HomeMy WebLinkAboutHealth & Human Services 11-19-08 t '
Berenschot will review vouchers.
Revised 11/18/08
NOTICE OF MEETING AND AGENDA
ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD
November 19, 2008 at 8:30
(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 - 11/05/08
DATE OF NEXT MEETING — 12/17/08
OLD AND NEW BUSINESS
1. Consideration of Claims and Vouchers and appoint member to review vouchers at next meeting
2. Financial Report
a. Monthly financial report for Nursing Home and Health and Human Services
b. aged receivable report
3. Report on Foster Parent Program
4. Youth Community Support Services Award
5. Presentation by Kevin Larson Spring Valley Health Care Center (9:00 AM)
6. Nursing Home Report
7. St. Croix Industries advertisement/marketing plan
8. Personnel Issues
a. New employees /vacancies
b. Hiring additional Economic Support worker
c. Health Officer appointment
d. Public Health Supervisor position
e. Recruitment for Nursing Home Administrator"
9. Semi Annual HHS Fleet Vehicle Mileage Report
10. Long Term Care Reform Transition (10:00 AM)
11. Agency Rate Setting
12. Economic Support Management Review
13. Governor Doyle Announcement regarding Agreement with Federal Government to Offer Health
Care to Childless Adults
14. Closed session pursuant to Wisconsin Statutes § 19.85 (1)(f) for preliminary consideration of a
specific personnel problem which, if discussed in public, would be likely to have a substantial
adverse effect upon the reputation of the person involved in such problem. Reconvene in open
session.
ADJOURN
(Items may be taken in different order)
Items for County Board approval must be submitted to the County Clerk's
office by Wednesday morning preceding a County Board meeting.
11/18/2008 8:14 AM
f '
** 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.
11/18/2008 8:14 AM
ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD
November 19, 2008
The St. Croix County Health and Human Services Board met on November 19, 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: None
STAFF PRESENT: Fred Johnson, Health and Human Services Director
Jennifer Pempek, Financial Manager
Kathy Dunlap, Family & Children's Coordinator
Ron Kiesler, Behavioral Health Coordinator
John Bretl, Foster Care Coordinator
Tim Markgraf, YCSS Lead Social Worker
Kathy Huston, ACSS Coordinator
Connie Sarauer, Contracted Director of Nursing- Nursing Home
Fay Strenke, Accounts Receivable Supervisor
Kim Dupre, Information Systems Analyst
Wendy Kramer, Public Health Officer /Public Health
Coordinator
Mary Squyer, Economic Support Supervisor
Clark Schroeder, St. Croix Industries Director
Malva Sirek, Secretary
OTHERS PRESENT: Tammy Funk, Human Resource Administrator
Kevin Larson, Spring Valley Health Care Center
Norm Matzek
Craig Smith
Dave Ostness
Ted Mackmiller
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, December 17, 2008 at 8:30 AM. Marzolf will review vouchers.
AGENDA Motion A motion was introduced by Berenschot, seconded by Larson,
and unanimously adopted: That the agenda be approved as distributed.
MINUTES Motion A motion was introduced by Larson, seconded by Berenschot,
and unanimously adopted: That the minutes of the 11/05/08 Health and Human
Services Board meeting be approved as distributed.
CONSIDERATION OF CLAIMS Health and Human Services Board member Berenschot
reviewed the vouchers.
Motion A motion was introduced by Berenschot, seconded by Larson, and
unanimously adopted: That the following vouchers be approved and be made a
part of the supplemental minute book:
St. Croix County Health and Human Services Board
Page 2
November 19, 2008
Human Services voucher 137223, dated November 23, in the amount of $1,121.00.
Human Services vouchers 137351 through 137355, dated October 30, in the
amount of $34,020.60.
Human Services voucher 137616, dated November 06, in the amount of $500.00.
Human Services vouchers 138101 through 137616, dated November 1330, in the
amount of $384413.79.
Human Services and Nursing Home vouchers 137050 through 137222, dated
November 23, 2008 in the amount of $161,438.51.
