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HomeMy WebLinkAboutSCC Health & Human Services Board 11-11-97x TACK DOWD WILL REVIEW VOUCHERS AT 7:30 A.M. ST. CROYX COUNTY NOTICE OF COMMITTEE FETING TO: Robert Soche, Chairman St. Croix County Board FROM: Robert Stephens (John Borup 246-8223) COMMITTEE TITLE: St. Croix County Health Board DATE: TIME: i�•Z•f�tiF�l� 11/11/97 s:oo a.m. an d Human Services St. Croix County Health and Human Services Complex, New Richmond CALL TO ORDER ROLL CALL ADOPTION OF AGENDA DATE OF NEXT MEETING: 11/25/97 ACTION ON PREVIOUS MINUTES: 10/10/97 ANNOUNCEMENTS APPOINTMENTS: UNFINISHED BUSINESS: 1. ECHO Computer Software "Upgrade" Needs 2: Action on keeping or selling Department's 1985 Ford 4 x 4 NEW BUSINESS: 1. Consideration of Claims and Vouchers Z. Financial Report 3. Personnel Issues 4. Health and Human Services/Nursing Home Report 5. Nursing Home Bed Decertification and Bed "Banking" Options 6. Setting 1998 Child Day Care Rates 7. Discussion of Board meetings and program Reports/Assignments 8. Resolution supporting State restoration of GPR funds to Women, Infants and Children (WIC) 9. Cost estimates to build garage for Department vehicles 10. Juvenile Justice Formula Grant Application 11. Action on County Farm House Lease ANNOUNCEMENTS & CORRESPONDENCE POSSIBLE AGENDA ITEMS FOR NEXT MEETING: ADJOURNMENT (Agenda not necessarily presented in SUBMITTED BY: John M. Borup DATE: November 3, 1997 COPIES To: COUNTY BOARD OFFICE COUNTY CLERK NEWS MEDIA/NOTICE this order) A JACK DOWD WILL REVIEW VOUCHERS AT 7:30 A.M, ST. 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: 11/11/97 TIME: 8:00 a.m. Health and Human Serv'iCes LOL'ATTON: St. CroiX County Health and Human Services CompleX, New Richmond CA�,L TO ORDER ROLL CALL ADOPTION OF AGENDA DATE OF NEXT MEETING: 11/25/97 ACTION ON PREVIOUS MINUTES: 10/10/97 ANNOUNCEMENTS APPOINTMENTS: UNFINISHEb BUSINESS: 1. ECHO Computer Software "Upgrade" Needs 2. Action on keeping or selling Department's 1985 Ford 4 x 4 NEW BUSINESS: 1. Consideration of Claims a.n.d Vouchers 2. Financial Report 3. Personnel Issues 4. Health and Human Services/Nursing Home ,Report 5. Nursing Home Bed Decertification and Bed "Banking" Options 6. Setting 1998 Child. nay Care Rates 7. Discussion of Board meetings and Program Reports/Assignments 8. Resolution supporting State restoration of GPR funds to Women, Ynfan•ts and Children (WIC) 9. Cost estimates to build garage for Department vehicles ANNOUNCEMENTS Se CORRESPONDENCE FOSS=8LE AGENDA ITEMS FQR NEXT MEETING: ADJOURNMENT (Agenda not necessarily SUBMITTED BY: John M. Borup )ATE: October 29, 1997 presented in this order) COPIES TO: COUNTY BOARD OFFICE COUNTY CLERK NEWS MEDIA/NOTICE T. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD NOVEMBER 11, 1997 The St. Croix County Health and Human Services Board met on November 11, 1997, at St. Croix County Health and Human Services complex in New Richmond, Wisconsin. MEMBERS PRESENT: Robert Stephens, Chair Leon Berenschot Chris Bethke Jack Dowd Einar Horne Fern Johnson Allen Limberg George Sinclear MEMBERS ABSENT: Mary Louise Olson, excused STAFF PRESENT: John Borup, Health and Human Services Director Carolyn Krieger, Nursing Home Administrator Karen Hall, Long Term Support Coordinator Marilyn Fruit, Economic Support Supervisor Barbara Nelson, Public Health Supervisor Ron Kiesler, Mental Health/AODA Coordinator Ralph Robole, Facilities Manager Fred Johnson, Family and Children's Supervisor Melinda Hanson, WIC Coordinator Judy Ziegler, Accountant Robin Hanson, Accounts Receivable Supervisor Ron Eichstaedt, St. Croix Industries Director Steve Kirt, Mental Health/AODA Clinical Services Supervisor Deb Lindemann, Public Health Malva Berg, Secretary OTHERS PRESENT: Eric Johnson, Director of Healthy Communities Chair Stephens called the meeting to order at 8:00 a.m., noting the meeting was properly and legally publicized. Stephens extended the Board's sympathy