HomeMy WebLinkAboutHealth & Human Services 11-14-07 Esther Wentz will review vouchers.
REVISED 11/07/07
NOTICE OF MEETING AND AGENDA
ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD
November 14, 2007 at 8:30
(Board Room, St. Croix County DHHS Building, New Richmond WI)
CALL TO ORDER
ROLL CALL
REVIEW OF AGENDA
CONSENT AGENDA
APPROVAL OF MINUTES OF PREVIOUS MEETING - 10/17/07
DATE OF NEXT MEETING — 12/19/07 at 8:30 a.m.
OLD AND NEW BUSINESS
1. Consideration of Claims and Vouchers
2. Financial Report
3. New Phone System **
4. Nursing Home Report
5. Nursing Home Subcommittee Update
6. Personnel Issues
7. Closed session pursuant to Wisconsin Statute§ 19.85 (1) (f) to consider the medical and
personal histories, and preliminary consideration of a specific personnel problem of a
department employee which, if discussed in public, would be likely to have a substantial
adverse effect upon the reputation of the person referred to in the histories and involved in
the problem. Reconvene in open session. **
8. Long Term Support-Long Term Care Reform
9. Aging and Disability Resource Center Governance
10. 2008 Routine Meeting Dates
11. Communicable disease update
12. Consideration to strengthen County's existing St. Croix County smoke -free policy
13. Economic Support program report on birth certificate and identity verification requirements
14. Vaccination Report
15. Comprehensive community services start up funding application **
16. Closed session pursuant to Wisconsin Statute§ 19.85 (1) (f) for preliminary consideration of
specific personnel problems within the department which, if discussed in public, would be
likely to have a substantial adverse effect upon the reputation of the persons involved.
Reconvene in open session. **
17. Psychiatric service coverage **
18. Update on children's wait list **
19. Resolution Supporting Change for Returning Federal Funds from Certified Public
Expenditures of County Nursing Homes **
ADJOURN
Items for County Board approval must be submitted to the County Clerk's office
by Wednesday morning preceding a County Board meeting.
11/7/2007 8:08 AM
(Items may be taken in different order)
** Additions /Changes /Corrections
Items for County Board approval must be submitted to the County Clerk's office
by Wednesday morning preceding a County Board meeting.
11/7/2007 8:08 AM
Esther Wentz will review vouchers.
NOTICE OF MEETING AND AGENDA
ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD
November 14, 2007 at 8:30
(Board Room, St. Croix County DHHS Building, New Richmond WI)
CALL TO ORDER
ROLL CALL
REVIEW OF AGENDA
CONSENT AGENDA
APPROVAL OF MINUTES OF PREVIOUS MEETING - 10/17/07
DATE OF NEXT MEETING — 12/19/07 at 8:30 a.m.
OLD AND NEW BUSINESS
1. Consideration of Claims and Vouchers
2. Financial Report
3. Nursing Home Report
4. Nursing Home Subcommittee Update
5. Personnel Issues
6. Long Term Support-Long Term Care Reform
7. Aging and Disability Resource Center Governance
8. 2008 Routine Meeting Dates
9. Communicable disease update
10. Consideration to strengthen County's existing St. Croix County smoke -free policy
11. Vaccination Report
12. Economic Support program report on birth certificate and identity verification requirements
13. Closed session pursuant to Wisconsin Statute§ 19.85 (1) (e) for preliminary consideration of
specific personnel problems within the department which, if discussed in public, would be
likely to have a substantial adverse effect upon the reputation of the persons involved.
Reconvene in open session.
ADJOURN
(Items may be taken in different order)
* Additions /Changes /Corrections
I
Items for County Board approval must be submitted to the County Clerk's office
by Wednesday morning preceding a County Board meeting.
10/31/2007 8:16 AM
Health and Human Services Board - November 14, 2007 Page 1 of 8
Croix 1 Wisconsin
Seuwe to a"4 PWtP"e! Home nd.
AGENDA - HEALTH AND HUMAN SERVICES BOARD
ST CRO1X COUNTY
NOTICE OF COMMITTEE MEETING
Esther Wentz will review vouchers.
