board of Commissioners does
hereby approve the acceptance of $24,960.00 in Nursing Home Quality Incentive Grant program funding
provided through the Michigan Department of Consumer and Industry Services.
Mr. Chairperson, on behalf of the General Government Committee, I move the adoption of the
foregoing Resolution.
s
General Government Committee Vote:
Motion carried on unanimous roll call vote with Law absent
State of Michigan
John Engler, Governor
Department of Consumer & Industry Services
Kathleen M. Wilbur. Director
November 22, 1999
Dear Administrator:
Re: Long Tenn Care Facility Innovation Grants
Bureau of Health Systems
,0
G. Mennen Williams Building, 5th Floor
P.O. Box 30664
Lansing, Michigan 48909
-;
OAKLAND COUNW /1-t-tacivwd
(i) GEC 3 VA
MEDICAL CARE
FACILITY
Section 321 of the Department's FY 2000 Budget Bill contained authorization for a nursing
home quality of care incentive program to provide financial incentives for nursing homes to
develop high quality care services. In response, the Department has initiated a Long Term Care
Facility Innovation Grant Program to award up to $188.00 per bed for eligible quality
improvement activities. This program supercedes the previous Continuous Quality Improvement
Program (CQUIP) which was administered by the Department of Community Health.
Eligible activities are those related to (1) applying for a Michigan Quality Leadership Award;
(2) developing and implementing an innovative quality care improvement program; or
(3) implementation of an Eden Alternative Program. The attached Bulletin issued by the
Department of Community Health on November 22, 1999 describes the program in more detail.
Although details of the program set forth in the Bulletin are subject to change based upon public
comment, we are confident that it will remain substantially the same, and we are enclosing an
application form to be returned if your facility wishes to apply for a grant. Applications must be
received before December 31, 1999. Applications must be submitted by mail or fax to:
Michigan Department of Consumer & Industry Services
do Lauren Van Steel
P.O. Box 30004
Lansing, MI 48909
This program is limited to licensed nursing homes. Facilities which have been determined to
have substandard quality of care in their last standard survey are not eligible to apply for this
grant.
We hope this information is of assistance to you. If you have further questions, please contact
Lauren Van Steel at 517/373-3467 or by fax at 517/373-7407.
SiiVcerely,
• . _
Walter S. Wheeler III, Directorbk VPRQ
Bureau of Health Systems
MICHIGAN DEPARTMENT OF CONSUMER & INDUSTRY SERVICES
LONG TERM CARE FACILITY INNOVATION PROGRAM
P.O. Box 30004
Lansing, MI 48909
LONG TERM CARE FACILITY INNOVATION GRANT APPLICATION
1. FACILITY NAME:
2. FACILITY LICENSE NUMBER:
3. FACILITY PHYSICAL ADDRESS:
(Street)
(City) (State) (Zip)
4. FACILITY MAILING ADDRESS IF
DIFFERENT THAN PHYSICAL (Street)
ADDRESS:
(State) (Zip)
5. APPLICATION CONTACT PERSON:
(Name) (Title)
(Phone #) (Fax #)
6. TYPE OF ACTIVITY FOR WHICH GRANT IS REQUESTED (CHECK ONE):
0 Activities to Obtain the Michigan Quality Leadership Award (MQLA) from the Michigan
Quality Council
0 Lighthouse Award 0 Navigator Award
0 Honor Roll 0 Quality Leadership Award
(City)
1
El
Michigan Department of Community Health
Medical Services Administration
• Distribution: Long Term Care Facilities 00-XX
Issued: December 1, 1999
Subject: LTC Facility Innovation Grants
Effective: January 1, 2000
Programs Affected: Medicaid
The purpose of this bulletin is to govern Medicaid financial participation in the Nursing Home Innovation
Grant Program administered by the Michigan Department of Consumer and Industry Services (MDCIS)
pursuant to Section 321 of the Public Acts of 1999. That section provides in part:
a[MDCIS]... shall develop a nursing home quality care incentive [program] .... to provide
financial incentives for nursing homes to develop high quality care services. Grants shall be
awarded to nursing homes that can demonstrate an existing commitment to providing high
quality care.... The department shall develop the specific criteria for the awarding of these
grants [which]... shall include some measure of resident satisfaction with the level of care
provided. The criteria may also include the results of the facility's annual survey conducted
by the department...."
