HomeMy WebLinkAboutHealth & Human Services 05-28-08 Wentz will review vouchers.
Revised: 05/14/08
NOTICE OF MEETING AND AGENDA
ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD
May 28, 2008 at 8:30 (Please note date 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 - 04/16/08
DATE OF NEXT MEETING — 06/18/08
OLD AND NEW BUSINESS
1. Election of Officers
2. Consideration of Claims and Vouchers
3. Financial Report
a. Monthly financial report for Nursing Home and Health and Human Services
b. aged receivable report
4. 2009 budget planning/timeline for DHHS and Nursing Home
5. 2009 capital outlay plan for HHS and Nursing Home
6. 2007 Annual Report
7. Nursing Home Administrator's Report
8. Review of estimated project cost for Nursing Home building/remodeling
9. Personnel Issues
a. New employees /vacancies
b. Filling Public Health Nurse Practitioner position- updated job description
10. ADRC (Aging and Disability Resource Center) Implementation Planning
11. County census growth
12. Review of County Board goal setting on 04/21/08.
13. Appointment to Birth to 3 Advisory/Family Support committee **
14. Mobile Crisis expansion of hours **
15. Health and Human Services consideration to make a recommendation to the County Board to
build a new nursing home and rescind the motion to do an advisory referendum in
November.
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.
5/14/2008 2:03 PM
ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD
May 28, 2008
The St. Croix County Health and Human Services Board met on May 28, 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
Richard Marzolf
Gerald Peterson
Deb Rasmussen
MEMBERS ABSENT: Dr. Glenn Hober �%
STAFF PRESENT: Fred Johnson, Health and Humaalervices �.,r
Dtor;
Kathy Dunlap, Family and Chi0 "fin's Coo A
Ron Kiesler, Behavioral Health C�rdinato
Harold Morris, Contractetk i±dursin me Adm
q iitlstrator
Mary Squyer, Economic ppoYt Supersor
Charlotte Sortedahl, Public Health Cod ' nator - Health
Officery"
Clark Schroeder,, rectorSt. Croix Industries
Norma Vrieze, Director, Biro, to Tiree Program
Kathy Huston r ," ',ACSS Cl' ical Coord nator
Ron Lockwoc LAg Term support Coordinator
Pat Haeny,ami1 y and Chair' s Supervisor
Malva Sek, `e�tary ,
yy m �
OTHERS PRESENT: Chuc kcl inistrative Coordinator
Art Token, %aciliti \ =Manager
11"er Rekaol` County Board Chair
Kim D "re, ormation Systems Analyst
s Mary Mazolfry,,j
L�yla Waskuly
% E "iris Rivard
+iormatz
Harvey L'e" son
rSa Hallquist
Delores Dahl
Jn Weinzierl
Joyce Hecht
Carol Votruba
Margery Yager
Karen Hornick
Chair Wentz called the meeting to order at 8:30 AM noting the meeting was
properly and legally publicized.
NEXT MEETING The next Health and Human Services Board meeting is scheduled
for Wednesday, June 18, 2008 at 3:30 PM. Larson will review vouchers.
AGENDA Motion A motion was introduced by Berenschot, seconded by Larson,
and unanimously adopted: That the agenda be approved as distributed.
St. Croix County Health and Human Services Board
-Page 2
May 28, 2008
MINUTES Motion A motion was introduced by Berenschot, seconded by Larson,
and unanimously adopted: That the minutes of the 04/16/08 Health and Human
Services Board meeting be approved as circulated.
ELECTION OF OFFICERS Wentz announced the election of officers would take
place. Wentz asked for nominations for the position of Chair. Berenschot
nominated Wentz for the Chair position, seconded by Rasmussen. Wentz called
for additional nominations three times. Nominations were closed. Wentz
requested a vote and a unanimous vote was cast for Wentz to be Chair.
Wentz asked for nominations for the position of Vice Chair. Wentz nominated
Berenschot for the position of Vice Chair, seconded by Peterson. Wentz called
for additional nominations three times. Nominations were c,�psed. Wentz
requested a vote and a unanimous vote was cast for Berenschot to be Vice
Chair.