Human Services and Nursing Home vouchers 137236 through 137350, dated October
30, 2008 in the amount of $389,553.32.
Human Services, ADRC and Nursing Home vouchers 137432 through 137615, dated
November 06, 2008 in the amount of $349,116.13.
Human Services, ADRC and Nursing Home vouchers 138142 through 138299, dated
November 09, 2008 in the amount of $79,936.82.
Human Services, Office on Aging, and Nursing Home vouchers 138335 through
138465, dated November 13, 2008 in the amount of $74,020.72.
Nursing Home vouchers 138300 through 138334, dated November 13, 2008 in the
amount of $28,372.96.
Human Services, Workshop, Public Health, Social Services vouchers 654 through
673, dated October 30, 2008 in the amount of $332,691.57.
Human Services, Workshop, Public Health, Social Services vouchers 674 through
703, dated November 13, 2008 in the amount of $388,550.72.
Human Services and Nursing Home vouchers 644 through 663 dated October 30,
2008 in the amount of $133,580.49.
Human Services and Nursing Home vouchers 664 through 693, dated November 13,
2008 in the amount of $154,086.72.
Workshop vouchers 128 through 133, dated October 30, 2008 in the amount of
$14,562.79.
Workshop vouchers 134 through 139, dated November 13, 2008 in the amount of
$13,305.73.
FINANCIAL REPORT The following financial report for Health and Human Services
through September, 2008 was distributed. To be on budget, the percent should be
75% and both revenues and expenditures are at 71 %. Dunlap, Kiesler and Pempek
will be working with the SED Program due to shifting of CIP lA and CIP 1B
slots. The figures for Long Term Support will decrease and the figures for SED
will increase.
St. Croix County Health and Human Services Board
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November 19, 2008
HEALTH AND HUMAN SERVICES - 2008
SUMMARY Total
OF REVENUES Budget September 30, 2008 Balance %
Administration 1,117,400.00 (13,584.82) 1,130,984.82 -1.2%
AODA Services 772,986.95 557,982.78 215,004.17 72.2%
Long Term Support 17,681,645.51 13,460,434.26 4,221,211.25 76.1%
Mental Health 3,303,479.98 2,281,306.60 1,022,173.38 69.1%
Family & Children's 3,037,821.28 2,394,749.39 643,071.89 78.8%
Public Health 1,678,621.37 1,305,585.11 373,036.26 77.8%
Economic Support 1,227,133.10 816,022.50 411,110.60 66.5%
General Relief 15,000.00 11,250.00 3,750.00 75.0%
Coordinated Services /SED 2,500,931.96 1,433,428.18 1,067,503.78 57.3%
REVENUES HUMAN
SERVICES PROGRAMS 31,335,020.15 22,247,174.00 9,087,846.15 71.0%
SUMMARY Total
OF EXPENDITURES Budget September 30, 2008 Balance %
Administration 1,117,400.00 816,852.06 300,547.94 73.1%
Alcohol -Drug Abuse 772,986.95 588,785.86 184,201.09 76.2%
Long Term Support 17,681,645.51 13,243,190.97 4,438,454.54 74.9%
Mental Health 3,303,479.98 2,235,723.38 1,067,756.60 67.7%
Family & Children's 3,037,821.28 2,098,733.70 939,087.58 69.1%
Public Health 1,678,621.37 1,266,775.23 411,846.14 75.5%
Economic Support 1,227,133.10 859,342.51 367,790.59 70.0%
General Relief 15,000.00 4,011.14 10,988.86 26.7%
Coordinated Service/SED 2,500,931.96 1,123,850.06 1,377,081.90 44.9%
EXPENDITURES HUMAN
SERVICES PROGRAMS 31,335,020.15 22,237,264.91 9,097,755.24 71.0%
Excess Rev over Expenses 9,909.09
The following financial report for Nursing Home through September, 2008 was
distributed. To be on budget, the percent should be 750. Nursing Home
carryover over funds will not be applied until year end. If those funds were
prorated and applied to the `net from all sources' figure of ($297,935.38), the
Nursing Home would be at approximately a positive $101,987.
