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HomeMy WebLinkAboutSCC Health & Human Services Board 08-12-9713 ..Alp 4 pi_ To: Robert Boche, Chairman St. Croix County Board FRo�t: Robert Stephens (&`ohn Borup 246-8223) COEMITTEE TITLE: St. Croix County Health and Board DATE TZI�E LOCATION: Q8/12/97 8:do a.m� Human Services 5t+ Croix County Health and Human Services Complex, New Richmond [kOLL CALL WOPTION OF AGENDA DATE OP NEXT mEETINGep 07/24/97 PREVIOUSNCTION ON hNNOUNCEMENTS kPPOINTMENTS NEW SII8I21ES8: 1. Consideration of Claims and Vouchers 2. Financial Report Personnel Issues a. Request to refill vacant "work services position 4. Health and Human Services/Nursing Home Report 5. 1998 Budget update a. General Relief b. Long Term Support waiting list c. Maintenance replacement items ADJOURNMENT (Agenda not necessarily SUBMITTED BY: John M. Borup BATE: July 30, 1997 in$tructor" STo CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD AUGUST 121 1997 The St. Croix County Health and Human Services BoarCi met on AuguSL 12, 1997, at St. Croix County Health and Human Services complex in New Richmond, Wisconsin. MEMBERS PRESENT: Robert Stephens Leon Berenschot Chris Bethke John Dowd Einar Horne Fern Johnson Allen Limberg Mary Louise Olson George Sinclear MEMBERS ABSENT: none STAFF PRESENT: John Borup, Health and Human Services Director Carolyn Krieger, Nursing Home Administrator Judy Ziegler, Accountant Karen Hall, Long Term Support Supervisor Barbara Nelson, Public Health Supervisor Marilyn Fruit, Economic Support Supervisor Ron Eichstaedt, Director of St. Croix Industries Ralph Robole, Facilities Manager Ron Lockwood, Long Term Support Ron Kiesler, AODA/Mental Health Coordinator Kathryn Beutel, Computer Services Malva Berg, Secretary OTHERS PRESENT: Ray Mealy, Long Term Support Committee Robert Boche, County Board Chair 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, August 28, 1997 at 6:30 p.m. at the St. Croix County Health and Human Services/Nursing Home complex. Stephens will not be at the August 28th meeting. AGENDA: Motion: A motion was introduced by Berenschot, seconded by Bethke, and unanimously adopted: That the agenda be approved as circulated. MINUTES: Motion: A motion was introduced by Bethke, seconded by Horne, and unanimously adopted: That the minutes of the 07/24/97 Health and Human Services Board meeting be approved as circulated. 2 ANNOUNCEMENTS: The $oard thaned staff for the Centennial Celebration. It was well organikzed, went very well and was all done on a volunteer basis. Boche read a letter from Governor Thompson regarding the Centennial and presented a plaque and commendation to John Borup from Governor Thompson. Borup accepted it on behalf of Carolyn Krieger and all the staff here. CONSIDERATION OF CLAIMS: Judy Ziegler, Accountant/Accounting Supervisor, distributed the following reports: transfer of funds report, fixed assets purchased, and cash report. Health and Human Services Board member, HOME HEALTH: iewed the July 9125: River Ridge Professional Services, $2,417.10, purchased services. We purchase physical therapy and occupational therapy services for Home Health clients. The clients f are then billed for these therapy services. 8930:Brotoloc Health Care Systems, $15,633.00, Long Term Support purchased services. Brotoloc runs two homes in St. Croix County that provide services for four Long Term Support clients. 9029: Tousley Ford, Inc., $231000, COP High Cost Services. Van for a Long Term Support client. This vehicle was approved by the State and will be totally paid for by COP funds. 9063: Trempealeau County HCC, $9,525.00, Mental Health purchased services. Cost of two clients for one month in an IMD facility. 9313: REM-WISC III, Inc., $31,399.83, Long Term Support purchased services. The home office of this organization is in Madison. They provide group home services to Long Term Support clients. Motion: A motion was introduced by Dowd, seconded by Stephens, and unanimously adopted: The following vouchers be approved and be made a part of the supplemental minute book pages 822 through 861: Home Health vouchers 9106 through 9127, dated July 21, 1997, in the amount of $4,954.40. Human Services vouchers 8923 through 8985, dated July 17, 1997, in the amount of $212,961.78. Human Services vouchers 8987 through 9033, dated July 24, 1997, in the amount of $62,936.440 Human Services voucher's 9034 through 90671 dated July 29, 19971 in the amount of $160,848.28. Human Services vouchers 9068 through 9105, dated July 30� 1997, in the amount of $23,547.77. Human Services vouchers 9128 through 9299, dated July 31, 1997, in the amount of $76,182.72. Human