Wentz asked for nominations for the position of Sec3�9t "r Luckey no, mated
Rasmussen for the position of Secretary. Wentz called fc1 add bona �
i
nominations three times. Nominations were close Wentz ej vote and
a unanimous vote was cast for Rasmussen to be`- ecitetary.`
ZIP �
CONSIDERATION OF CLAIMS Health and Hum t-- vices heard m
' e er Wentz
reviewed the vouchers.
y` a .;;. °,
Motion A motion was introduced by seconded,by Berenschot, and
unanimously adopted: That the fol �iaJ',ng vouchers b6 approved and be made a
part of the supplemental minute.
Human Services voucher 1240 dated Apri1%;7,,2008, in the amount of
$720.00. \
Human Services voucher/Ift243'85 though 124386, dated April 24, 2008, in the
amount of $23, 072.00. �� -
fx�
Human Services vot 12469 through 124910, dated May 08, 2008, in the
amount of $51,58027. °
O A"
Human Services ndursingome"vouchers 123906 through 124016, dated April
17, 2008 ,p the a 0uh % of $1%3 735.70.
yy ti
Human Seices anc�Nursing Home vouchers 124017 through 124046, dated April
17, „ 08 in the` %�mourib���f $13,020.70.
Human Sdrvices,�Nurng Home, and Farm vouchers 124387 through 124499, dated
April 24, 008 in the amount of $343,089.43.
Human Services and Nursing Home vouchers 124661 through 124773, dated May 01,
2008 in the amount of $130,655.19.
Human Services and Nursing Home vouchers 125056 through 125195, dated May 08,
2008 in the amount of $115,330.92.
Human Services and Nursing Home vouchers 124911 through 125055, dated May 08,
2008 in the amount of $307,156.02.
Human Services and Nursing Home vouchers 125686 through 125844, dated May 15,
2008 in the amount of $204,239.80.
St. Croix County Health and Human Services Board
-Page 3
May 28, 2008
Human Services and Nursing Home vouchers 125845 through 125879, dated May 15,
2008 in the amount of $14,451.95.
Nursing Home vouchers 125196 through 125211, dated May 08, 2008 in the amount
of $3,772.84.
Human Services, Workshop, Public Health, Social Services vouchers 235 through
263, dated April 17, 2008 in the amount of $396,473.89.
Human Services, Workshop, Public Health, Social Services vouchers 264 through
294, dated May 01, 2008 in the amount of $396,010.05.
Human Services, Workshop, Public Health, Social Services vchers 295 through
323, dated May 15, 2008 in the amount of $412,774.20. `\
Human Services and Nursing Home vouchers 219 through dat d�pril�7,
2007 in the amount of $162,293.57. �'
�.
ffA
Human Services and Nursing Home vouchers 249 t, ugh 278; d e Ma X 01, 2008
in the amount of $159,985.52."
Human Services and Nursing Home vouchers -7 - hrough "�07, dated May 15, 2008
in the amount of $157,939.59.
Workshop vouchers 44 through 49, dated Apr�L�,l 17, 2008 ifi" the amount of
$13,550.69."
Workshop ouchers 50 through �'
P g � .,, meted Ma, O1, 200$" in the amount of
$12,414.71.
Workshop vouchers 56 thrg 61; d May 2008 in the amount of
$11,568.24.
" _.
FINANCIAL REPORT The folibw�� financ' report for Nursing Home through
v v v �, g g
March, 2008 was�trted The Nursing Home budget is close to being on-
target through Match. N. ce' us has averaged in the mid -60's. Johnson
pointed out that c rryovermonia re typically not applied until year -end. The
Nursing Home la', $533,000 in carryover funds to apply to the 2008
budget fund wet- also moved to 2007 from 2008, by the auditors, so there
was a sa abib ' d u21ment . -9, r evenues between the February and March report.
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y
St. Croix County Health and Human Services Board
• Page 4
May 28, 2008
St. Croix Health Center
___
_ March 2008
Budget Actual Difference Percentage
r e..a,_. ,,,.,,,..c ............ ....... ...... ..... .. ..
ens f
us w...._.._. ..__ _.,...___.
� ,
. D
��
. .
1pprerating Revenue:_
Medicare
$642,975 $193 721 54 431 $1 .813, 0 75.28 $649 253 46 22 9B%
Medicaid _._ _ _.. _ .
