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HomeMy WebLinkAboutSCC Health & Human Services Board 08-28-97�y We Robert Boche, Chairman St. Croix County Board FROM: Robert Stephens (John Borup 246-S223) COMMITTEE TITLE: St. Croix .Board DATL: TIffiE: LocAT�QN: 08/28/97 6:30 p.m. St. Croix County New Richmond VIA County Health and Human Services Health and Human Services Complex CALL TQ ORDER ROLL CALL ADOVVTON OF AGENDA DATE OF NEXT MELTING: 09/10/97 ACTION ON PREVIOUS MINUTES: 08/12/97 MOUNCEMENTS APPOINTMENTS IINFINISHED BUSINESS: NEW SIISINESS: 1. Presentation and Action on 1998 Budget for Health and Human Services and Nursing Home 2. Personnel Issues 3. Health and Human Services/Nursing Home Report 4. Resolution to Administer Welfare Fraud Investigation Program 5. Subcontract with Wisconsin Job Service for Wisconsin Works (W- 2) 6. Long Term Support Single Entry Point "Pilot" Application ANNOIINCEMENTB � coRRESPONDENcE POSSIBLE AGENDA ITEM$ FOR NEgT MEETING: SIISMIT"fED BY: John M. 8orup DATE: August 15, 1997 COPIES TO: COUNTY BOARD OFFICE 09 G ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD August 28, 1997 The St. Croix County Health and Human Services Board met on August 28, 1997, at the St. Croix County Health and Human Services/Health Center complex. MEMBERS PRESENT: Jack Dowd, Vice Chair Leon Berenschot Chris Bethke Einar Home '_ Fern Johnson Allen Limberg Mary Louise Olson George Sinclear MEMBERS ABSENT: Robert Stephens, excused S 1 AFF PRESENT: John Bor�ip, Heal`�l-i and Human Services Director Carolyn Krieger, Nursing Home Administrator Judy Ziegler, Accountant Karen Hall, Long Term Support Coordinator Ron Kiesler, Mental Health/AODA Coordinator • Fred Johnson, Family & Children's Supervisor Kathy Dunlap, Family & Children's Supervisor Ron Lockwood, Long Term Support Marilyn Fruit, Economic Support Supervisor Debbie Willink, Social Worker, Family Support Program Steve Kirt, Mental Health/AODA Clinical Services Supervisor Judy Aronson, Secretary OTHERS PRESENT: Robert Boche, County Board Chair Lee KellaherI Long Term Support Committee Vice Chair Dowd, called the meeting to order at 6:30 P.M. noting the meeting was properly and legally publicized. NEXT MEETING: The next Health and Human Services Board meeting is scheduled for Wednesday, September 10, 1997 at 8:00 a.m. at the St. Croix County Health and Human Services/Health Center complex. Bethke will review the vouchers at 7#30 a.m. 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 Olson, and unanunously adopted: That the minutes of the 08/12/97 Health and Human Services Board meeting be approved as circulated. Copies of the 1998 Budget were delivered to Board members in advance of this meeting. Borup stated this is the fifth consecutive budget without an increase in County costs for both Health and Human Services and Nursing Home. The 1998 Budget applies $88,962 in "prior year carryover" funds, compared with $167,715 in 1997. No funds from the Farm or Home Health accounts are applied as they have been in past years. Some of the major factors in accomplishing this are. W-2 revenues; reduced alternate care costs; $113,942 new revenues from Comsr�unity Deficit Reduction Program, management position elimination. The fund increases generated by these events will not generate the same gains in 1999. Salary increases and the $168,000 added to the budget to reduce the Long Term Support waiting list are the major cost increases. These costs will be duplicated in 1999. Borup stated he does support the reduction of the Long Term Waiting List with the condition. (1) that it will not decrease funding to other Health and Human Services Programs; (2) the Board recognize it's fiscal impact. Horne asked about the Kinship Care Program. The State believes a child should stay with a relative rather than to go to a foster home. The Kinship Care Program was a part of the AFDC Program and is now a part of Family and Children's. F. Johnson stated the state mandates the new county money and we do not have final numbers from the state as to how much money they will give us in revenues. To date there are nineteen families with about 25 children in the program. The maximum monthly amount is $215.00/month. Johnson stated if there is any other source to support that child in the family, the Kinship Care Program is then secondary. Horne questioned the W-2 profits of $85,209 versus the cost in 1997 of $87,697 which included all of the programs in Economic Support. Horne stated we have gone from a tremendous number of people, are we cutting effectively. Fruit stated the dollar amount is an estimate. Fruit stated we may have more profit in 1997 or we may