Annual Report - Northern Bridges

northernbridges.com

Annual Report - Northern Bridges

2010

NW-LTCD Board

Annual Report

January 2009 - December 2009


Oliva King has known

only one home in her life.

She was born in 1919 in

the house she lives in

today.

History outside its walls

was written in the Great

Depression, two World

Wars, and men on the

moon.

Inside its walls Olivas

parents raised ten

children, Oliva cared for

her aging parents until

they died, and she cared

for two of her brothers

until they went to

nursing homes.

Best Life Possible

T

he real measure of NorthernBridges’ success is in the successful outcomes of

our members. It’s what we call helping our members live the best life possible.

The best life possible is an elderly gentleman moving from a nursing home and

achieving his goal of living independently and growing a vegetable garden. It is a

young woman with fetal alcohol syndrome confined to doing nothing more than

watching TV every day of her life but, with Family Care, blossoming outside of the

home in supported work environments. It is a man with ALS getting help to go deer

hunting and bagging a 6-point buck.

Connections made so people can play cribbage, go fishing, and one mother to see a

son before she died. Such stories, and those that follow, write the story of Family

Care and NorthernBridges.

Oliva is able to stay in her

home through services

coordinated by

NorthernBridges. Services

such as weekly

housekeeping and help in

obtaining a grant to

better insulate her house.

Two tall oaks frame a

milk house and woodshed

just a few steps from the

back porch. These trees

were planted by her

parents in 1916.

Its not hard to

understand why it is so

important for Oliva to

stay in the house she calls

home. They are very old

friends.

T

hough they have developmental disabilities in a world that limits their

options, Jamie Correll, Jennifer Sanders, Ben Anderson, and Melissa

Dollaway are successful entrepreneurs. These members had similar goals of

wanting to learn job skills and become active participants in their

communities.

For members who have the capability and desire to hold a job,

NorthernBridges makes the connections to community supports and grants

available to give members some of the same opportunities as others.

Social interaction may be very limited for those with disabilities. Very often,

such isolation can lead to depression, which can cause some very real health

issues. In order to help members live the best life possible, NorthernBridges

finds ways for them to reach their goals and add value to their lives.

Oliva King

With the help of Ventures Unlimited, an organization that supports those with

disabilities in developing skills for employment, this group of friends

developed a business to offer regular social events to the disabled

community, which has proved to be a great success. They are also

developing the skills to write a resume and interview for employment.

1


F

or more than 15 years, Ruth Ritter’s son,

Fred, who has a developmental disability,

was on a county waiting list waiting for

services. Last fall, she finally got the call that

the wait was over.

NorthernBridges and the Family Care

program is a dream come true for me,” said

Ruth.

Ruth has cared for her son alone since her

husband died in 1994.

“I was always worrying when I had to leave him at home,” said Ruth. “One day I

won’t be here. Now I feel like I have NorthernBridges to back me up.”

Today both mother and son are busy. Ruth works as a substitute teacher and is

taking classes in computer training.

Fred is learning daily living skills such as managing money and going to the grocery

store and job skills such as cleaning restrooms. NorthernBridges contracts with

providers to support this as well as services to help Fred with tasks such as

grooming and bathing.

“I couldn’t do it all,” said Ruth. “Now I don’t have to do it all. Fred needed a life outside

the house and independent of me. Now he and I can both move forward.”

V

olunteers to the rescue!

When a NorthernBridges’ member in Rice Lake needed easier access to his mobile

home, NorthernBridges contacted the Volunteer Services of Barron County Interfaith

Services.

Our first encounter

with NorthenBridges was

with my mother. You

helped make it possible

for her to continue to live

in her apartment, which

made mom extremely

happy.

This long-term assisted

care lengthened her life. I

am sure of that!

My second encounter

with NorthernBridges

was just recently when

my critically ill 38-yearold

son was released to

our home.

Within 24 hours, your

staff had a team of

needed assistants in place

and ready to go. Without

this type of immediate

support, my son would

have to be in an assisted

living facility.

There truly are not

enough words of

appreciation for you and

your staff.

Joanne Maddux,

Danbury, WI

Volunteer Jim Fangman took hammer and saw in

hand and went to work. Jim assisted in drawing

up a plan for a ramp then went to the lumber

store. Later that same evening the ramp was

built.