$2, 627.013 $1 903.75 $564 09 25 25.76% '
Private Pay $760 413.00
All Other Sources
$217 774.130
$58.B33.86 $15B 27.02%
_._. _ _..
Total Operating Revenue .. $4,252,78940 m $1,067,010.87 $3,185,778.13 25.09%
_..,._.
_... .
_.
; Operating Expenses _.
Dada Patient Services ,$3,DB1 . 764.76 $788 $2 08 25.513%
Special Services $284 516 00 $63.426.00, $221 090.013 22 29%
_..
General Services _-..
_. $1,167 643.63 $265 641.66
$902,001.97 22.75
a7
Administrative Services $547 561.00__
Unassi ned
$188,967.78 $358,593.22 34.51 %'
...Depreciation (% Based
_..Others: _..._ _
$0 00
_
$294,394.00
..... . $75,674.46
$218,719.54 1 25.71%
Workers leers Comp a $49 175.32'
p mputer Tech
$3
Insurance _
_ _ 2 931 00 €
... .. $
Total Operating, Ex Expenses _
p $5,375,879.39
... $1,381,874 58 $3,994,004.81 25.71
- _._
Net From Operations ($314 863 71
(Cost of doing business prior to --
.
a I in lev & outstandm rev — �— — —_.. .
Pp Y Y _ . ..., _. ..__.
' Outstanding Revenues; � _ .___ ___._.. _._ _ ,
-
Outstanding Rate Appeal rev $12 000 DD 2 SO 00� $1 00
Revenue IGT Funds $316 ODO DO $D 00
% of Outstandirn IGT Rev $D OD $0.00 DOD %`
Co Allocations % Based
( -- ..
$259 $64 ,965.013 $194 ,894.39 25 DD % l
Nursing Home Carry, $533 _. .. .
Y _ _._._ _ _
$0 00
Total Outstanding _ ... ..._.._ $ 1 . 123,090 . 39 206,894.39
$64
00, $
.Net from all Sources
- $249,898.71;
The follower fnancial report for Health and Human Services through March,
2008 was distr Johnson said approximatel
2006 will be applied to the administration line of OO the ar Health and s Human
Services report at the end of the year. He said the Behavioral Health expenses
reflected are low for psychiatric time and hospitalization but will be reviewed
and will likely see an increase in expenses in future reports.
St. Croix County Health and Human Services Board
-Page 5
May 28, 2008
HEALTH AND HUMAN SERVICES 2008
SUMMARY
_ ... . _.. _ _.._..... _ . _...._ ...._.. _ _.
Total
OF REVENUES
Budget March 31, 2008
Administration 1 . 17 400 00
1j
1 37 6
AOdA Services _... _ _..
772 986 95 168 @66.42 604120. 53 21 8
L . ong Term Su crt 17 6 @1 645 51
4,434,18 ' 13,247,462.13 , 25.1
PFD.... .
Mental Health
3 303 479.98 737 460.83 2 566 019.15
Famil 22 3i
&Children's
_...... .. ,_..._.. 3 037 821 733 945.15
2, 3 03 87613 2
' Public Health 24
1,678 621.37 406 428.67 1 272192.70 24 2..,
1,227,133.10 _....._. 206,615.83 y 1,020,517.27 ; 16. 8r
'Genera , 0
Serv ices /SED_........__ 2 . 5 0
Coordinated 0,931.96 551,77259 949,159.37 00
49,159.3 22.1
REVENUES HUMAN
�. _.
SERVICES PROGRAMS 31.335,020.15 7,222,926.20 24,112,093.95 23.1
SUMMARY
Total
_...
OF EXPENDITURES 31
Budget March , 2008 Balance a`
Administration 1,117
249 225.24 868174 76 22.3%
Alcohol Drug Abuse 772 986 95 1 @6 741 70 _ 586 245 24 2
_._.
