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HomeMy WebLinkAboutHealth & Human Services 05-06-10 ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD May 06, 2010 The St. Croix County Health and Human Services Board met on May 06, 2010 at the St. Croix County Health and Human Services/Health Center complex. MEMBERS PRESENT: Esther Wentz, Chair Leon Berenschot Frederick Horne Roger Larson Linda Luckey Richard Marzolf Dr. Lisa Ramsay Deb Rasmussen Alfred Schrank STAFF PRESENT: Fred Johnson, Health and Human Services Director Frank Robinson, Nursing Home Administrator Kathy Dunlap, Family and Children's Coordinator Kim Dupre, Information Systems Analyst Sharon Reyzer, Public Health Supervisor Tammy Wilson, HIS Supervisor Brad Beckman, ADRC Coordinator Clark Schroeder, St. Croix Industries Director Mary Squyer, Economic Support Supervisor Ron Kiesler, Behavioral Health Coordinator Cari Myer, Behavioral Health Emergency Services Social Worker Malva Sirek, Secretary OTHERS PRESENT: Chuck Whiting, Administrative Coordinator Daryl Standafer, County Board Chair Michelle Pietrick, Finance Director Art Tobin, Facilities Manager Tammy Funk, Human Resource Administrator Dave Geske, LaCrosse County Vector Control Manager 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 Thursday, June 16, 2010 at 4:00 PM. Marzolf will review vouchers. AGENDA Motion A motion was introduced by Berenschot, seconded by Larson, and unanimously adopted: That the agenda be approved St. Croix County Health and Human Services Board Page 2 May 6, 2010 MINUTES Motion A motion was introduced by Schrank, seconded by Berenschot, and unanimously adopted: That the minutes of the 03/17/10 Health and Human Services Board meeting be approved as distributed. ELECTION OF OFFICERS Wentz asked for nominations for Chair. Berenschot nominated Wentz, seconded by Schrank. Wentz called for other nominations three times. Motion A motion was introduced by Schrank, seconded by Horne, and unanimously adopted: To close the nominations and cast a unanimous ballot for Wentz as Chair. Wentz requested nominations for Vice Chair. Berenschot nominated Larson. Wentz called for other nominations three times. Motion A motion was introduced by Schrank, seconded by Horne, and unanimously adopted: To close the nominations and cast a unanimous ballot for Larson as Vice Chair. Wentz asked for nominations for Secretary. Luckey nominated Rasmussen. Wentz called for other nominations three times. Motion A motion was introduced by Horne, seconded by Larson, and unanimously adopted: To close the nominations and cast a unanimous ballot for Rasmussen as Secretary. 2010 ROUTINE MEETING DATES Discussion was held regarding meeting dates for the balance of the year. Motion A motion was introduced by Marzolf, seconded by Berenschot, and unanimously adopted: That the Board approves meeting the third Wednesday of the month with the meeting start time of 8:30 AM. The Open Budget Hearing will be held June 16, at 6:00 PM. The regular Health and Human Services meeting will begin at 4:00 PM on 06/16/10. CONSIDERATION OF CLAIMS Health and Human Services (HHS) Board member Wentz reviewed the vouchers. Motion A motion was introduced by Wentz, seconded by Berenschot, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book: Human Services vouchers 170076 through 170044, dated March 17, 2010 in the amount of $12,068.00. Human Services, Nursing Home, ADRC, and St. Croix Industries vouchers 170078 through 170185, dated March 17, 2010 in the amount of $44,976.90 Department of Aging and ADRC vouchers 170201 through 170229, dated March 17, 2010 in the amount of $8.966.51. St. Croix County Health and Human Services Board Page 3 May 6, 2010 Human Services and Nursing Home vouchers 170433 through 170436, dated March 17, 2010 in the amount of $1,767.55. Human Services, Nursing Home, St. Croix Industries, and Government Center vouchers 170437 through 170503, dated March 24, 2010 in the amount of $102,708.80. St. Croix Industries voucher 170504, dated March 24, 2010, in the amount of $248.00. Department of