HomeMy WebLinkAboutHealth & Human Services 01-10-19964
ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD
January 10, 1996
The St. Croix County Health and Human Services Board met on January 10, 1996, at the St.
Croix County Health and Human Services/Health Center complex.
MEMBERS PRESENT: LuVerne Burke, Chair
Karen Bailey
Chris Bethke
Jack Dowd
Fern Johnson
Allen Limberg
Len Nyland
George Sinclear
Robert Stephens
MEMBERS ABSENT: None
STAFF PRESENT: John Borup, Human Services Director
Cindy Griffin; Deputy Directory
Carolyn Krieger, Nursing Home Administrator
Judy Ziegler, Accountant
Judy Aronson, Secretary
Ron Kiesler, Mental Health Coordinator
Karen Hall, Long Term Support Coordinator
Ron Lockwood, Social Work Supervisor
Barbara Nelson, Public Health Supervisor
Kathy McClelland, R.N.
OTHERS PRESENT: John Krizek, Administrative Coordinator
Robert Boche, County Board Chair
Chair Burke, called the meeting to order at 8:00 A.M. noting the meeting was properly and
legally publicized.
NEXT MEETING: The next meeting of the Health and Human Services Board will be
Thursday, January 25, 1996 at 6:30 p.m. at the St. Croix County Health and Human
Services/Health Center complex.
AGENDA: MOTION: A motion was introduced by Bailey, seconded by Bethke, and
unanimously adopted: That the agenda be approved as circulated.
MINUTES: MOTION: A motion was introduced by Stephens, seconded by Bailey, and
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unanimously adopted: That the minutes of the 12/ 12/95 Health and Human Services Board
meeting be approved as circulated.
Consideration of Claims: Judy Ziegler, Accountant/Accounting Supervisor, distributed the
following reports: transfer of funds report, unemployment, fixed asset, and cash report.
Human Services Board member, Bethke, reviewed the December vouchers and questioned or
reviewed the following vouchers:
HUMAN SERVICES:
5688: More 4, $48.93, GR-Medical, we paid for a prescription for a General Relief
client.
5715: Indianhead CAA Home Service, $25,918.52, Long Term Support purchased
services. This is for contracted services for Indianhead staff to work in COP
client homes performing personal care services.
5722: Rineck Repair & Service, $1,961.68, maintenance expense for repair of nursing
home generator.
5766: Woodland Youth and Family, $4,210.5, Group home care for one month for
children in alternate care.
5923: Lawson Products, Inc., $215.84, maintenance expense, maintenance purchases
supplies (nails, drills, wire connectors, etc.) from this company,.
6081: St. Paul Ramsey Medical Center, $8,612.40, GR-Medical, cost of hospital stay
for a General Relief client, we pay at the medicaid rate.
MOTION: A motion was introduced by Bethke, seconded by Stephens, and unanimously
adopted: The following vouchers be approved and be made a part of the supplemental minute
book pages 1169 through 1195:
Home Health vouchers 254 through 272, dated January 10, 1996 in the amount of $70, 308.94.
Human Services vouchers 5683 through 5704, dated December 14, 1995 in the amount of
$15,673.57.
Human Services vouchers 5705 through 5723, dated December 21, 1995 in the amount of
$76,346.15.
Human Services vouchers 5724 through 5734, dated December 28, 1995 in the amount of
$56,668, 36.
K
Human Services voucher 5735, dated December 28, 1995 in the amount of $54,000.00.
Human Services vouchers 5736 through 5766, dated January 4, 1996 in the amount of
$32,494.19.
Human Services vouchers 5771 through 6083, dated January 10, 1996 in the amount of
$167,901.97.
Nursing Home voucher 841, dated December 14, 1995 in the amount of $513.00.
Nursing Home voucher 842, dated December 21, 1995 in the amount of $1,975.27.
Nursing Home voucher 843, dated December 28, 1995 in the amount of $375.00.
Nursing Home vouchers 851 through 888, dated January 10, 1996 in the amount of $40,242.02.
Human Services and Nursing Home vouchers 536 through 562, dated December 12, 1995 in the
amount of $292,055.88.
Social Services and Human Services vouchers 379 through 396, dated December 13, 1995 in the
amount of $94, 824.86. '
Human Services and Nursing Home vouchers 563 through 589, dated December 26, 1995 in the
amount of $233,707.27.
Social Services and Human Services vouchers 397 through 413, dated December 27, 1995 in the
amount of $78,586.05.
Social Services and Human Services vouchers 01 through 18, dated January 10, 1996 in the
amount of $106.331.38.
Human Services and Nursing Home vouchers 01 through 25, dated January 9, 1996 in the
amount of $294.422.13.
Health and Human Services/Nursing Home Issues: Kiesler stated the end of November we
received a letter from Luther Hospital with the notice as of January 1, 1996 Luther Hospital in
Eau Claire is refusing to accept any admissions (i.e. children, adolescents, or adults) from St.
