HomeMy WebLinkAboutHealth & Human Services 06-20-07 Esther Wentz will review vouchers.
NOTICE OF MEETING AND AGENDA
ST. CROIX COUNTY HEALTH AND HUMAN
] �SERVICES BOARD
June 20, 2007 at 4: 00 1
(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 - 05/16/07
DATE OF NEXT MEETING - 07/18/07 at 8:30 a.m.
OLD AND NEW BUSINESS
1. Consideration of Claims and Vouchers
2. Financial Report
3. Nursing Home Report
4. 2007 Capital Improvement Plan Review
5. 2008 Capital Improvement Plan
6. Personnel Issues
7. Representative Payee Services
8. Reorganization Plan for Long Term Support Children's Services
9. Long Term Support-Long Term Care Reform/ADRC
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.
5/30/2007 9:38 AM
ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD
June 20, 2007
The St. Croix County Health and Human Services Board met on June 20, 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. Michael Kretz
Linda Luckey
Deb Rasmussen
Ron Troyer
MEMBERS ABSENT: none
STAFF PRESENT: Fred Johnson, Health and Human Services Director
Jennifer Pempek, Accountant /Fiscal Manager
Bill Van Offeren, Nursing Home Administrator
Lisa Leahy, Director of Social Services- Nursing Home
Kathy Dunlap, Family and Children's Coordinator
Ron Kiesler, Behavioral Health Coordinator
Kathy Huston, CSP'Coordinator
Norma Vrieze, Early Intervention Director
Malva Berg, Secretary
OTHERS PRESENT:
Chair Wentz called the meeting to order at 4:00 PM noting the meeting was
properly and legally publicized.
NEXT MEETING The next Health and Human Services Board meeting is scheduled
for Wednesday, July 18, 2007 at 8:30 AM. Berenschot will review July
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 Troyer, seconded by Burri, and
unanimously adopted: That the minutes of the 05/16/07 Health and Human
Services Board meeting be approved as distributed.
Johnson announced the strategic planning kick off event was held today and
was well attended by staff. Results of work of the planning committee were
relayed to staff. The event was held to solicit staff support for
implementing strategic planning.
CONSIDERATION OF CLAIMS Health and Human Services Board member Wentz
reviewed the vouchers.
Motion A motion was introduced by Wentz, seconded by Caflisch, and
unanimously adopted: That the following vouchers be approved and be made a
part of the supplemental minute book:
Human Services vouchers 101158 through 101163, dated May 17, 2007 in the
amount of $42,940.00.
St. Croix County Health and Human Services Board
Page 2
June 20, 2007
Human Services voucher 101164, dated May 17, 2007 in the amount of $1,398.60.
Human Services voucher 101188, dated May 17, 2007 in the amount of $310.00.
Human Services vouchers 102326 through 102361, dated June 07, 2007 in the
amount of $59,191.42.
Human Services and Nursing Home vouchers 101030 through 101157, dated May 17,
2007 in the amount of $285,093.60.
Human Services and Nursing Home vouchers 101165 through 101187, dated May 17,
2007 in the amount of $10,006.91.
Human Services, Nursing Home, and Farm vouchers 101393 through 101489, dated
May 03, 2007 in the amount of $350,395.77.
Human Services and Nursing Home vouchers 101571 through 10,1603, dated May 31,
2007 in the amount of $94,275.81.
Human Services, Nursing Home, and Government Center vouchers 102137 through
102278, dated June 07, 2007 in the amount of $90,986.23.
Human Services and Nursing Home vouchers 101992 through 102136, dated June
07, 2007 in the amount of $320,984.83.
Human Services and Nursing Home vouchers 102887 through 103061, dated June
14, 2007 in the amount of $170,169.93.
Human Services and Nursing Home vouchers 103062 through 103090, dated June
14, 2007 in the amount of $13,262.85.
Nursing Home vouchers 102279 through 102325, dated June 07, 2007 in the
amount of $27,375.45.
Human Services, Workshop, Public Health, vouchers 294 through 323, dated May
15, 2007 in the amount of $372,885.65.
Human Services, Workshop, Public Health, Social Services vouchers 324 through
344, dated May 29, 2007 in the amount of $319,756.79.
Human Services, Workshop, Public Health, Social Services vouchers 345 through
375, dated June 12, 2007 in the amount of $379,575.77.
