Loading...
HomeMy WebLinkAboutHealth & Human Services 03-17-10 Esther Wentz will review vouchers. Revised: 03/12/2010 NOTICE OF MEETING AND AGENDA ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD DATE AND TIME. March 17, 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 - 02/17/10 DATE OF NEXT MEETING — 04/21/10 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 - January 2010 b. aged receivable report 3. 2009 Financial year and closeout update 4. 2010 Updated Budget Summaries 5. Nursing Home Administrator's Report 6. Update on Long Range Facility Planning ** 7. Personnel Issues a. New employees /vacancies b. Report on position request from January and February HHS meeting 8. Fund raising by Health and Human Services Departments 9. Juvenile Treatment Court Implementation 10. Public Health 140 review 11. Health and Human Services and Nursing Home Strategic Planning 12. Tobacco Use Resolution Review 13. Review of Health and Human Services Day at the Capital" 14. Closed session per Wisconsin Statutes 19.85 (1) (c) for Director's performance evaluation. Reconvene in open session 15. Possible agenda items for next meeting 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. 3/12/2010 7:59 AM ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD March 17, 2010 The St. Croix County Health and Human Services Board met on March 17, 2010 at the St. Croix County Health and Human Services /Health Center complex. MEMBERS PRESENT: Esther Wentz, Chair Leon Berenschot Charles Grant Roger Larson Linda Luckey Richard Marzolf Gerald Peterson Deb Rasmussen MEMBERS ABSENT: Dr. Lisa Ramsay, excused STAFF PRESENT: Fred Johnson, Health and Human Services Director Jennifer Pempek, Financial Manager Frank Robinson, Nursing Home Administrator Wendy Kramer, Public Health Officer /Public Health Coordinator Kathy Dunlap, Family and Children's Coordinator Kim Dupre, Information Systems Analyst Malva Sirek, Secretary OTHERS PRESENT: Chuck Whiting, Administrative Coordinator Greg Timmerman, Corporation Counsel 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, April 21, 2010 at 8:30 AM. Berenschot will review vouchers. AGENDA Motion A motion was introduced by Berenschot, seconded by Larson, and unanimously adopted: That the agenda be approved MINUTES Motion A motion was introduced by Peterson, seconded by Grant, and unanimously adopted: That the minutes of the 02/17/10 Health and Human Services Board meeting be approved as distributed. 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 167983 through 168002, dated February 17, 2010 in the amount of $17,148.73. Human Services, Nursing Home and St. Croix Industries vouchers 168003 through 168061, dated February 17, 2010 in the amount of $128,584.14. St. Croix County Health and Human Services Board Page 2 March 17, 2010 Human Services and Nursing Home vouchers 168333 through 168346, dated February 24, 2010 in the amount of $42,146.29. Department of Aging voucher 168347, dated February 24, 2010 in the amount of $2,369.87. Human Services, Nursing Home, St. Croix Industries, and Government Center vouchers 168375 through 168464, dated February 24, 2010 in the amount of $57,521.62. Human Services, ADRC and Department on Aging vouchers 168709 through 168750, dated March 03, 2010, in the amount of $10,097.24. Human Services, Nursing Home, Government Center, ADRC and St. Croix Industries vouchers 168751 through 168840, dated March 03, 2010 in the amount of $62,634.50. Human Services vouchers 168696 through 168708, dated March 03, 2010 in the amount of $3,333.87. Human Services vouchers 169137 through 167173, dated March 10, 2010 in the amount of $35,160.21. Human Services vouchers 169526 through 169564, dated March 10, 2010 in the amount of $18,627.18. Human Services, Nursing Home, and St. Croix Industries vouchers 169566 through 169687, dated March 10, 2010 in the amount of $75,849.42. Department on Aging, and ADRC vouchers 169688 through 169742, dated March 10, 2010 in the amount of $6,816.59. Human Services, Nursing Home, St. Croix Industries, Department on Aging, ADRC and Government Center vouchers 169743 through 169840, dated