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
History outside its walls
was written in the Great
Depression, two World
Wars, and men on the
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
Best Life Possible
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
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
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
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.
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.
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 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.”
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
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
This long-term assisted
care lengthened her life. I
am sure of that!
My second encounter
was just recently when
my critically ill 38-yearold
son was released to
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
There truly are not
enough words of
appreciation for you and
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
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
Year in Review
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
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
• 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
• 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
• 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.
Year in Review
NW-LTCD Board of Directors Committees
David Willingham, Chair
Jeff Kieffer, Vice Chair
Terri Stone, Secretary
Bob Kopisch, Chair
Mike Hamm, Chair
David Markert, Chair
CONFLICT OF INTEREST
Larry Main, Chair
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
Year in Review
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
Eight hub offices
were opened to
support the 11-county
Pictured below are
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
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.
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
• NorthernBridges promotes member-centered care by including members and their
supports in planning their care and in the interdisciplinary team from the time of
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
(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
John T. McMahon, NorthernBridges’ CEO
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
Capitation Revenue $ 32,639,240
Member Share Revenue 2,704,585
Other Revenue 5,489,466
Total Operating Revenue 40,833,291
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)
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
CEO John McMahon (left) and Board Chair David Willingham.
We are the
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