to Dr. Limberg for the loss of his wife. NEXT MEETING: After discussion, it was the consensus of the Board to call the night meetings for November 25 and December 23 only if a meeting is needed. AGENDA: Motion: A motion was introduced by Bethke, seconded by Berenschot, and unanimously adopted: That the agenda be approved as circulated. MINUTES: Motion: A motion was introduced by Stephens, seconded by Dowd and unanimously adopted: That the minutes of the 10/10/97 Health and Human Services Board meeting be approved as circulated with the following changes: Page 3, paragraph 8, should read as follows: ". . . Beds are banked for 18 months. The state automatically takes 100 of the banked beds as of January 1 of each year." Discussion held on bed banking and decertification options. Krieger said this applies to all nursing homes, county and private. Horne requested information be included each month in the minutes regarding the farm cash report, including the number of acres under cultivation, rent income from the barn, land, and house. ECHO COMPUTER SOFTWARE UPGRADE NEEDS: This is a follow ua p of request made to the Board in August to upgrade ECHO with a Windows software upgrade, which would make ECHO an accessible software package for accounts receivable department and clinical staff. Cost for this upgrade is $28,978. Borup said this would replace the DRI accounts receivable software. He said DRI is obsolete and costs us in billing revenues. Kiesler said mental health is successfully using ECHO for client information but is not very user friendly. He said the only way to prevent ECHO from becoming obsolete is to upgrade with the Windows 95 software upgrade. He said upgrades are a routine part of computer operation. Horne asked who is responsible to integrate the upgrade into the system. Kiesler said a position in computer services is needed to implement the Windows upgrade. Stephens said not getting adequate help from computer services is a separate issue. Kiesler said the relationship with computer services and Human Services is healthier than it was a year ago. Stephens asked Kiesler to bring computer services policy up to date and bring to the Board. Discussion followed. Motion: A motion was introduced by Horne, seconded by Berenschot, indows and unanimously adopted: That the Board approve the W software upgrade for ECHO at the cost of $28,978. MAINTENANCE TRUCK: We recently purchased a military surplus 1979 Dodge 4 x 4 "dually" with 200 miles for $4,200. It was an ambulance and will need the back of the cab replaced. Kadinger Salvage has agreed to take the old highway truck in trade. The Dodge should be ready about mid -November. Kadinger will repair and paint the cab. Questioned Board as to what to do with the 1985 Ford 4 x 4 with about 86,000 miles and an estimated value of $4,000. Discussion followed. 3 3 Motion: A motion was introduced by Horne, seconded by Dowd, and unanimously adopted: That the Board approves advertising for bids to sell the 1985 Ford 4 x 4. CONSIDERATION OF CLAIMS: Ziegler distributed the following reports: transfer of funds report, fixed assets purchased, and cash report for October. Health and Human Services Board member, Dowd reviewed the October vouchers and questioned or reviewed the following vouchers: HEALTH AND HUMAN SERVICES: 10522: Lund Builder, Inc. $9,194.50, Jenny R. Long Term Support Purchased Services. Cost of remodeling for brain injured client. Brain injury tract from State has been amended to cover this client. 10735: Phoenix Group Home, $4,912.57, group home. Cost for two Family and Children's clients for one month. This facility is located in Woodbury, Minnesota. It cares for youth with chemical dependency issues. 10780: Surplus Services, $4,709.38, maintenance truck. Purchase of Army surplus vehicle to be remodeled and used as the maintenance truck at the New Richmond facility. NURSING HOME: 668: Holy Family Hospital, $1,786.10, Medicare lab expense. Cost of lab work done for Medicare residents done at the hospital. 