County Map
REVISED 11/07/07
November 14, 2007 at 8.3o
(Board Room, St. Croix County DHHS Building, New Richmond WI)
CALL TO ORDER
ROLL CALL
REVIEW OF AGENDA
CONSENT AGENDA
APPROVAL OF MINUTES OF PREVIOUS MEETING - 10/17/07
DATE OF NEXT MEETING — 12/19/07 at 8:30 a.m.
OLD AND NEW BUSINESS
1. Consideration of Claims and Vouchers
i
2. Financial Report
3. New Phone System **
4. Nursing Home Report
5. Nursing Home Subcommittee Update
6. Personnel Issues
7. Closed session pursuant to Wisconsin Statute§ 19.85 (1) (f) to consider the medical and personal histories, and
preliminary consideration of a specific personnel problem of a department employee which, if discussed in
public, would be likely to have a substantial adverse effect upon the reputation of the person referred to in the
histories and involved in the problem. Reconvene in open session. **
8. Long Term Support-Long Term Care Reform
9. Aging and Disability Resource Center Governance
10. 2008 Routine Meeting Dates
11. Communicable disease update
12. Consideration to strengthen County's existing St. Croix County smoke -free policy
13. Economic Support program report on birth certificate and identity verification requirements
14. Vaccination Report
15. Comprehensive community services start up funding application **
16. Closed session pursuant to Wisconsin Statute§ 19.85 (1) (f) for preliminary consideration of specific personnel
problems within the department which, if discussed in public, would be likely to have a substantial adverse effect
upon the reputation of the persons involved. Reconvene in open session. **
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Health and Human Services Board - November 14, 2007 Page 2 of 8
17. Psychiatric service coverage **
18. Update on children's wait list ** f
19. Resolution Supporting Change for Returning Federal Funds from Certified Public Expenditures of County
Nursing Homes **
ADJOURN
(Items may be taken in different order)
** Additions /Changes /Corrections
MINUTES
HEALTH AND HUMAN SERVICES BOARD j
NOVEMBER 14, 2007
The St. Croix County Health and Human Services Board met on November 14, 2007 at the St. Croix County Health
and Human Services /Health Center complex.
MEMBERS PRESENT: Esther Wentz, Chair
Gordon Awsumb
Leon Berenschot
Lois Burri
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Tom Caflisch
Dr. Glenn Hoberg
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Linda Luckey
Deb Rasmussen
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MEMBERS ABSENT: Ron Troyer, excused
STAFF PRESENT: Fred Johnson, Health and Human Services Director
Jennifer Pempek, Financial Manager
Bill Van Offeren, Nursing Home Administrator
Mary Squyer, Economic Support Supervisor
Charlotte Sortedahl, Public Health Coordinator - Health I )
j
Officer
Geralyn Karl, St. Croix County Health Educator and Tobacco Control Specialist
Steve Kirt, Behavioral Health Clinical Services Supervisor
Ron Lockwood, Long Term Support Coordinator
John Bretl, Foster Care Coordinator
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Jaye Hay, Public Health RN
Malva Sirek, Secretary
OTHERS PRESENT: Clarence Malick, County Board Chair
Tammy Funk, Human Resource Administrator
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Health and Human Services Board - November 14, 2007 Page 3 of 8
Kjersti Olson, Director Department on Aging
Larry Lester, WIPFLI
Kim Dupre
Loyla Waskul
Thor Backus
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Jeff Hommes
Kristen Stevenson, Intern
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Chair Wentz called the meeting to order at 8:3o AM noting the meeting was properly and legally publicized.
NEXT MEETING The next Health and Human Services Board meeting is scheduled for Wednesday, December 19,
2007 at 8:3o AM. Berenschot will review vouchers.
AGENDA Motion A motion was introduced by Burri, seconded by Dr. Hoberg, and unanimously adopted: That the
agenda be approved as circulated.
