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HomeMy WebLinkAboutHealth & Human Services 03-16-11 Larson will review vouchers. Revised 03/10/11 NOTICE OF MEETING AND AGENDA ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD DATE AND TIME: March 16, 2011 at 8:30 LOCATION.• (Board Room, St Croix County DHHS Building, 1445 N. Fourth Street, New Richmond WI) CALL TO ORDER ROLL CALL REVIEW OF AGENDA CONSENT AGENDA APPROVAL OF MINUTES OF PREVIOUS MEETING - 02/16/11 and 02/25/11 DATE OF NEXT MEETING — 04/20/11 at 8:30 a.m. OLD AND NEW BUSINESS 1. Consideration of Claims and Vouchers and appoint member to review vouchers at next meeting 2. * *Financial Reporting format and planning. 3. Financial Report a. Monthly financial report for Nursing Home and Health and Human Services b. aged receivable report 4. Nursing Home Administrator's Report 5. * *Capital Outlay Proj ects - Health Center 6. Personnel Issues a. New employees /vacancies b. Positions delayed for consideration at County Board 7. State Budget Updates 8. Follow up on Business Plan for St. Croix Health Center 9. Multi - Systemic Therapy program report 10. Court Services for Parental Conflict Mediation 11. Budget Priority Planning 12. * *Public Health program report Breastfeeding and Postpartum home visits 13. * *Wisconsin Counties Association Regional Legislative Meeting 14. "Human Services Day at the Capital 15. * *Closed session per Wisconsin Statute 19.85 (1)(c) for Director's performance evaluation, reconvene in open session. 16. Possible agenda items for next meeting NOTE: A quorum of the St. Croix County Board of Supervisors (County Board) may be present at this meeting. Therefore, this notice also serves as notice of a meeting of the County Board for the purpose of obtaining information relating to subjects listed above for use at future County Board meetings. ADJOURN (Items may be taken in different order) Items for County Board approval must be submitted to the County Clerk's office by Wednesday morning preceding a County Board meeting. 3/10/2011 10:31 AM ** 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. 3/10/2011 10:31 AM ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD March 16, 2011 The St. Croix County Health and Human Services Board met on March 16, 2011 at the St. Croix County Health and Human Services/Health Center complex. MEMBERS PRESENT: Roger Larson, Vice Chair Leon Berenschot Frederick Horne Linda Luckey Deb Rasmussen Alfred Schrank MEMBERS ABSENT: Richard Marzolf, excused Dr. Lisa Ramsay, excused Esther Wentz, excused STAFF PRESENT: Fred Johnson, Health and Human Services Director Frank Robinson, Nursing Home Administrator Tonya Kusmirek, Financial Manager Ron Kiesler, Behavioral Health Coordinator Wendy Kramer, Public Health Officer/Public Health Coordinator Sharon Reyzer, Public Health Supervisor Ronda Brown - Anderson, Economic Support Supervisor Malva Sirek, Clerical Supervisor OTHERS PRESENT: Michelle Pietrick, Finance Director Daryl Standafer, County Board Chair Tammy Funk, Human Resource Coordinator Art Tobin, Building Services Director Kim Dupre, Information Systems Analyst Jeff Holmquist, New Richmond News Vice Chair Larson 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 Friday, April 8, 2011 at 8:30 AM. The following meeting is scheduled for Wednesday, April 20, 2011 at 8:30 AM. Rasmussen will review vouchers. AGENDA Motion A motion was introduced by Berenschot, seconded by Horne, and unanimously adopted: That the agenda be approved as distributed. MINUTES Motion A motion was introduced by Berenschot, seconded by Schrank, and St. Croix County Health and Human Services Board Page 2 March 16, 2011 unanimously adopted: That the minutes of the 02/16/11 and 02/25/11 Health and Human Services Board meetings be approved as distributed CONSIDERATION OF CLAIMS All check registers for February for funds 205, 225, 230, 600 and 625 were reviewed by Health and Human Services (HHS) Board member Larson. All questions were answered satisfactorily. Motion A motion was introduced by Larson, seconded by Rasmussen, and unanimously adopted: To approve the February vouchers. CAPITAL OUTLAY PROJECTS - HEALTH CENTER Tobin reported the Administration Committee reviewed the bid for the Nursing Home loading dock and asked that the project be