March 10, 2010 in the amount of $70,249.14. Nursing Home vouchers 169841 through 169867, dated March 10, 2010 in the amount of $16,411.01. ANNOUNCEMENTS Johnson announced the second annual Community Health and Wellness Expo is scheduled for Saturday, March 27, 2010 from 9:00 AM to 1:00 PM at WITC, New Richmond. It is sponsored by St. Croix County ADRC. FINANCIAL REPORT The following financial report for Health and Human Services through January 31, 2010 was distributed. The State is still working on take backs from past and current payments for long term care services. Carryover has been applied to Administration to prevent variation in all line items. Administration does not generate revenue, but all the WIMCR monies are applied to this line item so that fiscal transfers for this funding stream are tracked in one line item. Pempek suggested possibly creating a side sheet for next month to further explain the negative balance in Administration. St. Croix County Health and Human Services Board Page 3 March 17, 2010 HEALTH AND HUMAN SERVICES - 2010 SUMMARY Total OF REVENUES Budget January 31, 2010 Balance % Administration 187,070.00 (22,961.78) 210,031.78 - 12.3 °t AODA Services 768,662.00 34,944.22 733,717.78 4.5 Long Term Support 0.00 36,584.00 (36,584.00) 0.0% Mental Health 3,702,935.00 193,313.37 3,509,621.63 5.2 Family $ Children's 3,168,401.00 158,123.01 3,030,277.99 5.05 Public Health 2,035,641.00 130,435.74 1,905,205.26 6.451 Economic Support 1,021,895.00 52,234.82 969,660.18 5.1 General Relief 1,375.00 125.00 1,250.00 9.1% Coordinated Services(SED 2,802,917.00 213,355.75 2,589.561.25 7.65 ARDC 2,457,878.00 0.00 2,457,878.00 0.0 Department on Aging 924,053.00 795.00 923.258.00 0.1 % Carryover Funds 1,049,211.00 87,434.25 961,776.75 8.35/ REVENUES HUMAN SERVICES PROGRAMS 18,140,038.00 884,383.38 17,255,654.62 4.95 SUMMARY Total OF EXPENDITURES Budget January 31, 2010 Balance 51 Administration 1,236,281.00 107,355.15 1,128,925.85 8.7% Alcohol -Drug Abuse 768,662.00 62,645.71 706.016.29 8.1% Long Term Support 0.00 12,501.38 (12,501.38) 0.0% Mental Health 3,702,935.00 198,061.26 3,504.873.74 5.35 Family & Children's 3,188,401.00 239,801.11 2,948,599.89 7.5% Public Health 2,035,641.00 197,833.25 1,837,807.75 9.7% Economic Support 1,020,270.00 122,874.79 697.395.21 12.0% General Relief 3,000.00 0.00 3,000.00 0.0% Coordinated Service/'SED 2,802,917.00 143,844.09 2,659,072.91 5.1 % ARDC 2,457,878.00 34,554.25 2,423,323.75 1.4% Department on Aging 924,053.00 29,240.81 894,812.19 3.25 EXPENDITURES HUMAN SERVICES PROGRAMS 18,140,038.00 1,148,711.60 16,991,326.20 6.3% Total S (264.328.42) The following financial report for St. Croix Industries through January 31, 2010 was distributed. St. Croix County Health and Human Services Board Page 4 March 17, 2010 St. Croix Industries - 2010 SUMMARY Total OF REVENUES Budget January 31, 2010 Balance WS Operations 1,375,209.00 111,225.76 1,263,983.24 8.190 WS Production 306,513.00 30,177.17 276,335.83 9.8% WS Helping Hands 86,500.00 4,634.41 81,865.59 5.4 WS Pop/Vending 6,300.00 332.70 5,967.30 5.3% WS Ram 3,350.00 875.63 2,474.37 26.1% WS Vocational Placement 341,488.00 28,459.20 313,028.80 8.390 WS Comm Based Day Prog 197,730.00 11,093.63 186,636.37 5.6% REVENUES 2,317,090.00 186,798.50 2,130,291.50 0.1% SUMMARY Total OF EXPENDITURES Budget January 31, 2010 Balance % WS Operations 1,375,209.00 109,889.94 1,265,319.06 8.0% WS Production 306,513.00 18,557.81 287,955.19 6.1% WS Helping Hands 86,500.00 2,514.98 83,985.02 2.9% WS Pop/Vending 6,300.00 134.53 6,165.47 2.1% WS Ram 3,350.00 163.14 3,186.86 4.9 WS Vocational Placement 341,488.00 32,008.02 309,479.98 9.4% WS Comm Based Day Prog 197,730.00 13,965.42 183,764.58 7.1% EXPENDITURES 2,317,090.00 177,233.84 2,139,856.16 7.6% Total f 9.564.66 The following financial report for the Nursing Home through January, 2010 was distributed. Pempek said traditionally, the first few months of the financial reports have shown negative numbers. Robinson reminded the Board that Medicare census was budgeted for an average of 12 for the first half of 2010 and 16 for the last six months of 2010, so