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HomeMy WebLinkAboutHealth & Human Services 12-15-10 + v Marzolf will review vouchers. Revised 12/13/2010 NOTICE OF MEETING AND AGENDA ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD DATE AND TIME. December 15, 2010 at 8:30 LOCATION. (Board Room, St. Croix County DHHS Building, 1445 N. Fourth Street, New Richmond WI) CALL TO ORDER ROLL CALL REVIEW OF AGENDA CONSENT AGENDA APPROVAL OF MINUTES OF PREVIOUS MEETING - 11/17/10 DATE OF NEXT MEETING — 01/19/11 at 8:30 a.m. 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 c. Transition account report 3. * *2011 Health Center Budget Summary 4. Nursing Home Administrator's Report 5. Personnel Issues a. New employees /vacancies 6. 2011 Routine Meeting Dates 7. Health and Human Services Bylaws 8. Business Plan report from LarsonAllen for St. Croix Health Center 9. * *Wisconsin Child and Family Services revellue review report 10. Birth to Three Waiver -State Initiative 11. Birth to Three caseload discussion 12. Community Health Partnership utilization update for St. Croix Industries services 13. * *St. Croix Health Center Economic Impact Report from Wisconsin Association for Homes and Services for the Aging (WASHA) and Wisconsin Health Care Association (WHCA) 14. * *Partner Services for HIV in the Western Region 15. * *Public Health Food Share Collaborative Report 16. * *Medicaid Certified Crisis Intervention Funding Resolution 17. * *Legislative agenda items for January 10 Committee of the Whole meeting 18. * *Fraud Prevention Programming 19. Possible agenda items for next meeting NOTE: A quorum of the St. Croix County Board of Supervisors (County Board) may be present at this meeting. Therefore, this notice also serves as notice of a meeting of the County Board for the purpose of obtaining information relating to subjects listed above for use at future County Board meetings. 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. 12/13/2010 10:27 AM ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD December 15, 2010 The St. Croix County Health and Human Services Board met on December 15, 2010 at the St. Croix County Health and Human Services/Health Center complex. MEMBERS PRESENT: Esther Wentz, Chair Frederick Horne Roger Larson Linda Luckey Richard Marzolf Dr. Lisa Ramsay Deb Rasmussen Alfred Schrank MEMBERS ABSENT: Leon Berenschot, excused STAFF PRESENT: Fred Johnson, Health and Human Services Director Frank Robinson, Nursing Home Administrator Tonya Kusmirek, Financial Manager Wendy Kramer, Public Health Officer/Public Health Coordinator Norma Vrieze, Birth to Three Coordinator Ruth Lehman, Public Health Nutritionist Malva Sirek, Secretary OTHERS PRESENT: Michelle Pietrick, Finance Director Tammy Funk, Human Resource Coordinator Chuck Whiting, Administrative Coordinator Daryl Standafer, County Board Chair Art Tobin, Building Services Director Kim Dupre, Information Systems Analyst Sharon Norton - Bauman, County Board Member Trenton Fast, LarsonAllen (via phone conference) Jeff Holmquist, New Richmond News Norm Matzek 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, January 19, 2011 at 8:30 AM. Schrank will review vouchers. AGENDA Motion A motion was introduced by Schrank, seconded by Rasmussen, and unanimously adopted: That the agenda be approved as amended with item #9 — Wisconsin Child and Family Services revenue report delayed to the next meeting. St. Croix County Health and Human Services' Board Page 2 December 15, 2010 MINUTES Motion A motion was introduced by Marzolf, seconded by Schrank, and unanimously adopted: That the minutes of the 11/17/10 Health and Human Services Board meeting be approved with modifications noted. CONSIDERATION OF CLAIMS All check registers for November for funds 205, 225, 230, 600 and 625 were reviewed by Health and Human Services (HHS) Board member Marzolf. All questions were answered satisfactorily. Motion A motion was introduced by Marzolf, seconded by Schrank, and unanimously adopted: That the November vouchers be approved. FINANCIAL REPORTS The following financial report for Health and Human Services through November, 2010 was distributed. Kusmirek reported significant progress has been made. The transition account has been cleared. She reported desktop deposit and new receipting procedures are underway. Work is being done on the CARS (Community Aids Reporting System) report. Approximately $1.5 million was received from the CARS report in early December. As of December, Department of Health and Human Services is on the same processing schedule as the Government Center. The cut off for paid/receipted monies is now at the end of the month so the following report is the first financial report with a cut off of the end of the month or 11/30/2010. The goal is to get members the most current information