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HomeMy WebLinkAboutHealth & Human Services 12-19-07 1 f i Berenschot will review vouchers. REVISED 12/14/07 NOTICE OF MEETING AND AGENDA ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD December 19, 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 - 11/14/07 DATE OF NEXT MEETING — 01/16/08 at 8:30 a.m. OLD AND NEW BUSINESS 1. Consideration of Claims and Vouchers 2. Financial Report a. Update on Accounts Receivable write off b. 2008 Budget adjustments c. Accounts Receivable write off request ** 3. Nursing Home Report a. Report on worker comp and liability insurance costs and action taken to reduce these expenses ** 4. Nursing Home Subcommittee Report 5. Update on the new phone system 6. Personnel Issues 7. Long Term Support-Long Term Care Reform Financial Review 8. Resolution to Release Community Aids and Local Tax Levy Funding to help fund Long -Term Care Reform ** 9. Update on children's wait list 10. Resolution Supporting Change for Returning Federal Funds from Certified Public Expenditures of County Nursing Homes 11. Aging and Disability Resource Center application and Governance 12. Consideration to strengthen County's existing St. Croix County smoke -free policy 13. Request to utilize office space in Government Center for Health and Human Services ADJOURN (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. 12/14/2007 10:04 AM Berenschot will review vouchers. NOTICE OF MEETING AND AGENDA ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD December 19, 2007 at 8:30 (Beard 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 - 11/14/07 DATE OF NEXT MEETING — 01/16/08 at 8:30 a.m. OLD AND NEW BUSINESS 1. Consideration of Claims and Vouchers 2. Financial Report a. Update on Accounts Receivable write off b. 2008 Budget adjustments 3. Nursing Home Report 4. Nursing Home Subcommittee Report a. Report on worker comp and liability insurance costs and action taken to reduce these expenses 5. Update on the new phone system 6. Personnel Issues 7. Long Term Support-Long Term Care Reform Financial Review 8. Update on children's wait list 9. Resolution Supporting Change for Returning Federal Funds from Certified Public Expenditures of County Nursing Homes 10. Aging and Disability Resource Center application and Governance 11. Consideration to strengthen County's existing St. Croix County smoke -free policy 12. Request to utilize office space in Government Center for Health and Human Services ADJOURN (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. 11/29/2007 10:07 AM ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD December 19, 2007 The St. Croix County Health and Human Services Board met on December 19, 2007 at the St. Croix County Health and Human Services /Health Center complex. MEMBERS PRESENT: Esther Wentz, Chair Gordon Awsumb Leon Berenschot Lois Burri Tom Caflisch Dr. Glenn Hoberg Linda Luckey MEMBERS ABSENT: Deb Rasmussen Ron Troyer, excused STAFF PRESENT: Fred Johnson, Health and Human Services Director Jennifer Pempek, Financial Manager Harold Morris, Contracted Nursing Home Administrator Kathy Dunlap, Family and Children's Coordinator Charlotte Sortedahl, Public Health Coordinator - Health Officer Geralyn Karl, St. Croix County Health Educator and Tobacco Control Specialist Ron Lockwood, Long Term Support Coordinator Connie Sarauer, Contracted Director of Nursing John Bretl, Foster Care Coordinator Malva Sirek, Secretary OTHERS PRESENT: Clarence Malick, County Board Chair Chuck Whiting, Administrative Coordinator Kjersti Olson, Director Department on Aging Kim Dupre Norm Matzek Dr. Paul McGinnis Chair Wentz called the meeting to order at 8:30 AM noting the meeting was properly and legally publicized. NEXT MEETING The next Health and Human Services Board meeting is scheduled for Wednesday, January 16, 2007 at 8:30 AM. Wentz will review vouchers. AGENDA Motion A motion was introduced by Berenschot, seconded by Burri, 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 11/14/07 Health and Human Services Board meeting be approved with the following corrections... Page 8, paragraph 8. "Currently, no new clients are being accepted for psychiatric services unless there is an =_gent emergency need." Page 8, paragraph 9. "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 2008. 