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HomeMy WebLinkAboutHealth & Human Services 03-21-07 Leon Berenschot will review vouchers. Revised - 03/13/07 NOTICE OF MEETING AND AGENDA ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD March 21, 2007 at 8:30 AM (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 - 02/21/07 DATE OF NEXT MEETING — 04/18/07 8:30 AM OLD AND NEW BUSINESS 1. Consideration of Claims and Vouchers 2. Financial Report 3. Accounts Receivable write off policy and procedure 4. Nursing Home Report 5. Health and Human Services Facility Planning 6. Personnel Issues 7. Long Term Support-Long Term Care Reform/ADRC Resolution 8. Success by 6 (8:30) ** 9. Birth to Three Program Report 10. Discussion regarding phone conference with members not in attendance 11. Economic Support- General Relief Update 12. Review of lease agreements 13. Closed session pursuant to Wisconsin Statutes sec. 19.85 (1) (e) to review preliminary negotiations regarding nursing home proposal(s). 14. Reconvene to open session pursuant to Wisconsin Statutes sec. 19.85 (2). 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. 3/12/2007 12:22 PM ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD March 21, 2007 The St. Croix County Health and Human Services Board met on March 21, 2007 at the St. Croix County Health and Human Services /Health Center complex. MEMBERS PRESENT: Esther Wentz, Chair Gordon Awsumb Lois Burri Linda Luckey Deb Rasmussen Ronald Troyer MEMBERS ABSENT: Dr. Michael Kretz, excused Leon Berenschot, excused Tom Caflisch, excused STAFF PRESENT: Fred Johnson, Health and Human Services Director Bill Van Offeren, Nursing Home Administrator Ron Lockwood, Long Term Support Coordinator Fay Strenke, HS Accounts Receivable Norma Vrieze, Early Intervention Coordinator Mary Squyer, Economic Support Supervisor Kathy Leisch, Secretary OTHERS PRESENT: Buck Malick, County Board Chair John Coughlin, United Way 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, April 18, 2007 at 8:30 AM. Rasmussen will review April vouchers. AGENDA Motion A motion was introduced by Troyer, seconded by Burri, and unanimously adopted: That the agenda be approved as circulated. MINUTES Motion A motion was introduced by Luckey, seconded by Rasmussen, and unanimously adopted: That the minutes of the 02/21/07 Health and Human Services Board meeting be approved with the following changes in italics: Page 5, last paragraph, sentence 3 should read as follows: The State expects 95% of cases to be processed timely, and St. Croix County is at 81 %. Page 6, paragraph 3, last sentence should read as follows: Dunlap will follow up with Risk Management on insurance options should a youth enter care and is not a citizen. SUCCESS BY 6 : John Coughlin was present to review the program. The priority issues are: a. That communities will understand the importance of the early childhood years and work to strengthen programs and services; b. Parents and caregivers will have the knowledge and training to provide children with safe, stable and supportive environment. St. Croix County Health and Human Services Board Page 2 March 21, 2007 Success by 6' is a nationwide United Way initiative that promotes community support and investment in early childhood development. Coughlin stated that the care and attention that a child receives in the first three years are critically important and influence him or her for life. The vision of our local Success by 6 is that "all children in St. Croix and Pierce Counties with the strong support of family and community will, by age six, have the necessary physical, mental, emotional and social development to successfully grow and learn." BIRTH TO THREE PROGRAM REPORT Vrieze reviewed mandates, current enrollment, county staff and contracts for services. Vrieze is a member of the State Birth to 3 Council. Vrieze stated the Birth to 3 Program is committed to children under the age of three who have developmental delays and disabilities and to their families. Referrals are generated from hospitals, physicians, nurses or someone in the medical community. Vrieze stated they are required to serve children in their natural environment. They are required to do home visits which is part of the state mandate. Vrieze stated there were 125 children enrolled in the Birth to 3 Program in 2006. Average active