Minutes for September 8, 2005

Meeting Location: Four Points Sheraton Midway, St. Paul

Present:  Lois Johnson, Karen Larson, Mark Eggen, Bryan Jensen, Roberta Cich, Ann Zick, Sharon Johnson, Larry Lura, Mary Pennington, Roseann Faber, Gloria Lafriniere, David Hancox, Bradley Westerlund, William Bauer.

Absent:  Phyllis Coppess (excused), Linda Lingen (excused), Barbara Chromy (excused)

Guest: David Schwartzkopf

Call to Order, Introductions

The September 8, 2005 meeting of the Statewide Independent Living Council (SILC) was called to order at nine a.m. by Lois Johnson, chairperson. Introductions followed.

Approval of August Minutes and September Agenda

There were no requests for additions or revisions to the August 11, 2005 minutes. Mark Eggen moved, Larry Lura seconded, that the minutes be approved as submitted. There was no discussion and the motion carried. As to the September agenda, William Bauer requested a meeting with Lois Johnson, Mark Eggen, Bryan Jensen, and Ann Zick to discuss facilitating the upcoming consumer forums and to answer any questions. Larry Lura moved, David Hancox seconded, that the September agenda be approved as revised. There was no discussion and the motion carried.

State Rehabilitation Council for the Blind Report

Roseann Faber reported that there has been no SRCB meeting since the last SILC meeting. The next SRCB meeting will be held on October 1, 2005.

She announced that the SRCB is in the planning process, and the Senior Services Unit will be drafting the SRCB's annual report. Various writing styles are under consideration to make the report easier and more enjoyable to read.

Centers for Independent Living Report

David Hancox announced that the CMS grant for the promotion and facilitation of nursing home relocation and accessible, affordable housing needs has been extended for one year. There will be no "new" money throughout this extension. Additional local forums will be conducted to bring together additional vendors, service-providers, et al. SILC members were advised to contact the nearest CIL to learn about upcoming forums in their area.

David Hancox announced that he recently attended ILICIL's annual meeting and was impressed by the large turnout and a large cross-section of disability groups represented. Several legislators were in attendance. Door prizes were given -- all of which were donated by local businesses.

Metro Center's annual meeting will be held on October 26, 2005 in the Jackson Room of St. Paul Travelers Insurance.

David Hancox reported on the Center's independent audit for which the written report was submitted to the governing board in August. Negotiations for the MOU addendum were recently completed. Vicki Dalle Molle is undergoing the interview and review processes for her appointment as the CIL representative on the SILC. The eight Center directors will be holding their annual fall retreat on September 29-30, 2005 in Walker. In response to a request from NCIL, the MN Association of Centers is making a cash contribution to assist those Centers damaged or destroyed by Katrina. The Metro CIL will also be sending a contribution.

2005 SILC Appointments

William Bauer reported that the Governor's meeting with John Berns, appointment coordinator, to discuss this year's SILC applicants was rescheduled due to Governor Pawlenty's need to travel to Fort Ripley where individuals who were evacuated from the Gulf Coast were to be temporarily housed. William Bauer commented that he anticipates the appointments will be announced at some point in September.

State Rehabilitation Council Report

Lois Johnson reported that accessibility, including formatting, has been placed back into the state plan. During the last SRC meeting, Kim peck discussed VR policy changes pertaining to service-delivery. VR customers on a waiting list will receive information and referral assistance, and counseling; the former service will focus on referrals to and resources available at Workforce Centers. There will also be referrals to CILs.

The SRC will meet in Rochester on September 28. Discussion followed.

State Council on Disability Report

David Schwartzkopf announced that he will now serve as the State Council's representative to the SILC.

The MNSCD is involved in relocation activities. The council is working with DHS and the MN Housing Finance Agency on developing a relocation strategy, which will be presented to the legislature at some point in October 2006.

The SILC asked David Hancox to continue to represent the SILC and IL's interests in such relocation activities. Hancox agreed to do so.

121 Project Report

Gloria Lafriniere announced that White Earth's 121 has a new staff member who will focus on transition-aged youth. There will be a technical assistance training held in White Earth in November. Options CIL will provide training on IL services to the 121 staff and consumers on what Centers do; in particular, in the areas of information and referral, and advocacy.

FFY 05 Section Eight Report and 06 Application

William Bauer reviewed this year's Section Eight report for 723 States, and the application to maintain Minnesota 's 723 status for FFY 2006. Sharon Johnson moved, David Hancox seconded, that Lois Johnson sign the FFY 05 report and 06 application. There was no discussion and the motion carried.