669: Holy Family Hospital, $940.00, respiratory therapy expense. Monthly charges from hospital for providing therapy services for nursing home residents. 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 941 through 9826 Home Health voucher 10459, dated October 29, 1997, in the amount of $59.50. Home Health vouchers 10843 through 10867, dated October 31, 1997, in the amount of $7,064.60. Human Services vouchers 10379 through 10417, dated October 16, 1997, in the amount of $87,874.22. 0 Human Services vouchers 10419 through 10458, dated October 23, 1997, in the amount of $77,783.086 Human Services vouchers 10460 through 10493, dated October 29, 1997, in the amount of $179,750.64. Human Services vouchers 10494 through 10563, dated October 30, 1997, in the amount of $55,429.09. Human Services vouchers 10835 through 108421 dated October 28, 1997, in'the amount of $2,1076500 Human Services vouchers 10564 through 10817, dated October 31, 1997, in the amount of $163,979.679 Human Services voucher 10868, dated October 31, 1997, in the amount of $2,016.32. Nursing Home vouchers 668 through 675, dated October 16, 1997, in the amount of $9,262.69. Nursing Home vouchers 680 through 739, dated November 11, 1997, in the amount of $96,639.830 Human Services and Nursing Home vouchers 1205 through 1234, dated October 15, 1997, in the amount of $289,155.36. Social Services and Human Services vouchers 362 through 381, dated October 15, 1997, in the amount of $96,457.96. Human Services and Nursing Home vouchers 1235 through 1265, dated October 29, 1997, in the amount of $245,986.92. Social Services and Human Services vouchers 382 through 401, dated October 29, 1997, in the amount of $79,268.81. DISCUSSION OF PROGRAM REPORTS/ASSIGNMENTS: Discussed the possibility of having Board members represent specific program areas, e.g. Public Health, Nursing Home, Home Health, Long Term Support, Mental Health/AODA, Economic Support and Family and Children's. Borup distributed a survey to Board members regarding reports presented to the Board. Borup said it would be helpful to have Board members represent certain areas when staff come in with a report so Board members would have areas of expertise. Stephens would rather the Board members have a broader knowledge of the workings of the department. Stephens said when the annual report was given to the County Board, Health and Human Services were treated rudely and this department will not give a report to the County Board again unless ordered to and then only if treated with courtesy. Borup said according to statutes, the Board should have representatives from different disability areas. Stephens said he is happy with the way things are now. He said the Chair position will probably change in April and the new Chair may make any changes in appointments, etc6 if needed or wanted. NURSING HOME BED DECERTIFICATION AND BED BANKING OPTIONS: The Nursing Home "bed banking" (decertifying) option has been proposed by the State as a method to reduce beds for facilities below a 91% occupancy to retain the MA rate. The St. Croix Health Center had an occupancy rate for 1996 of 81%. In order to reach 91%, the number of beds banked (decertified) would be 14. If the beds are not banked, the financial impact would be about $200,000. The ability to CIP these beds is a possibility but it would result in the Nursing Home permanently losing the beds and being penalized in the MA rate for two years so this is a separate issue. Krieger said the deadline for this plan was October 31, 1997. If beds are banked now it would be effective 01/01/98. She said the beds can be kept and some of the monies can be recaptured through ITP (Intergovernmental Transfer Program). The 07/01/98 rate will not be impacted by the occupancy rate because the 07/01/98 rate will be a rate -on -rate increase of 3%* and will be applied across the board to all nursing