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HomeMy WebLinkAboutHealth & Human Services 01-26-95REVISED ST. CROIX COUNTY NOTICE OF COMMITTEE MEETING TO: Robert Boone, Chairman St. Croix County Board FROM: Karen Bailey comMITTEE TITLE: St. Croix County Health and Human Services Board DATE: 0�,/26/95 TIME: 6:30 p.m. LOCATION: St. Croix County Health and Human Se�cv�.ces Complex New Richmond y TO ORDER ROLL CALL ADOPTION OF AGENDA DATE OF NEXT MEETING" 02/10/95 ACTION ON PREVIOUS MINUTES: 01/11/95 UNFINISHED BUSINESS: ANNOUNCEMEN'Z'S 1. Capital Improvement Report NEW BUSINESS: 1. FilAanc�-al Report 2. Health and Human services/Nursing Home Report 3. Mental Health Wasting List Strategies 4. 1996 Funding Issues 5. Review of State Mandate List 6. River Ridge Rehabilitation Contract 74 out-of-state training request ANNOUNCEMENTS fi CORRESPONDENCE POSSIBLE AGENDA ZTENS FOR NEXT MEETING: ADJOURNMENT {Agenda not necessar�.ly presented in this order) SUBMITTED BY: John M. Borup DATE- January 25, 1995 COPIES 'I,'O: COUNTY BOARD OFFICE COUNTY CLERE NEWS MEDIA/NOTICE BOARD COMMITTEE MEMBERS I �r REVISED S'T, CROIX COUMIX NOTICE OF COMMITTEE MEETING TO: Robert Boche, Chairman St. Croix County Board FROM: Karen Bailey COMMITTEE TITLE: St. Croix County Health and Human DATE: TIME: LOCATION: O1/26/95 6:30 p�m. Services st. croix County Health and Human Services comples� New Richmond CALL TO OR15ER ROLL CALL ADOPTION OF AGENDA DATE OF NEXT MEETING: 02/10/95 ACTION ON PREVIOUS MINUTES: 01/11/95 AT&OUNCEMENTS "UNFINISHED BUSINESS: 1. Capital Improvement Report HEFT BUSINESS : 1. Financial Report 2: Health and Duman Services/Nursing Home 3. Mental Health Waiting List Strategies 4-. 1996 Funding Issues 5. Review of State Mandate List 6. River Ridge Rehabilitation contract ANNOUNCF�iENTS � CORRESPONDENCE POSSIBLE AGENDA ITEMS FOR NLXT I+�EEmIT�G: Report AD�TO�II�T (Agenda not necessarily presented in this order) SUBMITTED BY: Jahn M. Borup DATE: January 19, 1995 ::OPIES TOM ST . CROIX C()UNTY ITbTICE OE COI+IIdITTBE FAG TO: Robert Boche, Chairman St. Croix County Board FROM: Karen Bailey COMMITTEE TITLE: St. Croix County Health Board 1yATE TIME: LOCATION: 01/26/95 6:30 P•m- and Human. Services St. Croix County Health and Human Services Complex New Richmond CAI,t. Tb ORDER ROLL CALL ADOPTION OF AOMDA DATE OF NEXT KEETING: 02/10/95 ACTION ON PREVIOUS HINUTES: 01/11/95 ANNOUNCEMENTS UNFINISHED BUSINESS: 1. Capital Improvement Report N� BUSINESS 1. FinancA.al Deport 2. Health and human Services/Nursing Home A'NNOUNCEHENTS & CORRESpONU�iCE POSSIBLE AGENDA ITEMS FOR NEXT MEETING: ALW Report OURNMENT resented in this order) (Agenda anot rieaessarily p SUBMITTED By John M. Borup DATE: January 16, 1995 COPIES TO: COUNTY BOARD OFFICB COUNTY CLERK NEWS MEDIA/NOTICE BOARD COMMITTEE NEKSERS ,� l S I CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD January 26, 1995 The St. Croix County Health and Human Services Board met on January 26, 1995, at the St. Croix County Health and Human Services/Health Center complex. MEMBERS PRESENT: Lerman Nyland, Vice Chair Chris Bethke Allen Limberg Robert Stephens George Sinclear Karen Bailey, excused LuVerne Burke, excused Jack Dowd, excused One Vacancy STAFF PRESENT: John Borup, Human Services Director Judy Aronson, Secretary Carolyn Krieger, Nursing Home Administrator Ron Kiesler, Long Term Clinical Services Supervisor Cindy Griffin, Deputy Director Steve Kirt, Mental Health Therapist Donna Patterson, Family Resource Unit Supervisor Karen Hall, Long Term Support Coordinator Ralph Robole, Maintenance Supervisor OTHERS PRESENT: Robert Boche, County Roard Chairman Don Gjesfjeld, DCS Regional Office Vice Chair, Lerman Nyland, called the meeting to order at 6:30 P.M. noting that the meeting was properly and legally publicized. Mr. Nyland stated that Robert Boche, County Board Chairman would make up the quorum until Allen Limberg arrives. NEXT MEETING The next meeting of the Health and Human Services Board will be Friday, February 10, 1995 at 8:00 a.m. at the St. Croix County Human Services/Health Center complex. Chris Bethke will review the vouchers at 7@30 A.M. AGENDA MOTION: A motion was introduced by Robert Stephens, seconded by Chris Bethke, and unanimously adopted: That the agenda be approved and open for discussion. Mr. Stephens stated we have serious concerns at this time for the placing of items on the agenda. Discussion followed. MOTION: A motion was introduced by Robert Stephens, seconded by Chris Bethke, and unanimously adopted: That the Health and Human Services Board approve to place on the agenda for the next meeting a discussion of a process of what and how