This program was authorized in part to replace the former Continuous Quality Improvement Program
(CQU1P) and supersedes Bulletin LTC 94-11 dated September 30, 1994.
ELIGIBILITY AND AMOUNT OF THE GRANT
All Medicaid certified long term care facilities are eligible to apply for an Innovation Grant under this
program. Only those facilities that are approved by MDCIS to receive a grant will be eligible for a
maximum of $188.00 per bed, based on the licensed bed capacity as of October 1, 1999. A facility
with a demonstrated record of past non-compliance with licensure or certification requirements shall
not be eligible for a grant under this program.
A long term care facility wishing to use the funds allocated to it for an Innovation Grant under this
program must apply to MDCIS on or before December 31, 1999. Innovation Grant awards may or may
not cover the entire cost of eligible activities.
Proposed Policy Draft
Page 2 of 4
ELIGIBLE ACTIVITIES
This grant program is competitive and activities will be accepted for a grant award only if judged by
MDCIS to meet the requirements and purpose established for eligible activities. An Innovation Grant
may be granted to reimburse a LTC facility for expenditures for three eligible activity areas as follows:
Activities to Obtain the Michigan Quality Leadership Award (MQLA)
MQLA awards are awarded through the Michigan Quality Council (MQC). The MQLA is a four
level award process that uses the Baldrige Performance Excellence criteria and is modeled after
the National Malcolm Baldrige Award process. MQC has trained examiners that review and
• provide feedback reports for improvement. The four levels include the following:
• The Lighthouse Award - This award is the initial step to introducing the MQLA process into
the facilities. The customized Long-Term Care Starter Guide Application includes
customized questions to assist the facility with the development of improvement action
plans.
• The Navigator Award - This award is the next step in the process and requires the facility to
complete a 20 page application following the Baldrige National Quality Award Health Care
Criteria.
• The Honor Roll - Is an award for facilities that have made significant progress in their
approach and deployment in several areas of the criteria. These activities are typically
areas noteworthy of bench marking.
• Quality Leadership Award - This top level award is for facilities that demonstrate approach,
deployment and positive results throughout the facility.
The MQLA process is based on seven criteria that together provide organizations with the
foundation necessary for demonstrating business excellence. The seven categories include:
• Leadership
• Strategic Planning
• Focus on Patients, Other Customers and Markets
• Information and Analysis
• Staff Focus
• Process Management
• Organizational Performance Results
Activities to obtain one or more MQLA awards are eligible activities.
Proposed Policy Draft
Page 3 of 4
Innovative Projects
Innovative Projects which may improve the quality of care provided to residents in the facility may
be eligible for a grant under this program. Each application will be reviewed by the MDCIS which
will determine whether the project is likely to improve the quality of care. Evaluation of the impact
of the projecf may be required as a condition of the grant.
Projects in this category may include activities to address issues identified as part of a continuous
quality improvement program; activities to improve labor relations or lessen staff turnover; or other
innovative approaches to quality improvement.
Activities to Implement the Eden Alternative
The core concept of the Eden Alternative is to transform nursing homes into habitats for human
beings rather than institutions for the frail and elderly. The Eden Alternative is a tool and process
for improving the quality of life for people who live in long term care facilities by enlivening their
environments and eliminating unnecessary medical therapies. This is accomplished through
companion animals, the opportunity to care for other living things, the variety and spontaneity that
mark an enlivened environment and improvements in the relationships between management,
staff and residents. Activities to implement the Eden Alternative in a LTC facility are eligible
activities.
DISTRIBUTION OF THE GRANT
The award for each facility will be made by MDGIS as soon as the application is approved.
The facility will be required to abide by all of the rules of the program, including acceptance that the
decision of the MDCIS as to eligibility of the application and amount of eligible activities is final and not
subject to administrative or judicial appeal.
VERIFICATION OF EXPENDITURES
Application for Innovation Grant funds and supporting documentation must be made to MDCIS in
accordance with a process and on a form it develops. At the end of the fiscal year, the recipient will be
required to submit a listing of all grant expenditures along with supporting documentation. Any unspent
funds shall be returned to MDCIS.