Services vouchers 9188 through 9375, dated July 31, 1997, in the amount of $70,964.42. Nursing Home vouchers 444 through 454, dated July 17, 1997, in the amount of $11,729.74. Nursing Home vouchers 462 through 522, dated August 12, 1997, in the amount of $90,567.02. Human Services and Nursing Home vouchers 1007 through 1036, dated July 09, 1997, in the amount of $285,000.26. Social Services and Human Services vouchers 220 through 238, dated July 09, 1997, in the amount of $94,050.29. Human Services and Nursing Home vouchers 1037 through 1068, dated July 23, 1997, in the amount of $247,880.08. Social Services and Human Services vouchers 239 through 256, dated July 23, 1997, in the amount of $77,666.43. Human Services and Nursing Home vouchers 1069 through 1095, dated August 06, 1997, in the amount of $2881621.65. Social Services and Human Services vouchers 257 through 275, dated August 06, 1997, in the amount of $96,624.08. 1998 BUDGET UPDATE: 1998 budget work is progressing. It is anticipated the overall Health and Human Services budget will remain at $2.98 million in County money through alternate care cost cuts in cn Family and Children's, eliminate deputy director position, and profits in W-2. Echo Windows Upgrade: Discussion held on an Echo window upgrade that would make the system more user friendly with the window application. This update would include the Clinician's Desktop for treatment plans, assessments, information referral and scheduling; Informix upgrade, Fund Accounting System for general ledger, accounts payable, and quick receivables, and Accounts Receivable, which is the driving force behind the proposed upgraded ECHO 0 purchase. The Accounts Receivable portion would not be available until the second quarter of 1998. Horne said he has heard bad things regarding ECHO for the past year and asked why we want to put more money into the'System when it hasn't been working for us. Beutel said ECHO has had management changes and the County has had excellent response from them now. She said Health Experts was bought out to do the Clinician's update. Borup stated our experience has improved, we are making the system work. is Loney is interested in the general ledger portion of thupdate for the County. He said the Office on Aging is on ECHO and said it would provide more uniform operation and is more user friendly with a window -based operation. Sinclear asked if the system could be put in on a 30-day trial basis to see if it would work for the County. Horne asked what the cost would be for training staff. Stephens asked what the cost would be for an alternate system. Stephens said that he is concerned that a year ago Health and Human Services was looking at suing to get money back from this company and now are looking to do an upgrade with the same company. Loney said the County needs to move to a different general ledger package and the conversion needs to happen as of January 1, not in the middle of the year. He said the County general ledger package has been.rin use since 1983 and it would be very economical for the general county to make this move. It would also provide a compatible use between the two departments. Sinclear asked if leasing or renting the programs would be an option. Beutel said with a windows -based operation, Computer Services would be able to update system, whereas before computer services was not able to do this. Borup said he is looking for direction from the Board on this matter. Stephens said the subject needs to be researched further to see what would work for Health and Human Services and the County with a recommendation made back to the Board. At this time, the whole Board has doubts regarding ECHO. Berenschot asked regarding the financial status of ECHO Company and Loney will request a copy of their financial statement. The next Information Services Committee meeting will be 08/13/97 at 1in the Government Center. Stephens appointed Olson to attend :30 this meeting. Stephens said the Board would spend money on computers, but not on ECHO at this time. General Relief: General Relief is a non -mandated program. All clients must meet both non -financial and financial eligibility criteria established by the Health and Human Services Board. Fruit would like to cut the General Relief budget from $42,124 in 1997 to $17,190 in 1998. Discussion followed. The Board supported this cut. Fraud/Front-End Verification: Fruit said that Counties have the option of f0rst selection to contract with the Department of Workforce Development (DWD) to administer the fraud investigative contract. The Department will pay a maximum of $500 per case for investigative