homes. Stephens recommended not banking or decertifying beds now as this has a financial impact on the facility's value. It was recommended that this issue be looked at again before the election and if it is the Board's recommendation to bank/decertify beds at that time, to present the issue to the Finance Committee. SETTING 1998 CHILD DAY CARE RATES: Motion: A motion was introduced by Horne, seconded by Dowd, and unanimously adopted: That the Board approves the Child Day Care Rates as outlined on the last page of these minutes. Horne said he studied the Office on Aging budget and had some questions on the Meals on Wheels Program. He wanted to know why the Nursing Home was not providing meals for this program and was sure the Nursing Home had the ability to do this. Krieger said she has approached the Office on Aging to do this, but they were not I nterested. Health and Human Services does not have any control over the Office on Aging. COST ESTIMATES TO BUILD GARAGE FOR DEPARTMENT VEHICLES: Stephens said Krizek contacted the Department to ask if a pole shed recently purchased by the County could be used by Human Services. The building would have to be tore down and moved. It was the consensus of the Board that this could not be used by the department. Eichstaedt distributed a proposal for a 30' x 80' x 14' building with a 16' x 80' x 14' two-sided shed attached for an approximate cost of $40,000. Borup said he does not support this building unless the money comes from non -service monies. Sinclear said he would only support the building if the monies came from the farm C� account. Discussion followed. Stephens recommended postponing this until June, 1998 so it could be worked into the 1999 budget. Motion: A motion was introduced by Horne, seconded by Dowd, to delay action on building the garage for department vehicles until it can be worked into the 1999 budget. No vote was taken on this motion. Motion: A motion was introduced by Bethke, seconded by Berenschot, and unanimously adopted: That the Board postpone action on building the garage for department vehicles until February. The Board recessed from 9:25 a.m. to 9:30 a.m. Horne left the meeting at 9:30 a.m. PIERCE-ST. CROIX TOBACCO FREE COALITION: Deb Lindemann from Public Health and Eric Johnson, Director of Healthy Communities, gave a brief presentation on current activities being done by the coalition. Lindemann is currently running a tobacco cessation class. She said November 20 is the date of this year's Great American Smokeout. Johnson works out of the Hudson Hospital and received a grant from Allina to provide alternatives to drug and alcohol use for youth. Discussion followed. NURSING HOME REPORT: Krieger reported that beginning 111O1198, the new State budget had mandated criminal background checks for all new employees of nursing homes, CBRF's, home health, hospitals, residential care facilities, adult day care centers, adult family homes, hospices, treatment facilities, personal care agencies, and supportive care agencies. Similar checks for existing employees will be required 11/01/99. Presently facilities are responsible for the check through the Department of Justice at $5.00 cost to the facility. Check not always done in a timely manner. Krieger reported new employees under 18 cannot be checked and there is no coordination between states to detect criminal backgrounds for those who move around. Berenschot recommended that advertising be done to include idents testimonials of residents or former res. FINANCIAL REPORT: Krieger said the Nursing Home census is 107 with tending . The following financial report was wo admissions p distributed and discussed. PLEASE SEE NEXT PAGE. ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD O1/01/97 THROUGH 09/30/97 NURSING HOME Reconciled Cash Balance 09/30/97 Add: Accounts Receivable, 09/30/97 Private Pay Medicare Medicaid General Accounts Payable-09/30/97 $329,202.34 $3031921.67 $180,295982 $392.32 ($283,374.93) Net Current Items, 09/30/97 $524,553.02 1997 Revenue Recorded through 09/30/97 $3,476,013.10 Includes Allocations of Anticipated Revenues 1997 Expenses Recorded through 09/30/97 $3,622,537.68 Includes Allocations of Expected Expenses Add or Deduct any nursing home related items not recorded on nursing home books: 1997 bond principle $246,794.50 (93.1390 of total 1997 bond principle of $265,000) NH97sum * Operations = $204,257.09 Capital Acquisitions = 124,945.25 * SUMMARY OF REVENUES 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 1997 HUMAN SERVICES BUDGET hs97-sum HUMAN SERVICES - 1997 Total Jan. -Sept. Budget 407,156.45 284,701.14 5,601,043.89 1,297,392.06 1,606,502.26 611,426.88 23,642.23 508,055.00 365,476900 8,036,806.00 1,620,643.00 2,076,775.00 1,309,495.00 42,124.00 9,831,864.91 13,959,374.00 Total Jan. -Sept. 347,269.30 184,335.09 5,483,485.71 633,238.33 1,120,586.31 1,259,230.38 9,456.83 Budget 508,055.00 365,476.00 8,036,806.00 1,309,495.00 1,620,643.00 2,076,775.00 42,124.00 9,037,601.95 13,959,374.00 Balance o 100,898.55 80,774.86 2,435,762.11 323,250994 470,272.74 698,068.12 18,481.77 4,127,509.09 Balance 160,785.70 181,140a91 2,553,320.29 676,256.67 500,056.69 817,544.62 32,667.17 solo 77.91 69.7 6 80.1% 77.40 46.70 56.1a 70.40 68.40 50.4I 68.2a 48.4% 69.1% 60.60 22.4% 4,921,772.05 64.7% HOME HEALTH Total Jan. -Sept. Budget Balance o* TOTAL REVENUES** 317,947.49 531,636.00 213,688.51 59.80 TOTAL EXPENDITURES 344,550.87 531,636.00 187,085.13 64.806 **8 months of.revenue=67.Oo, 9 months of expense=75.00 PUBLIC HEALTH (12 month programs) Total Jan. -Sept. Budget Balance o* TOTAL REVENUES 592,084.58 845,706.00 253,621.42 70.0% TOTAL EXPENDITURES 620,020.93 845,706.00 225,685.07 73.3% *TO BE ON BUDGET, PERCENTAGE SHOULD BE 75.00%. ph97-sum 10 INFANTS AND CHILDREN (WIC): Hanson explained that St. Croix County WIC received an 11% reduction for FY 97-98 (a total of $7,608)1 which includes the eliminated high risk counseling activities funding. It appears that the state is not including High Risk Counseling Activities. These funds would no longer be provided as an administrative add -on, but rather the functions would be considered as core functions to be supported within the per capita base for administration. Clients regularly receive nutrition education, high risk counseling as needed, and monitoring for improved outcomes (i.e. low birth weight babies, low hemoglobins, inappropriate weight gains for infants, children, and pregnant women, etc.). Without nutrition and outcome -based components, the WIC Program loses it's cost effectiveness. Motion: A motion was introduced by Berenschot, seconded by Bethke, and unanimously adopted: that the following resolution be approved by the Health and Human Services Board. RESOLUTION WHEREAS, The State of Wisconsin Supplemental Nutrition Program (WIC) high risk counseling activities in and, Women, Infant and Children eliminated add -on funding for FY 97-98 for local projects, WHEREAS, in St. Croix County this funding was $6,017 for high risk counseling activities in FY 96-97, and, WHEREAS, in St. Croix County approximately 53% of the total caseload (729 in October, 1997) are identified as high risk, and, WHEREAS, nutrition services for high risk counseling are needed to maintain the estimated $3.00 saved in medical costs for every $1.00 spent in WIC. NOW THEREFORE BE IT RESOLVED, that the St. Croix County Department of Health and Human Services Board hereby encourage Wisconsin Senator Alice Clausing, Representative Sheila Harsdorf, Representative Joe Plouff, and Governor Tommy Thompson to make additional funding ($239,500 in FY 97-98 and $539,000 in FY 98-99) available to the Wisconsin WIC Program for High Risk Counseling Activities. JUVENILE JUSTICE FORMULA GRANT APPLICATION: Fred Johnson requested to apply for grant monies for "intensive supervision services" for juveniles involved in the court process. Intensive supervision would