possible to use to make decisions. Johnson reported he will be meeting with department heads twice a month starting in January after the recent move of two Financial Assistants to the Government Center. The first meeting of the month will focus on financials and fiscal reports will be reviewed prior to the Board meetings. Johnson said the state contracts for 2011 are being updated now. St. Croix County Health and Human Services Board Page 3 December 15, 2010 Health & Human Services - Fund 225 November 2010 Annual November Budget % of Revenue by Service Budget Actuals Balance Budget Administration $ 187,070 $ (81,486) $ 268,556 -43.6% AQDA Services 768,662 542,873 225,789 70.6% Mental Health 3,702,935 3,037,538 665,397 82.0% Family & Children's 3,188,401 2,475,382 713,019 77.6% Public Health 2,035,641 1,770,927 264,714 87.0% Economic Support 1,020,270 834,622 185,648 81.8% General Relief 3,000 1,125 1,875 37.5% Coordinated Services /SED 2,802,917 1,974,346 828,571 70.4% Carryover Funds 1,049,211 961,777 87,434 91.7% Service Revenue $ 14,758,107 $ 11,517,102 $3,241,005 78.0% Annual November Budget % of Expenditure by Service Budget Actuals Balance Budget Administration $ 1,236,281 $ 1,070,253 $ 166,028 86.6% Alcohol -Drug Abuse 768,662 668,246 100,416 86.9% Mental Health 3,702,935 2,854,173 848,762 77.1% Family & Children's 3,188,401 2,185,588 1,002,813 68.5% Public Health 2,035,641 1,747,203 288,438 85.8% Economic Support 1,020,270 1,025,878 (5,608) 100.5% General Relief 3,000 - 3,000 0.0% Coordinated Service /SED 2,802,917 2,248,607 554,310 80.2% Service Expenditures $ 14,758,107 $ 11,799,949 $2,958,158 80.0% Revenues Over fUndei) Expenditures $ ( 282,8461 Expected Percent of Budget 91.7% The following financial report for St. Croix Industries through November, 2010 was distributed. Expenses for St. Croix Industries were light in November but the report will even out in December with the new reporting process. St. Croix County Health and Human Services Board Page 4 December 15, 2010 5t. Croix Industries - Fund 625 November 2010 Annual November Budget % of Revenues Budget Actuals Balance Budget WS Operations $ 1,375,209 $ 1,396,807 $ (21,598) 101.6% WS Production 306,513 333,326 (26,813) 108.7% WS Helping Hands 86,500 126,956 (40,456) 146.8% WS Pop/Vending 6,300 12,572 (6,272) 199.6% WS Ram 3,350 6,590 (3,240) 196.7% WS Vocational Placement 341,488 340,747 741 99.8% WS Comm Based Day Prog 197,730 93,549 104,181 47.3% Total Revenue $ 2,317,090 $ 2,310,548 $ 6,542 99.7% Annual November Budget % of Expenditures Budget Actuals Balance Budget WS Operations $ 1,375,209 $ 1,044,872 $ 330,337 76.0% WS Production 306,513 322,318 (15,805) 105.2% WS Helping Hands 86,500 84,749 1,751 98.0% WS Pop/Vending 6,300 5,374 926 85.3% WS Ram 3,350 2,884 466 86.1% WS Vocational Placement 341,488 268,177 73,311 78.5% WS Comm Based Day Prog 197,730 126,121 71,609 63.8% Total Expenditures $ 2,317,090 $1,854,494 $ 462,596 80.0% Revenues Over (Under) Expenditures $ 456,053 Expected Percent of Budget 91.7% The following financial report for the Nursing Home through November, 2010 was distributed. Nursing Home numbers are close to projections with a profit of $4,017 for November. St. Croix County Health and Human Services, Board Page 5 December 15, 2010 St. Croix Health Center - Fund 600 November 2010 Operating Revenue: Budget Actuals Difference of Budget Medicare $ 2,223,908 $ 1,265,256 $ 958,652 56.9% Medicaid 2,043,172 1,818,473 224,699 89.0% Private Pay 975,919 1,094,318 (118,399) 112.1% Revenue - IGTlSupplemental Funds 469,000 501,170 (32,170) 106.9% Out Patient Therapy - 16,191 (16,191) 0.0% All Other Sources 18,458 10,745.58 7,712 582% Total Operating Revenue $ 5,730,457 $ 4,706,153 $ 1,024,304 82.1% Operating Expenses Daily Patient Services $ 3,827,182 $ 3,417,607 $ 409,575 893% Special Services 287,498 242,828 44,670 84.5% General Services 1,239,492 1,018,273 221,219 822% Administrative Semces 610,305 535,858 74,447 87.8% Sub Total $ 5,964,477 $ 5,214,567 $ 749,911 87.4% Unassigned: Depreciation (% Based) Others. Utilities $ 208,461 $ 87,406 $ 121,055 41.9% Workers Comp, Computer Tech 264,602 117,082 147,520 442% Insurance 55,000 74,119 (19,119) 134.8% Unassigned Sub Total $ 528,063 $ 278,607 $ 249,456 52.8% Total Operating Expenses $ 6,492,540 $ 5,493,173 $ 999,367 84.6% Revenues Over (Under Expenditures) from Operations $ (787,020) County Revenues Insurance Dividend - unexpected revenue not result of Operations $ 9,160 $ 100,858 $ (91,698) 1101.1% Cc Allocations - Levy (% Based) 616,131 564,787 $ 51,344 91.7% Nursing Home Carry Over 136,792 125,393 11,399 91.7% Total Outstanding $ 762,083 $ 791,037 $ (28,954) 103980% Revenues Over (Under) Expenditures Including County Contributions $ 4,017 Expected Percent of Budget 91.7% 2011 HEALTH CENTER BUDGET SUMMARY The Nursing Home