MINUTES Motion A motion was introduced by Berenschot, seconded by Awsumb, and unanimously adopted:
That the minutes of the 10/17/07 Health and Human Services Board meeting be approved with the following
correction...
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Page 8, paragraph 9, add... "Awsumb questioned if Public Health paid for abortions or referred abortion patients and
Sortedahl answered no, Public Health does not refer, perform or pay for abortions."
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CONSIDERATION OF CLAIMS Health and Human Services Board member Wentz reviewed the vouchers.
Motion A motion was introduced by Wentz, seconded by Burri, and unanimously adopted: That the following
vouchers be approved and be made a part of the supplemental minute book:
Human Services vouchers 111988 through 112027, dated November o8, 2007 in the amount of $55,52
Human Services and Nursing Home vouchers 111246 through 111398, dated October 18, 2007 in the amount of
$286,193.46.
Human Services, Nursing Home, and Farm vouchers 111399 through 111446, dated October 18, 2007 in the amount of
$29,394.3
Human Services and Nursing Home vouchers 111586 through 111680, dated October 25, 2007 in the amount of
$421,980.28. i
Human Services and Nursing Home vouchers 111826 through 111871, dated November o1, 2007 in the amount of
$85,264.51.
Human Services and Nursing Home vouchers 112330 through 112473, dated November 08, 2007 in the amount of II
$ 1 17, 2 53. 6 o.
Human Services and Nursing Home vouchers 112520 through 112672, dated November 08, 2007 in the amount of
$300,41o.63.
Nursing Home vouchers 112474 through 112519, dated November o8, 2007 in the amount of $36,299.9
Nursing Home voucher 112673, dated November 08, 2007 in the amount of $11,505.00. j
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Human Services, Workshop, Public Health, vouchers 620 through 649, dated October 18, 2007 in the amount of
$378,97
Human Services, Workshop, Public Health, Social Services vouchers 650 through
68o, dated November 01, 2007 in the amount of $383,577.
Human Services and Nursing Home vouchers 557 through 586, dated October 18, 2007 in the amount of $147,937.3
Human Services and Nursing Home vouchers 587 through 617, dated November 01, 2007 in the amount of
$152,831.32.
Workshop vouchers 121 through 126, dated October 18, 2007 in the amount of $11,662.89.
Workshop vouchers 127 through 132, dated November 01, 2007 in the amount of $12,363.74•
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Health and Human Services Board - November 14, 2007 Page 4 of 8
NEW PHONE SYSTEM A kickoff meeting for the new phone system was held on 10/31/07. It was determined that
caller ID will not be available with the new system due to Frontier Communications not having PRI service available.
Alternatives have been explored but caller ID will not be available until PRI service is available in New Richmond.
The system being installed is compatible with either T -1 or PRI and can be reprogrammed to have caller ID when PRI
service is available. Awsumb recommended contacting legislators regarding PRI service as they regulate the phone
service.
A planning meeting with Marco is scheduled for 11/15/07 to begin implementation plans. A meeting with St. Croix
County staff is scheduled for 11/20/07 to discuss phone maintenance, wiring, etc. Staff will continue to update the
Board as implementation of the new system progresses.
FINANCIAL REPORT Pempek announced an internship with a student from WITC is being explored to work with
accounts receivable and accounts payable staff in January. The following financial report for Nursing Home through
September, 2007 was distributed. Pempek reported IGT funds have been held up due to delay in approval of the State
budget but will be arriving as forecasted. Pempek reported private pay payor source continues to run higher than
anticipated. Pempek indicated PPD has been fully implemented in the Nursing Home to reflect a staffing to census
ratio. Census for the Nursing Home is down from the budgeted amount. Johnson reported carryover monies from
2oo6 have been applied to the 2oo8 budget.
HEALTH AND HUMAN SERVICES - 2000
SUMMARY Total
OFREVENUES Budget September 30,2000 Balance
AdmAstdon 1,117,400.00 (13,584.82 1,130,904.82 •12%
AODAServices 772,986.95 557,982.78 215.00417 722%
Lang Term Support 17,681,64551 13,460,434.26 4221,21125 761%
Mentaihealth 3,303,479.98 2,281,30660 1,022.173.38 691%
Family& Children's 3,037.821,28 2,394.749,39 643.071,89 78 r/.