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 St: Croix County Health and Human Services Board Page 2 December 19, 2007 to offer choice to consumers between care management organizations." Add the words `the' and `a' as noted in italics above. Page 10, paragraph 1. " Awsumb also voiced that there is ne see d ev d. nee are no new clinical studies that secondhand smoke is harmful. The Surgeon General report wasn't based on new clinical studies and used meta analysis." Page 10, paragraph 2. "It has been determined by the State the county will now get the client a birth certificate at the county's cost." Add by the State as noted in italics above. Page 10, paragraph 6. " 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 Information Center that you should not administer with other vaccines." Additions noted in italics above. Sortedahl noted that public health reviewed lot numbers of vaccines and public health does not have the lot numbers of the Hib vaccine involved in a recent recall. CONSIDERATION TO STRENGTHEN COUNTY'S EXISTING ST. CROIX COUNTY SMOKE -FREE POLICY Dr. Paul McGinnis, a physician at Hudson Physicians, gave a presentation on Hudson Hospital's move to a smoke -free campus. He is a member of the St. Croix /Pierce Tobacco -Free Coalition. The Coalition looked at environments of area hospitals. He said the move to a smoke -free campus cannot happen overnight; it has to be a conscious, thoughtful process. Clients and staff need to be given notice of the change. In the Hudson campus case, a six month notice was given to clients and staff of the move to a smoke -free campus. Opportunities were offered to clients and staff to assist with quitting smoking. He reported tools need to be in place when people reach out for help with quitting smoking. He also said patients expect their physician to comment on quitting smoking. Awsumb commented that information was brought forward to the Board regarding smoke -free workplaces for the entire county over a year ago and the item was put on hold due to pending legislation and questions on a legal opinion regarding imposing rules on municipalities. It is understood that the county has no jurisdiction over municipalities but a county non - smoking ordinance would fill in the gaps not covered by city and village ordinances. Discussion on restricting smoking in County - licensed foster homes took place. Dr. McGinnis commented that the county assumes responsibility for the welfare of children placed in foster care. Bretl indicated current licensed foster care providers agree not to smoke in their vehicles or homes when a foster child is placed in their home. Dr. McGinnis indicated Karl has been very helpful in the medical campuses going smoke free. Wentz questioned local government taking on an issue that the Federal and State government should do and questioned the role of local counties. There is a County policy in place now. Awsumb suggested drafting language for an ordinance for early 2008. Issues arose regarding who would enforce an ordinance, the radius for non - smoking or an entire campus being smoke free, among other details. Comments in response to enforcement indicated this has typically not been an issue on other smoke -free campuses. Johnson said the process needs to be clarified. He suggested starting with the New Richmond campus and licensing for foster parents and other steps would be St: Croix County Health and Human Services Board Page 3 December 19, 2007 identified, including development of a county -wide ordinance. Caflisch suggested a special meeting of the Board to discuss smoking policy /ordinances only and to draft rules and regulations. Corporation Counsel and Geralyn Karl should be involved in this meeting. It was the consensus of the Board to hold a second meeting in January to discuss smoking policy /ordinances only. Date will be determined later. Motion A motion was introduced by Berenschot, seconded by Burri, and unanimously adopted: That the Board approves moving forward with a smoke -free policy and County ordinance at the second meeting in January. The board recessed from 9:41 to 9:45. CONSIDERATION OF CLAIMS Health and Human Services Board member Berenschot reviewed the vouchers. Berenschot raised concern over the amount paid for County cell phone service. Caflisch said this issue should be reviewed every year. Baker did a comprehensive study of cell phone plans for the entire county in mid -2006. Johnson will follow up with more detail regarding cell phone charges for next meeting. Motion A motion was introduced by Berenschot, seconded by Caflisch, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book: Human Services voucher 113634, dated November 20, 2007 in the amount of $430.00. Human Services vouchers 113635 through 113637, dated November 20, 2007, in the amount of $27,537.00. Human Services vouchers 114311 through 114350, dated December 06, 2007, in the amount of $54,257.60. Human Services vouchers 115137 through 115138, dated December 13, 2007, in the amount of $2,700.00. Human Services and Nursing Home vouchers 113328 through 113458, dated November 15, 2007 in the amount of $122,789.88. Human Services and Nursing Home vouchers 113459 through 113472, dated November 15, 2007 in the amount of $9,121.56. Human Services, Nursing Home and Farm vouchers 113477 through 113633, dated November 20, 2007 in the amount of $92,136.02. Human