this will skew this revenue percentage. St. Croix County Health and Human Services Board Page 5 March 17, 2010 St. Croix Health Center January 2010 Budget Actual Difference PercentagE Census 0 Operating Revenue: Medicare $2,223,906.00 $129,876.25 $2,094,031.75 5.84% Medicaid $2,043,172.00 $176,103.32 $1,867,068.68 8.62% Private Pay $975,919.00 $102,544.59 $873,374.41 10.51% Revenue - IGT /Supplemental Funds $469,000.00 $0.00 $469,000.00 0.00% All Other Sources $27,618.00 $24,695.45 $2,922.55 89.42% Total Operating Revenue $5,739,617.00 $433,219.61 $5.306.397.39 7.55% Operating Expenses Daily Patient Services $3,627,182.32 $351,813.63 $3,475,368.69 9.19% Special Services $287,498.00 $30,380.71 $257,117.29 10.57% General Services $1,239,492.00 $113,821.15 $1,125,670.85 9.18% Administrative Services $610,305.00 $71,341.21 $538063.79 11.69% Unassigned: Depreciation (% Based) $0.00 Others: $528,063.00 $0.00 $528,063.00 0.00% Utilities $208,461.00 $0.00 Workers Comp, Computer Tech $264,602.00 $0.00 Insurance $55,000.00 $0.00 Total Operating Expenses $6,492,540.32 $567,356.70 $5,925.183.62 8.74% Net From Operations ($134,137.03) (Cost of doing business prior to applying levy & outstanding rev) County Revenues Co Allocations (% Based) $616,131.32 $51,344.00 $564,767.32 8.33% Nursing Home Carry Over $136,792.00 $11,399.33 $125,392.67 8.33% Total Outstanding $752.923.32 $62.743.33 $690,179.99 Net from all Sources ($71.393.76) 2009 FINANCIAL YEAR AND CLOSEOUT UPDATE Updated financial reports through December 2009 for Health and Human Services and Nursing Home were distributed and discussed. Pempek explained that the CARS report is still outstanding. She said the final report is due to us in June; however, the agency's books will be closed out before that time. Further take backs are expected. Pempek explained additional revenues were recorded for the Nursing Home and Nursing Home revenues ended at 103.67% on the financial report. Pempek reported the auditors will be in the facility next week to begin the Nursing Home audit. Johnson expressed concern over the unassigned expense line item on the report, in particular the utilities. Johnson would like to see consistency on how expenses are posted. Discussion has been held on installing a meter for utilities on each building. Currently the total amount of utilities is being split based upon square footage. Johnson will follow up with Building Services St. Croix County Health and Human Services Board Page 6 March 17, 2010 Director on how these bills are processed and report back. Johnson also identified the need to be more specific with the Board on the details of State take backs and how this impacts the revenues on a monthly basis and at year end. General discussion provided a good backdrop for how funding occurs, but will be working to provide more specific detail in the monthly report to address this issue. AGED HEALTH AND HUMAN SERVICES RECEIVABLES REPORT: The aging Accounts Receivable report for Health and Human Services through January was reviewed. Pempek explained 2007 receivables have been cleaned off the books and either sent to collections or written off. Accounts Receivable staff has stayed on top of billings and there has been no lost opportunity to collect. Tax intercept has been utilized to collect on bad debts and a line will be added to the report that identifies collections on these items. 2010 UPDATED BUDGET SUMMARIES Updated 2010 budget summaries were distributed. Johnson offered to present additional detail and answer any questions after members have a chance to review. This will be on the April agenda. NURSING HOME ADMINISTRATOR'S REPORT Requested positions for the Nursing Home were approved at the County Board meeting on 03/16/2010. Robinson said the average monthly census for January was 67, with 10 Medicare, 28 Medicaid, 18 private pay and 1 Family Care resident. Medicare reimbursement is $40 higher /day than what was budgeted and is the highest Medicare rate we have been paid. The kiosks are getting up and operational, which will allow for more accurate charting. Robinson is waiting for the results