PubiicHpalrn 1.678.621,37 1.305.585.11 373.03626 778'/
EwnomrcSupport 1,227.13310 816.02250 411.11060 6651
GenoralAeliel 15.00000 11.250.00 3.75000 750 %.
Coordinated Service uSED 2.500 93196 1433.428.18 1.06 7.50378 57� 7.3%
REVENUES HUMAN
SERVICES PROGRAMS 31.335.020.15 22.247.174.00 9.087,846.15 710% j
SUMMARY Total
OF EXPENUIIURES Budget September 39. 2000 Balance
Administration 1,117,400.00 816,052.05 300,547.94 73.1%.
Alcohol -Drug Abuse 772,906.95 588,785.86 184,201.09 75.2%
Long Term Support 17,681,645.51 13,243,190.97 4438,454.54 749%
MentalHeal;h 3,303,479.98 2,235,723.38 1,067,756.60 67.7°x.
Family& Children's 3,037,821.2B 2098,733.70 939,087.58 69.1%
PubiicHealth 1,678,621.37 1,266,775.23 411,846.14 755°x.
Ecanornz Support 1,227.133.10 859.342.51 367,790,59 700%
GeneralReliet 15,000,00 4,011.14 10,98886 267
CoordinatedServicelSED 2,500.931.96 1,123.850.06 1,377,081.90 449%
FXPENDITURES HUMAN
SFRVICFS PROGRAMS 31.335.02015 22.237.26491 9.097.75524 710%
Excess Rev over Expenses f 9.909,09
The following financial report for Health and Human Services through September, 2007 was distributed. Pempek
reported there have been significant take backs from BCA monies. She reported Behavioral Health has experienced an
increase in inpatient admissions.
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Health and Human Services Board - November 14, 2007 Page 5 of 8
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St. Croix Health Center
TeN1e ulLer 2000
i
PYd YYe Acnenl nimw ar Vwr
t en;rJS cw0 I
0,.arneiny Rwvenrew:
i
M. . .342,905 00 1,941687 UYi.73 555569327 7. 51 %
P".1. P )2.73 .4 M 4[.' 68
.9 7 4 {5`715737 26 73 71%,
Prr.ale Pay 5760,71307 5175,345.00 4215A64.W 71,41
�n rmnr =a,rre=
$217.777 m s17c xr, 72 bne, 9r,7 � m 47%
Total VVetaliny Ierveane 40.2 tl•1.00 53.331.125.8Y {918.662.11 7tlA0•.
V ywralirrY Elrporraww
Lts"7 Fa[lenl Serr gas 3l,l i 3 f2.S.V,Jtl 97 0.1 Uut 757 19 at "1 ,
Sloe :gal Sen x'84,51616 007 $ 112,01301 IS470023 . 6990%
r; «naral?en'4.3 11167)'7.367 4712,05'40 1054 ?0027 vA 3.
7.ermnr.lru[n�a lf•44,+_ -gI W 55_Y.2`.fi 98 8-15 5 O0. 99 3U°b
urea °siyne7
( °4 B 50.00
[leer e. anon asec
Olf ens' 5297 4700 14001
U1ii4r: SM1n I,T97 i9
V'i ar4 ers r_gi.y, Gom yalsr iecy 516,136.01
Ir swar ce 570.306.00
T..1.a1 Oywr..elrly Fa,rorawes 45_375879.39 N,)55,555.)7 51.1) 374.)) 79.16•.