budget for 2011 has been updated as adopted by the County Board on 10/26/2010 and was distributed. Johnson offered Board members copies of the full budget versus just the summary. AGED HEALTH AND HUMAN SERVICES RECEIVABLES REPORT: The aging Accounts Receivable report for Health and Human Services through November was briefly reviewed. Work is being done to restructure the reports. Staff are reviewing the write -off process for doubtful accounts. BIRTH TO THREE WAIVER -STATE INITIATIVE Vrieze reported the Birth to 3 Program currently has 99 kids enrolled. She said a child count is done every year on October 1. The program has grown from a count of 67 in 2008 to 99 today with no more staff. She reported there are currently six additional intakes in progress with an additional three clients to screen to determine if these clients are eligible for services. Vrieze also reported there are three clients to discharge. She said the Program has contracted for more direct services in an effort to manage growth. Vrieze reported fewer families have insurance or have high deductible insurance. The County is the payer of last resort. There are three possible Medicaid (MA) initiatives for Birth to 3; however, no start date or reimbursement rate has been received from the State. The Birth to 3 waiver will only cover St. Croix County Health and Human Services Board Page 6 December 15, 2010 Birth to 3 services, no equipment or respite care. The number of slots for the waiver has not been determined. The waiver monies will be our discretion on how to award slots and a meeting will be held on this. Any child on the waiver will also be eligible for MA card. The request for the initiative was sent to Center for Medicaid Services (CMS) on November 1, 2010 and they have six months to respond. A second M.A. initiative involves billing M.A. for special education services. This will provide some reimbursement to the program for special education services to children who have Medical Assistance. There is a third initiative which allows counties to bill for unreimbursed therapy costs and recoup 60% of those costs. The reimbursement must go back to the Birth to 3 Program. BIRTH TO THREE CASELOAD DISCUSSION Vrieze expressed concern for staff coverage during an upcoming staff family leave. She hopes to partially cover with temporary contract staff and current staff cover the balance. Birth to 3 services are mandated to be provided in a natural environment so staff are going out to homes. Vrieze reported most referrals come from the medical community. Other referrals come from WIC clinics, Public Health nurses, Family and Children's, Early Headstart, and the Family Resource Center. The sooner a child receives help and services, the easier it is to make a difference. Birth to 3 is not a medical model but supports children in their development. The program has grown as the population is more aware of the program and a good partnership has been developed with the medical community; however, consideration will have to be given as to how to manage the growth of the program over the next few years. BUSINESS PLAN REPORT FROM LARSONALLEN FOR ST. CROIX HEALTH CENTER Trenton Fast from LarsonAllen joined the meeting via phone. He provided a report regarding Nursing Home strategic planning. He looked at scenarios and modeling work for the Nursing Home. One scenario would be a move to a 40 bed Nursing Home with 48 bed assisted living facility. This scenario was the most cost effective from the financial standpoint. Fast considered the following assumptions: ■ Assumed decrease in the Supplemental Payment Program (IGT) to approximately $300,000. • 25% one -time increase in private pay revenue effective 01/01/2011. • 1%-2% annual increases in payment rates from all payors in subsequent years. • 2 % -3% overall increase in operating expenses. • Current assumption for 12% annual increase for health insurance costs based on industry averages. • Increase in occupancy to 93% in care center due to reduction in beds. • Assisted living occupancy and ramp up to 95% by 2013. ■ Increase Medicare /short stay payor mix to 15 %. • Gain operating efficiencies with construction of one level facility. o Reduce expenses $500,000 (one time reduction) ■ Salaries due to staffing $300,000 ■ Utilities, dietary, housekeeping - $200,000 ■ Revenue enhancement from outpatient therapy services. In this scenario, the facility would continue to operate at a loss for the projections going out as far as 2019 when depreciation and amortization interest expenses are included in the overall St. Croix County Health and Human Services Board Page 7 December 15, 2010 calculations. Without these expenses, the operations show a positive cash flow. A reduction in Nursing Home size and increase in assisted living puts the facility in a