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HomeMy WebLinkAboutHealth and Human Services 07-19-06 NOTICE OF MEETING AND AGENDA ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD July 19, 2006 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 - 06/13/06 DATE OF NEXT MEETING — 08121106 8.30 AM OLD AND NEW BUSINESS 1. Consideration of Claims and Vouchers 2. Financial Report 3. Program reports a. Nursing Home Report b. Family and Children's Services Report 4. Personnel Issues a. Springsted update 5. Long Term Support-Long Term Care Reform Consortium 6. Public Health a. Kim Miner - Epidemiologist report b. St. Croix Co. Public Health presentation at National Conference c. Preparedness activities update d. Surgeon's General report ** 7. Nursing Home/Health and Human Services Audit Report 8. Health and Human Services Governing Body By -laws Review 9. Capital Outlay 10. Barn/farm lease update 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. 7/11/2006 1:56 PM ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD July 19, 2006 The St. Croix County Health and Human Services Board met on July 19, 2006 at the St. Croix County Health and Human Services /Health Center complex. MEMBERS PRESENT: Esther Wentz, Chair Leon Berenschot Lois Burri Tom Caflisch Bill Cranmer Dr. Michael Kretz Linda Luckey Deb Rasmussen MEMBERS ABSENT: Ronald Troyer STAFF PRESENT: Fred Johnson, Health and Human Services Director Jennifer Pempek, Accountant /Fiscal Manager Barbara Nelson, Public Health Supervisor - Health Officer Bill Van Offeren, Nursing Home Administrator Kathy Dunlap, Family and Children's- Coordinator Malva Berg, Secretary OTHERS PRESENT: Michelle Pietrick, Finance Director Kim Miner, Epidemiologist, Western Region Partnership for Public. Health Preparedness (WRPPHP) Steve Tracey, Tracey and Thole 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 Monday, August 21, 2006 at 8:30 AM. Dr. Kretz will review August 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 Kretz, seconded by Rasmussen, and unanimously adopted: That the minutes of the 06/13/06 Health and Human Services Board meeting and Open Budget Hearing be approved. Dr. Kretz indicated consumers who gave testimony and sent letters should be named. All correspondence read is a part of the minutes and is included in the minute book only. CONSIDERATION OF CLAIMS Health and Human Services Board member Rasmussen reviewed the vouchers. Motion A motion was introduced by Rasmussen, 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 77121, dated June 09, 2006 in the amount of $1,220.00. Human Services vouchers 77251, dated June 15, 2006 in the amount of $148,707.22. St. Croix County Health and Human Services Board Page 2 July 19, 2006 Human Services vouchers 77572 through 77578, dated June 22, 2006 in the amount of $30,337.45. Human Services vouchers 78594 through 78628, dated July 06, 2006 in the amount of $51,683.15. Human Services vouchers 78630 through 78828, dated July 13, 2006 in the amount of $154,912.82. Human Services vouchers 78829 through 79008, dated July 13, 2006 in the amount of $126,614.10. Human Services and Nursing Home vouchers 77129 through 77225, dated June 15, 2006 in the amount of $124,620.08. Human Services and Nursing Home vouchers 77226 through 77250, dated June 15, 2006 in the amount of $17,017.31. Human Services and Nursing Home vouchers 77454 through 77571, dated June 22, 2006 in the amount of $260,105.67. Hu�nati Services and--Nursing Home vouchers 77743 through - 7785 - 71 -- da-t -ed June -2 - 2006 in the amount-of $340,102.67. Human Services and,_Nursing Home vouchers 78149 through 78197, dated July 06, 2006 in the amount of -$160,830.57. Nursing Home voucher 77251, dated June 15, 2006 in the amount of $394.00. Nursing Home vouchers 79009 through 79077, dated July 13, 2006 in the amount of $41,523.08. Human Services, Workshop, Public Health, Social Services vouchers 352 through 381, dated April 18, 2006 in the amount of $353,716.77. Human Services, Workshop, Public Health, Social Services vouchers 382 through 402, dated May 02, 2006 in the amount of $308,768.21. Human Services, Workshop, Public Health, Social Services vouchers 403 through 434, dated April 18, 2006 in the amount of $354,102.39. Human Services and Nursing Home vouchers 360 through 391, dated April 20, 2006 in the amount of $171,496.14. Human Services and Nursing Home vouchers 392 through 414, dated May 02, 2006 in the amount of $136,904.45. Human Services and Nursing Home vouchers 415 through 446, dated April 20, 2006 in the amount of $163,774.28. Workshop vouchers 67 through 72, dated April 18, 2006 in the amount of $11,751.24. Workshop vouchers 73 through 78, dated