enrollment is approximately 65. Eligibility is based on a diagnosed disability or significant delay in one or more areas of development. The team will evaluate the child's ability to: learn (cognitive development); move, see and hear (physical /motor development); communicate and understand other's communication (speech and language development); respond to and related with others (social and emotional development); and eat, dress and care for daily living needs (adaptive development). A County Birth to 3 service coordinator helps the family understand and participate in the evaluation process. Services and supports a child and family receive are based on individual needs. Eligibility for this program is not affected by the family's income; however, parents may need to contribute to the costs of services. The Board recessed from 9:30 to 9:40 AM. LONG TERM SUPPORT -LONG TERM CARE REFORM /ADRC Lockwood reviewed planning to look at adult wait list needs. At the last board meeting board members questioned who was on the waiting lists and what services they are waiting for. Lockwood stated the adult wait list consists of CIP2 /COP -W and CIP1B. There are 77 on the CIP2 /COP -W wait list and 76 on the CIP1B wait list. A handout was provided to the Board with more detail. The CIP2 /COP -W consists of persons waiting for: hourly supportive home care and personal care; Residential Care Apartment Complex; Community -based Residential Care Facilities; Adult Family Care; accessibility modifications for home or vehicle. The CIP1B consists of persons waiting for Adult Family Care; Community -based Residential Care; Supported Employment; Day Services; accessibility modifications for home or vehicle. Lockwood discussed what the County cost would be to provide services to all people on the adult wait list. Net County cost is estimated at $1,236,146, without the addition of additional administrative staff. Johnson stated there was a Long Term Care Redesign meeting held on February 2, 2007. At that time there was a list of questions for Secretary Hayden from the directors from the five counties that are moving forward with this resolution. The Secretary indicated they would be getting back to us and they are chipping St. Croix County Health and Human Services Board Page 3 March 21, 2007 away at the issues but have yet to address all the questions which were previously given to the Board. Discussed protesting the way the RFP is structured. Johnson reviewed letter to be sent to Secretary Hayden to address the concerns regarding RFP process as awards will be made with no consideration in regards to cost. Johnson will draft letter and copy letter to: WCA, the Legislature, Local Representatives, Consortium Partners, Pierce County, Dunn County, Eau Claire County, Chippewa County, Center for Medicaid Services (CMS) and Governor Doyle. Wentz stated that all members have had a chance to look at the resolution and asked if there were any questions. Luckey asked if this resolution has changed since the last one. Johnson stated the last page was changed to break out the Council on Aging and Health & Human Service Board members. Luckey stated there was a loss of consistency in the ; and at the end of the paragraphs. Johnson stated he didn't think the Council on Aging would have a problem with adding the ; and at the end of the paragraphs and then forward to Corp. Counsel to review. MINUTES Motion A motion was introduced by Awsumb, seconded by Rasmussen, and unanimously adopted: That the Resolution Regarding Long Term Care Redesign in St. Croix County be approved as modified with the following changes in italics: Page 2, third paragraph, should read as follows: WHEREAS, there are several experienced private entities in the area who could be the CMOs; and Page 2, fifth paragraph, should read as follows: WHEREAS, the anticipated fiscal impact of this action limits the County's fiscal risk for all covered services to all eligible Long Term Care consumers in the future; and Page 2, sixth paragraph, should read as follows: WHEREAS, the state Department of Health and Family Services has established a process whereby they will release a competitive Request for Proposal for the Care Management Organization when notified by a group of Counties that they are ready for the RFP in their area; and Add paragraph on page 2, before