Lang Term Su ort _....
pP_ ._.. 17 681 645 51 _......... 4 054 395 66 _... 627 249 85 22.9
Mental Health 3 687 43@ 68 am 2 616 041 30 2D 8%'
Family & Child
_. ren's _... -_ _ 3 037 @21 28 _..... 644 08715 2,393 73413 21.2%
Public Health 1 678 621.37 40
575 58 1 276 045 79 24 0 % "`
Economic Supp 1 227133.10 263,416.30 963,716.80 ° °..._ 21.5'
taeneral Relief
15,000.00 766.98 14 233.02 51 °
Coordinated Service /SE[ ._ 2500931.96 309.372.73 2,191,559.23 12.4%'
'EXPENDITURES HUMAN
SERVICES PROGRAMS 31,335,020.15 6398,020.02 1 24,537.000.13 21.7
Excess Rev over Ex enses -
.. _ ___ ° # 424.906.18
. ...
_.
AGED RECEIVAB; §,EPORT \ hns6 . aid the numbers for 2005 -2006 are going down
slowly as a cbpnts are gq %L V/ cleaned up. He said Wipfli performed an
independe t,aud aril, revie,of the Accounts Receivable unit. The staff have
,�
worked o cazng�tped uceivables and aged accounts are being written off
as not 1 ``�`c4lectib1'e, reported the balance of the 2005 -2006 accounts should be
com14 ''kp th;nex.; - w months. He also reported that current statements are
going b out irk a t/4mely fashion for Medicare, Medicaid and insurance. Johnson
reported self pay up slightly and this area will be broken out in more
n�
detail ithe fture.
le
NEW MEMBERS �T*entz introduced the new members of the Board: Roger Larson,
Charles Grant, Buzz Marzolf, and Gerald Peterson. Wentz pointed out that Roger
Rebholz was also in attendance and is the new County Board Chair
2009 BUDGET PLANNING /TIMELINE FOR DHHS AND NURSING HOME: The time line for the
2009 budget was distributed. He said Tobin will join the meeting later to
outline some capital outlay building needs. Capital outlay plans will be
reviewed and approved at the June meeting.
NURSING HOME ADMINISTRATOR REPORT Johnson introduced Harold Morris, contracted
Nursing Home Administrator through Pathways, who has been in this position
since December, 2007. Morris reported the state survey was done recently with
no health care deficiency cites received for the Nursing Home. There were two
St. Croix County Health and Human Services Board
-Page 6
May 28, 2008
minor engineering cites regarding fire drills and building inspection. Morris
said there was a potential infection control issue with shelving in the Nursing
Home. This shelving has been replaced. Also, the garbage disposal and the ice
machine in the nursing home had to be replaced in the last month. Morris
reported a swing which can accommodate a wheelchair was purchased with donated
funds for the patio of the Nursing Home. He invited members to view the new
swing. Morris reviewed several of the special activities that were celebrated
during nursing home week and how Nursing Home staff were recognized.
The census in the Nursing Home is 64 today. Morris has been looking at
contracts for x -ray, oxygen services, and podiatry. He said the oxygen
services will change in July. He is investigating alternate podiatry services
due to quicker response time and x -ray services due to dew digital systems
being available.
Johnson said the Nursing Home Administrator and Di r ,r of Nu r'sing sitions
are being contracted through Pathways Health Services etVs Coun t`q e loyees.
Johnson reported Pathways is more expensive to hung` County employees;
however, recommends this agreement continue to .maintain Cori ntiy `bf services
until the County makes a firm decision regarding ie Nursi' Homes long range
plan.
Morris said steps are being explored to did some bed reallocation in the Nursing
Home. This reallocation would not chance the number �b beds available but
would create possibly twelve addit nal I xivate rpoms��� He said he has not
applied to make the change as woulc�'hi e thechange t happen all at one time.
o� „ may
The 2007 summary of Cons �nfor on Report for Nursing Homes was
distributed to the Board. is report will be made available to all Nursing
Home residents, families an 'hew admissions Fa hin the next month. This report
is issued yearly.
REVIEW OF ESTIMATED PROJECT COS R NURSING HOME BUILDING /REMODELING:
Johnson reviewed peviousYsued co r' estimates to remodel the Nursing Home
or build new. He rerre to the following from the March 18, 2007 County
y
Board meeting:
Motion by Supr sleh9, 2 1* Supr. King to keep the Nursing Home operating as a
county ent anc� pu,��this o an advisory referendum for November 4, 2008, and
in the heantiml, get Yf eA information regarding
and and remodeling
and appoint a -perso ad hoc committee to draft exact words of the referendum.
y,
Johns created a summary document with current information. The document
include,, cost `� tim3tes received from Derrick Construction. This is not a firm
bid but s guess' based on a walk through of the building. Johnson
indicated ebst timates from other vendors were significantly higher than the
estimates receied from Derrick. Johnson indicated not all cost estimates were
in for miscellaneous costs, i.e. building assessment, etc.