flee Fenar OpernOorre (5921.326.38)
I': n u c• lorn9 busrne 4s flr. yr to
�aPlvrnn tau) R nrrl :cnn7ng rav)
Vumau.6nY Revenre4
C rtst antluag Rate RPF•al rev 512,OCeJ 0] 1445 W 611 265 W 371%
Rwmr ia 'f.T Fund-. 591fl f3Y] flu $426,159 fl0
ur Jol :ari�iry IGT {.•ev W UU SU NDNi01
l c A ",ytanne s (es. Barre 11 5:59,259 3? 5197,635 00 $6C964,19 19 ?9 7S,00-11 N�r;u10 'lane Cary 6.er 5233. "'1 O 93.W Soo
Twt.al 09K1andlray 51.1)],0911.39 N.2],393.09 j76,519.39
Net born all (297.935.36)
Pempek gave an update on Accounts Receivable. Kim Dupre is writing a script to be able to remove uncollectibles
from the system. It is in the testing stage currently. Also, GL mapping is being created to automate payments when
they come in to be able to track to appropriate accounts. There have been some glitches in the system but staff
continue to work on it. Also reasonable and customary reimbursement charges being applied to accounts is being
tested. This would occur through a mass edit whereas previously individual records needed to be accessed to write off
amounts. A report will be available.
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Staff attended a meeting on Sage. Sage has changed its name to alio. It was discovered alio has a fixed asset module'
and accounts receivable application plus budget reports are available in alio. Currently various departments have a
variety of spreadsheets that are presented by department.
Health and Human Services has agreed to a pilot program for alio applications. At the recent meeting budget
protocols were discussed as it relates to budget entry and set up on the budget module the County currently uses.
These new protocols will be the basis of the testing that the Family and Children's unit will pilot in conjunction with
Health and Human Service Finance department. Johnson said an advisory group will need to be formed to decide on
purchasing modules, to send staff to training and decision making on who has the final decision authorization on
access to the system. Johnson said Eau Claire County has used this program and we may also need to do a site visit to
learn how they are working with the software.
Specific recommendations came out of the Wipfli audit report. Question was raised on the status of implementing
those recommendations. Separation of duties cannot happen as there is not enough staff. A financial assistant and
receptionist position were eliminated by the County Board at the ii /o6 /07 meeting and administration will need,
some time to finalize adjustments within the Health and Human Services Department to align staffing as close as
possible to the Wipfli recommendations. The 30 -6o -90 day reports will soon be available. Awsumb questioned if
software is lagging in updates and may be more of a problem than sufficient staff. The software has presented
problems but staff are actively working on solutions and we are not lagging on software upgrades.
Johnson reported a finding for the single audit for 2oo6. This finding has occurred in the past on contract services
and a correction plan is in place to consolidate contracts to the financial area to track, insure licensure and profit /loss I
and be managed by a financial assistant.
NURSING HOME REPORT Van Offeren reported admissions to the Nursing Home arrive from various entities.
Referrals are received by the Social Worker and Director of Nursing, who also discuss with the Administrator.
Admissions have been turned down due to the facility not being able to provide care. Each admission is treated
individually.
Van Offeren reported a forfeiture fine of $17,700 was received from the State for the 07/31/07 incident. $7,700 was
charged for failure to have updated policies and procedures. If the fine was paid in ten days, the fine was reduced to
$11,500. Van Offeren reported the attorney recommended paying the reduced fee, which was done. The Federal fine
was paid previously.
Brian Schoeneck, Financial Services Director for the Wisconsin Association of Homes and Services
for the Aging, Inc., will be at the Deer Park Village Hall /Community Center on November 15, 2007,
7:00 P.M. and will speak about Wisconsin's Intergovernmental Transfer Program, Certified Public
Expenditure Program, the role of Wisconsin's county nursing homes, and Medicaid funding for
nursing homes. All Board members are invited to attend. Kim Dupre is setting up to tape the
presentation. Supervisors will not receive per diem or mileage. Polk County supervisors have also
been invited to attend. He may also talk about the impact on the County if you do not have a County
nursing home.
Johnson reported Van Offeren submitted his resignation effective 11/29/07. Johnson contacted Pathways for an
interim administrator for the Nursing Home. Harold Morris will be contracted to fill this position at an increased
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Health and Human Services Board - November 14, 2007 Page 6 of 8
cost. Johnson indicated a preference to utilize a Pathways consultant to maintain continuity of service as we currently
contract with Pathways for Director of Nursing services. When decisions for the future operation of the Nursing
Home are made, it would appear to then be an appropriate time to review these contracts. He indicated Morris has
been contracted with a two -week out clause and a month -to -month contract.