Medicare D Program

Barbara Smith, director of DEED's Work Incentives Connection, opened with an overview of this prescription drug coverage program for people on Medicare. Starting January 1, 2006, Medicare will offer Medicare Part D for prescription drug coverage. Pharmacies will sign-up with various plans that have been approved by government. The differing plans have differing formularies; i.e., differing plans will cover various prescription drugs. Plans must provide their customers sixty days notice should any drug be dropped from a plan's formulary.

There are classes of medications that all plans must cover; e.g., anti depressants, anti psychotics, immune suppressants, and others. Should a plan not cover a medication that one needs, one can request an exception. The plan must respond to any such request within seventy-two hours. Should one's request be rejected, one can appeal. Medicare D participants are advised to carefully review how the plans they are considering handle exceptions and appeals. There are some medications that all plans do not cover; e.g., barbiturates, certain vitamins and minerals, and over-the-counter cough and cold medications. There are supposed to be at least two plans available to any person in order to provide Part D consumers with options. Minnesota currently has twenty-three plans. Information regarding the plans available in one's area is supposed to be available on October 1, 2005. On that date, plan representatives can send you information or call you, but cannot appear in person at your door. If you are on the DNC list, plans' representatives cannot call you. Once you've selected a plan, it takes thirty days for the plan to go into effect.

In Minnesota, the Senior Linkage Line and the Disability Linkage Line are available to provide information on the plans. One can also go to medicare.gov to review which plans cover which prescription drugs, and which plan is best for your needs. The medicare.gov site will be on-line on October 1.

Any person on MA or Medicaid only need not concern him/herself with Medicare Part D. Those participating in a Medicare Advantage Plan need to talk with the plan providers in their area. Those in LTC facilities should talk with facility administrators.

There are four other groups of people who are impacted by Medicare Part D, and these individuals will fall into one of four "boats."

Please refer to the handouts submitted in the September mailing for additional information. The following is a press release from CMS which summarizes the Medicare Part D Program:

CMS Public Affairs
(202) 690-6145
Friday, September 30, 2005 MEDICARE UPDATE
CMS: New Drug Coverage Includes Options For Additional Benefits And Saving Money
COST, COVERAGE AND CONVENIENCE CAN BE FOCUS OF CHOICE

All people with Medicare will have a range of choices to enable them to get prescription drug coverage that reflects their preferences, including options with low premiums and options offering more coverage than Medicare's standard drug benefit, the Centers for Medicare & Medicaid Services (CMS) announced today.

Medicare drug coverage is coming with lower costs and better coverage options than many people expected, and there will be help available locally and nationally to assist people in making a decision, HHS Secretary Mike Leavitt said.

Everyone in Medicare, no matter what their income or how they get their health care, can choose coverage that reflects what they want, including lower cost, more complete coverage, and convenient access, said CMS Administrator Mark B. McClellan, M.D., Ph.D.

For example, for people who want to get their coverage in traditional Medicare, the lower cost choice could be a stand-alone plan with a low premium and low prices for a beneficiary's drugs. The more complete coverage choice could be a drug plan that offers coverage for generic drugs and in some cases even brand-name drugs through the coverage gap in the standard Medicare benefit, a plan with no deductible, and a plan that covers almost all of the commonly used drugs. And for convenient access, a beneficiary can choose a plan that provides coverage through their own preferred pharmacies.

In every state, Medicare beneficiaries will have options that include coverage in the standard benefits coverage gap. In every state, beneficiaries will have access to options with deductible below the standard $250. All states except Alaska have options with premiums below $20 a month, and many states have options with premiums for significantly less than that. Also to simplify coverage, many plans have flat copays or tiers of drug payments. For example, a plan might offer generic drugs for one rate, preferred brand name drugs for slightly more and most other brand name drugs for a somewhat higher charge.

Beneficiaries have options that permit even more savings with additional coverage in Medicare Advantage plans, which are available in every state but Alaska and Vermont. In 2006, 70 percent of beneficiaries across the country will have access to a Medicare Advantage plan where the total monthly premium, not including the Part B premium, is zero. This kind of plan would get a beneficiary Medicare's medical and hospital coverage, drug coverage and additional benefits beyond Medicare standard health benefits.

In all but nine states (Connecticut, Idaho, Iowa, Maine, Nebraska, New Hampshire, North Carolina, North Dakota and South Dakota), beneficiaries will have the option to select a Medicare Advantage plan with at least some coverage through the Medicare drug benefits coverage gap. Medicare Advantage plans, which enable people to get their Medicare through health plans such as HMOs and PPOs, offer drug coverage on top of a package of health benefits that generally exceed Medicare benefits.