Member Clint Taflinger is very happy with his new

ramp. He says it gives him more freedom

because it’s easier for him to get in and out.

NorthernBridges paid for the materials and Jim

supplied the volunteer labor. It is a good example

of how NorthenBridges works with volunteers to

meet members’ needs in the most cost-effect way,

in order to serve more members.

Pictured: Jim Fangman, volunteer; Rita Vaneck,

volunteer coordinator; Clint Taflinger, member;

and Jill Keefer, NorthernBridges’ Social Service

Care Manager.

2


Year in Review

T

he NW-LTCD Board of Directors 2009 activities were focused on continued

unique and proactive policy governance oversight of commencement of phasedin

operations to provide Family Care services to eligible citizens in the 11-county

Northwest Long-Term Care District.

The board’s policy governance development efforts included:

1) Implementation of board process policies that emphasized its distinctive role,

strategic leadership, and accountability.

2) Commitment to yield member-centered outcomes.

3) Preparing the MCO for the future.

Northwest Long-Term Care Board

Mike Hamm

Ashland County

Director

Tom Innes

Iron County

Director

Howard Johnson

At-Large

Director

Jeff Kieffer

Consumer

Director

Dee Kittleson

Bayfield County

Director

Bob Kopisch

Price County

Director

3


D

uring 2009, in pursuit of these ends, the board:

• Introduced a series of Procedural Guidelines for implementation of

specific policies on conflict of interest, confidentiality and open

meetings, and bylaws voting requirements.

• Set priorities for definition and implementation of CEO’s monitoring

reports to the board, and reviewed the MCO’s initial Quality

Management program.

• Reviewed MCO start-up readiness plans, commenced review and

approval of CEO’s written interpretations and report designs to

demonstrate implementation of the board’s Outcomes and

Management Limitations policies, reviewed MCO 3-year Business

Plan, and planned for Independent Audit of 2009 financial

operations.

• Spelled out board members’ duties and expectations, evaluated

first-year operations of its Executive Committee and its first-year

board operations under the Board Process policies, planned and

chartered four board policy monitoring committees (Financial

Management, Member Relations, Quality Management and Conflict

of Interest), reviewed and approved the 2nd Edition of the Board

Policy Book, conducted its first annual meeting, and endorsed

statewide MCO Funding Principles for presentation to the

Department of Health Services on behalf of Family Care managed

care organizations.

• Approved curriculum for and steadfastly engaged in monthly board

education seminars for board and board member development and

planned for filling two At-Large Directorships with persons having

extensive knowledge and/or experience in managed-care programs

and awareness of long-term care within that context.

Mike Linton

Consumer

Director

Larry Main

Burnett County

Director

Ken Mosentine

Barron County

Director

Mark Novotny

Consumer

Director

Don Quinton

Washburn County

Director

Sue Reinardy

At-Large

Director

4


Year in Review

NW-LTCD Board of Directors Committees

EXECUTIVE

David Willingham, Chair

Jeff Kieffer, Vice Chair

Terri Stone, Secretary

Bob Kopisch

Dale Schleeter

FINANCIAL MANAGEMENT

POLICY MONITORING

Bob Kopisch, Chair

Dee Kittleson

Mike Linton

Jack Sweeney

Don Quinton

MEMBER RELATIONS

POLICY MONITORING

Mike Hamm, Chair

Jeff Kieffer

Mike Linton

Ken Mosentine

Sue Zieke

QUALITY MANAGEMENT

POLICY MONITORING

David Markert, Chair

Mike Hamm

Tom Innes

Ken Mosentine

Terri Stone

CONFLICT OF INTEREST

POLICY MONITORING

Larry Main, Chair

Mark Novotny

Dale Schleeter

Dale Schleeter

Sawyer County

Director

Terri Stone

Consumer

Director

Jack Sweeney

Douglas County

Director

David Markert

Polk County

Director

David Willingham

Rusk County

Director

Sue Zieke

Consumer

Director

5


N

orthernBridgesʼ first year was remarkable alone for

the epic implementation and expansion of both the

Family Care program and the budding managed-care

organization itself. Extreme rapid growth and change

were daily companions for everyone as we launched both

managed long-term care and a managed-care business

simultaneously on an 11-county platform known as the

Northwest Long-Term Care District.