Human Services and Nursing Home vouchers 298 through 329, dated May 17, 2007
in the amount of $144,269.88.
Human Services and Nursing Home vouchers 230 through 251, dated May 31, 2007
in the amount of $121,867.58.
Human Services and Nursing Home vouchers 252 through 283, dated June 14, 2007
in the amount of $157,452.27.
Workshop vouchers 55 through 60, dated May 15, 2007 in the amount of
$12,576.47.
Workshop vouchers 61 through 66, dated May 29, 2007 in the amount of
$11,952.42.
St. Croix County Health and Human Services Board
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June 20, 2007
Workshop vouchers 67 through 72, dated June 12, 2007 in the amount of
$12,257.14.
FINANCIAL REPORT Pempek distributed the following financial report for Health
and Human Services through April, 2007. Health and Human Services revenues are
higher due to WIMCR monies received. The auditors will move these monies to
2006. She mentioned Behavioral Health and Alcohol /Drug Abuse (AODA) revenues
are lower due to lower collections. Johnson reported contracted service usage
is down in AODA, thus lower expenditures are reflected in the report. Also new
staff have been hired in AODA, which also lowers expenses due to new staff
coming into positions at a lower wage.
HEALTH AND HUMAN SERVICES - 2007
SUMMARY Total
OF REVENUES Budget April 30, 2007 Balance %
Administration 1,080,749.83 1,219,809.50 (139,059.67) 112.9%
AODA Services 765,599.92 220,535.87 545,064.05 28.8%
Long Term Support 18,196,351.85 6,625,568.41 11,570,783.44 36.4%
Mental Health 2,879,503.70 888,526.52 1,990,977.18 30.9%
Family & Children's 3,132,978.40 1,062,913.20 2,070,065.20 33.9%
Public Health 1,617,175.53 594,517.48 1,022,658.05 36.8%
Economic Support 1,112,508.60 474,707.64 637,800.96 42.7%
General Relief 15,000.00 5,000.00 10,000.00 33.3%
Coordinated Services /ED 900,066.00 396,558.24 503,507.76 44.1%
REVENUES HUMAN
SERVICES PROGRAMS 29,699,933.83 11,488,136.86 18,211,796.97 38.7%
SUMMARY Total
OF EXPENDITURES Budget April 30, 2007 Balance %
Administration 1,080,095.83 335,936.04 744,159.79 31.1%
Alcohol -Drug Abuse 765,599.92 199,251.60 566,348.32 26.0%
Long Term Support 18,196,351.85 5,492,087.26 12,704,264.59 30.2%
Mental Health 2,879,503.70 1,081,047.75 1,798,455.95 37.5%
Family & Children's 3,132,978.40 959,103.55 2,173,874.85 30.6%
Public Health 1,617,837.53 545,677.61 1,072,159.92 33.7%
Economic Support 1,112,508.60 328,422.06 784,086.54 29.5%
General Relief 15,000.00 1,719.33 13,280.67 11.5%
Coordinated Service /SED 900,066.44 186,708.55 713,357.89 20.7%
EXPENDITURES HUMAN
SERVICES PROGRAMS 29,699,942.27 9,129,953.75 20,569,988.52 30.7%
Excess Rev over Expenses 3 2,358.183.11
Dr. Kretz questioned utilizing mobile crisis, mandating use of mobile crisis
and a possible incentive being offered to officers to utilize mobile crisis.
Johnson said he will add mobile crisis as an agenda item to the July meeting.
Pempek distributed the following financial report for the Nursing Home through
April, 2007. The average census is 66. The census in the Nursing Home today
is 59. Pempek pointed out the higher private pay patient mix reflected in the
report.