Aging and ADRC vouchers 170616 through 170628, dated March 31, 2010 in the amount of $2.720.44. Human Services, Nursing Home, St. Croix Industries, Government Center, and ADRC vouchers 170629 through 170738, dated March 31, 2010, in the amount of $77,881.54. Nursing Home voucher 170997, dated April 7, 2010, in the amount of $688.41. Department of Aging and ADRC vouchers 171085 through 171180, dated April 07, 2010 in the amount of $20.775.08. Human Services, Nursing Home, St. Croix Industries, and Government Center vouchers 171181 through 171291, dated April 07, 2010 in the amount of $80,592.03. Nursing Home vouchers 171292 through 171308, dated April 7, 2010, in the amount of $5,934.01. Human Services, Nursing Home, and St. Croix Industries vouchers 170998 through 171084, dated April 07, 2010 in the amount of $76,854.41. Human Services vouchers 171406 through 171443, dated April 7, 2010, in the amount of $32,320.42. Department on Aging, and ADRC vouchers 171825 through 171878, dated April 07, 2010 in the amount of $10,309.75. Nursing Home vouchers 171879 through 171898, dated April 07, 2010 in the amount of $34,370.22. Human Services, Nursing Home, St. Croix Industries, Government Center, Department on Aging, and ADRC vouchers 171899 through 171949, dated April 07, 2010 in the amount of $38,604.28. Human Services, Workshop, Public Health, Social Services vouchers 156 through 183, dated March 18, 2010 in the amount of $107,916.41. Human Services and Nursing Home vouchers 142 through 166, dated March 18, 2010 in the amount of $174,742.66. St. Croix County Health and Human Services Board Page 4 May 6, 2010 Workshop vouchers 31 through 36, dated March 18, 2010 in the amount of $14,445.24. Human Services, Workshop, Public Health, Social Services vouchers 184 through 214, dated April 01, 2010 in the amount of $112,531.49. Human Services and Nursing Home vouchers 167 through 194, dated April 01, 2010 in the amount of $210,245.14. Workshop vouchers 37 through 42, dated April 01, 2010 in the amount of $13,192.43. FINANCIAL REPORT The following fmancial report for Health and Human Services through February, 2010 was distributed. Johnson said Long Term Support is a zero - budgeted item. It was discovered the expenses allocated to Long Term Support should be in ADRC so those funds will be re- allocated to ADRC. Also there will be journal entries made to move some COP (Community Option Program) funds to Behavioral Health and Youth Community Support Services (YCSS) so monies are reflected in the correct department. St. Croix County Health and Human Services Board Page 5 May 6, 2010 HEALTH AND HUMAN SERVICES - 2010 SUMMARY Total OF REVENUES Budget February 28, 2010 Balance % Administration 187,070.00 (43,088.22) 230,158.22 -23.0% ACDA Services 766,662.00 75,594.77 693,067.23 9.8% Long Term Support 0.00 36,368.23 (36,368.23) 0.0% Mental Health 3,702,935.00 392,552.94 3,310,382.06 10.6% Family & Children's 3,188,401.00 409,807.39 2,778,593.61 12.9% Public Health 2,035,641.00 293,968.88 1,741,672.12 14.4% Economic Support 1,022,020.00 103,498.24 918,521.76 10.1% General Relief 1,250.00 250.00 1,000.00 20.0% Coordinated Services /SED 2,802,917.00 421,356.11 2,381,560.89 15.0% ARDC 2,457,878.00 78,693.00 2,379,185.00 3.2% Department on Aging 924,053.00 56,609.37 867,443.63 6.1% Carryover Funds 1,049,211.00 174,868.50 874,342.50 16.7% REVENUES HUMAN SERVICES PROGRAMS 18,140,038.00 2,000,479.21 16,139,558.79 11.0% SUMMARY Total OF EXPENDITURES Budget February 28, 2010 Balance % Administration 1,236,281.00 198,627.91 1,037,653.09 16.1% Alcohol -Drug Abuse 768,662.00 118,027.58 650,634.42 15.4% Long Term Support 0.00 8,914.88 (8,914.88) 0.0% Mental Health 3,702,935.00 466,045.43 3,236,889.57 12.6% Family & Children's 3,188.401.00 416,331.26 2,772,069.74 13.1% Public Health 2,035,641.00 348,943.81 1,686,697.19 17.1% Economic Support 1,020,270.00 204,808.43 815,461.57 20.1% General Relief 3,000.00 0.00 3,000.00 0.0% Coordinated Service/SED 2,802,917.00 311,581.46 2,491,335.54 11.1'x/ ARDC 2,457,878.00 85,021.48 2,372,856.52 3.5% Department