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HomeMy WebLinkAboutHealth & Human Services 06-18-08 Roger Larson will review vouchers. NOTICE OF MEETING AND AGENDA ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD June 18, 2008 at 3: 30 PM (PLEASE NOTE TIME CHANGE) (Board Room, St. Croix County DHHS Building, New Richmond WI) CALL TO ORDER ROLL CALL REVIEW OF AGENDA CONSENT AGENDA APPROVAL OF MINUTES OF PREVIOUS MEETING - 05/28/08 DATE OF NEXT MEETING – 07/16/08 OLD AND NEW BUSINESS 1. Consideration of Claims and Vouchers 2. Financial Report a. Monthly financial report for Nursing Home and Health and Human Services b. aged receivable report 3. 2009 Capital outlay plan for HHS and Nursing Home 4. Review Department mission statements and business responsibilities. 5. Nursing Home Administrator's Report 6. Personnel Issues a. New employees /vacancies b. LEAP Project Report (Linking Education and Practice for Excellence in Public Health Nursing) 7. ADRC (Aging and Disability Resource Center) Implementation Planning 8. County census growth 9. Review of County Board goal setting on 04/21/08 10. Preparedness planning report for Health and Human Services 11. Tobacco -free parks —report on meeting with Land and Water Conservation Committee ADJOURN (Items may be taken in different order) ** Additions /Changes /Corrections Items for County Board approval must be submitted to the County Clerk's office by Wednesday morning preceding a County Board meeting. 6/2/2008 12:36 PM ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD June 18, 2008 The St. Croix County Health and Human Services Board met on June 18, 2008 at the St. Croix County Health and Human Services /Health Center complex. MEMBERS PRESENT: Esther Wentz, Chair Leon Berenschot Charles Grant Roger Larson Linda Luckey Gerald Peterson Deb Rasmussen MEMBERS ABSENT: Richard Marzolf STAFF PRESENT: Fred Johnson, Health and Human Services Director Ron Kiesler, Behavioral Health Coordinator Harold Morris, Contracted Nursing Home Administrator Mary Squyer, Economic Support Supervisor Ron Lockwood, Long Term Support Coordinator Steve Kirt, Behavioral Health Clinical Services Supervisor Fay Strenke, Accounts Receivable Supervisor Wendy Kramer, Public Health Supervisor Geralyn Karl, St. Croix County Health Educator and Tobacco Control Specialist Brad Beckman, ADRC Manager OTHERS PRESENT: Chuck Whiting, Administrative Coordinator Art Tobin, Building Services Director Roger Rebholz, County Board Chair Dave Ostness, County Board member Chair Wentz called the meeting to order at 3:30 PM noting the meeting was properly and legally publicized. Wentz stated that Dr. Glenn Hoberg is no longer a member of this committee and another replacement will have to be found. Wentz said if anybody knew of a physician that was willing to be a member of the committee to notify her. NEXT MEETING The next Health and Human Services Board meeting is scheduled for Wednesday, July 16, 2008 at 8:30 AM. Rasmussen will review vouchers. AGENDA Motion A motion was introduced by Berenschot, seconded by Rasmussen, and unanimously adopted: That the agenda be approved as distributed. MINUTES Motion A motion was introduced by Larson, seconded by Rasmussen, and unanimously adopted: That the minutes of the 05/28/08 Health and Human Services Board meeting be approved with the following changes requested by Luckey: Page 6, paragraph 3, second sentence should read as follows: Johnson reported Pathways is more expensive than hiring County employees; however, he recommends this agreement continue to maintain continuity of services until the County makes a firm decision regarding the Nursing Home's long range plan. St. Croix County Health and Human Services Board • Page 2 June 18, 2008 Page 6, paragraph 4, third sentence should read as follows: He said he has not applied to make the change as he would like the change to happen all at one time. Page 7, number 4 should read as follows: Information from a titled Elder Care Expo that recently took place in Minnesota was reviewed. it cited increases in Minnesota's 65 and older population. Page 7, number 6 should read as follows: Census Bureau says St. Croix County is the 95 1h fastest growing county in the nation. Page 10, paragraph 1, line 16 should read as follows: Kiesler attributed the lower number of inpatient hospitalizations in part to mobile crisis services. CONSIDERATION OF CLAIMS Health and Human Services Board member Larson reviewed the vouchers. Motion A motion was introduced by Larson, seconded by Berenschot, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book: Human Services vouchers 126583 through 126585, dated May 22, 2008, in the amount of $17,986.71. Human Services vouchers 127166 through 127210, dated June 05, 2008, in the amount of $58,810.16. Human Services voucher 127543, dated June 05, 2008, in the amount of $310.71. Human Services and Nursing Home