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HomeMy WebLinkAboutHealth & Human Services 06-16-10 Marzolf will review vouchers. Revised 06 /15/2010 NOTICE OF MEETING AND AGENDA ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD DATE AND TIME. June 16, 2010 at 4: 00 PM 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 - 05/06/10 DATE OF NEXT MEETING — 07/21/10 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 3. Nursing Home Administrator's Report 4. Health Center Department of Health Environmental Survey 5. SEH consultant expense on environmental survey plan of correction 6. Program review /analysis of HHS Accounts Receivable and support staff functions 7. Personnel Issues a. New employees /vacancies b. Finance department reorganization c. Consideration of Youth Community Support Services reorganization ** d. Proposed modification of vacant clerical/typist position to Youth Community Support Services Program Aide ** 8. Review ADRC survey 9. Ad Hoc Facility Planning Update 10. Employee Survey Results 11. Preliminary Capital Outlay Planning in 2011 Budget Process 12. WIMCR Report 13. HIPAA/HITECH Compliance Planning 14. 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. 6/15/2010 8:00 AM ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD June 16, 2010 The St. Croix County Health and Human Services Board met on June 16, 2010 at the St. Croix County Health and Human Services/Health Center complex. MEMBERS PRESENT: Esther Wentz, Chair Leon Berenschot Roger Larson Linda Luckey Richard Marzolf Deb Rasmussen Alfred Schrank MEMBERS ABSENT: Frederick Horne, excused Dr. Lisa Ramsay STAFF PRESENT: Fred Johnson, Health and Human Services Director Frank Robinson, Nursing Home Administrator Brad Beckman, ADRC Coordinator Ron Kiesler, Behavioral Health Coordinator Steve Kirt, Behavioral Health Clinical Services Supervisor Ronda Brown - Anderson, Economic Support Supervisor Clark Schroeder, St. Croix Industries Director Fay Strenke, Accounts Receivable Supervisor Tammy Wilson, HIS Supervisor Malva Sirek, Secretary OTHERS PRESENT: Art Tobin, Facilities Manager Michelle Pietrick, Finance Director Chair Wentz called the meeting to order at 4:00 PM noting the meeting was properly and legally publicized. NEXT MEETING The next Health and Human Services Board meeting is scheduled for Wednesday, July 21, 2010 at 8:30 AM. Berenschot will review vouchers. AGENDA Motion A motion was introduced by Berenschot, seconded by Schrank, and unanimously adopted: That the agenda be approved MINUTES Motion A motion was introduced by Schrank, seconded by Berenschot, and unanimously adopted: That the minutes of the 05/06/10 Health and Human Services Board meeting be approved as distributed. St. Croix County Health and Human Services Board Page 2 June 16, 2010 CONSIDERATION OF CLAIMS Health and Human Services (HHS) Board member Marzolf reviewed the vouchers. Motion A motion was introduced by Marzolf, seconded by Schrank, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book: Human Services voucher 173 88 1, dated May 13, 2010 in the amount of $262.78. Department of Aging and ADRC vouchers 174128 through 174135, dated May 19, 2010 in the amount of $1,578,817.80. Human Services vouchers 174136 through 174138, dated May 19, 2010 in the amount of $13,255.50. Human Services, Nursing Home, Government Center, ADRC and St. Croix Industries vouchers 174139 through 174230, dated May 19, 2010 in the amount of $119,059.13. Department of Aging and ADRC vouchers 174383 through 174393, dated May 26, 2010 in the amount of $1,512.73. Human Services vouchers 174394 through 174395, dated May 26, 2010, in the amount of $897.36. Human Services, Nursing Home, and St. Croix Industries, vouchers 174396 through 174557, dated May 26, 2010 in the amount of $150,708.86. Department of Aging and ADRC vouchers 174697 through 174718, dated June 02, 2010 in the amount of $6,701.56. Human Services, Nursing Home, St. Croix Industries, and Government Center, Aging vouchers 174719 through 174757, dated June 02, 2010, in the amount of $53,533.90. Human Services vouchers 174758 through 174769, dated June 02, 2010, in the amount of $4,939.00. Human Services vouchers 174890 