better financial situation. Fast indicated there are major changes going on in health care with health care reform. Revenues are going up slower than expenses. Fast indicated if the same assumptions were applied to different scenarios, the result would be similar numbers. Fast indicated another assumption was that it would take two years to complete construction on an assisted living facility, which would be occupied in 2013. Fast then reviewed the financial scenario for the 72 bed Nursing Home (no major projects or operational changes). This scenario also shows overall operational loss. In addition, this scenario included no salary increases for the 2011 budget. The 2011 budget also had a significant reduction in capital outlay in order to make budget, so the fiscal situation would likely show more operational loss. Johnson indicated the County is coming to the end of the monies budgeted for the contract with LarsonAllen. Fast did review previous work from WIPFLI. This was a March 18, 2008 report given to the County Board where the focus of the report was financial modeling that was done on the current facility for three scenarios which included 50 beds located on two floors, 50 beds with 20 units Community Based Residential Facility (CBRF), and 44 beds with 20 units CBRF. Fast reviewed this report and concurred with the WIPFLI findings. Each of these scenarios required tax for continued support and that given current estimates /assumptions for remodeling costs, the levy required in the estimates would likely be low. Fast indicated from a business standpoint a financial forecast needs to be examined before contacting a lender. Fast commented LarsonAllen would be hesitant to do an examined financial forecast due to feasibility of nursing home /assisted living. There is a gap in the projected bottom line and where the Nursing Home needs to be. In the scenarios that were reviewed by LarsonAllen, the Nursing Home will require many years of tax levy support and at this time, there is not a guaranteed contribution going forward. There is a question of long term feasibility of the Nursing Home without fund raising or County backing. The Board recessed from 9:52 — 10:02 AM. Johnson questioned the next step for facility planning. The Nursing Home may need to adjust long term strategic planning goals as the Nursing Home may not get off the levy by 2015. Johnson recommended that at this point there are no significant variables left to study. What will the County Board support for operation and future planning for the Nursing Home? Horne questioned if there were other county facilities in Wisconsin that were not on county tax levy. Horne requested information on other successful county models in Wisconsin. If someone else in the State can build a successful facility and St. Croix County cannot, what is the difference in the operations? Funk, Kusmirek, Johnson and Robinson will contact Dunn County regarding their planning and also speak with Dunn County's administrator. Robinson will send out a request to inquire if other county homes in Wisconsin are on or off the county levy. St. Croix County Health and Human Services Board Page 8 December 15, 2010 Arrangements will also be made to discuss LaCrosse County planning as well as make contact with WCHA and NACO regarding other county nursing homes in Wisconsin. It was suggested that a joint meeting be held with the Facilities and Planning Committee/ Administration Committee in January as a possible next step. NURSING HOME ADMINISTRATOR'S REPORT Robinson said the average monthly census for October was 61, with 5 Medicare, 34 Medicaid, 20 private pay, 1 insurance and 1 Family Care residents. The Medicare average daily rate paid is $532.43 compared to the budgeted amount of $426.00, which reflects the higher acuity level of residents being admitted. Robinson reported charting is also being done at the point of care. Staff are using the kiosks for charting. The new MDS became effective 10/01/10 and has resulted in higher reimbursement for Medicare residents. Sundance also retrained their therapists to optimize revenue due to the change. 