St. Croix County Health and Human Services Board
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June 20, 2007
St. Croix Health Center
April 2007
Budget Actual Difference Percentagf
Census 70 66 4
Operating Revenue:
Medicare $840,960.00 $244,449.75 $596,510.25 29.07%
Medicaid $2,466,310.60 $701,639.38 $1,764,671.22 28.45%
Private Pay $699,687.50 $309,105.00 $390,762.50 44.16%
All Other Sources $217,171.45 $60,950.65 $156,220.80 28.07%
Total Operating Revenue $4,224,325.55 $1,316,144.78 $2,808,184.77 31.16%
Operating Expenses
Daily Patient Services $3,557,580.61 $966,058.34 $2,591,522.27 27.15%
Special Services $274,024.76 $83,529.10 $190,495.66 30.48%
General Services $1,172,794.05 $329,784.03 $643,010.02 28.12%
Administrative Services $593,527.93 $189,279.72 $404,248.21 31.89%
Unassigned:
Depreciation (% Based) $0.00
Others: $286,002.20 $128,371.49 $157,630.71 44.88%
Utilities $43,117.49
Workers Camp, Computer Tech $4,088.75
Insurance $81,165.25
Total Operating Expenses $5,883,925.55 $1,697,022.68 $4,186,506.87 28.84%
Net From Operations ($380,877.90)
(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%
Co Allocations Cl. Based) $1,268,600.00 $422,868.00 $845,732.00 33.33°%
Total Outstanding $1,659.800.00 $422.868.00 $1,236,732.00
Net from all Sources $41,950.10
$196,000 Outstanding IGT Rev moved to 2006 via auditors
Pempek distributed an accounts receivable aging report as requested by the
Board. Peggy Van Zanten, the fraud investigator from WIPFLI, will make her full
report to the Board in August. No adjustments have been made in the over 90 -day
column. Billings in accounts receivable are going out in a timely fashion.
Temporary staff have been working on cleaning up accounts. It was discovered
billings were billed at full cost rather than reasonable and customary so
numbers are inflated. Staff has worked with two collection companies in the
past. It was suggested to hire a temporary worker to make collection calls. It
is possible some collection calls will be done through Child Support but this
process should wait until true costs are identified for accounts receivable
accounts. Child Support staff will be invited to the July meeting to discuss
collection efforts further. After true costs are identified for accounts, other
efforts could include tax intercept, home /vehicle liens, etc.
St. Croix County Health and Human Services Board
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June 20, 2007
NURSING HOME REPORT Van Offeren reported the State Engineer completed his
survey and again the survey was deficiency free. However, the surveyor
reported that the Nursing Home will need to install escutcheon heads on the
sprinkler system and install sprinklers in the dietary freezer area by next
year or he will cite the Nursing Home for not having that equipment.
A handout regarding selling the Nursing Home was distributed to Board members
for their information.
Questions for both the County Board and Christian Community Center were also
distributed to Board members. No answers are available at this time. Another
meeting with the union is scheduled for July 11, 2007.
2007 CAPITAL IMPROVEMENT PLAN REVIEW The borrowing resolution passed the
County Board on 06/19/07 so monies will be available for a new phone system
plus a parking lot for St. Croix Industries for 2007. However, it was
recommended that $14,000 for chipsealing the Health and Human Services parking
lot be delayed and only perform sealing of the cracks this year,and next until
more complete information is available on facilities planning.
Motion A motion was introduced by Bererischot, seconded by Dr. Kretz and
unanimously adopted: That the Board approves delaying the chipsealing in the
amount of $14,000 for the Health and Human Services parking lot and only
perform sealing of the cracks in the parking lot.
It was further recommended that $10,000 for ,chipsealing the Nursing Home
parking lot be delayed and only crack sealing be performed this year due to
current negotiations due to the RFP.
Motion A motion was introduced by Caflisch, seconded by Rasmussen and
unanimously adopted: That the Board approves delaying the chipsealing in the
amount of $10,000 for the Nursing Home parking lot and only perform sealing of
the cracks in the parking lot.
2008 CAPITAL IMPROVEMENT PLAN As part of the budget process, capital outlay
plans are presented to the parent committee in June and made a part of the
budget process. Dr. Kretz recommended discussion be suspended on capital
outlay for the Nursing Home until a decision is made on the RFP. The outlay
plans for Health and Human Services and St. Croix Industries will be forwarded
to Chuck Whiting and the Nursing Home capital outlay plan will be put on hold.
PERSONNEL ISSUES Johnson reported Jolene Summers has been hired in Economic
Support effective 06/11/07. There are two new staff in Economic Support in
need of state training.