vouchers 126437 through 126582, dated May 22, 2008 in the amount of $325,922.23. Human Services, Nursing Home, and Farm vouchers 126710 through 126792, dated May 29, 2008 in the amount of $301,012.54. Human Services and Nursing Home vouchers 126793 through 126815, dated May 29, 2008 in the amount of $45,045.86. Human Services and Nursing Home vouchers 126817 through 126956, dated June 05, 2008 in the amount of $341,832.60. Human Services and Nursing Home vouchers 127667 through 127776, dated June 11, 2008 in the amount of $56,105.70. Human Services and Nursing Home vouchers 127544 through 127666, dated June 11, 2008 in the amount of $52,846.92. Human Services and Nursing Home vouchers 127786 through 127895, dated June 11, 2008 in the amount of $321,313.89. Nursing Home vouchers 127777 through 127784, dated June 11, 2008 in the amount of $9,625.25. Human Services, Workshop, Public Health, Social Services vouchers 324 through 343, dated May 29, 2008 in the amount of $333,661.28. Human Services, Workshop, Public Health, Social Services vouchers 344 through 374, dated June 12, 2008 in the amount of $391,451.24. St. Croix County Health and Human Services Board Page 3 June 18, 2008 Human Services and Nursing Home vouchers 308 through 327, dated May 29, 2007 in the amount of $135,035.93. Human Services and Nursing Home vouchers 328 through 357, dated June 12, 2008 in the amount of $165,892.86. Workshop vouchers 62 through 67, dated May 29, 2008 in the amount of $11,401.48. Workshop vouchers 68 through 73, dated June 12, 2008 in the amount of $10,031.53. FINANCIAL REPORT The following financial report for Nursing Home through April, 2008 was distributed. Johnson stated at the end of April the Nursing Home was negative $205,000 in terms of client revenue, however, no carryover revenue has been applied. St. Croix County Health and Human Services Board Page June 18, 2008 St. Croix Health Center Alf r i 12008 Budget Actual Difference Percentag Census 0 Operating Revenue: Medicare $842,975.00 $304,138.83 $538,836.17 36.08% Medicaid $2,431,627.00 $842,157.64 $1,589,469.36 34.63 %°' Private Pay $760,413.00 $252,840.00 $507,573.00 33.25% All Other Sources $217,774.00 $75,048.19 $142,725.61 34.46 %° Total Operating Revenue $4,252,789.00 $1,474,184.66 $2,778,604.33 34.66% Operating Expenses Daily Patient Services $3,081,764.76 $1,104,532.30 $1,977,232.46 35.64% Special Services $284,516.00 $89,155.40 $195,360.60 31.34% General Services $1,167,643.63 $353,584.29 $814,059.34 30.28% Administrative Services $547,561.00 $226,580.59 $320,980.41 41.38% Unassigned: Depreciation (% Based) $0.00 Others: $294,394.00 $90,028.19 $204,365.81 30.58% Utilities _ $55,024.47 Workers Comp, Computer Tech $12,072.72 Insurance $22,931.00 Total Operating Expenses $5,375,879.39 $1,863.880.77 $3,511,908.62 34.67% Net From Operations ($389,696.11 (Cost of doing business prior to applying levy & outstanding rev) Outstanding Revenues Outstanding Rate Appeal rev $12,000.00 $0.00 $12,000.00 0.00 %' Revenue - IGT Funds $318,000.00 $98,000.00 % of Outstanding IGT Rev $0.00 $0.00 ' #DIV/01 Co Allocations (% Based) $259,859.39 $86,620.00 $173,239.39 33.33% Nursing Home Carry Over $533.231.00 $0.00 Total Outstanding $1,123,090.39 $184,620.00 $1$5,239.39 Net from all Sources $205,076.11 The following financial report for Health and Human Services through April, 2008 was distributed. On the Health & Human Services summary the excess revenue over expenses for April is $313,051.83. There are some missing revenue and expenses due to late entries because of the audit. St. Croix County Health and Human Services Board Page�5 June 18, 2008 HEALTH AND HUMAN SERVICES - 2008 SUMMARY Total OF REVENUES Budget April 30, 2008 Balance Administration 1,117,400.00 (26,921._29) 1,144,321.29 -2.4% AODA Services 772,986.95 267,589.68 505,397.27 34.6% Long Term Support 17,681,645. 7,681,645.51 5,479,577.42 12,202,068.09 31.0i Mental Health 3,303,479.98 1,141,154.08 2,162,325.90 34.5% Family & Children's 3,037,821.28 1,058,430.35 1,979,390.93 34.8 %' Public Health 1,678,621.37 539,531.72 1,139,089.65 32.1 Economic Support 1,227,133.10 301,207.82 925,925.28 24.5% General Relief 15,000.00 5,000.00 10,000.00 33.3% Coordinated Services/SED 2,500,931.96 768,07622 1,732,855.74 30.7% REVENUES HUMAN SERVICES PROGRAMS 31,335,020.15 9,533,646.00 21,801,374.15 30.4 %' SUMMARY Total OF EXPENDITURES Budget April 30, 2008 Balance o Administration 1,117,400.00 339,401.26 777,998.74 30.4% Alcohol -Drug Abuse 772,986.95 257,395.75 515,591.20 33.3% Long Term Support 17,681,645.51 5,396,441.74 12,285,203.77 30.5% Mental Health 3,303,479.98 970,476.88 2,333,003.10 29.4% Family & Children's 3,037,821.28 888,355.33 2,149,465.95 29.21 Public Health 1,678,621.37 572,289.65 1,106,331.72 34.1% Economic Support 1,227,133.10 374,010.97 853,122.13 30.5% General Relief 15,000.00. 