Services and Nursing Home vouchers 113639 through 113744, dated November 29, 2007 in the amount of $409,422.11. Human Services and Nursing Home vouchers 113745 through 113750, dated November 29, 2007 in the amount of $10,892.27. Human Services and Nursing Home vouchers 114151 through 114308, dated December 06, 2007 in the amount of $419,515.87. Human Services and Nursing Home vouchers 114701 through 114832, dated December 13, 2007 in the amount of $99,690.20. St: Croix County Health and Human Services Board Page 4 December 19, 2007 Human Services and Nursing Home vouchers 114878 through 115012, dated December 13, 2007 in the amount of $86,849.61. Nursing Home vouchers 114878 through 114877, dated December 13, 2007 in the amount of $42,901.00. Human Services, Workshop, Public Health, vouchers 681 through 710, dated November 15, 2007 in the amount of $378,189.29. Human Services, Workshop, Public Health, Social Services vouchers 711 through 731, dated November 29, 2007 in the amount of $265,184.74. Human Services, Workshop, Public Health, Social Services vouchers 732 through 762, dated December 13, 2007 in the amount of $379,824.03. Human Services and Nursing Home vouchers 618 through 647, dated November 15, 2007 in the amount of $148,485.50. Human Services and Nursing Home vouchers 747 through 767, dated November 29, 2007 in the amount of $126,093.86. Human Services and Nursing Home vouchers 768 through 798, dated December 13, 2007 in the amount of $164,436.39. Workshop vouchers 133 through 138, dated November 15, 2007 in the amount of $11,927.30. Workshop vouchers 139 through 144, dated November 29, 2007 in the amount of $12,992.92. Workshop vouchers 145 through 150, dated December 13, 2007 in the amount of $13,169.76. FINANCIAL REPORT The following financial report for Health and Human Services through October, 2007 was distributed. Pempek pointed out that Administration is currently at 198% and that number is going to drop dramatically over the next few months due to take back of (Basic County Allocation) BCA dollars. Pempek reported there is a transition of SED Children's Waivers from Long Term Support to Coordinated Family Services. Awsumb questioned if this report is a cash report. Pempek indicated the report is a cash report. Pempek will have a preliminary analysis available next month of where year -end figures will be. Pempek reported the CARS close out doesn't take place until the end of April or early May. The State then goes back to programs to determine who had excess funds, takes those funds back and divides back to counties. St: Croix County Health and Human Services Board Page 5 December 19, 2007 HEALTH AND HUMAN SERVICES - 2007 SUMMARY Total OF REVENUES Budget October 31, 2007 Balance % Administration 1,080,749.83 2,144,113.90 (1,063,364.07) 198.45' AODA Services 765,599.92 611,250.83 154,349.09 79.8 Long Term Support 18,196,351.85 16,732,682.61 1,463,669.24 92.0% Behavioral Health 2,879,503.70 2,314,671.55 564,832.15 80.4% Family & Children's 3,132,978.40 2,583,988.32 54$990.08 82.5% Public Health 1,617,175.53 1,472,465.00 144,710.53 91.1 % Economic Support 1,112,508.60 978,651.89 133,856.71 88.0% General Relief 15,000.00 12,500.00 2,500.00 83.3% Coordinated Services /SED 900,066.00 630,960.01 269,105.99 70.1 REVENUES HUMAN SERVICES PROGRAMS 29,699,933.83 27,481,284.11 2,218,649.72 92.5% SUMMARY Total OF EXPENDITURES Budget October 31, 2007 Balance % Administration 1,080,095.83 884,205.68 195,890.15 81.9% Alcohol -Drug Abuse 765,599.92 579,222.58 186,377.34 75.7% Long Term Support 18,196,351.85 14,626,527.79 3,569,824.06 80.4% Behavioral Health 2,879,503.70 2,535,495.90 344,007.80 88.1 Family & Children's 3,132,978.40 2,418,888.71 714,089.69 77.2% Public Health 1,617,837.53 1,342,612.10 275,225.43 83.0% Economic Support 1,112,508.60 841,964.44 270,544.16 75.7% General Relief 15,000.00 2,950.17 12,049.83 19.7% Coordinated Service /SED 900,066.44 467,386.86 432,679.58 51.9% EXPENDITURES HUMAN SERVICES PROGRAMS 29,699,942.27 23,699,254.23 6,000,688.04 79.8% Excess Rev over Expenses f 3,782.029.88 St: Croix County Health and Human Services Board Page 6 December 19, 2007 The following financial report for Nursing Home through October, 2007 was distributed. Pempek reported the percentage of private pay residents is higher than budgeted. She said the administrative services line is higher than budgeted due to items not originally included in the budget amount being assigned to that line item such as Pathways contracts, pool staff, fines, Wipfli fees, etc. After Van Offeren ended his contract, an administrative decision was made to contract with Pathways for administrator services until a definitive direction on the future of the nursing home is established. Awsumb recommended staying with outside management. He indicated the previous management was not making the changes recommended by