St. Croix County Health and Human Services Board
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November 19, 2008
St. Croix Health Center
Septembei 2008
Bgdget Actual Difference pelcentag�
Census 0
Operating Revenue:
Medicare $842,975.00 $687,081.73 $155,893.27 81.51%
Medicaid $2,431,627.00 $1,930,889.74 $500,737.26 79.41%
Private Pay $760,413.00 $545,349.00 $215,064.00 71.72%
All Other Sources $217,774.00 $170,806.42 $46,967.58 78.43%
Total Qpeiating Revenue $4.252.789.00 $3.334.126.89 $918.062.11 78.40
Operating Expenses
Daily Patient Services $3,081,764.76 $2,520,006.97 $561,755.79 81.77%
Special Services $284,516.00 $196,028.01 $88,487.99 68.90%
General Services $1,167,643.63 $812,863.40 $354,780.23 69.62%
Administrative Services $547,561.00 $538,255.98 $9,305.02 98.30%
Unassigned:
Depreciation (% Based) $0.00
Others: $294,394.00 $188,398.91 $105,995.09 64.00%
Utilities $101,797.19
Workers Comp, Computer Tech $16,195.72
Insurance $70,406.00
Total Opeiating Expenses $5.375.879.39 $4.255.555.27 $1.120.321.12 79.16'4
Not From Opelations 4921.428.381
(Cost of doing business prior to
applying levy & outstanding rev)
Owstanding Revenges
Outstanding Rate Appeal rev $12,000.00 $445.00 $11,666.00 3.71%
Revenue - IGT Funds $318,000.00 $428,153.00
% of Outstanding IGT Rev $0.00 $0.00 ' #DIV/0!
Co Allocations (% Based) $259,859.39 $194,895.00 $64,964.39 75.00%
Nursing Home Carry Over $533,231.00 $0.00
Total Otitstanding $1,123.090.39 $623.493.00 '$76.5'19.39
Net from all Sources $ 1297 935.381
AGED RECEIVABLE REPORT: The aging Accounts Receivable report through September
was reviewed. The clean up of Accounts Receivable is going well. In the next
few months, there will be further breakout details of outstanding receivables,
which will include monies written off for insurance, hospital charges, rate
charges, etc. The 90 -day figure reflected on the report is not a true 90 -day
figure due to accounts being billed to insurance, Medical Assistance, Medicare
before being billed to client. The report for the auditors has been cleaned up
and the process is moving forward. Staff are now looking at ECHO and a
workgroup is addressing ways to improve utilization and elimination of
duplicate entry. Additional updates will be provided to the Board in the
future.
REPORT ON FOSTER PARENT PROGRAM The foster parent banquet was held on
November 6 with the next banquet to be held in November, 2009. The department
St. Croix County Health and Human Services Board
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November 19, 2008
honored the services these families provide to the community. Currently there
are 33 county licensed foster homes in St. Croix County. Ages of foster
parents range from mid 20's to mid 70's and each has their own specialty.
Three of the homes are emergency shelter care homes. The county is competing
with private agencies for foster homes. The county is currently in need of
foster care homes that are willing to take in teenagers. St. Croix County
provides training to foster care parents. Bretl reported he receives two to
three calls per month regarding parties interested in becoming foster parents;
however, few of these inquiries complete the process. Placement in the homes
varies on a case by case basis. Additional homes are needed or children could
end up placed in treatment foster care, which is usually outside of the county.
Efforts are made to keep children in the community they are from to be close to
family, friends and school. Dunlap reported moving children from one placement
to another could be damaging to the child. Dunlap reported St. Croix County
has approximately 14 children /month in foster care placement at a cost of
approximately $11,300 /month. There are two children placed in residential care
(institution) at a cost of approximately $16,000 /month.