through 174931, dated June 02, 2010, in the amount of $36,160.85. Department of Aging and ADRC vouchers 175015 through 175105, dated June 09, 2010 in the amount of $12,866.10. Human Services, Nursing Home, St. Croix Industries, St. Croix Industries, Government Center, Department on Aging, and ADRC vouchers 175106 through 175193, dated June 09, 2010 in the amount of $57,312.70. St. Croix County Health and Human Services Board Page 3 June 16, 2010 Human Services vouchers 175194 through 175233, dated June 09, 2010, in the amount of $25,854.29. Human Services vouchers 175234 through 175236, dated June 09, 2010, in the amount of $18,406.25. Human Services, Nursing Home, Government Center, and St. Croix Industries vouchers 174933 through 175014, dated June 09, 2010 in the amount of $70,476.52. ANNOUNCEMENTS Johnson introduced Ronda Brown - Anderson as the new Economic Support Supervisor. FINANCIAL REPORT The following financial report for Health and Human Services through March, 2010 was distributed. Johnson reported the percentage should be 25 %. He reported the CARS report was filed a bit late due to staff changes. Johnson will continue to coordinate with Pietrick to meet financial department needs. St. Croix County Health and Human Services Board Page 4 June 16, 2010 HEALTH AND HUMAN SERVICES - 2010 SUMMARY Total OF REVENUES Budget March 31, 2010 Balance % Administration 187,070.00 (50,146.36) 237,216.36 -26.8% AODA Services 768,662.00 137,960.27 630,701.73 17.9% Long Term Support 0.00 39,069.23 (39,069.23) 0.0% Mental Health 3,702,935.00 622,661.61 3,080,273.39 16.8% Family & Children's 3,188,401.00 733,076.99 2,455,324.01 23.0% Public Health 2,035,641.00 579,913.85 1,455,727.15 28.5% Economic Support 1,020,27100 164,135.17 856,134.83 16.1% General Relief 3,000.00 375.00 2,625.00 12.5% Coordinated Services /SED 2,802,917.00 643,841.28 2,159,075.72 23.0% ARDC 2,457,878.00 578,185.50 1,879,692.50 23.5% Department on Aging 924,053.00 357,956.90 566,096.10 38.7% Carryover Funds 1,049,211.00 262,302.75 786,908.25 25.0% REVENUES HUMAN SERVICES PROGRAMS 18,140,038.00 4,069,332.19 14,070,705.81 22.4% SUMMARY Total OF EXPENDITURES Budget March 31, 2010 Balance % Administration 1,236,281.00 310.777.87 925,503.13 25.1% Alcohol -Drug Abuse 768,662.00 180.367.50 588,294.50 23.5% Long Term Support 0.00 9,249.08 (9,249.08) 0.0% Mental Health 3,702,935.00 743.401.05 2,959,533.95 20.1% Family & Children's 3,188,401.00 624,372.45 2,564,028.55 19.6 %. Public Health 2,035,641.00 523.370.45 1,512,270.55 25.7% Economic Support 1,020,270.00 293.966.27 726,303.73 28.8% General Relief 3,000.00 0.00 3,000.00 0.0% Coordinated Service/SED 2,802,917.00 515,470.96 2,287,446.04 18.4% ARDC 2,457,878.00 154,699.89 2,303,178.11 6.3% Department on Aging 924,053.00 145,571.79 778,481.21 15.8% EXPENDITURES HUMAN SERVICES PROGRAMS 18,140,038.00 3,501,247.31 14.638390.69 19.3% Total f 568,084.88 The following fmancial report for St. Croix Industries through March, 2010 was distributed. Revenue income has been a bit slow this summer but it is anticipated it will pick up in the fall. With less work, more client outings have been planned. St. Croix County Health and Human Services Board Page 5 June 16, 2010 St. Croix Industries - 2010 SUMMARY Total OF REVENUES Budget March 31, 2010 Balance % WS Operations 1,375,209.00 314,950.19 1,060,258.81 22.9'°/ WS Production 306,513.00 98,728.71 207,784.29 32.2° WS Helping Hands 86,500.00 14,893.84 71,606.16 17.2% WS Pop/Vending 6,300.00 3,114.52 3,185.48 49.4% WS Ram 3,350.00 2,051.71 1,298.29 61.2% WS Vocational Placement 341,488.00 76,978.70 264,509.30 22.5% WS Comm Based Day Prog 197,730.00 19,466.81 178263.19 9.8% REVENUES 2,317,090.00 530,184.48 1,786,905.52 22.9% SUMMARY Total OF EXPENDITURES Budget March 31, 2010 Balance % WS Operations 1,375,209.00 292,813.29 1,082,395.71 21.3% WS Production 306,513.00 80,203.83 226,309.17 26.2% WS Helping Hands 86,500.00 15,910.95 70,589.05 18.4% WS Pop/Vending 6,300.00 1,082.57 5,217.43 17.2% WS Ram 3,350.00 218.70 3,131.30 6.5% WS Vocational Placement 341,488.00 82,810.14 258,677.86 24.2% WS Comm Based Day Prog 197,730.00 37,837.83 159,892.17 19.1% EXPENDITURES 2,317,090.00 510,877.31 