The beginning of NorthernBridges could be told in

statistics alone, impressive ones at that. Beginning May 1

through August 1, 2009, 1,536 members from the countyadministered

waiver programs were transitioned from all

11 counties in the NW-LTCD to the Family Care program

administered by NorthernBridges. All of the new members

had their health and safety and continuity of service

assured during and after the transition period. It is worth

noting that such rapid long-term care expansion over four

months was the first of its kind in Wisconsin.

By the end of 2009, another 275 members were enrolled

from either the county-administered waiting lists, nursing

home relocations, or urgent referrals needing immediate

support. The elimination of the waiting list was central to

long-term care reform and this is occurring daily in our

region for many people who have waited too long.

continued next page

2009 ADRC Member Enrollments

2009 NorthernBridges Member Count by Target 2009 NorthernBridges Member Count by Gender

2009 NorthernBridges Member Count by Age Bracket

6


Year in Review

I

mplementation and expansion of Family Care was supported by the initial hiring,

training, and equipping of over 130 staff (77 percent Care Management staff) and

the opening of eight hub offices strategically located throughout the long-term care

district. All supported by a single integrated business infrastructure utilizing current

technology.

Eight hub offices

were opened to

support the 11-county

region in:

Superior

Rice Lake

Spooner

Ashland

Centuria

Ladysmith

Hayward

Park Falls

Pictured below are

ribbon cutting

ceremonies for the hub

office in Ladysmith.

Further statistics include approximately 675 provider contracts issued in our inaugural

year. At the beginning of implementation and expansion, initial contracts were issued

to assure continuity of care for transition members so as to alleviate their fear and

anxiety with the change to Family Care. Provider education and training, for both

groups and individuals, was initiated to support providers with the transition from

County Standard Program Categories to a claims-based system complete with HIPAA

compliant codes; another first for any MCO in the state implementing Family Care.

Our rapid growth and expansion required continuous improvement activities to

achieve a stable and forward-moving business. Our Quality Management system has

taken root by incorporating a systematic process for educating and supporting

members’ rights to appeals and hearings and by identifying and responding to critical

incidents. We proactively and systematically monitor our operations and outcomes to

“discover” how we are working, identify problems, and ensure that “remediation”

occurs to resolve the problem in a timely manner. Our quality improvement program is

data-based and incorporates input and participation from members, providers and

staff.

We have achieved our first-year financial goals in the midst of rapid member growth

and learning the managed-care business. The entire required monthly encounter

reports identifying members and costs of services have been DHS-certified since our

inception; again a first among MCOs. For all 37,495 claims paid from May 1, 2009,

through the end of January 2010, the average number of days from receipt to

payment is 18.4 days and

99.6 percent of all claims

were paid within 30 days of

receipt. Less than 1 percent

of claims received are being

rejected; all a direct result of

the way we are handling

claim submissions. Clear

financial goals with a means

of measuring performance

support our work to be a

financially viable business

that achieves our mission.

7


B

eyond all the statistics, however, the worth of any

doing is in the value added to people’s lives.

MetaStar, the state-selected quality assurance

organization, noted in its initial review of

NorthernBridges’ care management practices found:

NorthernBridges exhibits strengths that help ensure the

health and welfare of their members:

• The MCO has an intentional focus on membercenteredness

and has created a values-based

organization, identifying a mission that focuses on attitudes, conduct and

relationships.

NorthernBridges promotes member-centered care by including members and their

supports in planning their care and in the interdisciplinary team from the time of

enrollment.

One of our best successes and reason for increased business stability is our staff’s

commitment to the mission, vision, and values of NorthernBridges. This is exemplified

in the above findings and can be observed daily in their work with members, providers,

and other stakeholders. Much of our first-year success is directly attributable to how

well our staff embraced change and challenge and worked tirelessly to support our

members. During the many stressful and challenging moments in the first year, our

mission, vision, and values sustained us and kept us focused on the right things and

doing them the right way.

Family Care puts

members at the center of

a team that includes a

nurse and social services

care manager plus anyone

else the member chooses.

Pictured above is Betty

Johnson and her care

managers Dawn Durand

and Ashley Kludt.

While our first year was an experience many of us will always remember, even cherish

in achieving what many thought was impossible, we continually challenge ourselves to

be better than we are now. Looking ahead we will:

(1) Continue to grow our business systems to be more efficient and effective.