YOUTH COMMUNITY SUPPORT SERVICES AWARD Tim Markgraf, YCSS Lead Social Worker,
reported Dan Naylor nominated St. Croix County Department of Health and Human
Services for the Children Come First Award due to its commitment to the
development of its Coordinated Family Services Initiative. The YCSS unit works
with families /client to create one plan. Parents are actively involved in
advocacy and support for other families and actively participate in the
coordinating committee. St. Croix County also provides training and technical
assistance to other counties as well as training service for the State Child
Welfare Training Partnership. Coordinated Service Team (CST) is being piloted
in Community Support Program (CSP) for adults, which will consist of
coordinated adult teams. Huston reported the application has been written and
it is hoped the program will be certified in early 2009. Dunlap reported YCCS
is fiscally positive as 580 of the costs can be recouped from Federal funding.
Clients can return home more quickly with community supports being set up
versus county agency supports for the client. To date, only one YCSS case has
re- entered this system, which is a huge savings to the county and to law
enforcement. This program fits with the County Board goal setting initiative
of effective community services and diversification of funding. Staff deserve
credit for working as a team to make this initiative work. Johnson suggested
highlighting this initiative at a future County Board meeting.
Motion A motion was introduced by Marzolf, seconded by Grant, and
unanimously adopted: That the Board requests the YCSS award be placed on the
County Board agenda to highlight the staff's hard work and dedication to the
County.
PRESENTATION BY KEVIN LARSON SPRING VALLEY HEALTH CARE CENTER Larson was
invited to present at the Board to highlight what has been done for the Spring
Valley Health Care Center. Options are being explored regarding the future of
the Nursing Home, which could include the possibility of constructing a new
facility.
Larson cautioned the Board as they move forward as there are different playing
fields between Spring Valley and St. Croix County. Spring Valley is not a done
deal yet as they have not broken ground for the facility and there are more
pieces of the puzzle to work on to have it happen. Spring Valley's current
facility is aging. The facility was debt free; however, no upgrades had been
made. The facility worked with the Spring Valley Village Council for land and
funding was investigated. An application was submitted for an assisted living
facility with the tax credit program. This application was approved and will
fund about two- thirds of the assisted living facility. The facility will need
St. Croix County Health and Human Services Board
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November 19, 2008
to meet apartment code and will only be able to accept four private pay
individuals. The balance of the residents will be income adjusted.
The Wisconsin Department of Health Services realizes that the nursing home
buildings in the state are wearing out and started a property incentive program
last summer. Spring Valley Health Care Center applied to this program and up
to $135,000 /bed could be received for the project as it is 50 -bed facility.
However, the current market and economy has impacted the project and work on
the assisted living facility has been delayed until April. The nursing home is
still looking at funds to build and is pursuing tax exempt bonds. Larson said
there are strings attached to this as the nursing home must have an innovative
design as the institutional model does not work and expectations are changing
on how to meet senior citizens' needs. Larson described a household model for
the nursing home. Each house would be self - sufficient unto itself and be tied
to a main street or village square. Each house would have its own main door.
The facility would have to maintain a patient mix of 85% Medicaid /Medicare
eligible residents. Larson said the facility would be sustainable on Medicare
reimbursement but not on Medicaid reimbursement. He also pointed out that
critical access hospitals have swing bed units that compete with nursing homes
for residents. Hospital beds are taxed whether or not the bed is filled so
hospitals try to keep their beds filled. He said green initiatives were not
heavily weighted. He said his facility is on its third market study and this
project has been ongoing since 2000. He said the facility is applying for
grants through Focus on Energy and has been working with Patrick McCoy who is a
specialist on tax credits. He said consultant fees were included as part of
their budget and they have also received huge support from the Village of
Spring Valley. He said the facility at one time had 92 beds and now it is down
to 50 beds. The facility has also looked to identify niches or unmet needs for
the nursing home. He said assisted living is the preferred model for
geriatrics. He said areas investigated have been bariatric care,
hospice /cancer care (not met by hospitals), memory care and the largest unmet
need, mental health care. He also mentioned managed care is being implemented
in the area and managed care organizations will want the lowest cost placements
for their enrollees.
The Board recessed from 9:50 to 10:00 AM.