of the Phase II report for the life of the Nursing Home building before incurring additional renovation expense for the Nursing Home rooms. Robinson reported the Nursing Home is now in the survey window for the State survey. Surveyors could show up at any time. A new County website is being built and the Nursing Home will be included in that effort. Robinson said the new Nursing Home brochure has been sent to all referring hospitals. Robinson reported the Nursing Home will be represented at the Health and Wellness Expo on March 27 at WITC. Robinson reported the Centers for Medicare and Medicaid Services (CMS) ratings have been issued and St. Croix Health Center is still a 5 -star rated facility. He said only 10% of the facilities in the nation are rated at 5- stars. Johnson followed up with Westcap regarding the Spring Valley project funds. Johnson explained funds need to be distributed through a community housing organization, which is Westcap. The Spring Valley facility is set up with 16 income adjusted apartments and four full market fee apartments. The rental fee is basically subsidized through tax credits. This may be a funding option for the Health Center when planning around diversification of revenue moves forward. Spring Valley also used a developer to help with this process and this may be something that the County could consider as well. UPDATE ON LONG RANGE FACILITY PLANNING The Ad Hoc committee met in New Richmond on March 11th. The committee reviewed the facility issues and toured both Health and Human Services and the Nursing Home. The estimated repair costs based upon the requirement index (next 5 years) for the Health and Human St. Croix County Health and Human Services Board Page 7 March 17, 2010 Services (HHS) building were approximately $4.6 million. Included in the requirement index cost is the HHS facility condition index which is 0.26. This index equals approximately $2.7 million in repairs over the next 3 years. This cost is part of the 5 year overall estimated cost. Several other issues were discussed that were identified as intangibles regarding the HHS facility. One such issue was the inefficient lay out of the HHS building. The building is 63,000 square feet and has poor space utilization when compared to national averages for office space. The national average is 7 persons per 1,000 square feet and the HHS building averages 2 persons per 1,000 square feet. A similar review was also done on the Nursing Home building. The 5 year requirement index was approximately $3.9 million. The facility condition index was .17 and cost associated with the repair needs over the next three years was approximately $2 million. Again, the facility condition index is part of the overall requirement index cost of $3.0 million. Several additional issues were discussed and this included concerns about potential expansion for other revenue generating services as the HHS building and the St. Croix Industries house sit in prime locations for these opportunities. Board members were asked to review the powerpoint and associated SEH report and bring questions back to the next meeting. If required, Dave Simons from SEH will be invited to the meeting to answer questions. The Board recessed from 10:05 - 10:15 AM. JUVENILE TREATMENT COURT IMPLEMENTATION Dunlap reported there are three enrollees to the Juvenile Treatment Court as of today. The maximum number in the program at one time is 12 families. Dunlap distributed a booklet that is given to each participant of the program and outlines expectations of the program, rules, code of conduct, etc. The program is a joint effort of Behavioral Health, Family and Children's, Youth Community Support Services, Sheriff, Court, Law Enforcement, District Attorney, and Public Defender. Everything for the program has to be approved by the Department of Justice. Juvenile Treatment Court hearings are held every Wednesday from 3:30 to 5:00 PM. Youth for the program need to be adjudicated as delinquent and ordered into the program by the court. Some youth are waiver eligible and for those youth, service needs are covered 60% by