re- bid. Tobin also reported that another capital outlay project is upgrading the lighting in the Nursing Home at an estimated cost of approximately $18,170. He indicated a Focus on Energy rebate is available for this project. Another capital outlay project approved for the Nursing Home is replacing the ceiling tile on the first floor of the Nursing Home at an approximate cost of $7,500. He hopes to have this project completed before the State survey. Tobin is also investigating upgrading the toilets in the Nursing Home at an approximate cost of $21,200. NURSING HOME ADMINISTRATOR'S REPORT Robinson said the average monthly census for January was 65 and February was 57, with 6 Medicare, 36 Medicaid, 12 private pay, and 1 insurance resident. The Medicare average daily rate paid was $527.40 for January and $543.27 for February compared to the budgeted amount of $485.00. Robinson said the nursing home ratings report was revised 02/01/2011 and St. Croix Health Center was once again rated as a 5 -star facility. Robinson reported St. Croix Health Center has been reported as one of the top 50 nursing homes in Wisconsin in the 2011 U.S. News and Reports article, which will be out shortly. The Nursing Home has been very successful in reducing the need for paper reporting and paper charts with the move towards electronic medical records. The Nursing Home electronic medical record system is ECS, which has reported the St. Croix Health Center facility ranks #2 in the Country for total usage of their system. Other facilities are now coming to St. Croix Health Center to view how we are utilizing the kiosk system. When State surveyors arrive this year, they will be looking at an electronic version of a chart rather than a paper chart. Robinson said no definite information has been received as far as proposed Medicaid cuts and provider rate adjustments. Johnson mentioned an article issued by Wisconsin Counties Association (WCA) and offered to make copies for Rasmussen, Berenschot, and Dr. Ramsay. The Budget Adjustment Bill is due to be published March 25, 2011 with implementation expected the first payroll after the bill is published. The change for the employee share of the Wisconsin Retirement (WRS) contribution to 5.8% and 6.65% for elected employees will impact the Nursing Home budget by approximately $188,000. St. Croix County Health and Human Services Board Page 3 March 16, 2011 FOLLOW UP ON BUSINESS PLAN FOR ST. CROIX HEALTH CENTER Johnson has had a conversation with Trent Fast, LarsonAllen, regarding updating the Nursing Home business plan with the adjustments for WRS contributions. One consideration discussed at the 02/25/11 meeting to make the business model sustainable without levy is adjustments in wage and fringe. Johnson questioned the County Board commitment to levy contribution for the Nursing Home. He indicated the number of beds for the Nursing Home has been reduced to 72, technology has been upgraded, and staffing to census ratio is monitored. Horne questioned if there were other areas where the Nursing Home could become more efficient. Robinson indicated all areas have been examined. Robinson indicated some reallocation of ward clerk time could be done due to moving towards electronic medical records. Robinson said improved coding and charting have helped improve revenue. Motion A motion was introduced by Horne, seconded by Berenschot, and unanimously adopted: That the Board approves requesting an updated Nursing Home business plan from LarsonAllen. Johnson questioned the Board's desire regarding County levy for the Nursing Home, to step down the levy over a certain number of years or to stop the levy abruptly. It was questioned what costs need to be allocated to maintain a sustainable business practice. Two business plans will be created adjusting primarily wage and fringe with one showing tax subsidies needed with the changes made because of the budget repair bill and another showing no tax subsidies. An updated business plan will assist the Board in making a recommendation on the Nursing Home to the Committee of the Whole. It was the consensus of the Board to hold a special meeting on 04/08/2011 at 8:30 AM to review the updated business plan of the Nursing Home to have a recommendation to the Committee of the Whole meeting