The document included three remodeling options: The first scenario is for a 50-
bed Nursing Home utilizing both floors of the Nursing Home. The second
scenario is for a 50 -bed Nursing Home on first floor and 20 -bed CBRF (assisted
living) on second floor. The third scenario is for a 44 -bed Nursing Home on
first floor and 20 -bed CBRF on second floor. The new construction rough
estimates were drawn up by Larry Lester. The figures used were based on Ayres
and Associates estimated cost to build per bed. Johnson again said these are
not firm bids for either remodeling or building new, but rather a consolidation
of anticipated cost. These anticipated costs were reviewed with a Derrick
Construction representative and Building Services Director, Art Tobin, to
St. Croix County Health and Human Services Board
,Page 7
May 28, 2008
verify total anticipated expenses. Johnson said he has gone as far as he can
with getting cost estimates without the county paying someone for services. He
said the estimates received vary significantly. The Ad Hoc committee has been
appointed and Johnson has provided referendum questions posed for Jackson and
Calumet Counties. Johnson will forward the cost estimates to the County Board
Chair.
2009 CAPITAL OUTLAY PLAN FOR HHS AND NURSING HOME: Johnson indicated capital
outlay planning has begun and feedback from various departments has been
received. Final requests will be ready for the June Board meeting. Art Tobin
gave a brief summary of the status of capital outlay needs. He said
centralized oxygen for the Nursing Home would be a labor seer compared to the
current process. He said the HVAC is operating well wither '
uidelines. Tobin
reported the elevator will need capital improvement of a valve repYa -ement in
the next two years.
The Board recessed from 9:40 to 9:45.
Off-
y
HEALTH AND HUMAN SERVICES CONSIDERATION TO Ni��KA��
x �tECOMMEI , TION,TO THE COUNTY
BOARD TO BUILD A NEW NURSING HOME AND RES,IND THE MOTION'.TQ DO AN ADVISORY
REFERENDUM IN NOVEMBER Marzolf presented douts o the ` ealth and Human
Services Board that outline Ten Talking P ints: A ratianale� for building a new
county -owned and county- operated nurs } Summary ng Yome. Su o /9 0those ten
as follows: y p oints are
1. Because of the age of the bui, dings *nd the' tdatled mechanical systems, the
Nursing Home is inefficient`t, heatd cool iahen compared to present -day
benchmarks. Marzolf indi ated it is t cumbent upon our county to look to
alternative ways to hest anal cora�
l the buing, which is already being done
at the Government Cent`y
W
2. The Nursing Home I arc i.tectui Ily,deficient— floors are not on the same
plane.
3. Studies indicate that , �e near time, there will be rising demand in our
county foz��nur'sing homeh beef "tf "Marzolf cited various statistics related to
the aging t Croix
y`
population.
4. Infoatio \£rom��a t
�! Elder Care Expo recently took place in Minnesota
was r 6View6j tha�zted increases in Minnesota's 65 and older population.
"k, \ \:.
5. Co erns b,�lated to downsizing and moving the operation to the first floor
(mor &,,rooms, resident needs and overcrowded dining).
6. Census ea says St. Croix County ranks 95 fastest growing county in the
nation. "'
7. St. Croix County's total tax levy has more than doubled in the past several
years ($12 million to $27 million). Graphs were presented to show that costs
have not increased dramatically due to the Nursing Home.
a. Marzolf said the amount of levy requested by the Nursing Home is
low in relation to the total County budget.
b. Johnson warned that carryover monies have been added to lessen levy
requests as was identified on the charts and it is projected there
will be less carryover money in the future.
c. Johnson said Wipfli recommended operational efficiencies at the end
of 2005, which have been put in place helped create this surplus.
St. Croix County Health and Human Services Board
Page 8
May 28, 2008
However, he does not anticipate having the same surplus to apply in
the future. Johnson also reminded the Board that limited capital
expenditures have been made due to the RFP and warned that the levy
request will likely increase in 2009 budget request.