2,027.19 12,972.81 13.5 %' Coordinated Service/SED 2,500,931.96 420,195.40 2,080,736.56 16.8% EXPENDITURES HUMAN SERVICES PROGRAMS 31,335,020.15 9,220,594.17 22,114,425.98 29.4 Excess Rev over Expenses S 313.051.83 Percentage of Budget: 33.32% AGED RECEIVABLE REPORT: Strenke stated that overall the aged receivable is up $63,000. Part of that is the timing of the report. This report includes charges through the date on the report and any payments that are receipted as of the day the report is printed. The report was printed a little early in the month due to vacations which had a slight impact as well. Self -pay payments are a little bit slower. Blue Cross Blue Shield switched to a new processing system so they are behind in payments. They are catching up and payments have been received from them this week. The last two months of Medicare have been submitted and payment should be coming in shortly. Strenke stated the rest of the 2005 insurance balances that were approved to be adjusted off should be done by the end of next month so they should not be on the next aging report. Strenke stated they are working on mail returns and will be talking with the Clerk of Courts to get more details on the internet websites they utilize. Strenke will contact them to get more details on effectiveness and costs for services. Strenke stated we get hundreds of mail returned each month. Strenke has a batch of claims that she will be sending to the collection agency within the next week. Strenke said they recently went to ECHO training. Strenke stated there are new features that they have become aware of that have not been utilized. One of those features is the ability to scan in documents so we can scan in copies of insurance cards. Strenke stated they are still getting a St. Croix County Health and Human Services Board Page 6 June 18, 2008 number of errors but they have an update coming out at the end of the month that they are hoping will fix some of the problems. The other issue is historical aging reports. They are working to rewrite that report for us and this report will then be forwarded to the auditors. Wentz expressed thanks for all the hard work Strenke has done to get all the accounts up to date. Johnson stated last year we sent three staff to a national ECHO conference. The conference will be coming up in September and he stated it may be a good idea to send staff again. Johnson will update the Board when the agenda for the conference is published. PREPAREDNESS PLANNING REPORT FOR HEALTH AND HUMAN SERVICES: Johnson stated we have routine reviews of our emergency preparedness plans for Health and Human Services and updates have been completed annually. Kiesler stated they will be addressing Annex E, F and H. Annex E & F will be combined to a new ESF6 (Emergency Support Functions). Kiesler stated this will need coordination with a number of entities for sheltering of individuals in an emergency. Johnson has requested Jack Colvard, Director of Emergency Management, to participate in the discussion on the annex plans. Johnson felt there needed to be more dialogue on the content of the annex as Health and Human Services completes the annual updates and Jack Colvard has participated in these discussions. Johnson stated the annex plans are too broad and too vague and can be interpreted differently by different people. Johnson stated they are looking to move from generic to specific plans. Kiesler stated that Human Services would most likely not be the incident commander in a disaster situation, but would become a strike team or task force to support other entities in a focused way after a disaster. Karl stated they are also working to clarify what Public Health will do in a large scale disaster. Public Health received funding from the State to do Public Health preparedness planning. This year they focused on the Mass Clinic Plans and the Pandemic Influenza Plans. These are two of the plans that are part of the Public Health Emergency Plan. The State gave an assessment of those plans and we passed with flying colors. Karl stated they designated a few sites in St. Croix County as mass clinic sites. Karl stated we have memorandums of understanding with those sites and there are flow charts and security plans to show how to move people in and out of a mass clinic during a pandemic. Law enforcement officers have helped to determine how much staff would be needed to deal with security. Karl stated the Isolation and Quarantine policy has been updated. A closer look was needed as to how we would get orders for Isolation and Quarantine enforced if there was a disaster. Karl said there is a copy in the Public Health conference room for any board members that are interested. Karl stated there was an unannounced drill last week dealing with a potential novel influenza virus. The evaluators showed up on June 10 and started with suspicious activity in Nigeria. Karl said they were tested on their