on Aging 924,053.00 84,319.56 839,733.44 9.1% EXPENDITURES HUMAN SERVICES PROGRAMS 18,140,038.00 2,242,621.80 15,897,416.20 12.4% Total S (242.142.59) The following financial report for St. Croix Industries through February, 2010 was distributed. St. Croix Industries is waiting on invoices to be paid as expenses are up to date, but not necessarily receivables. The following report shows a loss of $6,246 over a two month period; however if receivables were up to date, the report would reflect approximately a $52,000 net gain. St. Croix County Health and Human Services Board Page 6 May 6, 2010 St. Croix Industries - 2010 SUMMARY Total OF REVENUES Budget Februarys 28, 2010 Balance WS Operations 1,375,209.00 194,325.62 1.1 80,883.38 14.1% WS Production 306,513.00 59,892.93 246,620.07 19.5✓ WS Helping Hands 86,500.00 8,983.65 77,516.35 10.4% WS Pop/Vending 6.300.00 1,711.53 4,588.47 27.2% WS Ram 3,350.00 1,372.93 1,977.07 41.0% WS Vocational Placement 341,488.00 43,652.30 297,835.70 12.8% WS Comm Based Day Prog 197,730.00 12,148.07 185,581.93 6.1% REVENUES 2,317,090.00 322,OB7.03 1,995,002.97 13.9° SUMMARY Total OF EXPENDITURES Budget February 28, 2010 Balance % WS Operations 1,375,209.00 190,500.19 1,1 84,708.81 13.9% WS Production 306,513.00 49,452.98 257,060.02 16.1 WS Helping Hands 86,500.00 8,742.32 77,757.68 10.1% WS Pop/Vending 6,300.00 134.53 6,165.47 2.1% WS Ram 3,350.00 192.81 3,157.19 5.8% WS Vocational Placement 341,488.00 54,010.61 287,477.39 15.8% WS Comm Based Day Prog 197,730.00 25,299.78 172,430.22 12.8% EXPENDITURES 2,317,090.00 328,333.22 1,988,756.78 14.2° Total S (6,246.19) The following financial report for the Nursing Home through February, 2010 was distributed. The Nursing Home made a positive swing from January to February due to year end entries. The census today is 65. Robinson reported the budget was built on a Medicare rate of $426 and we are currently receiving a rate of $450.26. Marketing has been increased. Robinson is part of the website committee, which is moving forward to update the county website. Staff are sending out notices to update doctors and hospitals on the status of residents that have been referred to St. Croix Health Center. A rehab reunion is being planned for residents who have discharged home from St. Croix Health Center. A new system has been established with the purchase of two beepers that allows staff to respond to admission calls within 30 minutes of referral. Robinson reported revenues received from therapy services are positive. He reported Medicare A revenue was $19,712 and Medicare B revenue was $2,774, which is very good. St. Croix County Health and Human Services Board Page 7 May 6, 2010 St. Croix Health Center February 2414 Budget Actual Difference Percentag4 Census 0 Opeiating Revenue: Medicare $2,223,906.00 $235,242.10 $1,988,665.90 10.58% Medicaid $2,043,172.00 $334,403.44 $1,708,768.56 16.37% Private Pay $975,919.00 $205,881.03 $770,037.97 21.10% Revenue - IGT /Supplemental Funds $469,000.00 $0.00 $469,000.DO 0.00% All Other Sources $27,618.00 $54,176.94 - $26,558.94 196.17% Total Operating Revenue $5,739,617.44 $829.743.51 $4,949,913.49 14.46% Operating Expenses Daily Patient Services $3,827,182.32 $649,261.09 $3,177,921.23 16.96% Special Services $287,498.00 $50,987.50 $236,510.50 17.73% General Services $1,239,492.00 $196,273.89 $1,043,218.11 15.84% Administrative Services $610,30500 $108,006.73 $502,298.27 17.70% Unassigned: Depreciation_ (% Based) $0.00 Others: $528,063.00 $21,077.75 $506,985.25 3.99% Utilities $208,461.00 $0.00 Workers Comp, Computer Tech $264,602.00 $544.75 Insurance $55,000.00 $20,533.00 Total Operating Expenses $6,492,544.32 $1.425,646.96 $5.46 6,933.36 15.80% Net From Operations ($195,943.45) (Cost of doing business prior to applying levy & outstanding rev) County Revenues Co Allocations (% Based) $616,131.32 $102,688.00 $513,443.32 16.67% Nursing Home Garry Over $136,792.00 $22,798.67 $113,993.33 16.67% Total Outstanding $752,923.32 $125.486.67 $627,436.65 Net from all Sources ($74,416.78} NURSING HOME ADMINISTRATOR'S