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HomeMy WebLinkAboutSCC Health & Human Services Board 03-11-97ST. CROIX COUNTY NOTICE OF COMMITTEE MEETING TO: Robert Boche, Chairman St. Croix County Board FROM: Robert Stephens (John Borup 246-8223) COMMITTEE TITLE: St. Croix County Board DATE: 03/11/97 TIME: 5:00 a.m. Health and Human Services LOCATION: St. Croix County Health and human Services Complex, New Richmond CALL TO ORDER ROLL CALL ADOPTION OF AGENDA DATE W NEX= MEETINGa 03/27/97 ACTION ON PREVIOUS MINUTES: 02/27/97 PERSONNEL ISSUES ANNOUNCEMENTS APPOINTMENTS: UNFINISSED BUSINESS: 1. Long Term Care "Redesign" Report 2. County Farm Buildings Leases 3. Family Preservation and Support Funds Awards NEN BUSINESS: 1. Action on bids to re -roof "1974" Health and Human Services Building 2. Consideration of Claims and 17 )a% rs 3. Financial Report 4. Reappointments and Privileges of Medical Staff 5. Health and Human Services/Nursing Home Report a. Review of county -owned nursing homes "levy 6. Personnel Issues 7. County Farm Land Conservation Reserve Program ANNOUNCEMENTS 6e CORRESPONDENCE POSSIBLE AGENDA ITEMS FOR NEST MEETING: ADJOURMENT (Agenda not necessarily SUBMITTED BY: John M. Borup )ATE: February 28, 1997 N survey " CRP ) presented in this older) COPIES TO: COUNTY HOARD OFFICE COUNTY CLERK NEW'S MEDIA/NOTICE l We CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD MARCH 11, 1997 The St. Croix County Health and Human Services Board met on March 11, 1997, at the St. Croix Industries in New Richmond, Wisconsin. MEMBERS PRESENT: Robert Stephens, Chair Chris Bethke Jack Dowd Einar Horne Fern Johnson Allen Limberg Mary Louise Olson Leon Berenschot-excused George Sinclear-excused STAFF PRESENT: John Borup, Health and Human Services Director Cindy Griffin, Deputy Director Carolyn Krieger, Nursing Home Administrator Judy Ziegler, Accountant Ron Lockwood, Long Term Support Karen Hall, Long Term Support Coordinator Ralph Robole, Facilities Manager Malva Berg, Secretary OTHERS PRESENT: John Krizek, Administrative Coordinator Ray Mealy, Long Term Support Committee Kent Sprague, Assistant Area Administrator, LTS Wendy Wayne, Soil Conservationist Harvey Halverson Joe Donahue, Donahue Roofing Jim LaPlant, Donahue Roofing John Schottler Chair Stephens called the meeting to order at 8:00 a.m., noting the meeting was properly and legally publicized. NEXT MEETING: The next Health and Human Services Board meeting is scheduled for Thursday, March 27, 1997 at 6:30 p.m. at the St. Croix County Health and Human Services/Nursing Home complex. AGENDA: Motion: A motion was introduced by Bethke, seconded Johnson, and unanimously adopted: That the agenda be approved as circulated. MINUTES: Motion: A motion was introduced by Dowd, seconded by Horne, and unanimously adopted: That the minutes of the 02/27/97 Health and Human Services Board meeting be approved as circulated. 2 FAMILY PRESERVATION AND SUPPORT FUNDS AWARDS: Family Preservation and Support Community Subgrants were tabled at the last meeting. The eleven proposals received were sent to each Board member for their review. Griffin explained the options outlined in the fact sheet for the use of the funds. Given The Board's hesitance regarding community subgrants, Griffin spoke with the State Regional Officer regarding alternative acceptable uses of the funds. The Regional Office gave verbal permission for St. Croix County to deviate from the Family Preservation first year plan and utilize some or all of the $25,500 for traditional child welfare services such as the in -home team. Griffin explained the in -home team consists of a therapist and social worker who work with families providing in -home treatment to prevent or shorten out -of - home placement for the children. Griffin said a Family Preservation Outreach Worker was hired last week for the Glenwood City area. Discussion followed. Motion: A motion was introduced by Stephens, seconded by Horne, and unanimously adopted: That the Board give grant monies to the Youth for Christ Lighthouse in Roberts and Baldwin and to utilize the balance of the funds