ability to communicate with partners that needed to know. These partners needed to be contacted and they needed to call us back within 60 minutes. Karl stated 22 of the 24 partners did respond with a 91% success rate. Karl stated they had to give a request to Corporation Counsel to respond to the needs for isolation and quarantine orders. Corporation Counsel had to initial the documents and sent them back to Public Health within a required time, which they did. They also discussed communication and satellite phones. A block of phone lines may be needed in Public Health for all the calls coming in during a disaster. Karl is working on the after action report at this time. Johnson wanted the Board to know the updated information and he signed the updated documents for Health and Human Services. Wentz stated it would be a good idea for the Board to sign the plan next year. St. Croix County Health and Human Services Board Page June 18, 2008 LEAP PROJECT REPORT (LINKING EDUCATION AND PRACTICE FOR EXCELLENCE IN PUBLIC HEALTH NURSING) : Johnson expressed concern about Public Health being in the forefront of nursing education programs, particularly with the demand for nurses and our current Nurse Practioner vacancy. Kramer stated the LEAP Project is a three year statewide collaborative. Kramer provided overview of the LEAP (Linking Education and Practice for Excellence in Public Health Nursing Project). Kramer stated the purpose of LEAP is to improve competency for public health nursing practice in a changing public health system by educating public health nurses, student nurses, and nursing faculty in the knowledge and skills required for providing population -based culturally competent public health nursing services. Kramer stated the project is expected to have direct impact on nursing in local, state, and tribal public health departments, and on nursing students and faculty in nursing education programs in all areas of the State. Kramer stated with the nursing shortage, we need more people interested in public health nursing. She stated there are scholarships available through various sources. Kramer stated St. Croix County has updated the link on our website so we could link with the DHFS website. We have also developed a demographic profile of LHD (Local Health Department) by looking at public health services in the different counties. An acronym list of public health terminology was developed and is now on the LEAP website. NURSING HOME ADMINISTRATOR'S REPORT Morris stated the nursing home has changed oxygen suppliers. They also have a new podiatry service and the new contract will begin in July. Morris stated the nursing home census is 70. There are 11 patients on Medicare. On June 15 the census was 64 so it has gone up quickly. Morris stated the computer system for charting notes will be updated within the next month. Morris stated with the lockdown and security discussions that have occurred he would like to set specific visiting hours from 7:00 AM to 8:00 PM. If there is a major health crisis with a patient, the families are still able to visit at any time. Morris also stated there is a registered nurse on call 24/7. He said there is one employee doing most of the on -call now and she can't do it all the time because she needs time off too. Johnson stated he will make this an item in the 2009 budget and it should be handled the same as individuals in other departments who are available 24/7. A supervising nurse is on call on weekends and at night. Rasmussen stated it would be nice to make it a shared responsibility instead of having only one person to take the responsibility. Morris stated he would like to do some advertising and will come up with more solid options next month. ADRC (AGING AND DISABILITY RESOURCE CENTER) IMPLEMENTATION PLANNING: Lockwood, Long Term Support Coordinator; Beckman, ADRC Manager and Squyer, Economic Support Supervisor discussed the current work being done on implementation planning. Lockwood stated the transition plan is to move 50 waiver cases each month over to the managed care program or the self directed support program. If a client chooses the managed care program, they have the option to change to the self - directed support program at any time. The transition start date is September 1, 2008. At the end of August, an estimated 304 waiver cases will need to be transitioned to the managed care program. The Long Term Support staff will take control of transitioning the waiver clients now and the clients on the wait list will be handled by ADRC. The objective is to keep people in their own home and to be able to make their own choices. Beckman stated that Economic Support will play a key role in transitioning clients to assure continued medical assistance eligibility. Johnson stated we are very fortunate St. Croix County Health and Human Services Board Page June 18, 2008 to have Lockwood, Beckman