8. Feedback is strong for our county to remain in the nursing home business.
Marzolf cited letters of support and signatures on a petition.
9. St. Croix County has 4.83 beds per thousand county residents, which ranks
13 from the bottom. Information from December 2001 County Board decision
to build a new nursing home was never acted upon. Recommendation to forward
a motion to County Board to build a new nursing how' "' and renovate the
current nursing home to multi - purpose facility. Morris explained there are
legal issues when office space is mixed with assisted liv 'hg space. Tobin
reported both the 1974 and 1982 buildings are app
ximately-�•62,00� square
feet each. Peterson said the question of whether c of the mount, , should
be in the Nursing Home business should be awered firs J813325`on again
reviewed the motion from March, 2008 regardin the Nur!Ang Rio
*fi "
lO.Capitalize on our excellent bond rating and eliminate expenses the county
continues to sustain due to delays in b, ng a neW,,,home A,a
Motion A motion was introduced by Petei on, seconded Rasmussen, That the
�?.
Health and Human Services Board recnends Ito the Count' Board that the County
Board consider building a new Nurs ;� J "ome to,be sup rted by the County and to
build a 20 -unit assisted living facility N
Roll call vote:
%.' \
Esther Wentz - yes i
Leon Berenschot - yes �,•
Charles Grant - yes ,
Dr. Glenn Hoberg absent %,
`�
a
Roger Larson - ye��,�'
Linda Luckey - no
Richard Marzo
- des
Gerald Peterson % - s
Deb Rasm
V,
� y s ,\\
Seven yes one no ; - one absent, motion passed.
Motion A ptios was introduced by Marzolf, seconded by Peterson, That the
Board mends tie ave motion to build a new 72 -bed Nursing Home due to need
increasing for r�ursing home beds. Motion failed with one yes, six no.
I
Rasmussen than' Marzolf for his in -depth report.
There was much discussion on 50 versus 72 beds for the Nursing Home. Johnson
said the consultant recommended the Nursing Home reducing to 50 -beds as the
Nursing Home could then be eligible for an enhanced Medicaid rate and more
monies would be available from the State and Feds. Bed need is not based on
just numbers but also specific care needs of residents. With family care, many
residents will be able to move into the community. Johnson said a feasibility
study would likely have to happen before a Nursing Home is built. Johnson will
work to get the above motion on the County Board agenda. Johnson questioned
the status of the advisory referendum question. Peterson said this is a
recommendation from the Health and Human Services Board to the County Board.
Copies of the presentation will be available to all County Board members prior
St. Croix County Health and Human Services Board
.Page 9
May 28, 2008
to presentation at the County Board meeting.
2009 CAPITAL OUTLAY PLAN FOR HHS AND NURSING HOME (continued): Several capital
outlay items for the Nursing Home were put in capital outlay in the past years
but were bumped off due to budget restraints. Items needed for capital outlay
include: laptops for med carts, Broda chairs, air mattresses, braising pan,
washer in laundry, replace floor machine, bladder machine (less invasive than
cath), dressers, software maintenance contracts, surveillance equipment, water
softeners, vehicles, structural issues, etc. Tobin questioned the direction of
the Nursing Home for the future to accomplish prudent budget planning.
Tobin pointed out foundation issues with the 1974 building and window wall
replacement, which do not affect the nursing home. He sa there are drainage
problems with the 1974 building which has resulted' in the foundation
deteriorating. The windows in the 1974 building are not efflcient`, Some of
the window skylights are down to a single pane. He rted the roof had been
re- foamed 5 -7 years ago. ��:
Tobin quoted the following estimates received f\ °'f t'he 1974 building
j
from Derrick Companies: 10.
$98,500 Cost for foundation excavation a'�air��,
72,000 Cost for site drainage and catch basin repair
43,900 Cost for window replacement,
36,000 Cost for wood stud wall /finshes
4,800 New metal downspouts /splah�� locks y
$255,200 TOTAL /
Tobin said these are prel Inary estimates to fix and repair the current
structure. Tobin questionec,thk route to�'ake for the future. Johnson
questioned the long range t ldAg'A4*ds for ealth and Human Services.