REPORT Robinson said the average monthly census for February was 64, with 9 Medicare, 35 Medicaid, 19 private pay and 1 Family Care resident. Robinson reported the State survey team showed up on Monday and left on Tuesday. Robinson reported a `B' level cite was issued and corrected the same day as the incident. This incident was a self -report and no fine has been associated with the cite as this point. A `D' level site was issued for hand washing concerns. Staff have been re- inserviced on proper handwashing and management is performing audits to make sure proper procedures are being followed. There was a State correction on our policy for changing oxygen tubing from 7 to 5 days. This change was also made during the survey. Robinson reinforced that the facility went three years without any St. Croix County Health and Human Services Board Page 8 May 6, 2010 cites and the cites received now are minor cites. Robinson said the life /safety part of the survey, which addresses fire dangers, water temperatures, return air, hood vents, sprinkler heads, etc., has not been completed. Building services is keeping up with code changes. Robinson reminded Board members that St. Croix Health Center has received five stars from the Centers for Medicare and Medicaid Services. 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 February was reviewed. Adjustments are made on fee schedules based on Medicare, Medicaid and ability to pay. Staff have made some recoveries on doubtful accounts through tax intercepts. Johnson reported Pempek's last day was 04/23 and thanked Michelle Pietrick and Mike Wanschura for their help with reporting and fiscal work for the agency. ST. CROIX INDUSTRIES ELECTRICAL UPGRADE BID The St. Croix Industries building was built in 1978 and has not been modernized for electrical use. There is not enough power in the building. The hope is to run additional wiring from the production area to the front part of the St. Croix Industries building and add another panel. Tobin is in charge of the project. Monies were not budgeted for this project. Work is currently underway to split the utilities for the buildings as we currently have one meter for the entire facility. A meter will be installed for each area, Health and Human Services, St. Croix Health Center and St. Croix Industries, for electric, water and gas. It is hoped all meter separations will be done by the end of this month with gas meters to follow at a later time. Motion A motion was introduced by Berenschot, seconded by Larson and unanimously adopted: That the Board approves going forward with the electrical upgrade for St. Croix Industries. AD HOC FACILITY PLANNING UPDATE The Long Range Facility Planning Committee met yesterday. All buildings are being studied for space utilization. Tobin said 40# of water pressure is needed to sprinkler heads in the Nursing Home. Tobin is working with the City of New Richmond regarding what can be done with the current water tower now and if we could operate without the current tower. More updates will follow at future meetings. Tobin reported there is a ventilation issue in the Nursing Home that is being dealt with by his crew. The industry standard for office space used is seven staff per 1,000 square feet and Health and Human Services is at 2 staff per 1,000 square feet, however, a lot of the space considered in Health and Human Services is in hallways, etc. More updates will be provided as information becomes available. The Board recessed from 9:40 — 9:47 AM. LACROSSE COUNTY HEALTH DEPARTMENT — REGIONAL VECTOR CONTROL PROGRAM Dave Geske, LaCrosse County Vector Control Manager, gave a presentation of Vectorborne Disease Control Activities in Western Wisconsin and Southeaster Minnesota during 2009. Currently the program is targeting mosquito and tick -borne diseases, which includes St. Croix County Health and Human Services Board Page 9 May 6, 2010 LaCrosse Viral and Viral Encephalitis, West Nile Virus and Lyme Disease, etc. He highlighted control activities occurring including surveillance, habitat control, and