on 04/14/2011. STATE BUDGET UPDATES Johnson distributed a powerpoint handout on the budget adjustment bill from February 22, 2011 and the 2011 -2013 State Biennial Budget from March 2, 2011. He highlighted the website listed http: / /www.phillipsborowski.com /budget - repair -bill- update/ as a good resource to get updated information regarding the bill and encouraged members to visit this site. Some items highlighted in the Biennial Budget are: • The possible consolidation of juvenile correctional institutes to keep rates at a more even level, which will reduce the cost to counties; • Possibly capping Family Care enrollment, which would appear to go back to the system that was in place before Long Term Care Reform which would include waiting lists; • 10% cut in Youth Aids allocation; • Income Maintenance (IM) centralization. Centralization issues for IM are very concerning as the current Enrollment Service Center (ESC) has not gone well. Preliminary numbers indicate the State is behind approximately 4,000 applications. The transition to centralized processing has been proposed to begin 07/01/2011 St. Croix County Health and Human Services Board Page 4 March 16, 2011 with the statewide change to be done by 05/2012. Per a Legislative Fiscal Bureau memo, ESC is the single largest source of the projected costs overruns for Medicaid administrative contracts. The State cannot take tax levy; however, they can reduce the Basic County Allocation (BCA) received from the State and this is part of the biennial budget proposal. Clients would need to apply primarily by phone or on -line, which is not feasible for many applicants /recipients without the knowledge and resources to apply in these manners. There are currently approximately 10,000 Medical Assistance recipients in St. Croix County and approximately 5,800 recipients on Food Share. Eliminating or reducing retroactive eligibility and presumptive eligibility are two additional cost saving measures that have been proposed that may have an impact on DHHS. Currently, Economic Support also serves as a resource referral source for clients to connect for services. This change will impact other Health and Human Services departments regarding services and ability to bill for services. If centralization is put in place and clients are not receiving timely and accurate benefits, and /or eligibility is reduced, clients will not have medical coverage and it would be expected that more clients would be on a sliding fee schedule. FINANCIAL REPORTING FORMAT AND PLANNING The auditors began the Nursing Home audit last week. The February financial format for the Nursing Home includes a column for accounts receivable billings to provide a more useful picture for the Board to make a decision regarding the Nursing Home based on what is truly in the billing system. Discussion has also included providing more than one month in the report so a history is provided with each report. The next step in the process for the reporting system is a focus on payables. The descriptions in the current report will be refined to make them more useful for the Board, which will be completed in May or June of this year. Other items being explored are setting a calendar to identify specific cut off dates so consistent dollars are reported each month and this will also be completed by finance in May or June of this year. Finance is also consolidating revenue in all five funds. Management met with the auditor to review account structure and this will be completed for a preliminary review at the April Board meeting. Consolidating expenses accounts will be completed in May or June, which is important as we will need this completed prior to opening the budget for 2012. Johnson distributed a sample financial report from Dunn County as this is a model that we are using as a guide. Standafer questioned if the current financial system is capable of creating a different report. The answer was no as the current system dumps information into an excel worksheet to create the report. We are not creating more work, just modifying the excel spreadsheet. FINANCIAL REPORTS The following financial report for Health and Human Services (HHS) through December, 2010 was distributed. HHS is still in the process of year -end reconciliations. Some