14 11 6
Tobin distributed pictures of Girl out, Troop 53209 taking care of one of the
cemeteries located on Couny `hand and' e praise and recognition for the work
° ,
the troop did.:
The Board rece1ssec from 1f' 25 tc 1: 37.
Luckey lef the meet g
0,,
2007 AItL OR Board members were introduced to staff. Staff presented
the 07 air e ort The Nursing Home had over 20o private p g H ° P pay residents in
2007 w hompare to st homes having 15% private pay. Nursing Home bed occupancy
rates h dec�ined nd with the change to family care more residents will be
placed ih the immunity compared to nursing homes. The transition to family
care is scdul to transition one -sixth of the Long Term Suport
family care sta " "rting September 1, 2008. The Nursing Home had a cp clients
te- -free survey
for health and engineering in 2007. Family and Children's Services are mandated
by statute. Dunlap reported in 1995, 17 year olds were moved to be treated as
adults; however, that may change back to Juvenile Court with no anticipated
additional state /federal dollars to the counties due to proposed legislation.
This will impact Family and Children's Services if the change occurs. Dunlap
outlined average daily cost of care for out -of -home placements. The number of
children in placement in St. Croix County is approximately one -third the amount
in placement in similar sized counties of LaCrosse and Eau Claire. St. Croix
County has a commitment to keep kids in their homes; however, kids are placed
out of home if it is not safe for the child in the home or if it is not safe
for the community to have the child at home. Dunlap reported the numbers of
relatives who care for relative children under Kinship Care increased by
St. Croix County Health and Human Services Board
, Page 10
May 28, 2008
approximately 20 in 2007. Dunlap explained the development of the YCSS (Youth
Community Support Services) Unit to utilize partnerships in an effort to
utilize federal dollars to save county levy. Services in this unit have been
combined to meet the needs for services. She reported Family and Children's
Services were reviewed by the state and received excellent marks due to the
work being done in part by the YCSS unit. The unit is a combination of two
Family and Children staff, two Behavioral Health staff, two Long Term Support
staff and one support staff. Sortedahl reported caseloads in Public Health are
increasing due to economic situations and reviewed statuary requirements for
Public Health, along with core functions and essential services. Also, the
dollars given to purchase food for the WIC program are not stretching to meet
the needs. WIC, along with other programs in Public Health, cannot have a
waiting list. Kiesler reported on collaborative efforts Aith drug court to
lessen recidivism for clients. He highlighted a change ire ychiatric service
Provision from one psychiatrist to now having five separa � ps§�qhiatrists
covering the same appointment needs. Kiesler contriYa � ,ed the 1'6,w n nber of
inpatient hospitalizations in part to mobile crisis "se v es. He sa .
crisis was utilized 60% of the time by law e orcemeht \ i 2007
Lockwood
reported in 2007 partially funded waiver slots /taere utii� o 64pture more
Federal funds so more people could be served t" All re orte �" i
, p �� n relation to all
counties in the state, St. Croix County has benef ed most from Nursing Home
Relocation monies and Nursing Home Di, � X5`3 n Program. L g Term Support
investigated 75 cases of reported negle't /abuse to v61neble adults due to
changes in statutes requiring mandatpry deporting. Lockod reported on Long
Term Care Reform and ADRC developme , which among c the " �benefits, will create
an entitlement to communit based e vices % i
community -based mlar ,,o the current entitlement
to nursing home care. He said clients will offered choices on range of
benefits with implementation � bN begin In September, 2008 and to be fully
implemented by July 1, 20VI Vreze reputed Birth to Three Services are
mandated services under the IgdifA duals wi A isabilities Education Act. She
also reported Birth to Thee canrag - ;cave a whit list.