Wipfli so the decision was made to move to contracted services. Discussion was held regarding monies being paid to Pathways compared to having the position filled by a county employee. Originally when Pathways was contracted for nursing services, three nurses came on board at a cost of approximately $25,000 per month compared to the wages of a county employee at approximately $5,800 per month. Currently, there is only the Director of Nursing position being contracted for nursing services through Pathways in addition to the Administrator position. Pempek reported that IGT revenue is still outstanding but the first half of the payment of approximately $196,000 should be here this week. She reported no one in the state has received IGT funds as yet as distribution of funds was waiting on State budget approval. St. Croix County Health and Human Services Board Page 7 December 19, 2007 St. Croix Health Center October 2007 Budget Actual Difference Percentage Census 68 61 7 Operating Revenue: Medicare $840,960.00 $645,660.07 $195,299.93 7678% Medicaid $2,466,310.60 $1,767,286.59 $699,024.01 71.66% Private Pay $699,887.50 $760,973.27 - $61,085.77 108.73% All Other Sources $217,171.45 $185,462.08 $31,709.37 85.40% Total Operating Revenue $4,224,329.55 $3,359.382.01 $864,947.54 79.52% Operating Expenses Daily Patient Services $3,557,580.61 $2,626,409.60 $931,171.01 73.83% Special Services $274,024.76 $217,492.89 $56,531.87 79.37% General Services $1,172,794.05 $874,109.80 $298,684.25 74.53% Administrative Services $593,527.93 $581,752.40 $11,775.53 98.02% Unassigned: Depreciation (% Based) $0.00 Others: $286,002.20 $179,402.57 $106,599.63 62.73% Utilities $92,850.57 Workers Comp, Computer Tech $5,386.75 Insurance $81,165.25 Total Operating Expenses $5, 683, 929.55 $4,479,167.26 $1,404,762.29 76.13% Net From Operations ($1,119,785.25) (Cost of doing business prior to applying levy & outstanding rev) Outstanding Revenues Outstanding Rate Appeal rev $14,000.00 $0.00 $14,000.00 0.00% % of Outstanding IGT Rev $377,000.00 $0.00 $377,000.00 0.00% Cc Allocations (% Based) $1,268,600.00 $1,057,170.00 $211,430.00 83.33% Total Outstanding $1,659,600.00 $1,057,170.00 $602,430.00 Net from all Sources 462,615.25 $196,000 Outstanding IGT Rev moved to 2006 via auditors UPDATE ON ACCOUNTS RECEIVABLE WRITE OFF The clean up of Medicare /Medicaid monies is done except for approximately $7,000 that we have not been able to process at this time but staff are still working on this. Staff are working on mail returns and updated addresses with Child Support. Some accounts have $25.00 no -show charges, which are being ignored and have been ignored for five to seven years and staff asked for Board direction to write off these charges. It was the Board's consensus that this would be a housekeeping duty and that no Board action was needed but that staff should follow write off guidelines. Pempek reported that balance forwards will be removed from the system if there is no documentation of charges or due to postage issues. Pempek reported the next step will be to provide regular reports to the Board. Awsumb requested a receivables report monthly along with the cash report. It was questioned the status of implementation of the recommendations made by Wipfli. Pempek St: Croix County Health and Human Services Board Page 8 December 19, 2007 reported staff functions cannot be broken down further due to lack of staff available. Staff are currently using the policy for write offs outlined by Wipfli but will bring this issue back to the Board soon. Administration is requesting a write off for a bad debt. The client has charges dating back to 2005 in the amount of $56,149.06. The client died in October of 2007. The family is disputing several charges on the account but the estate has offered payment of $28,074.53 in settlement of the outstanding charges, which would be paid now and not have to wait for probate to finish. Motion A motion was made by Caflisch, seconded by Berenschot, and unanimously adopted: That the Board accepts payment of $28,074.53 in settlement of the outstanding debt outlined above. 2008 BUDGET ADJUSTMENTS Staff are working with MPS staffing for temporary staff. An adjustment will need to be made to cover temp services and funds will be moved from purchased services dollars. PERSONNEL ISSUES Johnson reported a financial assistant position in Accounts Payable will go to half time due to the elimination of representative payee services provided by the county. This move has been discussed with Tammy Funk, Human Resources Director. The other half of this position will move to Accounts Receivable in a budget neutral move. A half -time clerical position from Long Term Support will also move to Accounts Receivable. Caflisch questioned filling these positions with a 45% position to avoid paying benefits. Pempek reported a