additional revenue is expected for HHS. There is an overage in Economic Support expense due to one additional staff being added, overtime expenses and a temporary staff in Economic Support, which was expected. St. Croix County Health and Human Services Board Page 5 March 16, 2011 Health & Human Services - Fund 225 December 2010 as Uarch 4, 2011 Annual December Budget % of Revenue by Service Budget Actuals Balance Budget Administration $ 4,562,746 $ 5,061,506 $ 498,760 110.9% AODA Services 768,662 658,707 114,955 85.0% Mental Health 2,566,089 2,310,822 255,267 90.1% Family & Children's 1,635,999 1,240,749 395,250 75.8% Public Health 1,042,872 1,115,200 72,328 106.9% Economic Support 748,945 764,925 15,980 102.1 General Relief 3,000 - 3,000 0.0°1 Coordinated ServiceslSED 2,380,583 2,669,929 289,346 112.2% Car over Funds 1,049,211 1,049,211 - 100.0% Service Revenue $ 14,758,107 $ 14,866,051 $ 107,944 100.7°6 Annual December Bud et % of Expenditure by Service Budget Actuals Balance Budget Administration $ 1,236,281 $ 1,226,087 $ 10,194 99.2% Alcohol-Druq Abuse 768,662 726,558 42,104 94.5% Mental Health 3,702,935 3,362,937 339,998 90.8% Family &Children's 3,188,401 2,577,115 611,286 80.8% Public Health 2,035,641 2,032,023 3,618 99.8% Economic Support 1,020,270 1,196,980 176,710 117.3% General Relief 3,000 - 3,000 0.0°1 Coordinated ServicelSED 2,802,917 3,059,258 256,341 109.1% Service Expenditures $ 14,758,107 $ 14,180,958 $ 577,149 961% Revenues Over (Under) Expenditures $ 685,094 Expected Percent of Budget 100.096 2010 Figures are acrid during the Year End Closing Process The following financial report for Health and Human Services through February, 2011 was distributed. The State is not prepaying revenues as they did in the past. Now they are paying after the expenses are incurred. All of the levy has been applied. St. Croix County Health and Human Services Board Page 6 March 16, 2011 Health & Human Services - Fund 225 Febi 207 7 Annual Budget % of Revenue by Service Budget Cumulative Balance Budget Administration $ 5,724,119 $ 5,112,302 $ 611,817 89.3% AC DA Services 696,880 35,955 660,925 5.2% Mental Health 2,561,597 74,954 2,486,647 2.9% Family & Children's 1,501,658 45,599 1,456,069 3.0% Public Health 1,127,707 34,251 1 1,093,456 1 3.0% Economic Support 814,943 5,414 849,933 0.6% General Relief - - - 0.0% CoordinatedServiceslSED 3,644,247 2,481 3,641,726 0.1% Service Revenue $ 16,071,121 $ 5,310,546 $ 10,760,575 33.0% Annual 0 Budget % of Expenditure by Service Budget Cumulative Balance Budget Administration $ 1,337,434 $ 148,291 $ 1,188,743 11.1 % Alcohol-Druq Abuse 797,658 144,468 697,594 12.5% Mental Health 3,516,766 324,745 3,192,421 9.2% Family & Children's 3,039,817 257,175 2,782,642 8.5% Public Health 2,1 12,632 240,258 1,872,364 11.4% Economic Support 1,187,786 146,799 1,040,987 12.4% General Relief 1,544 544 1,444 33.3% Coordinated ServlcelSED 3,977,928 225,755 3,752,173 5.7% Service Expenditures $ 15,971,121 $ 1,443,601 $ 14,527,520 9.096 Revenues Over fUndet) Expenditures $ 3,866,945 Expected Percent of Budget 16.7% The following financial report for St. Croix Industries through December, 2010 was distributed. St. Croix Industries will be the next department to move to the updated financial report to provide projections after the Health Center is completed. St. Croix County Health and Human Services Board Page 7 March 16, 2011 St. Croix Industries - Fund 625 December 2040 as March 4, 2011 Annual December Budget % of Revenues Bud et Actuals Balance Bud et WS Operations $ 1,375,209 1 $ 1,465,566 90,357 106.6% WS Production 306,513 356,554 50,041 116.3% WS Helpinq Hands 86,500 144,441 57,941 167.0% WS Po Nendin 6,800 - 6,800 0.0% WS Ram 8,350 7,817 8,967 218.4% WS Vocational Placement 341,488 358,307 16,819 104.9% WS Comm Based Day Prog 197,730 109,475 88,255 55.4% Total Revenue 2,317,090 $ 2,441,660 124,570 105.496 Annual December Budget % of Expenditures Budget Actuals Balance Budget WS Operations $ 1,375,209 $ 1,216,070 $ 159,139 88.4% WS Production 306,513 385,738 79,225 125.8% WS Helpinq Hands 86,500 96,918 10,418 112.0% WS PopNendinq 6,300 247 5,053 3.9% WS Ram 3,350 3,758 408 112.2% WS Vocational Placement 341,488 318,980 22,508 93.4% WS Comm Based Day Prog 197,730 143,699 54,031 72.7% Total Expendituresl $ 