and Squyer as they are all very experienced staff and will be very capable in handling consumer needs during the transition. Beckman said the State will be converting the current community waiver cases for Economic Support and that Economic Support would be taking all new applications for the people that are currently on the wait list. Squyer said there have been problems with the centralized conversion in other Counties which has required additional Economic Support staff time at the County level. It is expected that new positions will be necessary in Economic Support due in part to extra work processing applications from the waiting list. Beckman stated there have been four employees hired at this time. Three have been hired for the Information and Assistance positions and one person has been hired for the Disability Benefit Specialist. The Board will be updated on these Positions next month because not all of the employees have been notified. REVIEW DEPARTMENT MISSION STATEMENTS AND BUSINESS RESPONSIBILITIES: Johnson stated all departments have reviewed and will be modified with very minor changes. 2009 CAPITAL OUTLAY PLAN FOR HEALTH AND HUMAN SERVICES AND NURSING HOME: Johnson reviewed the capital outlay plans for DHHS and the Nursing Home. Johnson provided a narrative about the capital items and the actual items that are included in the capital outlay. This is a five year plan. The Human Services capital outlay plan includes two automobiles, vans and computer software for 2009. St. Croix Industries has a cost of $55,000 to keep the fleet of vans updated. The Nursing Home has equipment costs that should not be delayed any longer. These do not include plans from building services at this time. Tobin stated he received a list from Human Services and the Nursing Home on requested items and will work these into the five year plan. Tobin will be reporting back to Johnson and the Board as soon as he gets them done. Tobin stated there are two vehicles that will need to be replaced. Tobin also stated we got hit pretty heavy with the recent hail storm. Many of the buildings have substantial damage. Kristin Ziliak is working with the insurance company to get one deductible of $15,000 instead of having a deductible for each of the buildings. Johnson stated the Finance Committee did see the photos which highlight the foundation issues in the building and the Finance Committee felt it was not worth $250,000 to start major repairs. Tobin stated we will be fixing what needs to be fixed until a decision is made for the long term. Wentz asked if we would be able to utilize the CIP camp for help with the repairs. Tobin stated they will be able to utilize the CIP camp but they are busy and are backlogged 30 days. REVIEW OF COUNTY BOARD GOAL SETTING ON 04/21/08: Kirt stated they will be working with Marilyn Pash who has worked with the County Board Supervisors to develop the County strategic plan. There will be a review of internal planning to coordinate HHS strategic initiative with the County. Wentz asked if there were any other issues to bring before the Board. Wentz adjourned the meeting. Time: 5:37 PM Chair: Attest: (Secretary) 's NOTICE OF MEETING AND AGENDA ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD June 18, 2008 at 6:00 PM (Head Start area, St. Croix County DHHS Building, New Richmond WI) CALL TO ORDER ROLL CALL OLD AND NEW BUSINESS 1. Open Hearing- Review letters and take public testimony regarding the 2009 Health and Human Services budget process ADJOURN (Items may be taken in different order) ** Additions /Changes /Corrections Items for County Board approval must be submitted to the County Clerk's office by Wednesday morning preceding a County Board meeting. 6/2/2008 12:40 PM ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD AND COUNCIL ON AGING AND DISABILITIES PUBLIC HEARING June 18, 2008 The St. Croix County Health and Human Services Board conducted an "Open Hearing" on June 18, 2008, at the St. Croix County Health and Human Services /Health Center complex. MEMBERS PRESENT: Esther Wentz, Chair, HHS and Council on Aging and Disabilities Leon Berenschot, Vice Chair, HHS Deb Rasmussen, Secretary, HHS Charles Grant, HHS Roger Larson, HHS Linda Luckey, HHS Gerald Peterson, HHS and Council on Aging and Disabilities Lois Burri, Council on Aging and Disabilities Alfred Schrank, Council on Aging and Disabilities OTHERS PRESENT: See attachment Fred Johnson called the Open Hearing to order at 6:00 PM noting that the meeting was properly and legally publicized. Johnson welcomed everyone to the hearing. Johnson stated it is important that the people who came to provide testimony have an opportunity to do so as we begin preparing the 2009 budget for the Human Services and the Aging and Disability Resource Center. Johnson stated the County Board has moved towards programming that would incorporate Long Term Care