Federal dollars, which we anticipate will help to sustain the program when grant funding ends. Dunlap said the program is going well and will make a difference. PUBLIC HEALTH 140 REVIEW Kramer reported on the results of the HFS 140 Review conducted on July 16, 2009. The review defines the role of the local health department. The review team was impressed and complimentary of St. Croix County's Public Health Department. Public Health has a Level II designation and had a successful review. No deficiencies were cited. There were several commendation bullets from the review, one of which was the strong efforts to develop and implement a comprehensive Community Health Improvement Process (CHIP) to address population health needs, which was addressed at the last Board meeting. Johnson announced Public Health will sponsor a recognition luncheon on March 25 at 11:30 AM in the Nursing Home social room in appreciation for all the volunteers that helped with the H1N1 clinics. TOBACCO USE RESOLUTION REVIEW A resolution modifying the County policy regarding the use of tobacco on County properties was passed at the 03/16/2010 County Board meeting. The resolution allows private citizens and employees to St. Croix County Health and Human Services Board Page 8 March 17, 2010 use tobacco products in their own personal vehicles while on County property and all County employees will be allowed to utilize tobacco products in agreed upon designated tobacco use areas on County property work sites. PERSONNEL ISSUES NEW EMPLOYEES /VACANCIES Johnson announced Mary Feneis has announced her retirement effective 03/31/2010. Efforts are being made to fill this position that supports the chronically mentally ill in the community. Johnson announced Crystal Dubois has been hired as a contracted staff person in Adult Community Support Services (ACSS) . Johnson said Pat Spoentgen, Mental Health Therapist, will retire 03/31/2010, and Mike Griffith will be filling that position effective 03/29/2010. REPORT ON POSITION REQUEST FROM JANUARY AND FEBRUARY HHS MEETING A resolution regarding these positions was brought forward at the 03/16/2010 County Board meeting and approved 25 to 1. A copy of the resolution was offered to Board members. FUND RAISING BY HEALTH AND HUMAN SERVICES DEPARTMENTS Johnson would like to expand fund raising efforts to maybe offset operational or capital costs. He explained this would be a shift in our focus on fund raising as we currently raise funds or accept donations for specific consumer needs. Currently only the County Board can accept donations. We do receive client specific donations now. Motion A motion was introduced by Berenschot, seconded by Larson and unanimously adopted: That the Board approves fund raising by different departments in Health and Human Services, St. Croix Industries and Nursing Home. Johnson will update the Board as plans for fundraisers occur. The department will also coordinate with Corporation Counsel as County Board approval may be necessary. HEALTH AND HUMAN SERVICES AND NURSING HOME STRATEGIC PLANNING Robinson reviewed the long range strategic goals for the Nursing Home. He said the Nursing Home is on track for all goals for 2010. The Nursing Home has restructured from 14 private rooms to 34 private rooms. The 2010 Nursing Home budget has $329,000 reduction of County levy. Staff are assessing other programs and developing diversification criteria. An on -line orientation has been implemented for staff training, which will reduce training costs. A staff survey to measure Nursing Home staff satisfaction is planned for April 7 and 8. Johnson continues to meet with managers to discuss the bullet points for Health and Human Services strategic planning. Johnson reviewed the long range strategic goals for Health and Human Services. Motion A motion was introduced by Larson, seconded by Berenschot, and unanimously adopted: That the Board supports strategic planning and laying out operational plans and goals. REVIEW OF HEALTH AND HUMAN SERVICES DAY AT THE CAPITAL Johnson distributed a summary of the four key talking points from the Health and Human Services