2,317,090 1 1 $ 2,165,409 1 1 $ 151,661 1 1 93.596 Revenues Over(Under) Expenditures $ 276,251 Expected Percent of Budget 100.0% 2040 Figures are fluid during the Year End Closing Process The following financial report for St. Croix Industries through February, 2011 was distributed: St. Croix County Health and Human Services Board Page 8 March 16, 2011 St. Croix Industries - Fund 625 Febf Annual Budget % of Revenues Budget Cumulative Balance Bud et VAS Operations $ 1,496,000 $ 99,815 1,396,185 6.7% VAS Production 321,482 29,006 292,476 9.0% VAS Helpinq Hands 116,700 2,321 114,379 2.0% VAS PopNendinq 10,500 2,063 3,437 19.6% VAS Vocational Placement 365,500 18,843 346,652 5.2% WS Comm Based Day Prog 108,000 6,496 101,504 6.0% Total Revenue $ 2,418,182 $ 158,550 $ 2,259,632 6.6% Annual - Budget % of Expenditures Budget Cumulative Balance Budget VAS Operations 1,407,354 $ 147,623 1,260,231 10.5% WS Production 324,778 42,328 282,450 13.0% VAS Helpinq Hands 86,250 10,953 75,297 12.7% VAS PopNendinq 10,500 497 10,003 4.7% WS Vocational Placement 421,630 38,057 383,573 9.0% VAS Comm Based Day Proq 167,170 18,160 149,010 10.9% Total Expenditures $ 2,418,182 $ 257,617 $ 2,160,565 10.7% Revenues Ovef fonder) Expenditures $ 99,068 Exp ected Pefeent of Budg 16.7% The following financial report for the Nursing Home through December, 2010 was distributed. St. Croix County Health and Human Services Board Page 9 March 16, 2011 St. Croix Health Center - Fund 600 December 2010 as March 4, 2011 % of Operating Revenue: Budget Actuals Difference Budget Medicare $ 2,223,908 $ 1,417,391 $ 806,517 63.7% Medicaid 2,043,172 2,083,850 40,678 102.0% Private Pay 975,919 1,362,306 386,387 139.6% Revenue - IGPSupplemental Funds 469,000 742,420 273,420 158.3% Out Patient Thera - 19,896 19,896 0.0% All Other Sources 18,458 10,748.35 7,710 58.2% Total Operating Revenue $ 5,730,457 $ 5,636,611 $ 93,846 98.4% Operating Expenses Daily Patient Services $ 3,827,182 $ 3,954,114 $ 126,931 103.3% Special Services 287,498 278,547 8,951 96.9% General Services 1,239,492 1,200,640 38,852 96.9% Administrative Services 610,305 590,109 20,196 96.7% Sub Total $ 5,964,477 $ 6,023,410 $ (58,933) 101.0% Unassigned: De reciation % Based Others: Utilities $ 208,461 $ 126,546 $ 81,915 60.7% Workers Comp, Computer Tech 264,602 117,731 146,871 44.5% Insurance 55,000 74,119 19,119 134.8% Unassigned Sub Total $ 528,063 $ 31B,397 $ 209,666 60.3% Total Operating Expenses $ 6,492,540 $ 6,341,806 $ 150,734 97.7% Revenues Over Under Exp enditures from Operations $ ( 705,195) County Revenues insurance Dividend - unexpected revenue $ 9,160 $ 100,853 $ (91,693) 1101.0% Co Allocations - Le % Based 616,131 616,131 100.0% Nursinq Home Car Over 136,792 136,792 100.0% Total Outstanding $ 762,083 $ 853,776 $ (91,693) 112.03% venues 0ver(Undef) Expenditures Including CounP/ Con fribufions $ 148,581 Expected Percent of Budget 100.0% The following financial report for the Nursing Home through February, 2011 was distributed. St. Croix County Health and Human Services Board Page 10 March 16, 2011 St. Croix Health Center - Fund 600 February 2011 % of Operating Revenue: Budget Cumulative Difference Budget Medicare $ 1,646,150 $ 706 $1,645,444 0.0% Medicaid 2,178,532 - 2,178,532 0.0% Private Pay 1,548,651 - 1,548,651 0.0% Revenue - IGUSupplennental Funds 463,416 217,150 246,266 46.9% Out Patient Thera 20,000 - 20,000 0.0% All Other Sources 18,500 - 18,500 0.0% Cafe Revenue - 741 741 0.0% Total Operating Revenue $ 5,875,249 $ 218,597 $ 5,656,652 3.7% Operating Expenses Daily Patient Services $ 3,887,323 $ 432,260 $3,455,063 11.1% Special Services 277,387 35,825 241,562 12.9% General Services 1,259,760 139,833 1,119,927 11.1% Administrative Services 690,335 72,398 617,937 10.5% Cafe Expenses - - - 0.0% Sub Total $ 6,114,805 $ 680,316 $ 5,434,489 11.1% Unassigned: Others: Utilities $ 169,761 $ - $ 169,761 0.0% Workers Comp, Computer Tech 160,065 - 160,065 0.0% Insurance 55,000 19,465 35,535 35.4% Unassigned Sub Total $ 384,826 $ 19,465 $ 365,361 5.1% Total Operating Expenses $ 6,499,631 $ 699,781 $ 5,799,850 10.896 Revenues aver Under Exp endifures from O erafions $ [481,164] County Revenues insurance Dividend - unexpected revenue $ 9,000 $ - $ 9,000 0.0% Co Allocations- Le % Based 369,019 369,019 - 100.0% Nursinq