REPRESENTATIVE PAYEE SERVICES The software the department utilizes for this
service will no longer have support as of the end of 2007. Social Security
determines if clients are in need of support to manage funds and can appoint a
representative payee. There are currently 19 CSP clients and 57 Long Term
Support clients that have Health and Human Services designated as their
representative payee. Discussions on cost to upgrade software versus referring
individuals to private entities for this service have occurred and planning
within the Department is to transition consumers over the next six months to
private businesses that offer this service. There are five alternative payee
services in the Eau Claire /Menomonie area who offer representative payee
services for a fee of approximately $32 to $34 /month, the maximum allowed by
Social Security. Clients may have an issue paying for services that were once
free through Human Services. It may also be beneficial to client treatment to
St. Croix County Health and Human Services Board
Page 6
June 20, 2007
separate therapeutic and financial services and not provide this all through
Department of Health and Human Services. A letter will be sent out to clients
regarding the transfer of representative payee services occurring by the end of
the year.
REORGANIZATION PLAN FOR LONG TERM SUPPORT CHILDREN'S SERVICES As a result of
Long Term Care Reform, which only affects adults, staff have also looked at
longer range planning for the Children's service. This planning will combine
the children's waivers with the current Coordinated Family Services (CFS) team.
Two staff from Long Term Support will be relocated into the office with the
current CFS team by July 1. This will be a learning process to gain efficiency
and possibly serve clients more quickly to reduce waiting list numbers. This
unit is under the supervision of Kathy Dunlap and Ron Kiesler.
Johnson thanked Norma Vrieze for providing supervision for the Long Term
Support children's waivers for the last year.
LONG TERM SUPPORT -LONG TERM CARE REFORM /ADRC Copies of the Legislative Fiscal
Bureau, paper #395, was forwarded to Board members along with .a copy of the
Family Care Program Expansion - Omnibus Motion for review prior to the meeting.
Johnson said it is encouraging that the proposal includes a buy down of county
contribution to 22% of Basic County Allocation (BCA)' over a five year period.
Johnson said no response has been received from Secretary Hayden from letters
sent out.
Wentz asked if there were any other issues to bring before the Board.
Troyer expressed regrets that he would be unable to attend the Open Hearing
Meeting due to another commitment.
Wentz adjourned the meeting.
Time: 5:38 PM
Chair:
Attest:
(Secretary)
c '
NOTICE OF MEETING AND AGENDA
ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD
June 20, 2007 at 6:00 PM
(Head Start area, St. Croix County DHHS Building, New Richmond WI)
CALL TO ORDER
ROLL CALL
OLD AND NEW BUSINESS
1. Open Hearing- Review letters and take public testimony regarding the 2008 Health and
Human Services budget process
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.
5/30/2007 9:38 AM
ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD
PUBLIC HEARING
June 20, 2007
The St. Croix County Health and Human Services Board conducted an "Open
Hearing" on June 20, 2007, at the St. Croix County Health and Human
Services /Health Center complex.
MEMBERS PRESENT: Esther Wentz, Chair
Gordon Awsumb
Leon Berenschot, Vice Chair
Lois Burri
Thomas Caflisch
Dr. Michael Kretz
Linda Luckey
Deb Rasmussen, Secretary
Fred Johnson called the Open Hearing to order at 6:12 PM noting that the
meeting was properly and legally publicized. Johnson welcomed everyone to the
hearing.
Johnson stated he was pleased to see everyone in attendance tonight. Johnson
stated it is important that the people who came to provide testimony have an
opportunity to do so as we begin preparing for the 2008 budget.
Johnson asked Board members to introduce themselves and the district they
represent.
Johnson asked staff to introduce themselves:
Fred Johnson, Health and Human Services Director
Ron Lockwood, Long Term Support Supervisor
Charlotte Sortedahl, Public Health Coordinator - Health Officer
Ron Eichstaedt, Director, St. Croix Industries
Kathy Dunlap, Family & Children's Coordinator
Mary Squyer, Economic Support Supervisor
Norma Vrieze, Early Intervention Director
Bill Van Offeren, Nursing Home Administrator
Ron Kiesler BH /AODA Coordinator
Steve Kirt, Behavioral Health /AODA Clinical Services Supervisor
Malva Berg, Clerical Supervisor
Lisa Leahy, Nursing Home Director of Social Services
Sonya Skramstad, Job Placement Specialist -St. Croix Industries
Lori Becker, COTA, Nursing Home
Marilyn Bartos, Activity Therapy, Nursing Home
Kathy Huston, CSP Coordinator
Anne Fagnan, Ward Clerk, Nursing Home
Pam Benson, Family and Children's
Laurie Cameron, Social Worker, Family and Children's
Mike Traynor, Social Worker, Long Term Support
Deb Willink, Social Worker, Long Term Support
Colleen Hammer, Rehabilitation Coordinator, St. Croix Industries
Lois Worbes, Housekeeping, Nursing Home
Loyla Waskul, CNA Nursing Home
Jo DeWitt, RN, Nursing Home
Jim Dubeau, CNA, Nursing Home
Kjersti Duncan, Director, Department on Aging
Johnson thanked the staff for attending. Johnson stated it is important to
recognize the staff because they are the ones who make the budget work. Johnson
stated that it is important for everyone to hear the needs of the community and
the open hearing is an excellent way for that to happen.