In the traditional Medicare program, beneficiaries would have to pay premiums for Part B, Part D, and a Medigap plan to fill in some of the gaps in Medicare coverage. Including Medigap, these premium costs can easily amount to several hundred dollars per month. Beneficiaries in Medicare Advantage now save an average of about $100 in out of pocket costs compared to traditional Medicare.

The stand-alone prescription drug coverage and the Medicare Advantage coverage include many plans with very broad formularies. Next month, Medicare will provide specific information on the formularies and the costs of drugs in the formularies.

All approved prescription drug plans and Medicare Advantage plans meet Medicare requirements for providing access to medically necessary drugs, including formulary standards, as well as standards for access to convenient retail pharmacies and to drugs in nursing homes. The plans are required to provide coverage at least as good as Medicare's standard coverage, which pays on average 75 percent of drug costs after a $250 deductible up to $2,250 in total drug spending. The coverage also pays approximately 95 percent after $3,600 in out-of-pocket costs to protect against very high drug expenses. This means that for a monthly premium that is lower than expected, Medicare would pay more than half of a typical beneficiary's drug costs, or more than $1,100 a year. Medicare beneficiaries will have access to plans that cover much more than the standard benefit, as noted above.

Enrollment for Medicare prescription drug coverage runs from November 15 through May 15, 2006. Coverage begins on January 1 if a beneficiary enrolls before then. After that, coverage begins on the first of the month after a beneficiary enrolls.

Medicare will provide comprehensive support to help beneficiaries make a confident decision about drug coverage. That support includes community-based resources offering personalized counseling, materials on www.medicare.gov and through 1-800-MEDICARE, and the Medicare & You handbook with information about coverage in the local area.

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Note: All HHS press releases, fact sheets and other press materials are available at www.hhs.gov/news.

Note:Medicare Prescription Drug Plan Approvals By State are available at www.cms.hhs.gov/map/map.asp

FFY 2005 704 Reports

William Bauer summarized the proposed changes found in the draft edition of the revised 704 Parts I and II reports. All SILC members were e-mailed these drafts in August. He noted that the draft of the Part I report is no longer an aggregate; rather, the draft report includes only those services provided by the SILC and the SILS program.

Committee Reports

Mark Eggen reported that the advocacy and education committee met on the evening of September seventh. A retreat was recommended to work on education objectives in the areas of IL philosophy, choice, and self-determination among others. It was recommended that the SILC review and/or add 800 numbers, and a calendar of IL training opportunities to the SILC website. It was recommended that an upcoming SILC meeting should be utilized to gather input from the full council, Centers and others regarding new approaches to the committee's education and advocacy objectives. It was noted that this would also fulfill the "brainstorming" objective.

Mark Eggen moved, Karen Larson seconded, that the November 10, 2005 SILC meeting be dedicated solely to "brainstorming" advocacy and education objectives. There was no discussion and the motion carried.

Lois Johnson reported for the SPIL committee. A consumer forum will be conducted in the SMILES service-area on September 22, and she, Johnson, will serve as facilitator. On September 15, a consumer forum will be held at CILNM's Duluth satellite; Bryan Jensen will serve as facilitator. On September 29, a consumer forum will be held in Freedom CIL's service-area; Ann Zick will be the facilitator. The fourth and final consumer forum for FFY 2005 will be held in Red Wing, which is in SEMCIL's service-area. Mark Eggen will serve as the facilitator.

Visitor Comments

There were no visitor comments.

Issues, Announcement, Correspondence

David Schwartzkopf reported that MNSCD's annual awards program will be held on October 27 from 11:30 a.m. to 1:30 p.m. at the Four Points Sheraton Midway.

Brad Westerlund provided directions to the October 13 SILC meeting site; i.e., the Four Points Sheraton Minneapolis. This shall become the council's regular meeting location.

Bryan Jensen asked to be sponsored by the SILC at "Closing the Gap," which is a technology conference offered by STAR. He had no details on this conference. Ann Zick stated that she found it difficult to approve the utilization of Federal dollars for conference expenses without full information.

Council members were reminded to immediately inform either William Bauer or Bradley Westerlund of all changes to any SILC member's address, phone number and/or e-mail address.

Karen Larson reminded council members to submit non employee expense reports within five business days of any SILC meeting.

Karen Larson announced that The ARC's state convention will be held on November 11-12 at the St. Cloud Holiday Inn.

Next Meeting, Adjournment

The next SILC meeting will be held on October 13, 2005 from 9:00 a.m. to 2:30 p.m. at the Four Points Sheraton Minneapolis, 1330 Industrial Boulevard. The September 8, 2005 meeting adjourned at 1:30 p.m.