MQLA Projects
In the case of activities to develop an application or program for the Michigan Quality Leadership
Award (MQLA), MDCIS will rely both on facility submissions and on concurrent supporting
verification from the Michigan Quality Council that submitted expenditures are bona-fide.
Subsequent verification of expenditures by the Michigan Quality Council will be required.
Approved
James K. Haveman, Jr.
Director
Robert M. Smedes
Deputy Director for
Medical Services Administration
Proposed Policy Draft
Page 4 of 4
Innovative Projects
•
Each application will be reviewed by the MDCIS to determine whether the project is likely to
improve the quality of care provided to residents in the facility. Evaluation of the impact of the
project and subsequent verification of expenditures made will be required.
Endenization Projects
In the case of Eridenization activities, MDCIS will rely both on facility submissions and on
concurrent supporting verification from the from the Office of Services to the Aging (OSA) that
submitted expenditures are bona-fide. Evaluation of the impact of the project and subsequent
OSA verification of expenditures made will be required.
Applicants for an Innovation Grant under this program must sign a waiver to accept all
decisions of MDC1S, MSA, MQC or OSA, or a designated agent of any of them in this process as
final, with no right of administrative or judicial appeal.
Manual Maintenance
Retain this bulletin for future reference.
03/24/00 09:53 FAX 2488584026 OC NED. CARE FAC. DR GORDON a 016
Attachment to Long Term Care Facility Innovation Grant Application
Oakland County Medical Care Facility License # MI633510
Activities to Implement the Eden Alternative
Attached: 1) Memo to OSA and their letter of support
2) Eden Projects listing from BEAM
We will use the grant monies for the following Eden projects:
1. BEAM-approved meutoring services, education and assistance at an average
rate of $60.00 per hour, pins expenses; specifically specialized training in
creating a climate for cultural change to occur, and ongoing mentoring
services during the "Edenizanon" process to assure success.
8 hoursat$60.00perhour=$480.00
plus Expenses 200.00
$ 680.00
2. Facility systems analysis services focusing on process outcomes, approved by
or offered by BEAM, to determine system barriers to the cultural change
required for Edenizing.
8 hours at S100.00 per hour = 5300.00
plus Expenses 200.00
51000.00
3. Eden Associate certification training for staff.
5 staff members @ $900.00 each = S4500.00
plus Expenses 500.00
55000.00
4. Two-day team-building training for staff approval or offered by BEAM.
6 staff members (14 $480.00 each = S2380.00
plus Expenses 550.00
$3430.00
5. Two day staff empowerment/development training effort for staff, approved
or offered by BEAM.
6 staff members g $480.00 each = 53880.00
plus Expenses 550.00
53430.00
6. Membership for our nursing assistants in NAGNA at Level 3.
•
Annually= 53650.00
Fins travel 1000.00
$4650.00
Total for Edenization 513,190.00
Total for additional tables 52352.00
OC MED . CARE FAC . DR GORDON lib 017 03/24/00 09:53 FAX 2488584026
Innovation Project
To enhance and improve our dining experience for our resident by serving three
meals daily in the dining room. We have begun, and the improvement for the
resident's quality of life is evident. However, we need the following items to enhance
and/or improve what we've already begun.
1. New "space tables" to improve and/or enhance seating for residents. (Seating
current for 54 in a variety of chairs, i.e., Lames, wheelchair, regular chairs, etc.
and the caregivers who must assist and/or feed the resident).
460" Round #100060R-RE 5373.00 each — 51492.00
plus 4 603/606 bases @ 340.00 each 1360.00
$4352.00
Total for Edenizatiou 518190.00
Total for Tables 4352.00
Total Request = 522542-00
If we could receive additional grant monies, I would request more tables to facilitate
a more comfortable setting for our residents and guests.
4 Rectangle tables at 5248.00 each = 5992.00
10036X56RE
4 603/606 Bases at $340.00 each 1360.00
Communication Board — communication system for all employees with personalized
messages and messages pertinent to the industry (poster communication system).