Day at the Capital. The first point allows nursing homes to develop collaborative agreements so when a resident from another County is admitted, full costs for services are covered. This type of collaboration could possibly be around specialty units, which has been the case in two other counties in the State. St. Croix County Health and Human Services Board Page 9 March 17, 2010 The second point involves raising the age from 17 to 18 at which a person who is alleged to have violated a criminal law being subject to the criminal code. Many Counties support this initiative, but Counties have made it clear that if the 17 year olds come back to Juvenile Court, the State would have to fund this transition; however, allocation has not gone up in the last 20 years despite population increase. Federal stimulus funds were used to backfill cuts in county human services areas. The Federal stimulus funds are one -time funding. Counties lack the ability to backfill additional state cuts with property tax levy. The last point involved human services financing. Counties operate programs on behalf of the state. The state allocates aid to counties to offset the costs of providing these services; however, there is a disconnect between the level of services counties are required to provide and the amount of state funding necessary to offset program costs. The counties fill the gap with property tax levy. County tax levy is no longer the answer to decreasing state and federal human services funding. CLOSED SESSION PER WISCONSIN STATUTES 19.85 (1) (C) FOR DIRECTOR'S PERFORMANCE EVALUATION. RECONVENE IN OPEN SESSION Motion A motion was introduced by Berenschot, seconded by Rasmussen, That the Board enter into closed session per Wisconsin Statutes 19.85 (1) (c) for director's performance evaluation. Roll call vote: Esther Wentz -yes Leon Berenschot -yes Charles Grant -yes Roger Larson -yes Linda Luckey -yes Richard Marzolf -yes Gerald Peterson -yes Dr. Lisa Ramsay- absent Deb Rasmussen -yes Eight yes, one absent, motion passed. The Board entered into closed session at 11:23 AM. Motion A motion was introduced by Larson, seconded by Berenschot, and unanimously adopted: That the Board reconvene in open session per Wisconsin Statutes 19.85 (1) (c). The Board reconvened in open session at 1:30 PM. POSSIBLE AGENDA ITEMS FOR NEXT MEETING No items were brought to the Board. Wentz asked if there were any other issues to bring before the Board. Wentz adjourned the meeting. Time: 1:30 PM Chair: Attest: (Secretary) Revised: 04/26/2010 NOTICE OF MEETING AND AGENDA ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD DATE AND TIME: May 06, 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 - 03/17/10 DATE OF NEXT MEETING — 06/03/10 at 8:30 a.m. OLD AND NEW BUSINESS 1. Election of Officers 2. 2010 Routine Meeting Dates 3. Consideration of Claims and Vouchers and appoint member to review vouchers at next meeting 4. Financial Report a. Monthly financial report for Nursing Home and Health and Human Services b. aged receivable report (updated to include collection on bad debt) 5. St. Croix Industries Electrical Upgrade bid 6. Review of Administration Revenue from monthly fiscal report 7. Comprehensive Community Services Resolution 8. 2009 Update on year -end close out for Health and Human Services, St. Croix Industries and Health Center 9. Nursing Home Administrator's Report 10. St. Croix Health Center Department of Health Survey 11. Ad Hoc Facility Planning Update 12. Personnel Issues a. New employees /vacancies 13. County Bylaws and Advisory Committees 14. Mobile Crisis Program Update 15. Electronic Health Records 16. 2010 Updated Budget Summaries Questions 17. LaCrosse County Health Department — Regional Vector Control Program 18. Western Region WALHDAB -- Board of Health Educational Event 19. Head Start Lease 20. 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) Items for County Board approval must be submitted to the County Clerk's office by Wednesday morning preceding a County Board meeting. 4/26/2010 12:50 PM ** 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. 4/26/2010 12:50 PM