have less. Fruit stated that since 08/01/97, we have lost eight people; two have returned to previous jobs, two were deemed disabled, three declined further assistance, and we lost contact with one, who went to live with her mother in Minnesota. Dowd stated that more and more people are coming into St. Croix County. Horne questioned two items: the Long Term Support waiting list budget increase of $168,000, and the Kinship Care Program in the amount of $37,788 -which he stated in his opinion were open programs. Horne asked, "In 01/01/99 where are we going to be with the fund balance - $200,000, or less?" If we absorb the $168,000 this year, what about next year? This will be also need to be added to the 1999 budget. Borup stated Horne is exactly right. The $168,000 and salary increases will be duplicated in 1999. Borup stated we aren't prepared to discuss the 1999 Budget tonight. Borup and Ziegler conferred for a few minutes to provide "rough" 2 estimates for 1999. Bethke stated we can't cut back anymore on the programs - the job has been done well. Kellaher stated the Long Term Support Committee took a stand. The waiting list was increasing at such a high rate that it was just a humane thing to do, to not eliminate the waiting list but to take a conservative approach. Right now we have a 30 month waiting list. If we don't do something now it will come back to haunt us. Some clients are on three waiting lists. Lockwood stated there is a case plan for every person served. The state reviews every plan that we send in. Krieger stated that the 1998 nursing home budget was presented at the Board meeting on August 12th and was balanced at a census of 108. As was indicated by the Board, the budget remains unchanged. Today's census is 106. Krieger stated that South Coast Rehab. has taken one outpatient for therapy and has referrals for others. The outpatient clinic would be another revenue source for the nursing home. We would continue to bill Medicare Part B for a revenue source along with private insurance. Medicaid is the least profitable of the three revenue sources. The physicians are the source of referrals for the nursing home and have been informed and educated as to the potential for referrals to the therapy company for discharged residents as well as employees with work related injuries, however, there is competition with the hospital therapies and the therapies connected with the clinic. Krieger stated that the nursing home budget experienced the same problems as the Health and Human Services budget, which included salary increases of 5-6% for support staff absorbed for 1997 into the 1998 budget along with the 3 % in 1998. Another expense that is unpredictable is PTO usage. The nursing home has added three CNA float positions this year to cover the added PTO usage given to the part time staff in the arbitrator's settlement. Expenses that were cut in the 1998 budget is overtime and is another unpredictable item, although, overtime costs will be experienced. Dowd complimented the staff for the quality care given to his aunt. The turnover report was discussed and the turnover rate for full time RN's and LPN's is zero for the nursing home compared to 32% and 20% respectively statewide. Motion: A motion was introduced by Bethke, seconded by Johnson, and unanimously adopted: That the Health and Human Services Board approve this Nursing Home budget that Krieger presented. Borup and Ziegler stated the "rough" estimate of Health and Human Services fund balance for O1/O1199 would be $225,000 based on guessing and estimation and if all the grants and revenues are the same. They both cautioned the Board on the reliability of projecting 1999 numbers in 1997. Motion: A motion was introduced by Sinclear, seconded by Berenschot: That the Health and Human Services Board approve this Health and Human Services budget as presented. Horne opposed. Motion carried. 3 Resolution to Administer Welfare Fraud Investigation Program: A letter of support from Sheriff Paul Burch for the Welfare Fraud Contract under the new W-2 Works Program was distributed. This Resolution will need to be forwarded to the County Board on September 16, 1997 for their approval. Fruit gave a brief history of the fraud administration in the county. Our Fraud Coordinator does the initial investigative work, such as home visits, confronting the client, anonymous calls, etc. The state has chosen to put W-2 administration allocation and non-W-2 administration as part of the fraud contract. We are still required to make the referrals no matter who would be doing the investigation. _ Olson asked what the percentage of clients are fraudulent. Fruit stated there