2011 ROUTINE MEETING DATES The 2011 meeting schedule will remain the same schedule as 2010 except for the December meeting as this schedule fit well with other County committees. HEALTH AND HUMAN SERVICES BYLAWS Johnson indicated sections A and B of the bylaws were changed to match the information contained in the County bylaws. The document was reviewed with Greg Timmerman, Corporation Counsel. Motion A motion was introduced by Larson, seconded by Horne, and unanimously adopted: That the Board approves the revised Bylaws. PARTNER SERVICES FOR HIV IN THE WESTERN REGION The State is now pushing for a consortium for HIV services for the Western Region. This service receives a small reimbursement from the State. This is a policy shift to provide services in other counties. Administration is not recommending St. Croix County to be the lead county due to limited staff time available and projected limited funding. Polk County has indicated interest in being the lead agency. Motion A motion was introduced by Larson, seconded by Marzolf, and unanimously adopted: that the Board recommends maintaining HIV Partner Services for St. Croix County as they are now. PUBLIC HEALTH "FOOD RESOURCE COLLABORATIVE" REPORT The Food Resource Collaborative of St. Croix County (FRC) was re- structured in 1999. The FRC currently meets quarterly to share information with various agencies, food pantry representatives and various community members regarding hunger issues, what is happening around the county and how we can assist each other. Lehmann distributed the recently revised "Community Food Resource Directory" which lists how to access a variety of programs such as local food pantries, low cost resources, community meals at churches, Food Share, senior dining sites, etc. Lehmann also distributed information on ACCESS, a way to apply online for Food Share, the Federal poverty guidelines and at what level clients are eligible for Food Share and also the WIC program. Other information provided included an application form to apply for the WIC program and a pamphlet describing the WIC approved foods. Lehmann explained that if more people received Food Share there would be less demand at the local food pantries. The Food Resource Center located in St. Croix County Health and Human Services Board Page 9 December 15, 2010 Hudson and operated by United Way, assists in distributing surplus food to the food pantries and a variety of other agencies /programs, providing additional food resources to the food pantries in other communities. A brief explanation regarding the venison program was given also. COMMUNITY HEALTH PARTNERSHIP UTILIZATION UPDATE FOR ST. CROIX INDUSTRIES SERVICES A meeting is being held at 6:00 PM on 12/15/2010 at St. Croix Industries for consumers, families and guardians. It is an educational event to inform consumers what their rights, responsibilities, and options are for services for St. Croix Industries. The end result of projected Medicaid budget shortfalls is a potential reduction of services. Johnson and Schroeder also had a conversation with the State related to contingency planning if a CMO in the State fails. The State is working on such planning but highlighted that they are not concerned about CHP failing in the immediate future. Staff are continuing to monitor and following CHP. The St. Croix Industries client holiday party is scheduled for 12/18/2010 at noon at Ready Randy's in New Richmond. Board members were encouraged to attend. ST. CROIX HEALTH CENTER ECONOMIC IMPACT REPORT FROM WISCONSIN ASSOCIATION FOR HOMES AND SERVICES FOR THE AGING (WASHA) AND WISCONSIN HEALTH CARE ASSOCIATION (WHCA Wentz attended a government network meeting with township and city members. Dunn County was also represented at the meeting. At the meeting, there was discussion regarding the economic and employment impact of nursing homes in the State. Wisconsin Association for Homes and Services for the Aging (WAHSA) and Wisconsin Health Care Association (WHCA) enlisted NorthStar Economics, Inc. to analyze the nature, scope and impact of Wisconsin nursing homes on jobs and the state's economy. The report analyzed the economic impact of the St. Croix Health Center and a copy of that report was distributed to the board. Luckey asked for more detail on NorthStar Economics, Inc. MEDICAID CERTIFIED CRISIS INTERVENTION FUNDING RESOLUTION Agencies wishing to receive Medicaid reimbursement for crisis intervention are required to obtain an agency resolution. The resolution must state that the agency agrees to make available the non - federal share needed for Medicaid reimbursement of crisis intervention services. The 2011 contract with Northwest Connections and staff salary would be used as that match (non - federal share). Johnson discussed an agency resolution with Corporation Counsel Timmerman. This could be done, but then the resolution needs to come to full County Board and not sent to the State from an individual committee. The County Resolution to adopt the 2011 budget, along with the specific budget for crisis intervention could be sent as the County Resolution to make available the non - federal share. This documentation, along with a motion from this committee is anticipated to meet the requirement for our application. If a more specific resolution is needed, Johnson will put this back on a future agenda. Motion A motion was introduced by Horne, seconded by Rasmussen, and unanimously adopted, That the Health and Human Services Board has agreed to make available the