SEMI ANNUAL HHS FLEET VEHICLE MILEAGE REPORT Kiesler reported there are 14
fleet vehicles. Vehicles are used for about seven years at about 20,000
miles per year. It has been found that after vehicles have over 140,000
problems start occurring with engines and transmissions, etc so maintenance
costs cause vehicles to not be as cost effective after 140,000 miles. The
County does not pay the $.19 /gallon federal tax on gas purchased for these
vehicles. Kiesler distributed a spreadsheet explaining cost savings realized
utilizing fleet vehicles versus paying mileage to staff to use their own
vehicles. Dependent on gas prices, the savings range from $.338 /mile or
$84,983 annually if gas is $2.00 /gallon to $.261 /mile or $65,623 annually if
gas is $4.00 /gallon. The county contracts with Cox Motors to provide oil
changes, etc. New vehicles are bid through Dana Baker so costs for new fleet
vehicles are the State contract price or better. Vehicle maintenance
contracts are also bid locally every year. It was the Board consensus to
continue this program.
AGENCY RATE SETTING Kiesler explained the WIMCR cost report is not done the
same time every year. Rates are configured after the cost report is completed.
Rates also include the time of all staff, utility costs, etc. The State
encourages counties to have clients fund IDP assessment services. St. Croix
County has the highest assessment fee in the State, funded by the client;
however, treatment is provided on a sliding fee and may not be totally paid for
St. Croix County Health and Human Services Board
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November 19, 2008
by the client.
Motion A motion was introduced by Berenschot, seconded by Rasmussen, and
unanimously adopted: That the Board approves the following Behavioral Health
rates as presented to be effective January 1, 2009:
Standard Fee Hourly Rates
M.D. _ $300 (individual), $100 (group)
M.D. Med Check = $100 (1/3 hour)
Ph.D.= $225 (individual), $75 (group)
Master's= $200 (individual), $67 (group)
Bachelor's= $150 (individual), $50 (group)
AODA Counselor= $150 (individual), $50 (group)
Register Nurse= $150 (individual), $50 (group)
Registered Nurse Med Check= $ 50 (1/3 hour)
Mental Health Technician= $120 (individual)
IDP Assessment= $340.00
IDP RE- Assessment Fee= $340.00
IDP Final Report= $150.00
IDP No Show Fee= $340.00
IDP Out -of -State Referral= $ 40.00
AODA Court Ordered Evals= $300.00
MMPI Court Ordered Evals= $412.50
ATLAS House sliding rate= $ 23.00 /day
Kiesler explained the functions of Atlas House, an eight -bed Community Based
Residential Care Facility (CBRF) used to stabilize clients further after
hospitalization and then transition back into the community or to avert
hospitalization.
Johnson distributed a survey of nursing home private pay rates in this area.
Johnson questioned the Board regarding what to do with St. Croix Health Center
private pay rates. St. Croix Health Center's private pay rates have been lower
to keep in line with the rates at other homes in the area; however, the County
is currently subsidizing private pay rates at a cost of approximately $58 /day.
Major adjustments in private pay rates have not taken place as the County Board
has deliberated the future operation of the facility. As the Health and Human
Services Board looks at planning for the future operation, subsidizing private
pay will need to be reviewed.
ST. CROIX INDUSTRIES ADVERTISEMENT /MARKETING PLAN The St. Croix Industries
(SCI) quarterly newsletter was included in Board packets.
Schroeder reported SCI received an offer to have the newsletter printed in
color by a local company which has a color laser. He also reported negotiating
a non - profit rate of $85 to join the New Richmond Chamber. SCI is creating a
website for SCI clients, consumers, parents, etc. as a form of advertising SCI
and getting exposure in the community.
Schroeder is investigating purchasing jackets for the clients out of production
monies as another form of advertisement. The matter has been discussed and
approved by Corporation Counsel as long as the use of the jacket is voluntary.
The goal is to have the jackets to distribute at the client Christmas party
scheduled for December 19, 2008.
Motion A motion was introduced by Larson, seconded by Rasmussen, and
unanimously adopted: That the Board approves purchasing jackets for St. Croix
Industries clients as a medium to advertise for St. Croix Industries.
St. Croix County Health and Human Services Board
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November 19, 2008
Jackets will also be offered to staff and Board members to purchase.