public education. REVIEW OF ADMINISTRATION REVENUE FROM MONTHLY FISCAL REPORT Johnson further explained the negative amount in administration revenue. COMPREHENSIVE COMMUNITY SERVICES RESOLUTION Health and Human Services (HHS) is certified for the Youth Community Support Services (YCSS) and Behavioral Health (BH) billing. Comprehensive Community Services (CCS) is a Medicaid funded program that required a HHS resolution to go to the full County Board. After a telephone conference call regarding the program, it was determined a resolution is not needed. Johnson will submit a letter regarding the program instead. Staff are still evaluating the CCS program as some of the benefits of the program have been limited since the application was made. 2009 UPDATE ON YEAR -END CLOSE OUT FOR HEALTH AND HUMAN SERVICES, ST. CROIX INDUSTRIES AND HEALTH CENTER Johnson said final reconciliations have been made and sent in for updates. No questions were brought forward by the Board. PERSONNEL ISSUES NEW EMPLOYEES/VACANCIES Johnson announced Angie Magoon, current Financial Assistant, has accepted an Economic Support Specialist position to start in mid - May. He also announced that Dianne Keimig moved to a Financial Assistant position at the Government Center. Pam Estes has moved to a Financial Assistant position in Human Services administration. Johnson reminded the Board that Mary Squyer, Economic Support Supervisor, will retire 05/21 and Ronda Brown Anderson, former Pierce County Economic Support Supervisor, has been hired to fill this position. Johnson reported Pempek's last day was 04/23/10 and he is working closely with the Government Center Financial Department to fill the position and look at the financial needs for fiscal reports, etc. More information regarding the position will be available after the 05111110 Administration Committee meeting. Pietrick said there is a need for more cross training for the financial reports and centralized grant reporting. Wentz emphasized that HHS needs someone well versed in HHS and Nursing Home financial needs and reporting. Ronda Brown Anderson is scheduled to start 05/17/10 as Economic Support Supervisor. She will also help Pierce County as she transitions to St. Croix County. In return, Julie Billeter, Pierce County Financial Manager, will help St. Croix County about one day a week during the transition of the HHS Financial Manager position. Johnson consulted Corporation Counsel and there is no need for a formal contract. Billeter is working with Mike Wanschura regarding CARS reporting, HSRS and 942 reports. Johnson invited Board members to contact him with any questions. Johnson reported two Accounts Receivable vacancies have been filled with temp staff from MPS during the transition discussion in the Financial department. Johnson reported Jody Kroening, BH RN will be going on leave in July. A person from Medical Staff Solutions has been contracted to temporarily fill this position in her absence. St. Croix County Health and Human Services Board Page 10 May 6, 2010 Other staff changes include Kari Henry retiring as BH clerical position, Michele Osero moving to Medical Records and Nancy Peabody filling the BH Intake position vacated by Osero. Johnson said position openings are evaluated before moving forward to fill the positions. COUNTY BYLAWS AND ADVISORY COMMITTEES HSS Bylaws are reviewed annually by the Board. Johnson said the Bylaws should be revised to clarify all ad hoc and required subcommittees as far as who appoints committee members and who is on the committee. This will be updated in the HHS bylaws and Johnson will work with Timmerman and report back to the Board. MOBILE CRISIS PROGRAM UPDATE Emergency services are a vital part of what HHS does. Emergency services are required by law to provide 24/7/365 to anyone in mental health or alcohol or other drug abuse crisis. Northwest Connections has been contracted to do mobile work (telephone and on -site assessment). A change in the law on 06/30/2009 requires the approval of HHS staff in mental health crisis situations. When