services. They are projecting that St. Croix County will have 14 cases or a maximum of $7,000. Fruit said investigation is referred to the Sheriff's Department if staff are not able to do the fraud investigation. Discussion followed. Horne asked the amount of fraud involved and Fruit said approximately $40,000 to $50,000. At the 08/28/97 meeting the Board would like a statement from the Sheriff's Department regarding providing fraud investigation. Waiting List: Administration met with Chair Long Term Support Stephens and Long Term Support Committee member Lee Kellaher to discuss the potential to eliminate or reduce the waiting list, why we have it and annual cost to eliminate it. Two motions came from the Long Term Support Subcommittee but the subcommittee does not want these motions to affect or cut other programs in the agency or lower the non -lapsing account. Discussion followed. Sinclear said that Health and Human Services has received cuts from the County Board because we have too much money in our accounts when there was a definite need in Long Term Support and this is a shame. Mealey said the program will expand as word spreads that services are here. Hall said the figures given to reduce the waiting lists are a point in time assumption and the costs given are an average cost per client. There is a 60% Federal match for County dollars spent so to reduce the waiting lists would be approximately $1681000 County dollars and the rest of the $480,000 would be Federal dollars. Discussion followed. Borup asked if the Board wanted to take action to reduce or eliminate the Long Term Support waiting lists with the commitment to not reduce services in other areas. Motion: A motion was introduced by Sinclear, seconded by Johnson: That the Board support the following motions made by the Long Term Support Committee: That the 1998 budget include a provision to lower the maximum time on the CIP2/COP-W waiting list from six months to three months at an estimated county cost of $84,000, and That the 1998 budget include a provision to reduce the maximum time on the CIP-iB waiting list from 30 months to 24 months at an estimated cost of $84,000 per year. Horne said we are still only doing half a job and not eliminating the waiting list. Priorities need to be set by the County Board and will not get monies from Finance unless the dollars needed are over the amount available at Health and Human Services. Long Term Support has made recommendations to the Health and Human Services Board before to lower the waiting lists, but no action was taken. G-'� Roll call vote: Stephens -yes , Berenschot-yes Bethke -yes , Dowd -yes Horne -no _ Johnson -yes Limberg-yes Olson -no Sinclear-yes Seven yes, two no, motion passed PERSONNEL ISSUES: In 1995 we chose to not refill a "work services instructor" position vacated via retirement. This action saved County dollars. CIP IB monies are now available to fill this position with no County cost. This position will help reduce the waiting list for St. Croix Industries. Eichstaedt said when this position was not filled, St. Croix Industries downsized from 80 to 70 clients. He said there are currently 10 clients on the waiting list and there is not a great deal of turnover at St. Croix Industries. He said the last person who started at St. Croix Industries started in July, 1997 and had been on the waiting list for 18 months. Hall said we are now able to bill for services to persons on CIP IB who are not in institutions so the CIP-IB money is available to reinstate this vacant position. She said by reinvesting part of this CIP-IB revenue into the programs and into more vocational services, additional CIP-IB monies can be realized. Motion: A motion was introduced by Bethke, seconded by Sinclear, and unanimously adopted: That the Board approve filling the vacant work services instructor position. PUBLIC HEALTH: Nelson outlined the mandated services for Public Health and read the mission statement. She said Public Health provides population -based services. She distributed a graph showing staffing ratio per population in surrounding counties. St. Croix County has one of the lowest ratios at one nurse per population of 10,000. The Board recessed from 9:45 to 9:50 a.m. APPOINTMENTS: Stephens relieved Horne from the W-2 Subcommittee and replaced him with Berenschot. MAINTENANCE NEEDS: Robole was present to discuss some maintenance needs that need Board input before the 1998 budget can be completed. 