CLOSED SESSION PURSUANT TO WISCONSIN STATUTES § 19.85 (1) (F) FOR PRELIMINARY
CONSIDERATION OF A SPECIFIC PERSONNEL PROBLEM WHICH, IF DISCUSSED IN PUBLIC,
WOULD BE LIKELY TO HAVE A SUBSTANTIAL ADVERSE EFFECT UPON THE REPUTATION OF THE
PERSON INVOLVED IN SUCH PROBLEM
Motion A motion was introduced by Berenschot, seconded by Larson: That the
Board enter closed session pursuant to Wisconsin Statutes § 19.85 (1) (f) for
preliminary consideration of a specific personnel problem which, if discussed
in public, would be likely to have a substantial adverse effect upon the
reputation of the person involved in such problem.
Roll call vote:
Esther Wentz - yes
Leon Berenschot - yes
Charles Grant - yes
Roger Larson - yes
Linda Luckey - yes
Richard Marzolf - yes
Gerald Peterson - yes
Deb Rasmussen - yes
Eight yes, motion passed.
The Board entered closed session at 10:42 AM.
Motion A motion was introduced by Berenschot, seconded by Peterson, and
unanimously adopted: That the Board reconvene in open session.
The Board reconvened in open session at 10:58 AM.
LONG TERM CARE REFORM TRANSITION Paul Cook from Community Health Partners
(CHP) was scheduled to present at this meeting but postponed due to illness.
Johnson reported contracts are still being developed with providers. Part of
Long Term Care Reform agreement was that clients' vendors would not change;
however, he said if contracts are not settled the client plans may change.
Johnson said that Community Health Partners is working towards resolution and
he will continue to monitor for continuity and consistency of care for
consumers.
Contracts are in place between CHP and St. Croix Industries, Aging and
Disability Resource Center and the Nursing Home. Johnson said more updates
will be available in December.
PERSONNEL ISSUES NEW EMPLOYEES /VACANCIES Johnson reported Harold Morris is
no longer at the facility as contracted nursing home administrator. Another
interim administrator has been recruited through Pathways.
NURSING HOME ADMINISTRATOR'S REPORT The current Nursing Home census is 66.
Johnson distributed the nursing home bed availability report for the area.
This report is issued monthly and shows the number of open nursing home beds in
the event of an emergency. Sarauer indicated it is typical to have more beds
available at this time of year.
Johnson also briefly discussed an article regarding the legality of multi -
county nursing homes. Previously, information was forwarded regarding LaCrosse
County's collaborative effort to join with neighboring counties as business
St. Croix County Health and Human Services Board
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November 19, 2008
partners for the LaCrosse home. Johnson will continue to update the Board on
the status of this effort.
Also distributed was an article regarding Dunn County increasing 2009 property
tax levy due in part to increased need for county appropriations to fund their
health care center.
Johnson also brought attention to information given by DHS Secretary Timberlake
to the WAHSA Board. One point Johnson highlighted from Timberlake is that "The
demand for nursing homes and nursing home beds will continue to decline" into
the near future; however, the "Baby Boom" demographics no doubt will see a
future increase in the number of nursing homes but those facilities generally
will be smaller than today's nursing homes." Johnson said a market study would
identify future needs for the county and allow planning for the future.
Johnson questioned how to move forward for the Nursing Home and suggested an ad
hoc committee or group within the Health and Human Services Board to review and
evaluate information /data for the direction of the future of the Nursing Home
to present to the County Board. Suggestion was made to review niche markets,
including veterans. Johnson reported the VA is not extending contracts at this
time. The full impact of Long Term Care Reform is not clear and CHP could be a
partner regarding access issues for nursing home level of care. Consultants
utilized in the past addressed whether or not to keep, sell, or close the
nursing home, which is different information than the information needed now to
stay in the business. There are no specific monies in the budget for an updated
market study and funds to pay for a study may need to come from the contingency
fund.