1,806,212.69 22.0% Total S 19,307.17 The following financial report for the Nursing Home through March, 2010 was distributed. IGT funds of $375,750 were received, which contributed to a positive $237,634.29 balance at the end of March. Robinson said the Medicare census has been down a bit, but this is typical during the summer months, but he is confident it will come back. St. Croix County Health and Human Services Board Page 6 June 16, 2010 St. Croix Health Center March 2010 Budget Actual Difference Percentage Census 0 Operating Revenue: Medicare $2,223,906.00 $328,769.36 $1,895,138.64 14.78% Medicaid $2,043,172.00 $513,622.32 $1,529,549.68 25.14% Private Pay $975,919.00 $319,620.02 $656,298.98 32.75% Revenue - IGT /Supplemental Funds $469,000.00 $375,750.00 $93,250.00 80.12% All Other Sources $27,618.00 $74,938.24 - $47,320.24 271.34% Total Operating Revenue $5339,617.00 $1,612.699.94 $4,126,917.06 28.10% Operating Expenses Daily Patient Services $3,827,182.32 $935,772.48 $2,031,409.64 26.02% Special Services $287,498.00 $74,133.45 $213,364.55 25.79% General Services $1,239,492.00 $291,406.38 $948,083.62 23.51% Administrative Services $610,305.00 $157,301.92 $453,003.08 25.77% Unassigned: Depreciation (% Based) $0.00 Others: $528,063.00 $44,679.42 $463,383.58 8.46% Utilities $208,461.00 $23,601.67 Workers Comp, Computer Tech $264,602.00 $544.75 Insurance $55,000.00 $20,533.00 Total Operating Expenses $6,492,540.32 $1.563,295.65 $4,929,244.67 24 .08% Net From Operations $49,404.29 (Cost of doing business prior to applying levy & outstanding rev) County Revenues Co Allocations (% Based) $616,131.32 $154,032.00 $462,099.32 25.00% Nursing Home Carry Over $136,792.00 $34,198.00 $102,594.00 25.00% Total Outstanding $752,923.32 $188.230.00 $564,693.32 Net from all Sources '$237,634.29 AGED HEALTH AND HUMAN SERVICES RECEIVABLES REPORT (UPDATED TO INCLUDE COLLECTION ON BAD DEBT): The aging Accounts Receivable report for Health and Human Services through April was reviewed. Strenke noted there have been some staffing changes which resulted in a jump in the 0 to 60 and 60 to 90 charges plus the timing of the Medicaid and Medicare billings being submitted. She indicated temporary staff have filled the vacated positions while the positions were evaluated. At this time the positions have been posted but no in- house staff signed the postings so recruitment has begun from outside the facility. Strenke indicated addition of a line on the income statement to reflect the amount recovered from doubtful accounts. St. Croix County Health and Human Services Board Page 7 June 16, 2010 NURSING HOME ADMINISTRATOR'S REPORT Robinson distributed a spreadsheet measuring the progress of core topics of the Nursing Home Strategic Plan. He explained the Nursing Home staff survey took place June 9 and 10 with a deadline of June 23 for all staff to participate. A baseline regarding staff satisfaction will be established from this survey. Robinson said the average monthly census for February was 64, with 6 Medicare, 1 Medicare Advantage, 39 Medicaid, 19 private pay and 1 Family Care resident. He said the Nursing Home has experienced a higher acuity level for residents than anticipated which translates to an average daily Medicare rate of $478.39 versus the budgeted $426.00. Robinson said there is now a sign for St. Croix Health and Rehab Center on Highway 64. Robinson continues to work with Tom Boron and his committee on the new County web site. Robinson reported updates on how residents are doing in therapy. He also indicated that information is being sent to referring physicians and referring therapy departments so they have feedback on how their patients are doing. The first rehab reunion for residents who have been discharged home after successfully completing therapy treatment was held and was a success. Robinson is researching doing some advertising for the Nursing Home on WIXK radio. He reported the annual Nursing Home picnic will be held in August and the theme will be 50's Rock `N Roll. Robinson said meetings are being held every couple of weeks regarding the Nursing Home ECS system. An update of ECS, which will activate touch screens, is