provide an additional dispositional alternative to supervise youth in their community without out of home placement and 11 potentially cut our costs. This grant would be for youth who don't respond to traditional supervised services to provide more intensive supervision to keep youth out of group homes. Grant monies would be available for two years with the first year funded at 100% and the second year at 75% with 25% county match or youth aids monies. Johnson said services could be provided by County staff or contracted through private vendor. This could decrease alternate care costs. Motion: A motion was introduced by Sinclear, seconded by Dowd and unanimously adopted: That the Board approves Fred Johnson applying for grant monies for "intensive supervision services" for juveniles I nvolved in the court process. ACTION ON COUNTY FARM HOUSE LEASE: Received notice from Henk Van Dyk on 11/03/97 giving us 30 days notice for termination of the farm house lease. Borup presented a sample ad that could be used to advertise the house for rent. Discussion followed. Motion: A motion was introduced by Dowd, seconded by Berenschot, and unanimously adopted: That the Board approves leasing the farm house for a one-year lease for $500 per month plus security deposit and utilities. Motion: A motion was introduced by Berenschot, seconded by Stephens, and adopted with one no vote: that the lease include a no -pets clause. PERSONNEL ISSUES: Borup said Jim Williams and Kim Dupre began working in the Computer Services Department on 11/10/97. He said Kathryn Beutel is back to work half time. Fred Johnson announced that Family and Children's Services has hired Jean Williams in a social worker position to begin 11/24/97. Stephens asked if there were any other issues to bring before the Board. Barb Nelson said there are still spaces in a rabies workshop to be held by Public Health. Interested Board members should contact Public Health. Nelson also reported there have been increased numbers of whooping cough in St. Croix County. She said protection from immunization wanes in adolescents and adults. Motion: A motion was introduced by Berenschot, seconded by Sinclear; and unanimously adopted: that the meeting be adjourned. Time: 10*20 a.m. Chairman: Attest: secretary DEPARTMENT OF WORKFORCE DEVELOPMENT Division of Economic Support DES-2465 (REV. 9197) ; REQUEST FOR APPROVAL OF CHILD DAY CARE RATES Completion of this form meets the requirements of Wisconsin Statutes, S. 49.155 (6). and DWD 56.06 of the Wisconsin Administrative code NAME OF COUNTY/TRIBE9 Effective Date of New Rate: January 1, 1998 ST. CROIX COUNTY Weekly Ceiling 1. Licensed Group Child Care Hourly Rate a.) Under Age 2 3.71 130.00 $ b.) 2 12 Years Old $ 3.07 107 . SO - Hourly Rate Weekly Ceiling 2. Licensed Family Child Care $ a.) Under Age 2 $ 3.21 112.50 5 $ 100.00 b.) 2 -12 Years Old 2.86 3. Regularly Certified Child Care Hourly Rate a.) Under Age 2 2.41 b.) 2 -12 Years Old S 2.15 4. Provisionally Certified Child Care Hourly Rate a.) Under Age 2 1961 { b.) 2 -12 Years Old 1.43 What number was used to divide the Licensed Group Weekly ceiling into an hourly rate? 30—--35 What number was used to divide the Licensed Family Weekly ceiling into an hourly rate? 30 Counties and Tribes have authority to authorize child care reimbursement in excess of the weekly ceiling on z case by case basis if payment is for 50 or more hours of child care, or if other extenuating circumstances are involved within the case. Counties and Tribes have authority to authorize child care reimbursement in excess of the hourly rates or wet ceilings on a case by case basis if payment is for a child with a special need. Charlotte Skoviera Submitted by: (print) Office of Child Care Review Child Day Care Rates Are: Comments: Signature �w Q �� g/j ��,rtQ/�,�, Day Care Coordinator 715/246-8344 11 1 Signature Title Phone Date Aaaroved, effective• 1-1-98 Disapproved Office of Child Care 98regapp.doc