PERSONNEL ISSUES RECRUITMENT OF NURSING HOME ADMINISTRATOR Johnson reported
the Pathways contract is still in place and Dennis Reiman is scheduled to start
as interim Nursing Home Administrator on November 25, 2008. Johnson will
notify the state of the change. Johnson recommended recruiting to fill the
Nursing Home Administrator position as a County employee.
Motion A motion was introduced by Peterson, seconded by Rasmussen, and
unanimously adopted: That the Board approves beginning recruitment to fill the
Nursing Home Administrator position as a County employee.
Suggestion was made to budget monies to have an audit of the Nursing Home by an
outside firm regarding the finances and operation of the Nursing Home before
the position is filled. Marzolf recommended the salary and benefits for the
County employee to fill the Nursing Home Administrator position come from the
amount budgeted for the contracted employee for 2009. Ostness encouraged the
Board to look at the future of the Nursing Home if the home is downsized to 50
beds and the Director of Nursing and Nursing Home Administrator position could
be combined.
Motion A motion was introduced by Peterson, seconded by Marzolf, and
unanimously adopted: That the Board approves an operational assessment of the
Nursing Home by an outside entity as deemed necessary by the Health and Human
Services Board and the Health and Human Services Director.
Johnson mentioned that he is still working with Corporation Counsel regarding
the purchase or donation of a van for the Nursing Home. According to the
Attorney General's opinion, the County Board is the only entity allowed to
accept donations and Johnson will continue to address the issue.
PERSONNEL ISSUES HEALTH OFFICER APPOINTMENT The Health Officer position has
been open since the end of August. Wendy Kramer was appointed interim Health
St. Croix County Health and Human Services Board
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November 19, 2008
Officer and Johnson recommends that Kramer be appointed to this position
permanently. The Public Health department will move from a Level 3 to a Level
2 health department, but Johnson reported this will not change service delivery
and will result in minimal reimbursement change. This appointment needs to be
approved by the County Board also.
Motion A motion was introduced by Berenschot, seconded by Larson, and
unanimously adopted: That the Board approves appointing Wendy Kramer as Health
Officer and to forward this appointment to the County Board for approval.
PERSONNEL ISSUES PUBLIC HEALTH SUPERVISOR POSITION With Kramer being
appointed to the Health Officer position, the Public Health Supervisor position
will be vacant. The Birth to 3 Unit will be added to the Public Health
structure. Funk reported the Springsted review is still in progress. The
Supervisor job description was revised to add the WIC Director role. Funk
recommends an upgrade of the Supervisor position to a Grade 9. Johnson
recommended adding preparedness duties to the position and to increase the
position to a full time position. The 2009 budget was prepared with the
Supervisor position being at a Grade 8.
Motion A motion was introduced by Marzolf, seconded by Rasmussen, and
unanimously adopted: That the Board approves moving the Public Health
Supervisor position from a Grade 8 to a Grade 9 and the position being a full -
time position.
Johnson will work with Funk to bring the Public Health Supervisor position and
the Nursing Home Administrator position to the Finance Committee.
PERSONNEL ISSUES HIRING ADDITIONAL ECONOMIC SUPPORT WORKER Johnson
recommends filling this position immediately versus waiting until 2009. The
position is eligible to receive Federal pass- through monies in the amount of
approximately $25,800 annually or $.50 on the dollar for a full time position.
Motion A motion was introduced by Berenschot, seconded by Larson, and
unanimously adopted: That the Board approves filling the Economic Support
worker position as soon as possible.
GOVERNOR DOYLE ANNOUNCEMENT REGARDING AGREEMENT WITH FEDERAL GOVERNMENT TO
OFFER HEALTH CARE TO CHILDLESS ADULTS Squyer reported health care to
childless adults will be available beginning in March or April for adults over
19 or under 65 with no children and under 200% of the Federal poverty level.
The program will not go through Economic Support but expects the public to
contact the unit regarding the program.
ECONOMIC SUPPORT MANAGEMENT REVIEW This item will be delayed to the December
meeting.
Wentz asked if there were any other issues to bring before the Board.
Wentz adjourned the meeting.
Time: 12:22 PM
Chair:
Attest:
(SECRETARY)