Reform. Johnson stated as part of that process the County chose to have an Aging and Disability Resource Center. Johnson stated there will be a Council that governs the Aging and Disability Resource Center and that Council will report directly to the County Board. The Aging and Disability Resource Center will be part of Health & Human Services. Johnson stated we have representatives from both the Health & Human Services Board, the Council on Aging and the Aging and Disability Resource Center at the open hearing tonight to hear public testimony. Johnson asked Board members to introduce themselves and the district they represent. Members that were present (noted above) introduced themselves. Johnson stated there were people attending who would like to give testimony and invited all those who wished to speak to do so. Johnson stated there were letters that would be read from those who could not attend or did not wish to speak. See attachments in minute book. Johnson stated that Steve Kirt, Behavioral Health Clinical Services Supervisor, would speak about some of the work HHS has done with Strategic Planning over the last year. Kirt stated that in 2006 a consultant was hired to work with HHS Committee and staff to develop a strategic plan. Strategic Planning had not been done for a number of years and management felt it was important to do it now in the face of new initiatives from the State and Federal government, declining State and Federal dollars and increasing mandates. The first step was to do a Strengths, Weaknesses, Opportunities and Threats analysis with the HHS committee members and the staff. The information from that analysis was given to a 16 member committee to synthesize into strategies with a timeline for dealing with those strategies. With that accomplished, Kirt stated an oversight committee was formed with representation from the HHS committee and all the departments. The strategies for 2007 -2008 were to lower accounts receivables and develop an in -time reporting system between HHS finance and managers; volunteerism; uniform staff St'. Croix County Health and Human Services Board Page 2 June 18, 2008 and manager performance appraisals; and conflict resolution. A committee was also formed to organize events for the dissemination of information from management to staff. Kirt reported that all of the committees have made substantial progress and gave some examples of the progress. With that said, Kirt reported that the process was incomplete due to the lack of feedback from the outside. Therefore, in the fall of 2007, a contract was developed with U.W.River Falls Survey research Center to survey community partners, as well as, state and federal partners. From the information gleaned it was apparent that HHS is seen as providing quality services, having competent staff, and ranked highly as compared to other counties around the State. The survey also indicated a need to look to provide more services to adolescents and children, reduce waiting lists, and educate the public on the referral process. These needs will be incorporated in future strategic planning initiatives. Each Department within HHS is also either in the process of developing a strategic plan or about to start and will benefit from that information. Finally, Marilyn Pash has agreed to work with HHS to both fit their strategic planning process within the County Board process and to refine the future steps to allow for maximum efficiency and progress. Patty Draxler, Executive Director, Family Resource Center St. Croix Valley, thanked Fred for the chance to speak. Mary Sue Ash, Founder and Vice President of the Center, was also present. The Family Resource Center works in direct partnership with the Department of Health & Human Services and other organizations to maintain the system of support. Brochures were passed out giving an overview of the services provided by the Center. Draxler and the Family Resource Center Board of Directors are respectfully requesting financial assistance in serving the families referred to the Center through the Health & Human Services. Draxler stated the Center provides a great service to an increasing number of at -risk families. Draxler stated she looks forward to continuing our work together for children and families from St. Croix County. Ron Lockwood, Long -Term Support Supervisor, read a letter from a client that has used the Nursing Home Relocation Program and was concerned about the continuation of the Long Term Support Services. Without the help of the Nursing Home Relocation Program she would have to return to a nursing home. Lockwood also read a letter from a family with a developmentally disabled son concerned with the long wait list for services. Johnson stated that concerns about the wait list were heard by the County Board who ultimately took action to approve moving ahead with Long Term Care Reform and with