scheduled for the end of July. Electronic signatures are being piloted for Social Service staff. HEALTH CENTER DEPARTMENT OF HEALTH ENVIRONMENTAL SURVEY A few deficiencies resulted from the Department of Health Environmental Survey. It was discovered a policy and procedure book outlining fire ratings, alarm system, etc. was purged. A good faith effort is underway to replace this book. The Nursing Home has been inspected every year since it was built in 1982 and there have been no major problems. The State cited the Nursing Home on a corridor supply air plenum or a return air plenum situation. SEH, the engineering firm the County has contracted with to address facility planning was engaged in a contract to assist developing a plan to correct this cite. The estimated cost to correct is approximately $150,000. A waiver has been requested from the State to fix the plenum issue, which would allow a 12 month window to correct. Corporation Counsel is reviewing a contract with SEH for consultant expense to correct the cite from the environmental survey. Besides correcting the plenum issue, a camera will need to be installed in the basement of the Nursing Home. This camera will be `on tour' in the basement of the nursing home with views at 3- 6 -9 -12 with a tie back to the nurses station. The cost of the camera is approximately $8,000. Also tagged were wall penetrations. Wall penetrations are any holes St. Croix County Health and Human Services Board Page 8 June 16, 2010 created by cabling for cable TV, electrical, piping, etc. Approximately $3,000 has been spent on patching the holes so far. PROGRAM REVIEW /ANALYSIS OF HHS ACCOUNTS RECEIVABLE AND SUPPORT STAFF FUNCTIONS Kirt completed a time study and interviewed HHS Accounts Receivable (AR) staff and Behavioral Health (BH) support staff regarding job functions. With opening in each of the units, a review of the positions was conducted to assess needs and assist with future planning. Time in Steve's schedule was allocated to conduct this review and administration anticipates utilizing this time in the future to analyze other service areas and project manage various initiatives. Part to the review process included surveying other counties statewide. Each county varied in their approach to scheduling and transcription, but Steve found a model in Dodge County that may fit well in St. Croix County, but it would include moving transcription and scheduling under Medical Records. This would allow for the most flexibility and would be consistent with some of the suggestions made by Open Minds assessment. Moving staff into Medical Records will not solve the need for more screening /intake time and a decision must be made as to how much clinical staff time we want to spend in typing as we move toward an EHR (Electronic Health Record). As a result of this study and part of the process of this program review, we will be moving forward with replacing the two temporary staff in Accounts Receivable with permanent staff to increase stability and increase efficiencies. We will also be looking at a reorganization of the Behavioral Health receptionists' duties and likely bring in a temporary staff to handle transcription needs which will be discussed later in the meeting. FINANCE DEPARTMENT REORGANIZATION Now is a good time to review the Finance department as there are three vacant financial positions currently in New Richmond. There needs to be a consistent application of accounting principles across the county. It may be possible to reallocate some of the functions that may help to free some time in some of the accounting positions. A thorough review including a time study and analysis by location and duties needs to be done. Pietrick said it became apparent there has not been sufficient cross training between departments. The second interview phase of hiring the New Richmond Financial Manager will take place on Monday. Johnson said the two Financial Assistant positions for Accounts Receivable have been advertised. Johnson wanted to express recognition for staff that have put in extra effort to get work done in the absence of a Financial Manager. These staff included Darlene Krenz for extra help