for traditional child welfare services such as the in -home team if permission is received from the state. Olson said the application from Roberts emphasized what has already happened with the program whereas the River Falls application has emphasized what will happen if the grant is received. Griffin had asked Corporation Counsel about potential problems related to the separation between church and state in funding Youth for Christ. Corporation Counsel said if there were no eligibility requirements regarding religion and the program is not forcing religion on participants there would be no problem. The proposals from Youth for Christ requested several month's operation expenses, but designated no specific amount. Stephens said to not exceed $4,000 on either bid. Discussion on what should happen next year to divide monies if the grant is accepted again. The Board indicated that they would like to see all the proposals and familiarize themselves with the applicants. CONSIDERATION OF CLAIMS: Judy Ziegler, Accountant/Accounting Supervisor, distributed the following reports: transfer of funds report, fixed assets purchased, and cash report. Horne asked for the amount of the child care funds in one lump sum. He said the Board needs that amount every month. Ziegler said the child care expenses for February were $23,012. 3 Borup said we are having a problem with the server for the computer system, it is going down on almost a daily basis. Krizek said he s going to the Finance Committee to request moni ies from the contingency fund for purchasing a new server. Health and Human Services Board member, Bethke, reviewed the February vouchers and questioned or reviewed the following vouchers: HOME HEALTH: $1,154.541 membership. Organization. Consultant group agencies with the State Bureau of other state agencies. Provides client care, changes in the home HUMAN SERVICES: Wisconsin Home Care representing home care Quality Compliance and training for billing, health field, etc. 6329: Kiddy Land Care Center, #,408.12, day care. Net cost after family co -pay for 13 children for one month. 63560 REM-WISC III, Inc., $31,351.83, Long Term Support purchased service. New provider for services, one four - bed adult family care home in New Richmond and one four - bed adult family care home in Hudson. 6359: Marianne Sadee $50.00, restitution. Money collected from a juvenile for court -ordered restitution and reimbursed to the victim. 53950 Gymnastics Training Center, $65.00, Long Term Support CIP Expense. One year membership for a CIP client residing in Rice Lake to promote physical fitness and community skill training. 6557: Bernard's Northtown, $7,496.00, Long Term Support client expense. Cost to put a wheelchair lift in a van for a LTS client. 6603: E.O. Johnson, $262.85, copy machine maintenance. Expense of copy machine located at the Economic Support/Long Term Support area of the building. 6638: Minneapolis Clinical Association, $9,225.00, Dr. Colon, psychiatrist. We are able to bill for all clients that Dr. Colon sees. He is here two days a week seeing mental health clients. 6675: Nordstan Communications, $15,115.75, final bill for wiring project. Final bill approved by Ralph Robole. 6727: Postmaster, $5,000.00, postage for meter. Purchase postage for the meeting in the business office. 6771: Sunburst, $5,034.68, CCI 02/971 Child Care Institution bill for one youth for one month. CCI placements are court ordered. Motion: A motion was introduced by Bethke, seconded by Olson, and unanimously adopted. The following vouchers be approved and be made a part of the supplemental minute book pages 609 through 6490. Home Health vouchers 6505 through 6533, dated February 28, 1997 in the amount of $10,968.21. Human Services vouchers 6300 through 6374, dated February 13, 1997, in the amount of $162,585,42, Human Services vouchers 6376 through 6409, dated February 20, 1997, in the amount of $32,506.21, Human Services vouchers 6410 through 6454, dated February 27, 1997, in the amount of $46,919,56, Human Services voucher 6455, dated February 27, 1997, in the amount of $69,840.00. Human