items will be placed on the agenda. Mr. Borup stated Steve Weld will be at the next meeting to articulate how the agenda is set. MINUTES MOTION: A motion was introduced by Robert Stephens, seconded by George Sinclear, and unanimously adopted: That the minutes of the O1/11/95 Health and Human Services Board meeting be approved as circulated. John Borup introduced Don Gjesfjeld, Assistant Area Administrator, Division of Community Services. Mr. Borup stated Mr. Gjesfjeld is here to discuss M.A. Case Management for serving Severely Emotionally Disturbed (SED) children and their families. Mr. Gjesfjeld distributed a packet based on the questions he was asked. Cindy Griffin distributed her SED Case Management Fact Sheet. Allen Limberg arrived at 6:40 p.m. W. Gjesfjeld works with a 12 county area. He stated that the SED Case Management Program is fairly new, but there are more recipients every year. Mr. Gjesfjeld is encouraging the county 7 to get into this. He stated there are financial considerations: for each case management service, $20.52 is returned to St. Croix County. Mr. Gjesfjeld listed 6 clinical considerations: 1) An accurate diagnosis is important to any plan, 2) Almost all programs of the DHS have eligibility criteria, 3)There is no evidence that the labeling has hurt anyone, 4) Clinicians tend to be conservative about the label they attach, 5) It is highly confidential, and 6) There is explanation to child, family which exclude labeling. Board members expressed their opinion that labeling a child with SED is very detrimental to the child and that SED will be a label that is carried with him/her through adulthood. It would be a disservice to the child without an accurate diagnosis just to fit into that target group to capture funding. Mr. Gjesfjeld stated that each and every program has certain criteria that needs to be followed and stated the same holds true with the SED criteria. Mr. Gjesfjeld stated there is no need to be sharing this label with schools or the families. It is highly confidential. Mr. Stephens stated children need an accurate diagnosis, and said that he understands by what is being said here is that in order to capture the M.A. Services funding, the child needs the diagnosis of SED. Mr. Stephens also asked if the label of SED doesn't mean anything, why are we feeling uncomfortable with telling the family that their child has been labeled SED. Cindy Griffin stated if you apply that philosophy across the board, we would not bill M.A. for mental health outpatient services for children and would eliminate Donna Patteron' SED programs because both have labelling requirements. Mr. Borup stated if people make their labels public, that's their prerogative. Donna Patterson stated SED is a broad category and is used primarily for billing purposes and that we don't refer to clients by their label, but by their name. Mr. Borup stated as we all know, funding is dropping. He stated we are simply doing what we can to continue services by generating money, we are doing what we think appropriate. Mr. Gjesfjeld stated this is a catch-22, we need to categorize people in order to get the funding. Karen Hall stated her department has been billing the SED diagnosis since it was available. She stated when a child has that diagnosis, they do bill if they are on M.A. Mr. Gjesfjeld stated he fully expected our agency to bill M.A. in order to maximize the services. Mr. Stephens stated this Committee should obtain a full blown explanation prior to implementation of any new program. This is only a courtesy. He stated that the Board members are not figureheads and that administration asks for the support of the Health and Human Services Board without a full explanation. He stated the Board needs to be kept informed. Mr. Borup stated this has already been approved by the Board, consequently the Board has already been informed. Mr. Borup asked the Health and Human Services Board, where does the Board want administration to go with this? The decision from the Board was to table this and place this on the 02/10/95 agenda for the full Board to hear. Mr. Nyland thanked Don Gjesfjeld for attending our meeting. 