145 There were approximately
children served b
y t e' program in 2007. Schroeder reported St. Croix
Industries (SCI) serves "a graat ran of ages of people. He reported SCI does
have a waiting list in alms excep Day Services. Schroeder reported Long
�:
Term Care will so" fecf %\, future of SCI as the funding source for SCI
clients will charge. t wil have to competitively provide services to SCI
clients unde" Coununit `l
y 'Nealt� 4 Partners. Squyer reported Economic Support
provides manate�l s'vices The�only non - mandated service provided by Economic
Support is ,Gene Al lief, which has a budget of
` g $15,000, all of which is
county Sg 'ye r ted caseloads have increased along with increased
maintei"arrl;e o ca ,due to requirements to verify birth certificates and
cit #nshi�� Shy sai ;�_ he Economic Support unit is out of compliance and could
be fired $91 ,for �vexy $1 in error in Food Share and can also receive fines for
ever d ��
Y day beyond required time frames to schedule appointments after
applicatit y ns are received; however, many counties in the state are in the same
situation ��;
APPOINTMENT TO BIRTH TO 3 ADVISORY /FAMILY SUPPORT COMMITTEE: Wentz appointed
Deb Rasmussen to the Birth to 3 Advisory /Family Support Committee.
REVIEW OF COUNTY BOARD GOAL SETTING ON 04/21/08: Will be a routine agenda item
to review internal planning to coordinate Health and Human Services strategic
planning with the County goal setting. This item will be delayed to the next
meeting.
MOBILE CRISIS EXPANSION OF HOURS: Kiesler gave the following report. Mobile
crisis was established in 2006. The final grant monies in the amount of
$25,000 are anticipated to be received 07/01/08. Mobile crisis currently
covers from 4:OO PM to midnight seven days /week. Northwest Counseling provides
St. Qroix County Health and Human Services Board
.Page 11
May 28, 2008
the staff recruitment and we provide the staff supervision for this program.
There has been a 60% usage by law enforcement experienced with 750 of those
clients being diverted from inpatient hospitalization. Staff are studying
expanding that coverage from midnight to 8:00 AM; however, this is a difficult
shift to provide staff supervision coverage. It is estimated the cost to cover
this additional mobile time would be $15,000 /year, which is not in the 2008
budget. However, funding could be realized by reducing inpatient hospital days
by 15 days, which would be $15,000. Efforts have been made to get law
enforcement to utilize mobile crisis more as law enforcement has the final call
whether or not to inpatient hospitalize someone. Currently, there is an
understanding with law enforcement to utilize mobile crisis and staff would
like to seek a memorandum of understanding with law enforcement to utilize
mobile crisis. There seems to be a direct correlation the distance law
M ji enforcement has to travel to an available hospital ane utilization of
mobile crisis services. Staff will brainstorm with law enforcentincrease
mobile crisis utilization, but would recommend a pcy be devflope &, by the
Sheriff's Department to include mobile" crisis utilization p t 1 'or ��o all
p "" i
emergency detentions. Larson is a member of the4PublicProte riu
tion
Johnson and Kiesler volunteered to give a presep$j6tion to 1 \ublction.
ppp
P ERSONNEL ISSUES NEW EMPLOYEES /VACANCIES Johns'a annou ed James Roerdink
has been hired as Contract Specialist p "&ction pervis, for St. Croix
Industries with a start date of July 1 X008 Cand %
iceRo has been hired as
Financial Assistant for St. Croix Industrils with a star- t of May 28, 2008;
and Brad Beckman has been hired as RC MAnager with & date of June 9,
2008.. %
1:.
46
FILLING PUBLIC HEALTH NURSE PR Tll, IONER' OSITION'UpDATED JOB DESCRIPTION: Two
key changes were made in the-`'Public, Health Nurse Practitioner job description.
The first change is requiremen't ,a Master'& gree; however, if a certificate
was received prior to 19 ,,they ikd be g*' ndfathered in. The second change
involves preparedness a / Medica Branch Director is needed if a mass clinic
is required. SortedaY1 reported that Pierce County also lost their Nurse
Practitioner, Polk Count
�� one ripening for RN and Eau Claire has RN
openings. Public 3ea�'t is ontracting with a Nurse Practitioner for
$42 /hour
°
but this person has anbtherNfull time job and has only agreed to
temporarily.
"/
Motion A motion ,was m§de by Berenschot, seconded by Rasmussen, and
unanimously''d6ptea.- � the Health and Human Services Board approves the
Nurser ctitoneb*b description with modifications made and agrees to
forty °rd they. >.Oob "It escr � ion to the Finance Committee.
COUNTY CENSUS'GIROWT Will be delayed to the next meeting.
Wentz asked if ere were any other issues to bring before the Board.
Wentz adjourned the meeting.
Time: 1:47 PM
Chair:
Attest:
(Secretary)