clients are diverted, a safety plan is set up with the client via mobile crisis and Cari Myer provides follow up services. In January of 2006 law enforcement began voluntary usage of mobile crisis services, which focuses on diverting clients from acute locked psychiatric hospital settings; however, there has been more consistency in mobile crisis utilization since law enforcement was mandated in June, 2009 to receive approval from Behavioral Health prior to transporting a client to an approved facility. Meetings are held with area police chiefs every other month and Don Gillen has attended some of those meetings to help to clarify issues that may arise. St. Croix County has been very effective in keeping individuals in the community. As hospitalizations decrease and diversion to community services increase, Behavioral Health Services is exploring ways to reorganize services to provide the necessary diversion coverage without increasing staff. Kiesler reported that there have been eight suicides (none service connected with St. Croix County HHS) in St. Croix and Pierce Counties in the last three months as compared to 35 total suicides from 2001 to 2006. In an effort to promote education regarding suicide prevention, Behavioral Health participated with other community organizations in a summit that was coordinated by River Falls Chief of Police, Roger Leque. ELECTRONIC HEALTH RECORDS (EM Policies and procedures for Electronic Health Records (EHR) are being developed with the assistance of Kristen Ziliak, Risk Manager, and Heather Wolske, Assistant Corporation Counsel, along with Jon Tomes, HIPAA (Health Insurance Portability and Accountability Act) Compliance Attorney. A GAP analysis is being issued to determine where St. Croix County stands with HIPAA compliance. EHR is a major initiative to implement that will likely need additional funding, not only for system review, but also for any implementation efforts. Some things that came out of the Open Minds Assessment were looking at our organizational structure and some things that may implement process improvement are: quality assurance, centralized intake /transcription, and re- aligning scheduling. These, along with HIPAA compliance, are components of the EHR that will be looked at, but they are only a part of the larger project. St. Croix County Health and Human Services Board Page 11 May 6, 2010 WESTERN REGION WALHDAB — BOARD OF HEALTH EDUCATIONAL EVENT A registration form for the event was distributed to Board members. Any members interested in attending were requested to contact Johnson for further coordination. HEAD START LEASE Johnson explained that Head Start has changed some of its programming, which has increased the noise level in that area. The volume of the noise has become problematic. In addition, more space is needed to centralize Medical Records. The plan is to pull back some of the space for the Early Head Start program from the lease to utilize for implementation of centralized Medical Records. Early Head Start is the non - licensed portion of their program and from discussions with their program manager should be easier for them to relocate. The licensed Head Start has been verbally put on notice to look for alternate space given some of the preliminary discussion from the Ad Hoc Facility Planning Committee. This program will continue to occupy current space through the next academic school year. Johnson wished to inform the board of these change prior to sending notice which will be done this week to meet the 30 day written notice requirement. POSSIBLE AGENDA ITEMS FOR NEXT MEETING Wentz asked that the Board receive the results of the employee survey by the end of next month. Marzolf listed items to consider which rose up from the July 28, 2009 Nursing Home Strategic Planning Workshop. The ideas will be forwarded to Robinson. The Nursing Home `Vision Team' will have a meeting at the end of the month. Wentz asked if there were any other issues to bring before the Board. Wentz adjourned the meeting. Time: 11:42 AM Chair: Attest: (Secretary)