Croix County. Borup stated the moment notice was received, alternatives to Luther were looked
into. The following are the only facilities willing to accept emergency detentions from St. Croix
County at the present time: Mendota Mental Health Institute, St. Joseph's Hospital, Cumberland
Memorial Hospital, and Sacred Heart. Kiesler will continue to search for facilities. Kiesler will
gather comparative cost figures of last year and project the cost for 1996 and bring to the next
Human Services Board Meeting. St. Joseph's will cost $100-$200/day more than Luther.
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The initial responsibility begins with law enforcement if they have someone in custody who they
feel are a danger to themselves or others. Once a person is placed in emergency detention, we
are responsible for the cost of care. Krizek stated the Sheriff's Department received a 5 %
budget increase which included those additional revenues. Borup stated a meeting with law
enforcement has been set for January 29, 1996 at 1:00 p.m. here in our Board room to discuss
issues/roles concerning Emergency Detentions and Inpatient care.
Community Health Assessment Update: Nelson stated on December 14, 1995, the Community
Health Assessment Core Group and APEX -PH work group representatives met for the purpose
of sharing their final reports on the assessed priority health problems and plans. The seven work
groups, which consisted of Chronic Disease Prevention and Control, Communicable Disease
Control, Environmental Health, Injury Prevention, Infant/Child Health, Adolescent Health and
Reproductive/Prenatal Health, presented nineteen priority problems. Five problems emerged as
the top community health problems. The final phase of the Community Process (Part II) will
involve Core Group and interested community members developing specific goals and objectives
to carry out the plans for meeting the identified needs of those five problems, which were: 1)
Lack of support of all children, 2) Addiction to tobacco and alcohol, 3) Lifestyle issues: lack
of exercise; poor nutrition; increased obesity/childhood overweight and obesity, 4) Domestic and
societal violence, and 5) High risk pregnancy. Nelson stated if anyone is interested in being on
the coalition to let her know.
Financial Report and State/County Budget Update: The following financial report was
distributed to the Board. Please see next page.
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ST. CROIX COUNTY HUMAN SERVICES BOARD
FINANCIAL SUMMARIES
FOR THE PERIOD 01/01/95 THROUGH 11/30/95
NURSING HOME
Reconciled Cash Balance ii/3o/a5
Medicare
Add:
Accounts Receivable, 11/30/95
Private Pay
Medicaid/Medicare
General
Accounts Payable- 11/30/95
Net Current Items, 11/30/95
381,622.98
88,489.46
8,849.64
183,860.66
140.34
( 175,114.53 )
487,848.55
1995 Revenue Recorded through 11/30/95 4,020,004.02
Includes Allocations of Anticipated Revenues
1995 Expenses Recorded through 11/30/95 4,020,801.47
Includes Allocations of Expected Expenses
Add or Deduct any nursing home related items not
recorded on nursing home books: 1995
bond principle $232,825.00
(93.130 of total 1995 bond principle of $250,000)
HUMAN SERVICES
SUMMARY
Total
OF EXPENDITURES
Jan.-
Budget
Balance
%
Nov.
Administration
482,350.07
519, 769. 00
37,418.93
92.81
Alcohol -Drug Abuse
373,553.89
464,721.00
91,167.11
80.39
Long Term Support
5,172,569.58
5,980,252.00
807,682.42.
86.50
Economic Support
815,187.31
1,044,794.00
229,606.69
78.03
Mental Health Services
1,223,029.94
1,588,293.00
365,263.06
77.01
Social Services
1,776,254.25
1,952,835.00
176,580.75
90.96
General Relief
61,628.90
101, 508. 00
39,879.10
60.72
TOTAL 1995 HUMAN
SERVICES BUDGET
9,904,573.94
11, 652,172.00
1,747,598.06
85.01
SUMMARY
—OF REVENUES
Total
Jan.- Budget
Nov.
State
1,563,709.00
1, 705, 802. 00
County
2,596,211.83
2, 821, 239. 00
AODA Services
192,550.61
225,236.00
Long Term Support
4,265,971.93
4,679,162.00
Mental Health
Social Services
554,057.21
752,819.28
625,908.00
923, 868. 00
Economic Support
383,553.00
648, 457. 00
General Relief
TOTAL REVENUES
ALL PROGRAMS
7,253.73
10,316,126.59
22,500.00
11, 652, 172. 00
hs95-sum
Balance %
142,093.00
91.68
238,661.17
91.59
32,685.39
85.49
413,190.07
91.17
71,850.79
88.53
157,414.72
82.71
264,904.00
59.15
15,246.27
18.91
1,336,045.41 88.54
HOME HEALTH
Total
Jan.-
Budget
Balance
%*
Nov.
TOTAL
REVENUES
468,504.00
514,617,62
(46,113.62)
109.85
TOTAL
EXPENDITURES
468,504.00
462,347.09
6,156.91
98.69
PUBLIC HEALTH(12
month programs)
Total
Jan.-
Budget
Balance
%*
Nov.
TOTAL
REVENUES
845,352.00
763,363.64
81,988.36
90.31
TOTAL
EXPENDITURES
601,340.00
468,092.55
133,247.45
77.85
PUBLIC HEALTH(9
month programs)
Total
Jan.
Budget
Balance
%**
Nov.