Home Carry Over 246,363 246,363 - 100.0% Total Outstanding $ 624,382 $ 615,382 $ 9,000 98.56% venues 0ver(Under) Expenditures Including Co un ty Con trib ution s $ 134,198 Expected Percent of Budget__ 16.7% AGED HEALTH AND HUMAN SERVICES RECEIVABLES REPORT: The aging Accounts Receivable report for Health and Human Services through January was briefly reviewed. Previously accounts were written off collections once a year after they were moved out of the system. Now the accounts are written off when they are moved to collections to present a more realistic picture of the percent of collections. Johnson said if Medicaid is not available, more consumers will move to self -pay. The Board recessed from 10:40 - 10:47 AM. Horne left the meeting. PERSONNEL ISSUES NEW EMPLOYEES/VACANCIES Johnson reported Sara Sedahl started as AODA Counselor on 02/28/2011. Johnson reported there is one vacancy in Adult Community Support Services (ACSS), which was an employment agreement. Behavioral Health is exploring what can be done to offer more outreach St. Croix County Health and Human Services Board Page 11 March 16, 2011 services. There is no formal service model to present at this time regarding restructuring outreach and assessment services but more details will be ready for the April meeting. Kiesler said there is no definitive suicide assessment protocol that can perfectly predict suicide; however, anecdotally we know that suicide rates are low in individuals who are service connected. Kiesler said other Counties (WI and MN) are also experiencing the same upsurge in suicide. POSITIONS DELAYED FOR CONSIDERATION AT COUNTY BOARD Johnson said three vacant Nursing Home positions (CNA, evening RN supervisor, and food service worker) were delayed at the last County Board meeting until a more definite direction on the business plan for the Nursing Home can be determined. The vacant Economic Support position was also pulled as we awaited information on the biennial budget proposal. Johnson recommended temporary staff be brought in versus filling the position until the biennial budget is determined regarding centralization. Motion A motion was introduced by Schrank, seconded by Rasmussen, and unanimously adopted: That the Board approves contracting with MPS staff to support Economic Support staff until the biennial budget is determined. PUBLIC HEALTH PROGRAM REPORT BREASTFEEDING AND POSTPARTUM HOME VISITS In 2010 Public Health received 625 Postpartum/Newborn infant referrals. Of these 625 referrals, 185 women received at least one home visit from a Public Health Nurse (PHN) and 243 women received at least one telephone visit for support and education. Home visits are offered to all first time mothers, high risk infants and mothers and breastfeeding mothers as determined by the PHN. Efforts were made to assess breastfeeding initiation and duration rates. Breastfeeding duration improves when mothers can receive support early in the first two weeks when difficulties may arise. Heather Prigge, PHN, is currently working with Human Resources to provide breastfeeding mothers an area to pump or breastfeed at the Government Center and also at Health and Human Services. Johnson indicated the Public Health Accreditation Grant reported on last month has been awarded to Public Health for $12,000. MULTI- SYSTEMIC THERAPY (MST) PROGRAM REPORT Kiesler reported St. Croix County is the only agency (public or private) in the State of Wisconsin with a licensed MST Program. This program is also active in 35 other states and 9 other countries. St. Croix County is licensed to provide this service. St. Croix County's target population for this program is 12 -17 year olds who are at high risk for out of home placement. The program is approximately a 20 -week intensive in- home model of highly monitored therapy. This is a 24/7 program that includes weekend coverage. Studies are done at 6, 12, and 18 months to make sure changes continue to be effective. The goal of the program is to reduce out -of -home placements. The MST program has a very high degree of structure and accountability. There are currently two therapists with the program and seven open cases. There are eight cases on a waiting list. The program has a capacity of about 12 cases with two therapists. Due to the