contract is in place for an intern to work 20 /hours /week for accounting from January to May at no cost to the County. Johnson reported administration is reassessing the entire workload of the financial assistants throughout the agency and realigning work as necessary. NURSING HOME REPORT Johnson introduced Harold Morris as the new contracted Nursing Home Administrator. Morris reported the Nursing Home census is 66 with 19, or 29 %, of the population being private pay. He reported the nursing target for ppd (per patient day) is 3.65. He reported last week the ppd was 3.72 but that will drop due to additional admissions. He reported dietary is over in ppd but will remain over due to inefficiencies in the kitchen set up. He does not recommend going any lower for ppd in order to maintain good patient care. When Sarauer started as Director of Nursing, the ppd was 4.86. Now, through attrition, not filling vacant positions, combining MDS /staff education positions and quality assurance practices in place, the ppd is 3.72. Morris said resident needs are being met, the facility received a deficiency -free survey, and there are no resident complaints. Sarauer reported the 24 -hour report is being audited everyday and compared to nurses' notes with a follow up in person with the nurses. The nurses are also auditing CNAs. Matzek voiced concern over driving the staffing levels down too far as county homes typically have more difficult residents to care for and if the levels are too low, the facility will have problems. Morris again expressed the facility is at good levels of care and the hours for ppd are excellent. Morris also indicated that the residents at the facility are similar to residents in other area facilities. Awsumb questioned going to a 50 bed facility. This item will be added to the January Board agenda. Awsumb encouraged the Board to adopt a policy to continue to contract with outside management to oversee the Nursing Home as there are changes going on in the industry and for the County to keep up with those changes. Luckey questioned the cost associated with a management contract versus using County staff to run the facility. The Board questioned the size of St: Croix County Health and Human Services Board Page 9 December 19, 2007 an assisted living facility being considered. Morris suggested 18 -20 beds for efficiency. Assisting living use will increase over time and will act as a feeder for the nursing home. Awsumb questioned offering hospice care in the Nursing Home and wanted to examine hospice in the operation of the Nursing Home. Morris said there are currently no residents in hospice care but is a supporter of hospice as a good end of life experience which is a critical element in a nursing home if done properly. Hospice is run for the benefit of the resident, not to help the resident pass faster. Awsumb questioned the cost to run one floor compared to both floors in the nursing home and asked a report back to the Board in January. Johnson reported that this Board will need to respond to Supervisor Struemke's question from the November County Board meeting in January related to potential cost savings of moving the nursing home operations to the lower level. Johnson referenced the Wipfli study (December, 2005) that estimated cost savings to operate a 50 -bed facility and a 72 -bed facility. The additional savings on a 50 -bed facility would be $282,000 less cost of layoffs. Johnson did talk to Art Tobin and he indicated savings from building services perspective would be minimal. This analysis is not exact as the first floor will not accommodate 50 residents, but is an estimate that will be used to answer Supervisor Struemke's question. In addition, a fiscal analysis will be done for an 18 -20 bed assisted living facility and a 50 versus 72 bed nursing home facility. This may also provide details on cost savings on a small facility. Johnson will work with Larry Lester on this analysis and will schedule a Nursing Home Ad Hoc Committee meeting. Per Awsumb's request Johnson distributed a graph showing workman's compensation and liability costs. The worker's comp losses are reviewed by the Safety and Security Committee on a monthly basis. NEW PHONE SYSTEM Work is underway for updating to a new phone system, which should be completed in February, 2008. All avenues to obtain a PRI line have been explored to allow for the caller ID feature, but this will not happen at this time. Johnson recommended signing a letter of intent, with no commitment on the County's part, to Frontier requesting a PRI line. Motion A motion was introduced by Burri, seconded by Berenschot, and unanimously adopted: That Fred Johnson be authorized to sign a letter of intent with Frontier to express interest in obtaining a PRI line. PERSONNEL ISSUES Johnson announced Heather Gensen has accepted the Economic Support