Services vouchers 6456 through 6504, dated February 26, 1997, in the amount of $51,638.91. Human Services vouchers 6534 through 6722, dated February 28, 1997, in the amount of $192,187.79. Human Services vouchers 6619 through 6798, dated February 28, 1997, in the amount of $86,547.73. Farm vouchers 1, dated March 11, 1997, in the amount of $149.00. Nursing Home vouchers 68 through 71, dated February 13, 1997, in the amount of $3,998.10. Nursing Home vouchers 78 through 140, dated March 11, 1997, in the amount of $77,797.33. Human Services and Nursing Home vouchers 728 through 756, dated February 18, 1997, in the amount of $238,168.17. Social Services and Human Services vouchers 38 through 55, dated February 19, 1997, in the amount of $80,566.40. Human Services and Nursing Home vouchers 757 through 781, dated March 4, 1997, 9n the amount of $276,695.83. 5 Social Services and Human Services vouchers 56 through 74, dated March 5, 1997, in the amount of $98,569,41, PERSONNEL ISSUES: Borup said Gary Bender, Alcohol and Drug Abuse Counselor, resigned to join the private sector and we are currently recruiting for that position. Horne asked how long it would take to fill the position. He suggested the job description and educational requirements be upgraded. Griffin indicated that upgrading the requirements to include a college degree in addition to AODA certification would make it more difficult to find a qualified candidate and might necessitate a higher salary range. Discussion ensued regarding counselor qualifications, training and pay range. Stephens appointed Horne to be included in the interview process for the AODA position. ACTION ON BIDS TO RE -ROOF "1974" HEALTH AND HUMAN SERVICES BUILDING: Joe Donahue contends that North Central Insulation did not meet bid specs and thus the difference in bid amounts. He said the General Electric silicone roofing proposed by North Central offers no more options after it is installed, it cannot be re - coated or repaired. He said it would last about 10 to 15 years and it would cost close to $150,000 to re -coat. With the Conklinfs urethane system, you can re -coat or repair and it would last about 20 years and cost in the $80,000 to re -coat. The industry standard is to guarantee work for 10 years. Stephens instructed Robole to call Dr. Dupruis regarding the General Electric roofing. Discussion followed. Borup asked Donahue if he was saying if the bids were re -bid with the silicone roofing that Donahue would still bid more than North Central and Donahue said yes. It was the consensus of the Board to cancel all bids and re -bid the project. Robole was instructed to re -publish for bids and a decision would be made by the first meeting in April. Horne said the Board needs a recommendation from mechanical staff on the bids. Donahue said a project this size needs at least three weeks of good weather to complete the project. Motion: A motion was introduced by Horne, seconded by Olson, and unanimously adopted: That the Board rejects all re -roofing bids. COUNTY FARM LAND CONSERVATION RESERVE PROGRAM LCRPZ: Borup said 25.8 acres of the St. Croix County Farm are in the Conservation Reserve Program (CRP). He said we are paid $65.00/acre annually. Our contract with USDA expires 09/30/97. Sign up to extend for a minimum of ten years is between 03/03/97 and 03/28/97. This is a "bidding process" with USDA payments estimated to be in a range between $39.00 to $78.00 per acre. Borup said that in talking with John Schottler, he indicated he would match the CRP payments if we offered him a 10 year contract. Wendy Wayne and Harvey Halverson were present to discuss CRP. Discussion followed. Schottler has a contract for the farm land through the 1998 season. John Schottler said he has maintained the conservation plan and is C� willing to work with the Board. Discussion regarding possible acres released from contract due to road construction, etc. Schottler said he would like the number of acres specified that may be released in the contract. Horne said the contract will not be approved until it is presented to the