is about $50,000 of fraudulent activity per year. This is a good program operating with the Sheriff's Department. Motion: A motion was introduced by Horne, seconded by Olson, and unanimously adopted: That the Health and Human Services Board approve the Resolution Designating the Department of Health and Human Services as Fraud Investigative Agency and the Resolution to be forwarded to the County Board on September 16, 1997. (Resolution attached at the end of the minutes.) Subcontract with Wisconsin Job Service for Wisconsin Works (W-21: Fruit stated we are in the process of finalizing the W-2 Subcontract with the Wisconsin Job Service. The contract will be for 16 months for a total of $105,067. This will provide a .7 FTE position and the following. a. Basic Services ($50,000/year): $66,666 b. Employment position placements (@ $1,200/each): $38,400 c. Monthly reports relating to the delivery of services under this contract will include identification of the W-2 participants served, the exact services provided and a list of subsidized jobs developed and available by employment position, i.e. trial jobs, community services jobs, etc. . Motion: A motion was introduced by Bethke, seconded by Johnson, and unanimously adopted: That the Health and Human Services Board approve to accept the Subcontract with Wisconsin Job Services for Wisconsin Works (W-2). Long Term Support Single Entry Point "Pilot" Application: Back on May 22, 1997, the Health and Human Services Board authorized our involvement to Long Term Care "Redesign" and approved to "proceed to be a Long Term Care Provider." The State is now soliciting two to six counties to apply to be "pilot" counties to test the Single Entry Point concept. Notification of intent to be a pilot county needs to be submitted by 09/02/97. Horne asked what advantage is there for St. Croix County to be a pilot as you may have to increase staff time. Hall stated the advantage is we would have direct input of the tools to use, something that will work for St. Croix County. The counties who have been pilots in the past have had advantages as programs were implemented. Motion: A motion was introduced by Berenschot, seconded by Sinclear, and unanimously adopted: That the Health and Human Services Board approve to move ahead and send in the letter of intent to be a pilot county for the Single Entry Point concept, if accepted it would then need the County Board approval. This is not a leagal commitment. Dowd asked if there were any other issues to bring before the Board. MOTION: A motion was introduced by Sinclear, seconded by Bethke, adopted: That the Health and Human Services Board meeting be adjourned. Time: 7:SS_p.m. Chairman: Attest: 5 Secretary and unanimously RESOLUTION DESIGNATING THE DEPARTMENT OF HEALTH AND HUMAN SERVICES AS FRAUD INVESTIGATIVE AGENCY RESOLUTION NO. ST. CROIX COUNTY, WISCONSIN WHEREAS, the State Department of Workforce Development is creating a separate performance based contract for fraud investigation services; and WHEREAS, other fraud prevention activities, such as front-end verification, collections and prosecution, are covered under the Income Maintenance (Economic Support) and W-2 "Wisconsin Works" contracts; and WHEREAS, the Economic Support and W-2 "Wisconsin Works" agencies are responsible for program integrity and referrals for fraud investigation; and ..WHEREAS, additional federal matching dollars in excess of the allocated amounts are available for food stamps and medical assistance fraud prevention activities with county participation; and WHEREAS, St. Croix County will be allocated the amount of state money (plus the federal match of state funds to be claimed for actual expenses) as in previous years to perform fraud investigation services; and WHEREAS, St. Croix County has the option of first selection to contract with the Department of Workforce Development to administer the fraud investigative contract; and WHEREAS, the St. Croix County Department of Health and Human Services has a well established working relationship with the St. Croix County Sheriffs Department for fraud investigation. THEREFORE, be it resolved by the St. Croix County Board of Supervisors that the Department of Health and Human Services is designated the Fraud Investigative Agency and is authorized to administer the Fraud Investigative program. FURTHER, be it resolved that the Department of Health and Human Services may enter into an acceptable contract for two years, with two one-year renewal options, and shall review and determine, with the concurrence of the Health and Human Services Board, whether it should continue to administer the Fraud Investigative program.