TOTAL
EXPENDITURES
266,416.00
238,143.90
28,272.10
89.39
*TO BE
ON &OGET, PERCENTAGE SHOULD BE
91.67
**TQ BE
Ok BUDGET,
PERCENTAGE SHOULD BE
100.00
ph95-sum
Borup stated the numbers remain strong. Borup stated we are under budget in most areas with
good revenues noted. Expenditure/revenues reviewed with the Board.
The census in the Nursing Home is 105 with three admissions pending. Krieger stated we are
very optimistic, hopefully marketing and advertising will increase admissions. Krieger stated
we are striving to maintain what we have and move forward.
Krieger stated that John Sauer from Wausau will speak at the March 12th Human Services Board
meeting. He will speak specifically about the Health Center's long range plans.
Krieger stated on Tuesday, February 13, 1996 there is a forum for the nursing home to help us
understand what we need to do, to see what the trend is going to be for nursing homes, etc. If
anyone is interested, let Krieger know so you will be registered. The dinner is at 5:00 p.m. to
6:00 p.m., and the forum is from 6:00 p.m. to 8:00 p.m.
The Board recessed from 9:20 a.m. to 9:25 a.m.
Program Report: Long Term Support - MA Waivers: Hall and Lockwood were present to give
an overview of MA waivers. Medicaid is a funded program to provide community services to
the elderly and the disabled persons being diverted or relocated from a nursing home or ICF-
MR. Hall stated MA waivers come to us as a certain amount and cannot be put in the general
fund. Each case must have a plan and that plan needs to be approved by the State. The nursing
home is used a lot for people who want to go home but are not able to for whatever reason.
Another Medicaid Waiver - MA Waiver IA - Northern Center, is for persons moved from their
state institution, some of the money follows them. As of January 1, 1996, if the person could
benefit from community care, we are mandated to move them or pay 100 % of their care at
Northern Center. MA Waiver 113 - is to move people with mental retardation who live in local
nursing homes into the community. CSLA (Community Supported Living Arrangement) - This
was a pilot grant from the federal government, the federal government did not renew so this was
moved under CIP-113. Lockwood stated MA Waiver CIP2/COP-W is for the elderly and
physically disabled and has grown the most. Wisconsin has the highest number of nursing home
beds and also has the strong tradition for providing medical care for persons. There is continued
emphasis on non -medical care. This has prompted the community care movement. There are
now more people in the community needing intermediate care. The nursing homes are for those
who need 24 hours care/supervision. COP is state funded and has not see much growth over
the past years. The MA Personal Care Program has grown. The average cost in the waiver
programs is $20.00 less per day than in nursing homes.
Burke thanked Hall and Lockwood for their presentation.
Personnel Issues: Patty Belisle has replaced Marlene Barlow (retired 1/1/96) at the main
reception desk effective 1/2/96. Patty will work from 10:45 a.m. to 7:15 p.m. Kari Henry will
cover the front desk from 7:30 a.m. to 10:45 a.m.
H.
Hall stated Long Term Support Unit has two persons sharing a case manager position since the
fall of 1992. Co-workers, providers and clients were polled to evaluate how the job -sharing was
working. Hall states this is a successful job share and is working real well.
Wisconsin Medical (MA) recently added "target" populations, retroactive action to 7/29/95.
These expanded populations, include: a) Persons diagnosed with HIV infection; b) Families with
child at risk; c) Birth to three; d) Children with asthma; and, e) Tuberculosis.
Borup stated we are interested in pursuing these monies as it would be a new source of revenue
for us. Program participation requires full County Board approval. While some of these
"target" populations may not provide much revenue, we would prefer being "certified" for all
at once, so we do not have to request the process in the future. Discussion followed.
MOTION: A motion was introduced by Stephens, seconded by Bailey, and unanimously
adopted: That the Health and Human Services Board approve pursuing certification under MA
"target" populations grant.
Communicable Disease - Tuberculosis Update: McClelland, TB Specialist, stated tuberculosis
has increased nationwide from 1985 to 1992. Factors that have been associated with the increase
include HIV/AIDS epidemic, immigration of persons from countries where the incidence rates
are 10-30 times higher than in the U.S., Transmission among persons residing in congregate
settings such as nursing homes, prisons, and homeless shelters, and declines in resources for TB
control. Statistics of TB in St. Croix County remain low but we must remain diligent in our
surveillance and prevention and control efforts. McClelland stated she is following 5 cases at
the present time and they were referrals from physicians. There is medications for infected TB.
McClelland has monthly visits to make sure persons are taking their medications and are having
no side effects.
Nelson announced there is a Legislative breakfast - no cost - on Monday, January 15, 1996 at
9:00 a.m in the nursing home conference room. Everyone is invited.
Krizek stated there is a meeting on January 17th, 1996 regarding arbitration with the Union.
Stephens left the meeting at 10:25 a.m.
Chair Burke asked if there were any other issues to bring before the Board.
MOTION: A motion was introduced by Bailey, seconded by Dowd, and unanimously adopted:
That the Health and Human Services Board meeting be adjourned.
Time: 10:28 a.m. Chairman:
Attest:
Secretary
W