Board. Schottler was agreeable to raise the rent for the 1997 crop year. Stephens instructed Borup, Bethke, and Schottler to meet with Corp Counsel and to bring a contract to the Board by the March 27, 1997 meeting. Motion: A motion was introduced by Bethke, seconded by Dowd, and unanimously adopted: That the Board agrees to rent the farm land to John Schottler at the rate of $48.00/acre for a 10-year contract and to try to put the 25.8 acres back into the CRP program. Stephens thanked Wayne and Halverson for their time and presentation. LONG TERM CARE "REDESIGN" REPORT: Kent Sprague, Assistant Area Administrator, State of Wisconsin -Long Term Support, was present to update us on Long Term Care Redesign. Sprague reported on the status of redesign and the county's role. Long Term Care Redesign has the potential to significantly change the county's role and it's relationship with the State. Sprague said the State will issue a Long Term Care Redesign "model" around 04/01/97. He said the plan continues to evolve. He said the mental health population has now been included in the redesign. He said the plan will offer more flexibility in monies, less earmarked funds. It will offer statewide integration of funds and services for long term care. He said everyone needing long term care would have access to services, not just Medicaid eligible client. It is possible the State will cut the county out of the action, but county overmatch monies may go to the State for the State to manage. Borup said this issue is a concern. Discussion followed. The Health and Human Services Board will have a joint meeting with the Long Term Support Committee in May. The Board felt a message needs to go to the County Board regarding funding. Krizek said a resolution should be presented including the following six points: - First, counties must be involved in the design and implementation of the new system because we have the sophistication and knowledge that will be necessary to make any new model work. WE have been the single point of entry for many years, and we believe we have much to add to the deliberations. - Second, quality standards should be set first and then rate setting should follow. This is not to say that standards for quality and service level might not be altered once the full costs are know, but we should proceed in this order. 7 - Third, counties need to have the ability to opt in or opt out of any new model. The system used by W-2 can serve as an appropriate way for counties to make their own local choice. Fourth, if counties do not opt in, and even if they do, counties should not be expected to continue their historic practice of overmatching funds. What the redesign confirms is that the programs are a state responsibility. County government, if we choose not to participate, should not be expected to continue to pay. Fifth, because we have clearly determined that the clients are a State responsibility, the risk of court -ordered costs must also become a state responsibility. Transference of this risk from counties to state is essential under any new system. - Finally, as with any managed care system, if counties are the vendor of choice, and if we are smart enough and efficient enough to provide the required levels of service and have funds left over from the capitated rate, we should be allowed to keep the profits. It may be appropriate to designate those profits to related human services, but the bottom line remains that the counties have the right to keep any remaining dollars. Karen Hall said comments should be made after the model comes out in April. Horne asked for a presentation to the County Board with information regarding the redesign given out to the County Board the week before the presentation. Sprague said counties may be asked to be a pilot for this project. Krizek said Aging has also been combined in the redesign and should be under one roof. Stephens instructed Borup, Krizek and Hall to draft a resolution to present to the Health and Human Services Board at the April 10, 1997 meeting and to the County Board at the April 15, 1997 meeting. Gerald