The Board thanked Van Offeren for his leadership.
Johnson reported Art Tobin has given the elevator company a 45 -day notice. Tobin has created a fix for the worn out
weather stripping for the nursing home windows that does not require replacement of the windows but does require
work by in -house staff.
Larry Lester distributed a report on Medicaid acuity scores by facility. He also compared homes operated by a
government (county, municipal) entity to private homes. The reports were prepared using 2oo6 data. He reported
Medicaid rates are less than cost of care, although a facility may make money from private pay or Medicare residents.
He reported Wisconsin is the third worst state for Medicaid costs. On o7/oi /o8 there will be a 5% increase in
Medicaid dollars from the State. Lester reported the current nursing home building is inefficient for providing
services due to having two floors, two dining rooms and a ramp, which impacts labor costs. He reported we may see a
staffing crunch in the future for CNAs and RNs. A copy of this report will be given to the Nursing Home
subcommittee members.
Van Offeren distributed an article on fees being imposed for return survey visits for nursing homes.
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Van Offeren reported a 20% ward clerk position resigned and a decision was made to not replace the position. Work
is being coordinated with Tammy Funk and Connie Sarauer to adjust the schedule.
The board recessed from 10:15 to 10:25.
NURSING HOME SUBCOMMITTEE REPORT The Nursing Home Subcommittee is scheduled to meet on 11/16/07
at 9:30. A letter from Simenstad Nursing Care Unit was distributed to Board members. The letter reported Ecumen
has ended their contract to operate Simenstad Nursing Care Unit as of June 30, 20o8.
Copies regarding Advisory Board Policy and Guidelines for Manitowoc Health Care Center as well as articles
regarding the sale of that facility to Health Dimensions were shared with the Board. Copies of this information will
also be forwarded to Nursing Home Subcommittee members.
A closed session is scheduled on 11/16 at 10:3o AM with Health Dimensions and another at 1:30 with Presbyterian j
Homes. Any County Board member may participate in any closed session meeting.
PERSONNEL ISSUES Johnson reported an LTE has been hired in Economic Support through the end of the year.
Johnson announced the following positions were approved by the County Board: Economic Support Specialist,
Coordinated Family Services Resource Aid, and Behavioral Health AODA Counselor. Recruitment efforts are
underway and will be coordinated with Human Resources.
Motion A motion was introduced by Berenschot, seconded by Burri, That the Board enter closed session pursuant to
Wisconsin Statute§ 19.85 (1) (f) to consider the medical and personal histories, and preliminary consideration of a
specific personnel problem of a department employee which, if discussed in public, would be likely to have a
substantial adverse effect upon the reputation of the person referred to in the histories and involved in the problem
and closed session pursuant to Wisconsin Statute§ 19.85 0) (f) for preliminary consideration of specific personnel
problems within the department which, if discussed in public, would be likely to have a substantial adverse effect
upon the reputation of the persons involved._
Roll call vote:
Esther Wentz — yes
Gordon Awsumb — yes
Leon Berenschot — yes
Lois Burri — yes
Tom Caflisch — yes
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Dr. Glenn Hoberg - yes
Linda Luckey — yes
Deb Rasmussen — yes
Ronald Troyer - absent
Eight yes, one absent, motion passed.
The Board entered closed session at 10:3o AM.
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RECONVENE TO OPEN SESSION PURSUANT TO WISCONSIN STATUTES SEC. 1A.8- (2)
Motion A motion was introduced by Berenschot, seconded by Burri, and unanimously adopted: That the Board
reconvene into open session per Wisconsin Statutes 19.85(2).
The Board reconvened in open session at 11:o8 AM.
Johnson noted in closed session a request for LOA was denied unanimously by the Board.