7 1. Maintenance would like to sell the three-quarter ton Ford purchase a government surplus truck pickup and Ford dump truck and from Arden Hills Surplus Center and install a dump box and snow plow on this truck. Discussion followed. Motion: A motion was introduced by Bethke, seconded by Dowd, and unanimously adopted: That the Board approve the proposal to sell the three-quarter ton Ford pickup and Ford dump truck and .purchase a government surplus truck from Arden Hills Surplus Center and to install a dump box and snow plow on this truck for an approximate final cost of $141376. 2. Three fuel tanks must be out of the ground by December, 1998. Robole said this has been mandated by the DNR and is State law that they need to be removed by December, 1998s A certified site assessment needs to be done. Stephens told Robole to call Skoglund to verify requirements. Stephens wants a written order that these tanks need to be removed. 3. The sidewalk that runs from the south Nursing Home parking iot to the south lower level entrance to the Nursing Home needs to be removed and replaced. The storm water drain is located on the wrong side of the walkway, requiring water to run across the sidewalk and towards the door. Discussion followed. Motion: A motion was introduced by Bethke, seconded by Berenschot, and unanimously adopted: That the Board approve removing and replacing the sidewalk that runs from the south Nursing Home parking lot to the south lower level entrance to the Nursing Home at a cost of approximately $2,000. FINANCIAL REPORT: Krieger said the Nursing Home census is 108 today with the possibility of going to 110 by the end of the week. Portions of the Medicare/Medicaid payments were held for the Nursing Home and Home Health for June and part of July. The following financial report was distributed and discussed: PLEASE SEE NEXT PAGE. ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD O1/01/97 THROUGH 06/30/97 NURSING HOME Reconciled Cash Balance 06/30/97 Add: Accounts Receivable, 06/30/97 Private Pay Medicare Medicaid General Accounts Payable-06/30/97 Net Current Items, 06/30/97 1997 Revenue Recorded through 06/30/97 Includes Allocations of Anticipated Revenues 1997 Expenses Recorded through 06/30/97 Includes Allocations of Expected Expenses $251,791.73 $200,112.37 $192,155.17 $182.64 ($125,941.28) $498,855.03 $2,273,629.06 $2,342,454.54 Add or Deduct any nursing home related items not recorded on nursing home books: 1997 bond principle $246,794.50 (93.13% of total 1997 bond principle of $265,000) NH97sum * Operations = $126,846.48 Capital Acquisitions = 124,945.25 HUMAN SERVICES - 1997. SUMMARY Total OF REVENUES Jan. -June Budget Balance % Administration 312,786.09 508,055.00 195,268.91 61.6% AODA Services 197,221.51 365,476.00 168,254.49 _ 54.0% Long Term Support 30460,970.15 8,036,806.00 4,575,835.85 43.1% Mental Health 879,428.80 1,620,643.00 741,214.20 54.3$ Family & Children's 1,145,614.40 2,076,775.00 931,160.60 55.2$ Economic Support 389,209.75 1,309,495.00 920,285.25 29.7� General Relief 15,826.21 42,124.00 26,297.79 37.6� TOTAL REVENUES ALL PROGRAMS 6,401,056.91 13,959,374.00 7,558,317.09 45.9� SUMMARY Total OF EXPENDITURES Jan. -June Budget Balance $ Administration 233,857.24 508,055.00 274,197.76 46.0% Alcohol -Drug Abuse 132,861.53 365,476.00 232,614.47 36.4% Long Term Support 3,429,744.54 8,036,806.00 4,607,061.46 42.7% Economic Support 466,566.39 1,309,495.00 842,928.61 35.6% Mental Health Services 719,046.70 1,620,643.00 901,596.30 44.4% Family & Children's 818,982.77 2,076,775.00 1,257,792.23 39.4% General Relief 7,152.19 42,124.00 34,971.81 17.0$ TOTAL 1997 HUMAN SERVICES BUDGET 5,808,211.36 13,959,374.00 8,151,162.64 41.6$ hs97-sum HOME HEALTH Total Jan. -June Budget Balance �* TOTAL REVENUES 193,233.07 531,636.00 338,402.93 36.3� TOTAL EXPENDITURES 234,813.74 531,636.00 296,822.26 44.2� PUBLIC HEALTH (12 month programs) Total Jan. -June Budget Balance $* TOTAL REVENUES 372,895.22 845,706.00 4?2,810.78 44.1� TOTAL EXPENDITURES 419,069.03 845,706.00 426,636.97 49.6� *TO BE ON BUDGET, PERCENTAGE SHOULD BE 50.0$ ph97-sum 11 NURSING HOME BUDGET: Krieger distributed the 1998 Nursing Home budget. She said no additional monies have been requested. She said Medicare expenses are up due to having a Medicare distinct part and contracting with therapy services, but revenue is also increased due to Part B Medicare billing. Krieger said the budget is based on a census of 108, the average yearly census for 1997 as of July was 102. The Board questioned if a census of'108 was realistic. Discussion followed. Stephens asked if there were any other issues to bring before the Board. Motion: A motion was introduced by Berenschot, seconded by Bethke, and unanimously adopted: that the meeting be adjourned. Time: 10:45 a.m. Chairman: Attest: (secretary)