St. Croix County Health and Human Services Board
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June 20, 2007
Johnson stated there were people attending who would like to give testimony and
invited all those who wished to speak to do so.
Johnson stated there were letters that would be read from those who could not
attend or did not wish to speak. See attachments in minute book.
Dunlap read a letter from Judy Green, teacher for the Hudson School District
and team member of Coordinated Family Services, supporting the Coordinated
Family Services (CFS) program. CFS has combined Long Term Support, Family and
Children's, and Behavioral Health in a wraparound model to provide services to
families.
Kiesler read a response from Mary Boots regarding programs managed by St. Croix
County. She requested that consumers, parents and guardians be kept informed
before changes are made in programs as there are concerns regarding the changes
being proposed regarding Long Term Care Reform.
Kiesler read a letter from Juanita Amundson praising the CFS program services
and supporting the CFS program continuing and expanding.
Jim Dubeau delivered a speech on the government's responsibility to the Nursing
Home. He supported the Nursing Home continuing to operate under County
Government. The audience applauded at the completion of the speech.
Kim Dupre gave a speech in support of the Nursing Home. The Nursing Home is a
good facility to take care of the elderly population. She reported 68% of the
residents in the Nursing Home are covered by Medical Assistance. She said the
poor are not going to go away. The audience applauded at the completion of the
speech.
A letter in support of the CFS Program from the Peters' family was read. They
praised CFS services to their family.
Lockwood read a response from Adam Berg regarding Long Term Support waiting
lists. Lockwood reported the main motivating factor behind Long Term Care
Reform to a managed care system is the length of time clients are on the wait
list before receiving services. Efforts are underway to recruit more vendors
for services other than just Community Health Partnership.
Margi Miller gave testimony on the difficulty of living with a disabled adult.
She asked the Board to put a face on a family when considering the budget.
A letter from Jean Olson was read outlining concerns with lack of available
home health caregivers and limited funds for many people with needs.
Margie Weiss gave testimony in support of St. Croix Industries. She said St.
Croix Industries serves a purpose in the community and services provided at St.
Croix Industries are needed.
Diane Bulman gave testimony in support of Birth to Three Program and the
Nursing Home.
Gordon Awsumb The Health and Human Services Board has tough choices to make.
The Health and Human Services and Nursing Home budgets are over $34 million.
County tax levy is $22 million. There are levy limit caps imposed at the
County Board level. Board members are on the Board and doing their job because
they are concerned about the County. There are 31 members on the County Board
and consumers /staff were invited to provide input to all 31 members.
Regarding the status of the Nursing Home, Johnson said he hopes information can
be disseminated soon. A public hearing was held at the Government Center in
February regarding disposition of County land. It is hoped another public
hearing will be held regarding the Nursing Home but a public hearing cannot be
held until information is disseminated out of closed session. A consumer
St. Croix County Health and Human Services Board
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June 20, 2007
questioned the committee's decision to keep the RFP negotiations in closed
session. A consumer expressed concern that the Nursing Home is the Board's
responsibility and the poor management of the previous administration should
not be held against the staff and cited remodeling of the dining rooms as an
example. Also mentioned was having contracted employees in key positions of
Administrator and Director of Nursing in the Nursing home.
A consumer questioned Dane County opting out of Long Term Care Reform. Johnson
said he could contact Dane County's Director for more information. Lockwood
indicated advocacy groups for the developmentally disabled may be part of the
reason for Dane County's decision.
Kretz addressed binge drinking in St. Croix County.
Johnson stated that on behalf of the Board we appreciate everyone coming to the
Open Hearing. Johnson stated that staff members and the Board were represented
tonight. Johnson stated the information given tonight will be reviewed and we
will do the best we can to serve the needs of the community.
Hearing adjourned at 7:25 PM.
Chairman:
Attest:
Secretary