(2) Manage the care of members by providing choice, align utilization of services

with desired member outcomes, and address the cost-effectiveness of

services.

(3) Continue reducing the waiting list of people needing long-term care.

(4) Continue to follow our vision and lead with our values to accomplish our

mission.

John T. McMahon, NorthernBridges’ CEO

8


2009 Audit

N

orthernBridgesʼ first audit was an unqualified success. Clifton Gunderson, an

independent auditing firm, found NorthernBridges financial systems and

management to be sound with no significant problems. Clifton Gunderson’s management

letter provided a “unqualified opinion,” as they found that the financial statements of

NorthernBridges are in conformity with generally accepted accounting principles and

present fairly, in all material respects, the financial position of NorthernBridges for

calendar year 2009.

The Statement of Revenues, Expenses and Changes in Net Assets below is audited and

represents the financial position of NorthernBridges for the year ending Dec. 31, 2009.

The company began providing services on May 1, 2009, when members from Douglas

and Barron counties transitioned to NorthernBridges. The 11-county transition continued

June 1 with Polk, Burnett, and Washburn counties, then on July 1 with Rusk, Ashland,

and Bayfield counties and finally on August 1 with the transitioning of members from

Sawyer, Price, and Iron counties.

Nearly 80 percent of total revenue comes from a state capitation rate. For 2009, the

amount of capitation per member per month was $3,017.

Eighty percent of revenue was used to provide direct services to our members, 15

percent for care management, and remaining 6 percent for administrative expenses.

Non-operating revenues include the grants and expenses the company received and

used in its start-up phase of operations prior to the May 1 roll out.

Summary Statement of Revenues, Expenses,

and Changes in Net Assets

OPERATING REVENUE

Capitation Revenue $ 32,639,240

Member Share Revenue 2,704,585

Other Revenue 5,489,466

Total Operating Revenue 40,833,291

OPERATING EXPENSES

Direct Member Service Costs 32,888,806

Care Management Costs 6,113,684

Administrative Expenses 2,470,930

Total Operating Expenses 41,473,420

Operating Loss (640,129)

NONOPERATING REVENUES 231,517

CHANGE IN NET ASSETS (408,612)

NET ASSETS, BEGINNING OF THE YEAR 200,144

NET ASSETS, END OF YEAR $ (208,468)

9


Moving Forward

B

y now you realize that this annual report is much more than a report. It is a group of

stories. Stories from members, staff and the board. Stories with a common theme:

The Best Life Possible for Members. Reports are about numbers and statistics, plans and

programs. NorthernBridges is about people and their stories.

On board a large ship, the passengers have no sense of the ship’s progress, the course

being taken, or subtle course adjustments that are made. Only an occasional look back

at the wake reveals if the course is straight and true and how much we may have learned

from the changes charted months ago.

Looking back, of course, has its risks. We may grow discouraged to see we have not

come as far as we had hoped, or that our course has not been as straight as the one we

charted when our journey began.

But seafarers know that you cannot steer by looking back. The vision, mission, and

values that have guided us thus far will continue to set the course for the future and will

continue to write the next chapters of the NorthernBridges’ Story. On this the anniversary

of our first year of operation, we do look back with a measure of pride for the progress we

have made and the obstacles we have overcome. That is why we tell the stories you read

in this report. That is why we celebrate our first year of operation.

Moving forward we expect, as in the past, that we will encounter rough seas, strong

winds, and times when the wheel is hard to hold. But we are more convinced than ever

before that the destination on the still-too-distant shore is achievable because it is right,

the crew has the will to reach it and, most of all, because it is the place where the stories

of The Best Life Possible can best be written.

David Willingham, NW-LTCD Board Chair

2010 Annual Report

adopted by NW-LTCD

Board 6/7/10.

CEO John McMahon (left) and Board Chair David Willingham.

10


Integrity

Respect

Passion

Mission

Providing

members

the

best life

possible.

Vision

We are the

leader and

standard of

excellence

in member

care.

Partnership

Creativity

Fun

Values

Integrity in what we say and do.

Respect by listening and valuing everyone.

Passion for learning and sharing.

Commitment to fostering partnerships.

Creative and innovative solutions.

Having fun every day.

www.northernbridges.net 15954 Rivers Edge Drive Suite 300 Hayward, WI 54843 1-866-306-6499

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