non - federal share needed for Medicaid reimbursement of crisis intervention services. This action was confirmed by the full County Board when the 2011 budget and approving other expenditures, Resolution No. 32 (2010) was approved as this budget includes the non - federal share needed for Medicaid St. Croix County Health and Human Services Board Page 10 December 15, 2010 reimbursement for crisis intervention services. FRAUD PREVENTION PROGRAMMING The state offered additional funding to the County to develop a consortium to address fraud prevention activities for FoodShare, Medicaid, and BadgerCare Plus. The application for the funding was due last week. The County is required to operate a fraud program; however, there are options on how to participate. St. Croix County has reviewed with Corporation Counsel regarding joining a consortium with Eau Claire County as the lead agency for fraud prevention programming. This option will require a 10% match to the amount allocated by DHS in order to participate and strengthen the program. Motion A motion was introduced by Schrank, seconded by Horne, and unanimously adopted: That the Board approves taking part in fraud consortium, utilizing Option 1 to participate as part of a regional consortium, for an additional approximate $6,000. LEGISLATIVE AGENDA ITEMS FOR JANUARY 10 COMMITTEE OF THE WHOLE MEETING A meeting with legislators is scheduled for January 10 with the Committee of the Whole to discuss priorities for St. Croix County. Board members were encouraged to get issues to Wentz or Standafer before January 10 PERSONNEL ISSUES NEW EMPLOYEES/VACANCIES Johnson distributed a vacancy report for December. Questions were raised regarding application of soft hiring freeze. Prevention/Nutrition Program Coordinator (move from 19 to 24 hours): Johnson indicated there are ten nutrition sites in St. Croix County. This position would include a sunset clause if funding is not available. Johnson recommended moving forward to increase this position from 19 to 24 hours. He reported this position request is also on the ADRC agenda for 12/16/10. Family and Children's contract/employment agreement (evenings and weekends juvenile monitoring services): Family and Children's are moving away from a vendor contract to an employment agreement. Youth Community Support Services (YCSS): two contract social workers were approved in the 2011 budget process. These positions are meant to address the waitlist (80 individuals). Focus of service authorization is health and safety concerns for clients. If these positions are not filled, the agency will lose approximately $23,000 in State funding and would need to review budget reductions in purchase service contracts and projected revenue from case management billing anticipated from these positions. Multi- Systemic Therapy (MST) Therapists: These two positions were built into the 2011 budget. This is an evidence -based practice for families to keep or get kids in the homes. This service provides intensive services in homes. The ADRC, YCSS, and MST positions were approved in the 2011 budget process. The positions went through all three steps and were approved on 10/26/2010. Having to get these positions approved again due to the soft hiring freeze is a duplication of the process that was just completed. St. Croix County Health and Human Services, Board Page 11 December 15, 2010 However, since there is some question about how the soft hiring freeze applies to positions, Johnson wanted them to be reviewed. All positions listed for St. Croix Industries are on -call positions. The State trend is for more integrated employment versus center employment. Johnson also reminded the Board that a staff person in the Birth to 3 program will soon be out on Family Medical Leave. Johnson reported prior to the soft hiring freeze any open positions in Health and Human Services were reviewed before filling. Open positions were not automatically filled. Motion A motion was introduced by Horne, seconded by Rasmussen, and unanimously adopted: That the Board approves moving all positions forward to the Administration Committee with the ADRC Committee reviewing the Prevention/Nutrition Program Coordinator position. If the ADRC Committee approves the Prevention/Nutrition Program Coordinator position then to also move that position forward to the Administration Committee. Also, the Board approves an eight -hour position for Birth to 3 for staff member on Family Medical Leave. POSSIBLE AGENDA ITEMS FOR NEXT MEETING • Wisconsin Child and Family Services review report • Business Plan report for St. Croix Health Center • Economic Support Program Report • Family Care Appeals Meeting Wentz asked if there were any other issues to bring before the Board. Wentz adjourned the meeting. Time: 11:52 AM Chair: Attest: (Secretary)