In the 12-county region that serves Hubbard County's elderly meals program, should the county be reimbursing Lutheran Social Service the maximum allowable rate?
That was the subject of the debate last week at the county board meeting. Commissioners have discussed the meals issue in the past, concerned why it costs a drastically reduced amount to provide inmates meals, while the rates for elderly and disabled meals - essentially from the same menu - is nearly twice as much.
Hubbard County Social Services Director Daryl Bessler has been given authority to gradually increase the monies the county reimburses LSS for those meals, but the larger question was when the state gives a reimbursement cap, should the county be expected to reach it?
That might prompt other providers of human services to expect maximum allowable reimbursement, money the county doesn't have and hasn't built into its current provider contracts, Bessler worries.
The meal program is state-subsidized under certain qualifications and provides "waivered" meals to the disabled, the elderly, persons suffering from traumatic brain injuries and people not eligible for medical assistance but who likely would be within six months.
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The aim is to divert people from institutional placements or keep them out of costly nursing homes, Bessler said.
And, in light of Gov. Tim Pawlenty's recent unallotments, "we're stuck with rate reductions," Bessler said. Starting July 1, those reductions will be 2.58 percent.
The county's 68 clients consumed 8,000 meals in 2008, said Monica Douglas, LSS Senior Nutrition Director.
Some of those meals are meals on wheels, some are provided in congregate living facilities, some are served in senior centers, and some in local diners through a "diner's club" ticket.
"We pay $3.75 to $4.85 (per meal) depending on what we negotiate." Douglas told the board.
Seniors who fit the criteria can eat similar meals at senior centers. There are suggested contributions or donations toward the meal costs.
"The individuals we serve don't have to come up with the money," Bessler said of the difference in programs.
The diners club has been popular because it gives more choice to people using the waivered program rather than a set meal plan, generally providing three to four different meal choices.
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The state maximum was set at $6.13 a meal; $6.32 for home-delivered meals. Hubbard County reimburses LSS $5.38 per meal, Bessler said. Under the reductions that state cap will go down to $6.16 July 1 for meals on wheels.
"We are one of the better payers," he said. "Average meal donations (from seniors) are not coming close to that." Those average $3 to $4 per meal according to spreadsheets LSS distributed at the board meeting.
Douglas disagreed, contending Hubbard County has the lowest reimbursement rate in the region for the waivered meals. Her request for the county to additionally waive the 25 to 50 cents per meal the jail's caterer charges LSS for the food preparation met opposition from the board.
The caterer, called A'viands, is a Twin Cities-based culinary company that specializes in food and services management. The county recently renewed its contract with the company amid some objections from board members that it should be competitively bid, rather than simply awarded.
"I'd like to keep the same caterer," former Sheriff Gary Mills told the board at the time. "Things are running smoothly."
"We were unable to get our sheriff to put it out on bids," board chair Lyle Robinson explained to Douglas. The county cannot waive the preparation fee because "we're probably subsidizing the program there," he said. "Competition in bidding would have solved that."
"We may have to look elsewhere for meals," Douglas said.
For the money the county is contributing, "you could go uptown and buy a pretty good meal," Bessler maintained.
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He understands LSS wants to unify the rates for meals in the region, but he balks at Douglas' contention the county "is contributing to the shortfall" LSS claims it experiences in the meals programs.
"We will try to be good neighbors but I don't want to do it all in one year," he said. "If you raise the meal rates by $1 it impacts other services and sends a message to other providers.
"We will move toward the state ceiling gradually."