3 OLD BUSINESS Capital Improvement Report: A copy of the five year capital improvement plans for Health and Human Services and Nursing Home was sent to each committee member. Ralph Robole was present to discuss these plans. The list included: 1) Front entryway and blacktop repair - already approved 2) Handicapped front door openers 3) Point of Use Boilers 4) Energy efficient electric motors 5) Computer cabling and electric 6) Telephones --backup and extension card 7) Water fountain -handicapped accessible 8) Carpeting 9) Drapes 10) Blacktop west parking lot 11) Roof repair 12) Computer training room 13) Windows This plan totals roughly $90,000. Mr. Robole recommended getting estimates on the point of use boilers for the 1974 Building. He stated is looks like a two year pay back or less. Mr. Robole stated there are engineering firms that will tell us which point of use boilers we would need. If we find a vendor we can write the specs right into the contract as to what it will heat, how big, etc. and then if it doesn't meet the specs, the vendor would be liable to rip out the point of use boiler and install one that will heat according to the specs. Mr. Robole stated there is an NSP rebate on 25 hp motors which would equal $500.00. The original cost was $700.00, our cost = $200.00. Mr. Robole did not know now long the rebate was is effect. Mr. Robole stated he will have more information in the future. Discussion followed on all items. George Sinclear asked that showing designs of the front entryway be put on the agenda of 02-10- 95. MOTION: A motion was introduced by Robert Stephens, seconded by George Sinclear, and unanimously adopted: 0 That the Health and Human Services Board approve giving the telephone --backup and extension card higher priority to #1. MOTION: A motion was introduced by Robert Stephens, seconded by Chris Bethke, and unanimously adopted: That the Health and Human Services Board approve to proceed on these upgrades of the capital improvement list as presented. Carolyn Krieger distributed a nursing home depreciation list. Ms. Krieger stated she started with the oldest equipment to depreciate out. Ms. Krieger stated the Nursing Home cash available is $166,209.40. Ms. Krieger also stated that much of this equipment is to old to buy parts for. She stated we need to place some monies aside for the unpredictable. Discussion followed. MOTION: A motion was introduced by Robert Stephens, seconded by George Sinclear, and unanimously adopted: That the Health and Human Services Board approve Carolyn Krieger to prioritize the list as presented and use the available $100,000 to replace items needed and to hold in reserve $41,000 for emergencies. We have no assurances of what funding will be in 1995-1996. Nursing Home Elevator Maintenance Contract: Schindler's now hold the contract. Ralph Robole stated Schindler's were in to evaluate the elevator. They stated it would cost $6,600.00 to repair the elevator vs. a $20,000 estimate from Lagerquist. Lagerquist would like to regain our business. Mental Health Waiting List Strategies: Currently, indigent and/or Medical Assistance clients who cannot obtain mental health outpatient services elsewhere are on our #1 priority for outpatient mental health services. This means that potential clients who are private pay or have health insurance may be referred elsewhere or placed at the bottom of the waiting list. This obviously has a negative impact on revenues. An alternative policy would be to prioritize our waiting list by segment (indigent, Medical Assistance, private pay, insurance) and move 5 clients off the waiting list by segment. Ron Kiesler and Steve Kirt stated we are currently operating by seeing clients with Medical Assistance coverage and insurance equally without having to prioritize clients. With the exception that when the waiting list gets too long, the insurance persons are referred elsewhere. The waiting list at present is 16, and it has been as high as 35. On March 20th, 1995, the Mental Health Therapist who was on maternity leave will be back, so the waiting list will be minimal or none at all. Mr. Kiesler stated that through a lot of hard work and a small miracle, we have filled the psychologist position. Gust Jenson will begin this position effective 02/28/95. Mike DeSanctis has been released from his contract. Mr. Kiesler stated that Dr. Jenson excels in child psychology and worked very effectively with our staff and psychiatrists previously. Mr. Kiesler stated Dr. Jenson will be a great asset to our agency. Out -of --state training request: Karen Hall stated there are two people who wish to attend the one day workshop on "Developmental Disabilities - Who Are Aging" in Northfield, Minnesota, Ms. Hall stated the workshop will be addressing behaviors on some who have come out of institutions. Ms. Hall also stated they are looking at bringing in speakers to our agency for all our staff to benefit. The cost for this workshop is mileage, lunch and the registration fee of $35.00 per person. MOTION: A motion was introduced by George Sinclear, seconded by Chris Bethke, and unanimously adopted: That the Health