highly intensive nature of the work, not all can be in the start-up phase at the same time. It is anticipated anywhere from 24 to 30 cases a year will be involved in this program. There has been a significant St. Croix County Health and Human Services Board Page 12 March 16, 2011 support from HHS departments, St. Croix County schools and the Courts. This is important to make the program successful. This program is a pay for performance program for the therapists, where they do not get paid unless they produce positive results. Staff are also working to bill the Medicaid Waivers as another funding source for the program. COURT SERVICES FOR PARENTAL CONFLICT MEDIATION This item will be delayed to the April meeting. BUDGET PRIORITY PLANNING Johnson said that Health and Human Services is preparing priorities to provide services with the monies available to present to the Committee of the Whole meeting in April. Staff will report priorities by: • Mandated - -focus on language in State Statute. • Essential - -if HHS does not provide the service, we will pay costs elsewhere, not just within HHS, but also for other providers within St. Croix County. • Optional -- neither of the above. HHS does not have to do it and there is not an expected cost elsewhere within the County, but may have added costs to the State. Other items staff will consider are: • The county may not be mandated to provide a service, but what are the reasons why county delivered is preferred. • Will the county experience revenue loss if the county does not provide the service? • Does the county create dependence and limit its ability to contain cost for services if privatized? • A service may be mandated, but mandated to what level? • What is the impact to local consumers if St. Croix County does not provide the service? • Will waiting lists be created if some services are not provided or increase current waiting lists? • Is there statutory language or administrative rule that does not allow waiting lists? Johnson also has a meeting scheduled on 03/18/11 with Pete Kling, John Shilts, Tim Ramberg and Tammy Funk to develop a preliminary format for departments to review HHS managers will provide Johnson with feedback and budget priority planning will be placed on the April HHS agenda. WISCONSIN COUNTIES ASSOCIATION (WCA) REGIONAL LEGISLATIVE MEETING Johnson reported there is a WCA meeting on 03/17/11 that will focus on the budget. Johnson and Larson plan to attend the meeting and invited other Board members to attend also. Schrank indicated an interest in also attending. HUMAN SERVICES DAY AT THE CAPITAL Johnson reported Wisconsin Counties Association (WCA) and Wisconsin Counties Human Services Association (WCHSA) sponsored day at the Capital to address HHS issues is scheduled for 04/06/11. There will be talking points regarding biennial budget impact to discuss with legislators. Discussion will focus on anticipated St. Croix County Health and Human Services Board Page 13 March 16, 2011 local impact. It was the consensus of the Board that Johnson should attend on 04/06/11 and 04/07/11 and bring information back to the Board. CLOSED SESSION PER WISCONSIN STATUTES 19.85 (1)(C) FOR DIRECTOR'S PERFORMANCE EVALUATION. RECONVENE IN OPEN SESSION Motion A motion was introduced by Berenschot, seconded by Schrank that the Board enters into closed session per Wisconsin Statutes 19.85 (1) (c) for director's performance evaluation. Roll call vote: Esther Wentz- absent Leon Berenschot -yes Fredrick Horne- absent Roger Larson -yes Linda Luckey -yes Richard Marzolf - absent Alfred Schrank -yes Dr. Lisa Ramsay- absent Deb Rasmussen -yes Five yes, four absent, motion passed. The Board entered into closed session at 12:06 PM. Motion A motion was introduced by Berenschot, seconded by Schrank, and unanimously adopted: That the Board reconvene in open session after completing the Director's evaluation per Wisconsin Statutes 19.85 (1) (c). The Board reconvened in open session at 12:35 PM. POSSIBLE AGENDA ITEMS FOR NEXT MEETING • Court Services for Parental Conflict Mediation • Budget Priority Planning • Updated Business Plan for St. Croix Health Center Larson asked if there were any other issues to bring before the Board. Larson adjourned the meeting. Time: 12:37 PM Chair: Attest: (Secretary)