with the audit process and State reporting, Fay Strenke for extra help during the audit and during the program review /analysis of the HHS accounts receivable review and Ron Kiesler for extra help with WIMCR. Further review will take place and a reorganization of the finance department will be brought to the County Board in August. PERSONNEL ISSUES NEW EMPLOYEES/VACANCIES Johnson distributed a vacancy report for June for HHS. This report will be completed monthly and forwarded to Tammy Funk. St. Croix County Health and Human Services Board Page 9 June 16, 2010 PRELIMINARY CAPITAL OUTLAY PLANNING IN 2011 BUDGET PROCESS Johnson distributed a preliminary plan for capital outlay expenses for 2011. A full plan will be part of the budget process. Building Services items will be reported on later. Johnson said `bricks and mortar' requests will be minimal for HHS given the preliminary conclusions from the Ad Hoc planning committee that the building is obsolete. Building Services will address life safety components for the facility while future plans are developed. The life safety components for HHS include GFI wiring, exit signage and electrical issues which are estimated to come to approximately $27,034. Tobin also reported Building Services staff are looking at changing lightning in the Nursing Home. PROPOSED MODIFICATION OF VACANT CLERICAL /TYPIST POSITION TO YOUTH COMMUNITY SUPPORT SERVICES PROGRAM AIDE Kiesler commended Kirt on the fantastic job he has done in Behavioral Health administration. Some of Kirt's duties have been reallocated to utilize his talents to analyze programs as was done earlier in the meeting. A proposal is being made to move a clerk typist position to a YCSS (Youth Community Support Services) program aide position, which would support the social workers. This would be a position upgrade and would need Administration Committee and County Board approval. This upgrade would allow more billing which would in turn generate additional revenue. Kiesler estimated there would be approximately $4,000 additional salary but revenues from billing would potentially increase by approximately $13,700. Temporary staff would be recruited to perform transcription work. Motion A motion was introduced by Rasmussen, seconded by Berenschot, and unanimously adopted: That the Board approves upgrading the Behavioral Health clerk typist position to a YCSS program aide and that the request be forwarded to the Administration Committee. CONSIDERATION OF YOUTH COMMUNITY SUPPORT SERVICES REORGANIZATION: Kiesler explained the YCSS (Youth Community Support Services) unit has grown from one or two staff to ten or eleven staff as more funding has been received from the State. Kiesler reported one item that came forward during the Pathways staff survey was confusion as to who reports to whom. A reorganization of the YCSS unit would clarify this item and recognize that this is no longer a pilot program. Johnson indicated at the time of LTC reform, the size of the department did not appear to support moving the LT Support Coordinator position to manage these services, so that position was eliminated. However, now it does appear that the need to consider changes in organizational structure is appropriate. Kiesler distributed a proposed restructure organizational chart for YCSS that could be a consideration in this process. Johnson expressed his appreciation for the work that both Kiesler and Dunlap have done to manage YCSS as the program has developed. The work they have done on program reorganization is also to be commended. While recommendations are yet to be finalized, we will work with Human Resources to assure any reorganization goes through the proper channels. POSSIBLE AGENDA ITEMS FOR NEXT MEETING Due to the Open Hearing scheduled for 6:00 PM, the following items were postponed to the July meeting: • Review ADRC survey • Ad Hoc Facility Planning Update St. Croix County Health and Human Services Board Page 10 June 16, 2010 • Employee Survey Results • WIMCR Report • HIPAA /HTTECH Compliance Planning Wentz asked if there were any other issues to bring before the Board. Wentz adjourned the meeting. Time: 5:50 PM Chair: Attest: (Secretary)