May 02, 2006 in the amount of $11,823.22. Workshop vouchers 79 through 84, dated April 18, 2006 in the amount of $12,399.21. St. Croix County Health and Human Services Board Page 3 July 19, 2006 NURSING HOME /HEALTH AND HUMAN SERVICES AUDIT REPORT Steve Tracey, Tracey and Thole, distributed audit reports for the Nursing Home and Health and Human Services. He described the Nursing Home as an enterprise account, which runs similar to a private business. The report consists of three parts, net assets (or balance sheet), income statement and cash flow. He said there is little change from 2004 to 2005 in the state of revenue and expenditure changes. IGT (or ITP) funds have been declining over past years and hopes are that the funds will stabilize soon. The Board moved money last year to cover DHHS deficit as well as moving money to the general fund, so the decision was made to utilize the general fund for working capital. Depreciation is not shown in the operation numbers but capital expenditures will need to be broken out. Improvement is needed in capital asset records so they can be moved on at a year -end basis. Accounts Receivable in the Nursing Home are at a similar level to accounts receivable in 2004. Tracey described Health and Human Services as a special revenue fund. Assets in excess of $5,000 are capitalized and depreciated for State reporting reasons. The fund balance at the beginning of 2005 was (- $360,000) and it was $898,371 at the end of 2005. Mental Health inpatient purchased services were less in 2005 than in 2004 due to fewer placements. There was an increase in WIMCR monies received _in 2005. A portion of the WIMCR dollars were budgeted in._ the -.2006-budget- a.nd will be transferred to 2006 budget. Tracey indicated_._._ _ _ - improvement is needed in Accounts Receivable and balances that are being carried on the books. Updates to - the ECHO program may improve this issue, but more work needs to be done with Accounts Receivable and Administration will continue to work on issues and update the Board on status. The Board recessed from 9:40 to 9:50 AM. SPRINGSTED UPDATE Johnson said the administrative workgroup has met several times regarding Springsted. Job descriptions were updated and reviewed by managers. Pointing was reviewed by managers and another meeting is scheduled for July 31 Springsted is a work in progress. Springsted overview will be added as an agenda item to the August meeting to update Board members. PUBLIC HEALTH The Health and Human Services Board presented Barbara Nelson with a plaque in recognition of her years of dedicated service in St. Croix County. KIM MINER - EPIDEMIOLOGIST REPORT Kim Miner, Epidemiologist, Western Region Partnership for Public Health Preparedness (WRPPHP) gave a presentation on communicable disease and WEDSS (WI Electronic Disease Surveillance System), an electronic program on communicable disease reporting. Miner is part of a nine - county consortium and studies diseases and what causes diseases. St. Croix County Public Health will go to electronic reporting /tracking on communicable diseases in January of 2007. She indicated outbreaks are unpredictable as to when and what the disease will be. Miner distributed estimates of the potential impact of the next influenza pandemic in St. Croix County for either a moderate scenario or severe scenario. Cranmer felt these statistics should be conveyed at a County Board meeting along with a brief explanation to the Board. Nelson indicated budget estimates to go along with severe scenarios are difficult to calculate. In severe scenarios there is much dependence on volunteers. Nelson distributed an organizational structure chart for the Division of Public Health from March, 2006 defining all the areas Public Health covers. St. Croix County Health and Human Services Board Page 4 July 19, 2006 Nelson distributed a letter from NALBOH regarding the 14th annual conference on July 26 -28 and informed Board members she has access to the by -laws if any Board members want to review. PREPAREDNESS ACTIVITIES UPDATE Nelson indicated preparedness continues to consume staff time. Numerous trainings are being mandated for the county's compliance with NIMS (National Incident Management System) and for Public Health's grant requirements. A pandemic influenza tabletop exercise is scheduled for August 29 for Health and Human Services staff and some outside community members. COMMUNICABLE DISEASES Nelson updated the Board on the 2006 data on West Nile Virus and provided DHFS website information. There have been three confirmed cases of West Nile Virus in birds (avian) in St. Croix County in 2006 thus additional testing ceases. Reports on dead birds