third paragraph, stating: WHEREAS, St. Croix County encourages competition in the open procurement process for the RFP and has sent a letter to that effect to Secretary Hayden of Health & Family Services on 3/21/07. DISCUSSION REGARDING PHONE CONFERENCE WITH MEMBERS NOT IN ATTENDANCE Johnson noted this will be postponed to a later date. ECONOMIC SUPPORT —GENERAL RELIEF UPDATE Squyer stated that unfortunately the woman she spoke to the board about last month for General Relief has cervical or uterine cancer. Squyer stated the woman has now been approved for the Wisconsin Well Woman Medical Assistance program and General Relief will not have to pay for her medical costs. Squyer stated that Wisconsin Well Woman Medical Assistance was introduced by Sue Thompson for women with no health insurance who have been diagnosed to have uterine or cervical cancer. By virtue of the fact they have cancer they are eligible for Medical Assistance until they are cancer free. To date General Relief has spent $293.90 and one bill pending for $209.59 for a total of $503.40. These charges are all for diabetic supplies and prescriptions. Squyer met with Linda Robertson who is employed by the Free Clinic in River Falls for Pierce and St. Croix County. Robertson will have St. Croix County Health and Human Services Board Page 4 March 21, 2007 access to free diabetic supplies and insulin which should diminish our general relief costs as we will refer clients to the free clinic. HEALTH AND HUMAN SERVICES FACILITY PLANNING Johnson stated all survey information for DHHS was forwarded to Ayres and Associates on February 27 Robert Brown will be meeting with administrative staff on 3/28/07 to review summary information and address any follow up questions. A report to the DHHS Board is planned for the April 18 Board meeting with Robert Brown. PERSONNEL ISSUES Johnson stated we are in the process of filling vacancies in Economic Support and AODA. The vacancy in Economic Support has been since January 5 Part of the delay has been that a qualified person was interested in coming into the position and we were working with the Union to bring them in at a higher rate. The person ended up taking a position elsewhere. The Economic Support interviews are set for March 27 Johnson stated this is a significant concern to have a vacancy this long. The Economic Support staff caseloads are over 500 and they are covering an additional workload for that period of time. There was a resignation in the Community Support Program so that position will need to be filled. Accounts Receivable has two open positions. Johnson stated the job positions have been updated and they are available for the Board to review. REVIEW OF LEASE AGREEMENTS Johnson stated the barn is vacant. Two parties have expressed interest. Johnson will plan to proceed with a lease with similar terms that would be reviewed with Corp Counsel sometime in May or June. Johnson stated he would go ahead and lease with potential exit clauses as we have done in the past. The Board makes recommendation to lease barn for conventional farm use with a 60 day exit clause as in the past. Motion A motion was introduced by Burri, seconded by Luckey, and unanimously adopted: That the Board approves motion to lease barn. The Board feels the income is worthwhile. This will be referred to Finance for approval. The water tower lease ended 11/20/05. Nobody has expressed interest at this time. The farmland is rented and leased through 12/31/08 at $88.00 per acre. New Richmond School previously held a lease in the basement of the house (near the Nursing Home) and they are interested in leasing again through the academic school year. Johnson stated he will execute a lease similar to the one they have now. CESA 11 rents the gymnasium area for $13,000 per year for a 12 month lease. The lease expires June 30 The house lease expires May 31, 2007 for $610.00 per month. The house has had the same tenants for some time and is anticipated to continue. CONSIDERATION OF CLAIMS Health and Human Services Board member Wentz reviewed the vouchers. Motion A motion was introduced by Wentz, seconded by Troyer, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book: St. Croix County Health and Human Services Board Page 5 March 21, 2007 Human Services vouchers 94893 through 94930, dated February 15, 2007 in the amount