Born, Administrator of the Division of Supportive Living, will be at the May 13, 1997 Health and Human Services Board meeting. NTY FARM BUILDINGS LEASES. Stephens said this item will be COU tabled until the next meeting as he and Borup are meeting with Van Dyk at 2:00 p.m. on March 13, FINANCIAL REPORT: Borup and Ziegler presented the following preliminary financial reports. St. Croix County is under contract with Tracey and Thole for "single audit" services. They will not perform our audit until late March or early April. Reconciliation figures have not yet been received from the County Finance Department. "Close out" figures have not yet been received from the State of Wisconsin. Discussion followed. PLEASE SEE NEXT PAGE. ST. CROIX COUNTY HUMAN FINANCIAL SUMMARIES FOR THE PERIOD O1/01/97 NURSING HOME SERVICES BOARD THROUGH 01/31/97 Reconciled Cash Balance 01/31/97 Add: Accounts Private Medicare Medicaid General Accounts Receivable, Pay Ol/31/97 Payable-01/31/97 Net Current Items, 01/31/97 1997 Revenue Recorded through O1/31/97 Includes Allocations of Anticipated Revenues $567,933.50 $4,324.17 $98,888.87 $186,022.75 $515.65 ($231,439.14) $626,245.80 $370,535.94 1997 Expenses Recorded through 01/31/97 $408,261.44 Includes Allocations of Expected Expenses Add or Deduct any nursing home related items not recorded on nursing home books: 1997 bond principle $232,825.00 (93.13% of total 1996 bond principle of $250,000) NH97sum * Operations Capital Acquisitions _ $469,105.46 = 183,082.18 We received an advance of $142,000 in January of our ITP grant SUNIlKARY OF REVENUES Administration AODA Services Long Term Support Mental Health Family & Children's Economic Support General Relief .. Z# L=-� RE SUNIlKARY OF EXPENDITURES Administration Alcohol -Drug Abuse Long Term Support Economic Support Mental Health Services Family & Children's General Relief TOTAL 1996 HUMAN SERVICES BUDGET hs97-sum HUMAN SERVICES - 1997 Total Jan. -Jan. 41,060.70 27,664.91 463,153.86 137,410.51 156,121.43 67,411.69 Budget 508,055.00 365,476.00 Balance 466,994.30 337,811.09 7,444,614.00 6,981,460.14 1,620,643.00 2,076,775.00 1,223,623.00 1,483,232.49 1,920,653.57 1,156,211.31 2,605.34 42;124.00 39,518.66 6.2% 895,428.44 13,281,310.00 12,385,881.56 6.7% Total Jan. -Jan. 40,751918 20,060.79 362,284.92 64,734.53 114,021.32 130,624.78 Budget 508,055.00 365,476.00 7,444,614.00 Balance 467,303.82 345,415.21 32908 7,082,. 1,223,623.00 1,158,888.47 1,620,643.00 1,506,621.68 2,076,775.00 1,946,150.22 % 958.88 42,124.00 41,165.12 2.3% 733,436.40 13,281,310.00 12,547,873.60 5.5% TOTAL REVENUES TOTAL EXPENDITURES TOTAL REVENUES HOME HEALTH Total Jan. -Jan. Budget Balance 38,034.79 526,243.00 488,208.21 37,061.95 526,243.00 489,181.05 7.2% 7.0% PUBLIC HEALTH(12 month programs) Total Jan. -Jan. Budget Balance %* 58,899.82 845,706.00 TOTAL EXPENDITURES 85,231.84 845,706.00 *TO BE ON BUDGET, PERCENTAGE SHOULD BE 8.33. ph97-sum 786,806.18 7.0% 760,474.16 10.1% ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD 01/01/96 THROUGH 12/31/96 (Preliminary) NURSING HOME Reconciled Cash Balance 12/31/96 $601,829.09 Add: Accounts Receivable, 12/31/96 Private Pay $36,060923 Medicare $90,737.32 Medicaid $181,741.22 General $505970 Accounts Payable-12/31/96 ($284,319.83) Net Current .Items, 12/31/96 $626,553.73 1996 Revenue Recorded through 12/31/96 $4,329,954.25 Includes Allocations of Anticipated Revenues 1996 Expenses Recorded through 1/31/96 $4,296,791.33 Includes Allocations of Expected Expenses Add or Deduct any nursing home related items not recorded on nursing home books: 1996 bond principle $232,825.00 (93.13% of total 1996 bond principle of $250,000) NH96sum * Operations = Capital Acquisitions $418,746.91 = 183,082.18 We received an advance of $142,000 in January of our ITP grant • Administration AODA Services Long Term Support Mental Health Family & Children's Economic Support General Relief TOTAL REVENUES ALL PROGRAMS SUMMARY OF EXPENDITURES Administration Alcohol -Drug Abuse Long Term Support Economic Support Mental Health Services Family & Children's General Relief TOTAL 1996 HUMAN SERVICES BUDGET hs96-sum HUMAN SERVICES - 1996 (Preliminary) Total Jan. -Dec, Budget Balance 416,488.85 523,032.00 106,543.15 384,502.12 301,352.00 6,371,909.21 6,776,175.00 1,659,386.08 1,562,302.00 1,927,321.65 2,128,883.00 976,133.83 49,364.72 974,037.00 47,500.00 11,785,106.46 12,313,281.00 Total Jan. -Dec. 522,579.52 366,102.74 Budget 523,032.00 301,352.00 6,482,894.13 6,776,175.00 980,648.99 974,037.00 1,502,848.75 1,562,302.00 1,671,783.20 2,128,883.00 (83,150.12) 127. 