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PSYCHIATRIC SERVICE COVERAGE Kirt reviewed psychiatric coverage arranged for Behavioral Health including
contracting with Dr. Floyd Anderson and Dr. John Simon until the end of the year, as Dr. Colon is no longer seeing
clients. A variety of options for coverage are being explored including an APNP position. Currently, no new clients
are being accepted for psychiatric services unless there is an emergency need.
LONG TERM SUPPORT -LONG TERM CARE REFORM /ADRC A report reflecting a projection of Long Term
Support expenses and revenues from 2oo8 through 2013 was distributed to the Board. Long Term Care is scheduled
to go into effect in 2oo8. August 1, 20o8 one -sixth of the clients will be converted to Long Term Care, followed by an
additional one -sixth each month until full implementation in 2009. Lockwood explained that as clients are moved to
managed care under Long Term Reform, the county will experience a different cost share, which will be reviewed in
detail at the next Health and Human Services meeting. Current waiver services are paid by 58% Federal match and
42% County cost. The report does not include St. Croix Industries or Birth to Three children's services. Lockwood
indicated representative payee services will no longer be provided by the County. Long Term Support will continue to
be responsible for elder abuse reporting as this will not transfer to the care management organization. There are
currently eleven staff in Long Term Support and it is anticipated there will be approximately four staff after Long
Term Care Reform is fully implemented. Staff are still waiting for the fiscal analysis which hopefully will be available
in December, but it is possible for the County to have a drop down by 25% per year in county match from 2009 to
2013, which is a significant local savings. There is a risk in the biennial budget process as the feds are pressing for
self - directed waiver option and choice may be an issue. The Department is pursuing partially funded waiver options
currently and it is hoped 25 clients will be removed from the wait list in the next few months with an additional 10 -15
removed in 2oo8. Both family care and Medicaid complete options will be offered through Community Health
Partnership due in part to a request from the Health and Human Services Board to offer choice to consumers between
care management organizations. Lockwood reported the fee - for - service Medicaid card and self - directed supports
waiver details are not available yet.
Staff will readdress fiscal transfer and benefit packages next month. The Board was again informed that caseload
numbers quadrupled under family care implementation in LaCrosse County, Portage County caseload tripled and St.
Croix may experience the same increase. The state's ability to go statewide with this initiative is questionable.
Options are to get in early to draw local taxpayer dollars down or to keep doing what we are currently doing, which
will likely include the continuation of local waiting lists.
AGING AND DISABILITY RESOURCE CENTER (ADRC) GOVERNANCE Governance has been a point of concern
for the Ad Hoc committee in completing the ADRC application. Buck Rhyme, a consultant hired by the state, will be
working with the committee members for ADRC planning. A meeting is scheduled for 11/26/07 at the Presbyterian
Church in Hudson to discuss governance. The ADRC is a collaboration with Aging and Health and Human Services to
serve consumers. Awsumb requested getting a summary of what others have done and how they have done it. Olson
will share that document with the Board. Volunteer hours are leveraged through the Department on Aging now and
that will continue. Olson reported we will continue to build up on current department strengths. Olson will submit
an announcement for the 11/26 meeting. Johnson recommended not going beyond January for submitting the
application.
2oo8 ROUTINE MEETING DATES A draft of meeting dates for 2oo8 was distributed. Wentz recommended setting
a second meeting date if needed when there are too many items on the agenda. It was the consensus of the Board a
second date could be set on an as- needed basis. Luckey expressed concern at having the County Board and Health
and Human Services meetings two days in a row. The meetings will be scheduled for the third Wednesday of each
month to begin at 8:30 with the exception of the June meeting when the Open Budget Hearing will be held.
COMPREHENSIVE COMMUNITY SERVICES START UP FUNDING APPLICATION Johnson announced a joint
effort of Family and Children's, Coordinated Family Services and Behavioral Health completed the application for'
Comprehensive Community Services Start Up Funding which was submitted before the 11/02/07 deadline. Johnson
offered copies of the application to the Board.