of $15,993.25. Human Services vouchers 95488 through 95491, dated February 22, 2007 in the amount of $26,756.00. Human Services voucher 95492, dated February 22, 2007 in the amount of $1,205.00. Human Services vouchers 95775 through 95776, dated March 08, 2007 in the amount of $850.00. Human Services vouchers 96698 through 96728, dated March 08, 2007 in the amount of $55,126.11. Human Services, Nursing Home, and Government Center vouchers 94724 through 94871, dated February 15, 2007 in the amount of $165,468.43. Human Services and Nursing Home vouchers 94875 through 94892, dated February 15, 2007 in the amount of $11,007.96. Human Services and Nursing Home vouchers 95181 through 95184, dated February 22, 2007 in the amount of $19,237.19. Human Services, Nursing Home, and Farm vouchers 95185 through 95276, dated February 22, 2007 in the amount of $234,916.56. Human Services and Nursing Home vouchers 95493 through 95564, dated March 01, 2007 in the amount of $322,311.67. Human Services and Nursing Home vouchers 95948 through 96076, dated March 08, 2007 in the amount of $117,656.46. Human Services and Nursing Home vouchers 96077 through 96107, dated March 08, 2007 in the amount of $20,381.59. Human Services and Nursing Home vouchers 95779 through 95947, dated March 08, 2007 in the amount of $243,175.76. Human Services, Nursing Home, and Government Center vouchers 96729 through 96865, dated March 15, 2007 in the amount of $187,640.39. Human Services and Nursing Home vouchers 96866 through 96882, dated March 15, 2007 in the amount of $8,322.48. Human Services, Workshop, Public Health, Social Services vouchers 105 through 135, dated February 20, 2007 in the amount of $362,394.52. Human Services, Workshop, Public Health, Social Services vouchers 136 through 167, dated March 06, 2007 in the amount of $370,958.07. Human Services and Nursing Home vouchers 107 through 138, dated February 22, 2007 in the amount of $154,785.06. Human Services and Nursing Home vouchers 139 through 170, dated March 08, 2007 in the amount of $150,607.25. St. Croix County Health and Human Services Board Page 6 March 21, 2007 Workshop vouchers 19 through 24, dated February 20, 2007 in the amount of $10,780.48. Workshop vouchers 25 through 30, dated March 06, 2007 in the amount of $14,129.41. ACCOUNTS RECEIVABLE WRITE OFF POLICY AND PROCEDURE Johnson stated that Fay Strenke, new Accounts Receivable Supervisor, will give a brief update on accounts receivable work that has been done to date. Johnson reminded Board members that at audit time last year, one of the questions that came up was on the statement of net assets. The receivables went from $2.3 million to $4.4 million. Johnson stated we are working towards a remedy for some of those processing to date. Strenke discussed what the receivable balance is made of. The receivable balance is made up of Medicare, Medical Assistance, Insurance and self pay charges. Johnson stated the priority is to keep up with the current statements and to make sure they are accurate and up to date. Johnson stated there will be write offs on Medicaid and Medicare but on private pay we want to make sure we are doing the most fair and equitable way to address those payment issues for consumers. FINANCIAL REPORT Johnson noted our advances from the State were received in December. We will have to wait for the auditors to move those monies forward. The revenues are low in part because the revenues are in a transition account and not recorded for 2007. Long Term Support has a late billing cycle so their revenues and their expenses are low. They will be caught up next month. Johnson noted the totals on the Health and Human Services financials did not match (revenues and expense budgeted totals) . Adjustments were made by the Finance Director to take money out of the budget for capital expenditures which will be borrowed. Johnson will review the detail of the adjustments made with the Finance Director and report back at the next meeting. Johnson noted that when the budget was submitted by DHHS, it balanced. Johnson stated the auditors will review documents on March 26 The final projected net reduction in County allocation for 2006 will be $189,867. St. Croix County Health and Human Services Board Page 7 March 21, 2007 HEALTH AND HUMAN SERVICES - 2007 SUMMARY Total OF REVENUES Budget Jan Balance i