worker position as of 11/26/07. One additional position in Economic Support will be filled in 2008. The Board recessed from 11:25 to 11:30. REQUEST TO UTILIZE OFFICE SPACE IN GOVERNMENT CENTER FOR HEALTH AND HUMAN SERVICES Johnson reported a request had been submitted from Health and Human Services to utilize room 1259 (old lunch room) at the Government Center for Health and Human Services staff. After review, room 1255 (sick room) would accommodate some staff and Johnson will work with the judges on the designated Health and Human Services room that the Drug Court Coordinator is now using to maximize space for Health and Human Services staff. Based upon this, Health and Human Services request for room 1259 would be withdrawn. Motion A motion was introduced by Caflisch, seconded by Berenschot, and unanimously adopted: That the Board supports Health and Human Services staff St: Croix County Health and Human Services Board Page 10 December 19, 2007 taking over the sick room (room 1255) at the Government Center. This item will be forwarded to be put on the Finance Committee agenda. LONG TERM SUPPORT -LONG TERM CARE REFORM FINANCIAL REVIEW A powerpoint regarding the anticipated fiscal impact of Long Term Care Reform was presented to the Board. A brief history of the process to this point was outlined. It is projected in 2013 there will be one supervisor, two staff and one support staff in Long Term Support, which is the basis for the budget presented. The transition to Long Term Care is scheduled to begin in September 2008 with one - sixth of the caseload being transferred to Long Term Care every month with completion in January 2009. Every year in September there will be a 25% reduction in the Levy and BCA set aside for county to transfer to managed care, with the contribution frozen in 2013 at $31,334 (per month) for the maximum contribution for managed care. WCA negotiated this buy down for high contributing counties, of which St. Croix County is one. Berenschot left the meeting at 11:50. Long Term Care Reform would eliminate wait lists and allow more opportunity for choice in continuity of care. One area of concern is the transition of clients through the school district. The services through Long Term Care will be provided as an entitlement and will include supports required to transition young persons from school -based to adult- oriented community based services. These services will provide continuity in care and support for youth that have been served by the Family and Children's Unit through the Children's LTS Waivers. A resolution To Release Community Aids And Local Tax Levy Funding To Help Fund Long -Term Care Reform was distributed to the Board. The Board was asked to review this resolution so it may be addressed in January and forwarded to the County Board in February. Johnson questioned if the resolution should come from the Health and Human Services Board only or from both the Health and Human Services Board and the Council on Aging Committee. Costs for current elder -at -risk and adults -at -risk services provided by the county may be reduced by the outreach service activities of the ADRC that may be reimbursable under the Medical Assistance Pass Through /Administration Program at 50% of total costs. Community Options Program funding of $300,000 will be maintained by the County and transferred to the Behavioral Health Unit to be used as local match to the proposed Comprehensive Community Services (CCS) Program. Details will be worked out with the State for a final determination. St. Croix County has also been recommended to receive start up funds of $40,000 for CCS. Also, Health and Human Services will work with the State to transition some CIP lA and CIP 1B slots to serve children. Dr. Hoberg left the meeting at noon. RESOLUTION SUPPORTING CHANGE FOR RETURNING FEDERAL FUNDS FROM CERTIFIED PUBLIC EXPENDITURES OF COUNTY NURSING HOMES Discussion was held on the wording in this resolution. It was the consensus of the Board to remove the word difficult from the second paragraph. Motion A motion was introduced by Caflisch, seconded by Luckey, and unanimously adopted: That the Board approves the following resolution with revision suggested above: RESOLUTION SUPPORTING CHANGE FOR RETURNING FEDERAL FUNDS FROM CERTIFIED PUBLIC EXPENDITURES OF COUNTY NURSING HOMES e St% Croix County Health and Human Services Board Page 11 December 19, 2007 Resolution No. St. Croix County, Wisconsin WHEREAS, St. Croix County owns and operates one skilled nursing facility that provides services to the residents of St. Croix County; and WHEREAS, St. Croix County Health Care Center operates at a loss each year because of the high cost of providing care, and St. Croix County has been forced to supplement the facility's operating losses; and WHEREAS, the State of Wisconsin claims those losses in reports to the