and Human Services Board approve the request for two persons to attend the out -of --state training on Developmental Disabilities to cover mileage, lunch and the registration fee of $35.00 per person. River Ridge Rehabilitation Contract: River Ridge Rehabilitation has submitted a request to extend their contract by two years (expires 02/28/95). Corporation Counsel has been contacted and Mr. Borup and Greg Timmerman met with River Ridge and came to an agreement to get the building up to code. The total amount was $1, 400, of which $1,150.00 River Ridge Rehabilitation would pay and St. Croix County would pay $250.00. The verbal agreement between River Ridge Rehabilitation and St. Croix County was the rent would remain as the previous year for the next two years and to expire 02/28/97. Mr. Borup asked if they should proceed with the contract, sign it and bring it in. Mr. Stephens stated contracts regarding county rentals should go by the County Board rule which needs to be followed. The County Board Chair is to sign such contracts. Mr. Borup stated that in the past he has been directed to sign such contracts. Discussion followed. 0 A motion was introduced by Robert Stephens, seconded by Chris Bethke, and unanimously adopted: That the Health and Human Services Board move to have the contract signed for the rental agreement between River Ridge Rehabilitation and St. Croix County to expire 02/28/97 with rent to remain the same as the previous year. 1996 Funding Issues: Mr. Borup stated 1995 was a tough budget year. We anticipate 1996 will be tougher. With expected federal changes and a shifting of one billion dollars in taxes from the property taxes, we are very concerned. We have not issued program cut proposals because of uncertainty of funding as well as not wanting to create unnecessary anxiety for staff and clients. Karen Bailey, Robert Boche, and John Borup attended a board members, directors, and legislators meeting on 01/13/95 to discuss funding concerns. Mr. Borup stated if the funding is not there, we will have to discontinue programs, which would mean we would have to lay some people off. This is something we do not want to do. Governor Thompson's budget is scheduled for release on 0244-95. Mr. Borup distributed copies of a survey of counties and potential impact of cuts. Based on these estimates cuts over the next two years could be in excess of $800,000 to Health and Human Service programs. Review of State Mandate List: Mr. Borup distributed a list of mandates. This list includes Governor Thompsons task force findings and additions not covered by the task force, Mr. Borup feels this list is important to use if programs need to be cut due to budget cuts. Discussion followed. Health and Hiiman Services/Nursing Home Report: Carolyn Krieger stated she will have a report at the 02/10/95 Health and Human Services Board meeting regarding the remodeling in the nursing home. Ms. Krieger stated she has contacted Job Services and high schools to help recruit nursing staff. She also has met with Personnel to discuss a wage increase for nursing staff. Discussion followed. On 02/10/95, someone from More 4 Pharmacy will be attending the Health and Human Services Board meeting to discuss unit dose. Ms. Krieger stated she has tracked with letters over the years regarding timely and accurate billing from the pharmacies. She stated this affects the daily rate. If the bills do not come in on a timely manner, we lose money. She stated with unit dose this will double the problem as there will be more clients. It was suggested that in the contract for unit dose it should state that if there are any errors or late billing, More 4 will cover that cost. Discussion followed. i1 Financial Report: Mr. Borup stated Judy Ziegler is now working on closing the 94 books. 1994 bills are accepted thru 01-31-95. Mr Borup stated that Human Services numbers remain stable. We hope to have year end projections by mid -February. Mr. Nyland distributed a letter from Greg Timmerman, Corporation Counsel regarding the Open Meeting Laws and the Closed Session Exceptions. Mr. Stephens asked what are they going to do if I violate the law, slap my hands? Vice Chair Nyland told him not to ever say such things. Mr. Weld will attend the meeting on 02/ 10/95 . John Borup emphasized the need to not make any statements that will compromise the County's position. Vice Chair Nyland asked if there were any other issues to bring before the Board for discussion. MOTION: A motion was introduced by Robert Stephens, seconded by Chris Bethke, and unanimously adopted: That the meeting be adjourned. Time: 8:50 P.M. Chairman: Attest: Secretary