6% 404,265.79 94.0% (97,084.08) 106.2% 201,561.35 90.5% (1,864.72) 103.9% 528,174.54 Balance 452.48 95.7% 99.9% 5 (64,750.74) 121.% 293,280.87 95.7% 59,453.25 457,099.80 38,903.36 47,500.00 8,596.64 96.2% 5% 78. 81.9% 11,565,760.69 12,313,281.00 747,520.31 TOTAL REVENUES TOTAL EXPENDITURES TOTAL REVENUES TOTAL EXPENDITURES HOME HEALTH (Preliminary) Total Jan. -Dec, Budget 448,740.49 519,183.00 507,889.24 519,183.00 Balance %* 70,442.51 86.4% 11,293.76 97.8% PUBLIC HEALTH(12 month programs) Total Jan. -Dec, Budget Balance %* 673,874955 846,503.00 172,628.45 79.6% 730,125.08 846,503.00 116,377.92 86.3% *TO BE ON BUDGET, PERCENTAGE SHOULD BE 100.00%. ph96-sum 14 REAPPOINTMENTS AND PRIVILEGES OF MEDICAL STAFF: It is time for the annual reappointment and privilege of medical staff for 1997 per medical staff by-laws. Motion: A motion was introduced by Limberg, seconded by Dowd, and unanimously adopted: That the Board approve the following reappointments and privileges for medical staff: 1. REAPPOINTMENTS TO MEDICAL STAFF: The Credentials Committee of the Medical Staff recommends to the St. Croix County Department of Health and Human Services Board the reappointments to the Medical Staff of the following members: ACTIVE STAFF David DeGear, MD Bruce Hanson, MD David Olson, MD Joseph Powell, MD Clifford Tenner, MD CONSULTING STAFF Pastor Colon, MD Joseph Beuning, Colin Drury, MD Physician's Hamid Khan, MD Assistant Neal Melby, MD John Simon, MD 2. DELINEATION OF PRIVILEGES: The Credentials Committee of the Medical Staff recommends to the St. Croix County Department of Health and Human Services Board the approval of the Delineation of Privileges as applied for by the medical staff to include Group 1 privileges: 1. Care of non -critical medical and geriatric patients, and patients who are admitted for diagnostic purposes. 2. Care of terminally ill patients. 3. Care of first and second degree burns. 4. Minor surgery, including simply lacerations, incision and drainage of superficial abscesses, removal of lightly imbedded corneal foreign bodies, and emergency tracheostomy. For: David DeGear, MD Bruce Hanson, MD David Olson, MD Joseph Powell, MD Clifford Tenner, MD And recommends Group it by: David DeGear, MD Bruce Hanson, MD David Olson, MD Pastor Colon, MD Colin Drury, MD Hamid Khan, MD Neal Melby, MD John Simon, MD Specialty Privileges as applied for Pastor Colon, MD Colin Drury, MD Hamid Khan, MD Joseph Powell, MD Clifford Tenner, MD 15 Neal Melby, MD John Simon, MD Joseph Beuning, PA HEALTH AND HUMAN SERVICES/NURSING HOME REPORT: Review of county - owned nursing homes "levy survey": With census issues and concerns for funding such as Intergovernmental Funding (ITP), thought we would share the W.A.H.S.A. survey of county levy costs in n other counties for county -owned nursing homes. Krieger said only 31% or 15 of the county -owned nursing homes receive no county levy. Discussion followed. Stephens :asked if there were any other issues to bring before the Board. A meeting regarding the Community Assessment Process will be held April 1, 1997 from 40.00 p.m. to 5.930 p.m. at WITC and Board members are invited. Stephens reminded the Board that the terms for all citizen members of the Board (Stephens, Limberg, and Johnson) expire this month. The Board will need to reorganize the last meeting in April or the first meeting in May. Borup has contacted the Vice Chair to remind him that reappointments to the Board will need to be made soon. Motion: A motion was introduced by Stephens, seconded by Dowd, and unanimously adopted: That the meeting be adjourned. Time: 11e03 a.m. Chairman: Attest: (secretary)