federal government and receives 58% matching funds to compensate for the reported losses under the Certified Public Expenditure (CPE) program; and WHEREAS, the State of Wisconsin claimed approximately $90,000,000 in federal funds for state -wide governmental nursing home losses in budget years 2005 -2007, and diverted these funds from counties to the State's Medicaid Trust Fund; and WHEREAS, the State of Wisconsin decreased supplemental funding from the Intergovernmental Transfer Program (ITP) for governmental nursing homes from $54,773,148 to $37,100,000 and diverted $17,673,148 from counties to the State's Medicaid Trust Fund resulting in a $185,023 decrease in ITP funds to St. Croix Health Center; and WHEREAS, the 2007 -2009 State Budget proposed by Governor Doyle estimates claiming $77,000,000 in Federal Funds for state -wide governmental nursing home losses and diverting these funds from counties to the state's Medicaid Trust fund. NOW THEREFORE BE IT RESOLVED that the St. Croix County Board of Supervisors supports recovering all Federal funds received from the Certified Public Expenditures of county nursing homes to then be returned to the county nursing homes in order to bring direct tax relief to the citizens of St. Croix County. FURTHER, BE IT RESOLVED by the St. Croix County Board of Supervisors that the County Clerk shall forward a copy of this resolution to the Governor of the State of Wisconsin, St. Croix County's Legislative Representatives, to the Wisconsin Counties Association. AGING AND DISABILITY RESOURCE CENTER APPLICATION AND GOVERNANCE Johnson indicated material in the Board packet regarding the ADRC. He said model #4 outlined in the packet is the preferred structure with governance under the Health and Human Services Board as identified at a recent Ad Hoc ADRC planning meeting. This will be further reviewed at the January Health and Human Services Board meeting. The application for the ADRC is planned to be completed in February. UPDATE ON CHILDREN'S WAIT LIST This item will be delayed to the January meeting. e St% Croix County Health and Human Services Board Page 11 December 19, 2007 Resolution No. St. Croix County, Wisconsin WHEREAS, St. Croix County owns and operates one skilled nursing facility that provides services to the residents of St. Croix County; and WHEREAS, St. Croix County Health Care Center operates at a loss each year because of the high cost of providing care, and St. Croix County has been forced to supplement the facility's operating losses; and WHEREAS, the State of Wisconsin claims those losses in reports to the federal government and receives 58% matching funds to compensate for the reported losses under the Certified Public Expenditure (CPE) program; and WHEREAS, the State of Wisconsin claimed approximately $90,000,000 in federal funds for state -wide governmental nursing home losses in budget years 2005 -2007, and diverted these funds from counties to the State's Medicaid Trust Fund; and WHEREAS, the State of Wisconsin decreased supplemental funding from the Intergovernmental Transfer Program (ITP) for governmental nursing homes from $54,773,148 to $37,100,000 and diverted $17,673,148 from counties to the State's Medicaid Trust Fund resulting in a $185,023 decrease in ITP funds to St. Croix Health Center; and WHEREAS, the 2007 -2009 State Budget proposed by Governor Doyle estimates claiming $77,000,000 in Federal Funds for state -wide governmental nursing home losses and diverting these funds from counties to the state's Medicaid Trust fund. NOW THEREFORE BE IT RESOLVED that the St. Croix County Board of Supervisors supports recovering all Federal funds received from the Certified Public Expenditures of county nursing homes to then be returned to the county nursing homes in order to bring direct tax relief to the citizens of St. Croix County. FURTHER, BE IT RESOLVED by the St. Croix County Board of Supervisors that the County Clerk shall forward a copy of this resolution to the Governor of the State of Wisconsin, St. Croix County's Legislative Representatives, to the Wisconsin Counties Association. AGING AND DISABILITY RESOURCE CENTER APPLICATION AND GOVERNANCE Johnson indicated material in the Board packet regarding the ADRC. He said model #4 outlined in the packet is the preferred structure with governance under the Health and Human Services Board as identified at a recent Ad Hoc ADRC planning meeting. This will be further reviewed at the January Health and Human Services Board meeting. The application for the ADRC is planned to be completed in February. UPDATE ON CHILDREN'S WAIT LIST This item will be delayed to the January meeting. St'. Croix County Health and Human Services Board Page 12 December 19, 2007 Wentz asked if there were any other issues to bring before the Board. Wentz adjourned the meeting. Time: 12:10 PM Chair: Attest: (Secretary)