One year subscription = $2025.00 32025.00
Total additional request $4377.00
FISCAL NOTE (Misc. #00092) May 4, 2000
BY: FINANCE COMMITTEE, SUE ANN DOUGLAS, CHAIRPERSON
IN RE: DEPARTMENT OF HUMAN SERVICES/MEDICAL CARE FACILITY-APPLICATION AND
ACCEPTANCE OF THE NURSING HOME QUALITY INCENTIVE GRANT
TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-C of this Board, the Finance Committee has
reviewed the above referenced resolution and finds:
1. The Michigan Department of Consumer and Industry Services has
made available funds in the amount of $24,960, through its
Nursing Home Quality Incentive Program.
2. The grant period runs from October 1, 1999 through September 30,
2000.
3. A County match is not required, and no new staff is requested.
4. The following Amendment to the Fiscal Year 2000 Budget is
recommended:
Revenue:
16-300101-10000-0171 Grants - State
16-300101-20091-0171 Grants - State
$20,125.11
4,834.89
$24,960.00
Expenditure:
16-300102-10000-3172
16-300102-10000-3756
16-300102-20091-3172
16-300102-20091-4100
Membership Dues $4,650.00
Travel/Conference 15,475.11
Membership Dues 2,025.00
Exp. Equipment Expense 2,809.89
$24,960.00
//FINANCE COMMITTE
FINANCE COMMITTEE VOTE:
Motion carried unanimously on a roll call vote with Friedman-Appel and
Douglas absent.
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G. Mennen Williams Building, 5th F
P.O. Bex 30
Lansing, Michigan 43
Mete offehigen
John Engler, Governor
Department of Consumer A Industry Bervicea
Kathleen M. Wilbur, Director
April 20, 2000
Joelien Shortley
Financial Attorney
Oakland County Corporate Counsel
1200W. Telegraph
Pontiac, MI 48341
Dear Ms. Shortley:
'This letter responds to the question you raised in our telephone conversation of this date,
The Certification by Applicant on Page 2 of the Long TCM3 Care Facility Innovation Grant
Application form applies only to decisions regarding the grant application and the rant award,
Thank you for bringing this matter to my attention.
SiLerel
Wald S. Wheeler M. Director
Bureau of Health Systems
. .
' la .ittion
E FOREGOING RESOLUTri
5=7//i4,)
L ooks Patterson. County Executive Dafe 4--
I HEREBY
Resolution #00092 May 4, 2000
Moved by Taub supported by Schmid the Finance Committee Report be accepted.
A sufficient majority having voted therefor, the report was accepted.
Moved by Taub supported by Schmid the resolution be adopted.
Moved by Taub supported by Schmid the resolution be amended to coincide
with the recommendation in the Finance Committee Report.
A sufficient majority having voted therefor, the amendment carried.
Moved by Patterson supported by Schmid the resolution be amended further
by adding the following paragraph:
"BE IT FINALLY RESOLVED that the Oakland County Board of
Commissioners does hereby accept the Nursing Home Quality Incentive Grant
subject to the understanding conveyed in the attached April 20, 2000
letter from Walter S. Wheeler III, of the Michigan Department of Consumer
& Industry Services, that the language contained in the Long Term Care
Facility Innovation Grant Application: Section 9.A. - CERTIFICATION BY
APPLICANT, " applies only to decisions regarding the grant application and
the grant award."
A sufficient majority having voted therefor, the amendment carried.
Vote on resolution, as amended:
AYES: Gregory, Jensen, Law, McCulloch, McPherson, Melton, Millard, Moffitt,
Obrecht, Palmer, Patterson, Schmid, Sever, Suarez, Taub, Amos, Appel, Buckley,
Causey-Mitchell, Colasanti, Coleman, Dingeldey, Douglas, Galloway, Garfield. (25)
NAYS: None. (0)
A sufficient majority having voted therefor, the resolution, as amended,
was adopted.
STATE OF MICHIGAN)
COUNTY OF OAKLAND)
I, G. William Caddell, Clerk of the County of Oakland, do hereby certify that the
foregoing resolution is a true and accurate copy of a resolution adopted by the
Oakland County Board of Commissioners on May 4, 2000 with the original record
thereof now remaining in my office.
In Testimony Whereof, I have hereunto set my hand and affixed the seal of the
County of Oakland at Pontiac, Michigan this 441pday 91 May, 2000.
G. William Caddell, County Clerk