the Aging and Disability Resource Center. Transitioning for those programs will begin September 1 Johnson stated that comments from this forum and other forums such as this do make a difference. Wendy Kramer, Public Health Supervisor, read a letter from a nurse at Westfield's Hospital showing concern about the increasing need for our services due to the poor economy. Kim Dupre, IT Specialist, thanked the Health and Human Services Board for the motion approved to build a new nursing home and assisted living facility. Dupre thanked the Board for their wisdom in looking at the long term picture instead of the short term issues. Dupre stated she is advocating for a new 72 -bed nursing home. Dupre stated we need to keep these services intact so that we can provide them to the community. Dupre stated her personal opinion is that the public has been very vocal about how they feel about the nursing home and that a public referendum is not needed. She felt that there is no need to delay the decision any longer. Loyla Waskul, CNA— Nursing Home, gave testimony with concerns about the nursing home. She stated she has been employed by the County since 1983 and she would like to see County ownership resolved before she becomes a resident of where she works. She wonders when the limbo will end. She stated she has heard a lot about the studies that have been done and she feels that some of the studies that have been done have been a waste of the taxpayers' money. She stated she is one of those taxpayers. She attended a referendum ad hoc meeting on June 4th where she heard discussions about bottom line and costs. She stated that people who need help should never be bottom line throwaways. She felt the services provided here are needed but there is some waste and that we could do better. She also stated we should not contract out for services or studies. We should use our employees for that. She stated that residents, families of residents and employees and their families have been living in limbo for over a year. At the last May 28 Health & Human Services meeting a motion was made to present to the full County board to build a new nursing home, number of beds to be determined and an assisted living complex. She suggested making a decision and stop leaving the residents and their families living in limbo. Norma Vrieze, Early Intervention Director, read letters from two families that have used the Birth to Three programs. These programs have helped them immensely. They wanted to assure that these programs be available in the future for families that needed it. Kathy Dunlap, Family & Children's Coordinator, read two letters from families concerning the Youth Community Support Services program. One family has a child with autism, epilepsy and other delays. The letter was concerning the limited services available, particularly special needs day care. There was also concern about the lifetime limit of 35 hours for therapy. The family stated that more help for autism services would be great. Harold Morris, Nursing Home Administrator, read a letter from a husband whose wife has Alzheimer and dementia and has been a resident of the nursing home since 2007. He stated the nursing home has an outstanding staff and take wonderful care of the residents. He felt the County can not afford to close the nursing home. Ninette Nolen, a resident of St. Croix County, spoke about the services she has received in the Community Support Program. The services have been most helpful to her. She feels we need more prevention and education programs to help in preventing people from needing our services. Brad Beckman, Aging and Disability Resource Manger, read a letter stating how difficult it is to find transportation for the disabled. Ron Kiesler, Behavioral Health Coordinator, read a letter from a family stating they would like more information on the Youth Community Support Services. Mary Hofland, Family and Children's Social Worker, spoke on behalf of Project Lifesaver. She stated Project Lifesaver provides equipment to counties for clients with special needs. There is currently fundraising being done to purchase the tracking equipment. A family member would get a bracelet and if the family member is lost, then law enforcement is contacted to track the family member. Statistics show that the equipment has been 100% successful and the family member is found within an hour. Johnson wanted the individuals who gave testimony to know that the information they are presenting is received and addressed. Johnson thanked Board members, staff and the community for attending. Johnson stated the information given tonight will be reviewed and we will do the best we can to serve the needs of the community. Johnson stated the information will be forwarded to the Regional Office. Johnson thanked everyone for coming tonight. Hearing adjourned at 7:20 PM. Chairman: Attest: Secretary