Administration 1,080,749.83 28,479.54 1,052,270.29 2.6% AODA Services 765,599.92 41,038.57 724,561.35 5.4% Long Term Support 18,196,351.85 349,711.79 17,846,640.06 1.9% Mental Health 2,879,503.70 117,340.30 2,762,163.40 4.1 Family & Children's 3,132,978.40 197,450.57 2,935,527.83 6.3% Public Health 1,617,175.53 135,842.52 1,481,333.01 8.4% Economic Support 1,112,508.60 63,835.56 1,048,673.04 5.7% General Relief 15,000.00 1,250.00 13,750.00 8.3% Coordinated Services /ED 900,066.00 23,002.57 877,063.43 2.6% REVENUES HUMAN SERVICES PROGRAMS 29,699,933.83 957,951.42 28.741.982.41 3.2% SUMMARY Total OF EXPENDITURES Budget Jan. Balance Administration 1,080,095.83 81,534.21 998,561.62 7.5% Alcohol -Drug Abuse 765,599.92 50,924.60 714,675.32 6.7% Long Term Support 18,196,351.85 926,501.62 17,269,850.23 5.1 Mental Health 2,879,503.70 307,850.73 2,571,652.97 10.7% Family & Children's 3,132,978.40 223,969.29 2,909,009.11 7.1 Public Health 1,617,837.53 144,400.23 1,473,437.30 8.9% Economic Support 1,112,508.60 92,306.81 1,020,201.79 8.3% General Relief 15,000.00 523.91 14,476.09 3.5% Coordinated Service/SED 900,066.44 12,683.21 887,383.23 1.4% EXPENDITURES HUMAN SERVICES PROGRAMS 29,699,942.27 1,840,694.61 27,859,247.66 6.2% Excess Rev over Expenses ! (882.743.19) NURSING HOME REPORT The Nursing Home census is 65. Van Offeren reviewed current Pathways Nursing Service utilization. Van Offeren stated we are utilizing Pathways to conduct audits of this facility at this time to address what the State survey will be reviewing. Van Offeren stated the other utilization of Pathways is the Director of Nursing (DON) services. St. Croix County Health and Human Services Board Page 8 March 21, 2007 ST CROIX HEALTH CENTER JAN 2007 BUDGET ACTUAL DIFFERENCE % CENSUS 70 70 0 0.00% OPERATING REVENUE: MEDICARE $ 840 ,960.00 $ 95 ,474.98 $ 745 ,486.02 11.36% MEDICAID $ 2 ,203 ,300.60 $ 146 ,946.00 $ 2 ,056 ,354.60 6.67% PRIVATE PAY $ 962,897.50 $ 96,139.20 $ 866,758.30 9.98% RATE APPEALS - ACTUAL $ 14,000.00 $ - $ 14,000.00 0.00% IGT FUNDS - ACTUAL $ 377,000.00 $ - $ 377,000.00 0.00% ALL OTHER SOURCES*** $ 217,171.45 $ 16,445.99 $ 200,725.46 7.57% TRANSFER FROM CONTINGENCY $ - $ - $ - TOTAL OPERATING REVENUE $ 4,615,329.55 $ 355,006.17 $ 4,260,323.38 7.69% OPERATING EXPENSES: DAILY PATIENT SRVICES $ 3,557,580.61 $ 260,436.28 $ 3,297,144.33 7.32% SPECIAL SERVICES $ 274,024.76 $ 23,022.13 $ 251,002.63 8.40% GENERAL SERVICES $ 1,172,794.05 $ 79,906.07 $ 1,092,887.98 6.81% ADMINISTRATIVE SERVICES $ 593,527.93 $ 26,676.29 $ 566,851.64 4.49% UNASSIGNED: DEPRECIATION( %BASED) $ - $ - $ - OTHERS: (INS -WC- CAPITAL -UTIL) $ 286,002.20 $ 12,176.76 $ 273,825.44 4.26% Utilities $ 11561.01 Workers Camp, Computer Tech $ 615.75 Insurance TOTAL OPERATING EXPENSES $ 5,883,929.55 $ 407,217.53 $ 5,481,712.02 6.84% NET FROM OPERATIONS $ - $ (47,211.36) (COST OF DOING BUSINESS PRIOR TO APPLYING LEVY & OUTSTANDING REV) OUTSTANDING REVENUES OUTSTANDING RATE APPEAL REV $ - $ - 0.00% % OF OUTSTANDING IGT REV $ 377,000.00 $ 196,000.00 $ 181,000.00 0.00% CO ALLOCATIONS( %BASED) $ 1,268,600.00 $ 105,717.00 $ 1,162,883.00 8.33% TOTAL OUTSTANDING $ 1,645,600.00 $ 301,717.00 $ 1,343,883.00 NET FROM ALL SOURCES $ 254,505.64 CLOSED SESSION PURSUANT TO WISCONSIN STATUTES SEC. 19.85 (1)(e) TO REVIEW NURSING HOME PROPOSAL(S) Motion A motion was introduced by Luckey, seconded by Troyer, Closed session pursuant to Wisconsin Statutes sec. 19.85 (1)(e) to review nursing home proposal(s). Roll call vote: Esther Wentz - yes Gordon Awsumb - yes Leon Berenschot - absent St. Croix County Health and Human Services Board ' Page 9 March 21, 2007 Lois Burri - yes Tom Caflisch - absent Linda Luckey - yes Deb Rasmussen - yes Ronald Troyer - -yes Dr. Michael Kretz - absent Six yes, three absent, motion passed. The Board entered closed session at 11:35 AM. Johnson noted that himself, Bill Van Offeren and Buck Malick would be attending the closed session. RECONVENE TO OPEN SESSION PURSUANT TO WISCONSIN STATUTES SEC. 19.85 (2) Motion A motion was introduced by Rasmussen, seconded by Luckey, and unanimously adopted: That the Board reconvene into open session per Wisconsin Statutes 19.85(2). The Board reconvened in open session at 12:12 PM. Wentz asked if there were any other issues to bring before the Board. Wentz adjourned the meeting. Time: 12:13 PM Chair: Attest: (Secretary)