RESOLUTION SUPPORTING CHANGE FOR RETURNING FEDERAL FUNDS FROM CERTIFIED PUBLIC
EXPENDITURES OF COUNTY NURSING HOMES This resolution was tabled at the last County Board meeting due
to the amount recorded that the county is funding. Johnson explained the difficulty in getting a definite number due
to definition of loss, i.e. operation, operation without depreciation, etc. It was the consensus of the Board to
determine the average loss for 2005, 2oo6 and projected 2007 and put that amount in the resolution. The resolution
will be brought to the Board in December and to the County Board in January.
COMMUNICABLE DISEASE UPDATE Sortedahl gave a report on rabies from 2002 through 2oo6. She reported
there was one case of rabies in St. Croix County in 2007.
Wentz left the meeting at 12:15 PM and Dr. Hoberg presided over the remainder of the meeting as Vice Chair.
CONSIDERATION TO STRENGTHEN COUNTY'S EXISTING ST. CROIX COUNTY SMOKE -FREE POLICY Geralyn
Karl recently presented on how Wisconsin WINS has successfully lowered tobacco sales to minors in Wisconsin at a
national conference in Minneapolis. The last smoking policy change in St. Croix County happened in 1992. A smoke -
free policy for Wisconsin is still in discussion in the legislature.
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Health and Human Services Board - November 14, 2007 Page 8 of 8
Discussion was held surrounding policy on smoking in foster homes. John Bretl reported there are currently no state 1
restrictions on foster care licensing regarding smoking in the home. Foster care parents were surveyed in December,
2oo6. Out of 35 homes, only six to seven had residents that smoked and all smoking occurred outside of the
residence, none smoked in the home. Awsumb voiced he is firmly against a stronger non - smoking policy in homes as
a county policy and that tobacco is not an illegal or immoral substance. Awsumb also voiced that there are no new
clinical studies that secondhand smoke is harmful. The Surgeon General report wasn't based on new clinical studies
and used med analysis. However, previous information has been distributed by the Surgeon General that secondhand
smoke is harmful. Rasmussen voiced support of an agency policy for no smoking anytime a foster child is present in
the home or being transported in a vehicle. This item will be delayed to the next meeting. It was suggested that Dr.
McGinnis give a presentation as an outside expert at a future meeting.
ECONOMIC SUPPORT PROGRAM REPORT ON BIRTH CERTIFICATE AND IDENTITY VERIFICATION
REQUIREMENTS Squyer reported in late 2oo6 clients lost Medical Assistance due to not having a birth certificate.
It has been determined by the State the county will now get the client a birth certificate at the county's cost. The
Center for Disease Control will tell where people were born; however, the client needs to come into the facility and a
document needs to be notarized by the County's Fraud Investigator. Squyer reported it takes a whole position to do
this work. If a client has no ID, the client is sent to DMV to get an ID. Legislation has now gone through that the
county must provide this service; however, no extra money is coming from the state to administer or get the birth
certificates.
Squyer again reported there is no new worker training available from the state for new workers until March, 2008.
However, she is investigating an alternative option through LaCrosse County for training.
Squyer announced that Badger Care Plus implementation has been delayed to February, 2oo8.
UPDATE ON CHILDREN'S WAIT LIST This item will be delayed to the December meeting.
VACCINATION REPORT Sortedahl distributed vaccine information statements (VIS) for several vaccines
administered by Public Health to the Board and which are also given out for every vaccine administered to clients.
She also distributed a screening questionnaire for teens and children who receive vaccinations. Parents are required I
to consent if children are to receive vaccines. Awsumb expressed concern administering the HPV vaccine and not
administering the vaccine in conjunction with other vaccines because of a warning put out by the National Vaccine
Safety Council that you should not administer with other vaccines. Sortedahl reported all vaccines are voluntary, are
given upon request, and given with informed consent.
Dr. Hoberg asked if there were any other issues to bring before the Board.
I
Motion A motion was introduced by Caflisch, seconded by Berenschot, and unanimously adopted: That the meeting
be adjourned.
im CARM ICHAPLK AD - Ill?I)SO'., N I, - i 4uiG
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As r UrI)XI' : oct 1, 2010
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