can still be done through the toll free hotline or the health dept. There were 251 confirmed cases and 415 probable cases of mumps between March and June, statewide with no confirmed cases in St. Croix County. Nelson said there is a measles surveillance nationwide due to an outbreak of measles in Boston and in Germany at the World Tournament. Nelson educated_ the Board on blastomycosis, an uncommon but potentially serious fungal infection that primarily affects the lungs and skin. Nelson also distributed information on the'Wisconsin Department of Health and Family Services website which may be accessed to obtain more information regarding public health. SURGEON GENERAL'S REPORT A Surgeon's General report was issued which concludes there is no risk -free level of exposure to secondhand smoke. Secondhand smoke causes health problems and the only way to protect non- smokers from the dangerous chemicals in secondhand smoke is to eliminate smoking indoors. Nelson urged the Board consider their statutory "powers and duties under (251.04)...(7) A local board of health shall assure that measures are taken to provide an environment in which individuals can be healthy." Dr. Kretz distributed potential specific responses the Board could act on regarding the Surgeon General's report. This issue will be added as an agenda item on the August agenda. The Legislative Event for 07/24 has been cancelled. The next event is scheduled for October 16 from 9:00 to 11:00 AM. FINANCIAL REPORT Pempek distributed the following Health and Human Services financial report for January through May. Pempek reminded the Board that some of Family and Children's costs are a month behind. Motion A motion was introduced by Berenschot, seconded by Rasmussen, and unanimously adopted: That the Board approve moving $898,371 carryover monies from 2005 to 2006 Health and Human Services budget. The breakout of those dollars is as follows: $390,000 WIMCR, $264,000 WIMCR, $344,371 program carryover for a total of $898,371. St. Croix County Health and Human Services Board Page 5 July 19, 2006 HEALTH AND HUMAN SERVICES - 2006 SUMMARY Total OF REVENUES Budget Jan -May Balance % Administration 925,134.00 885,567.80 39,566.20 95.7% AODA Services 649,146.01 280,670.24 368.475.77 43.2% Long Term Support 17,542,262.00 9,181,209.83 8,361,052.17 52.3% Mental Health 2,909,D85.00 1,534,190.71 1,374,895.29 52.7% Family & Children's 3,129,265.00 1,924,013.50 1,196.251.50 61.7% SED 216,000.00 238,189.48 (22,189.48) 110.3% Public Health 1,537,680.00 624,168.92 913,511.08 40.6% Economic Support 1,010,360.00 561,030.69 449,329.31 55.5% General Relief 15,000.00 6,287.00 8,713.00 41.9% Coordinated Services 260,403.00 91,757.56 168,645.44 35.2% REVENUES HUMAN SERVICES PROGRAMS 28.185.336.01 15.327.085.73 12.858.250.28 54.4% SUMMARY Total OF EXPENDITURES Budget Jan - May Balance % - Administration 925,134.00 422;963.92 502,170.06 45.7% Alcohol -Drug Abuse 649,146.01 - - 258,135.68 _ 391,Q19.83 39.8/0 Long Term Support 17,542,262.00 6,792,183.29 10,750,078.71 38.7% Mental Health 2,909,086.00 1,138,617.96 1,77DA68.04 391% Family & Children's 3,120,265.00 1,199,823.16 1,920,441.84 38.5% SED 216.000.00 14:271.00 201,729.00 6_6% Public Health 1.537,689.013 619,526.35 918,153.65 40.3% Economic Support 1,010,360.00 424,712.81 585,647.19 42.0% General Relief 15,000.00 2,708.28 12,291.72 18.1% Coordinated Services 260,403.00 67,927.72 192,475.28 26.1% EXPENDITURES HUMAN SERVICES PROGRAMS 28,185,336.01 10,940,870.17 17,244,465.84 38.8% Excess Rev over Expenses S 4386.215.56 Percentage of Budget: 41.65 ""WIMCR revenues recorded $ 4,386,215.56 Revenues above include state advances Jan - May 06 $ 4,386,215.56 Pempek distributed to following Nursing Home report for January through May. A worker's comp assignment is reflected in this report. IGT monies received in December, 2005 were applied to 2005 but were designated as 2005 -2006 monies. No IGT monies were received the first six months of 2006 but $95,000 was received in July. Pempek recommended a portion of the December, 2005 IGT monies be moved forward to 2006 as carryover monies Motion A motion was introduced by Caflisch, seconded by Berenschot, and unanimously adopted: That the Board approve moving $102,000 (IGT monies) carryover monies from 2005 Nursing Home close out to the 2006 Nursing Home budget. St. Croix County Health and Human Services Board Page 6 July 19, 2006 ST CROIX HEALTH CENTER OPERATIONS REPORT Jan - May 2006 Jail - _.._ 2006 BUDGET ACTUAL DIFFERENCE % PPD CENSUS 66 W 2, OPERATING REVENUE: MEDICARE $ 629,623.05 $ 442,901.78 $ 186,721.27. TOW 4.46 MEDICAID $ 2,609,616 $ 908,589.51 $ 1,701,026.56 35%. 9.15 PRIVATE PAY `` $ 547,475.00 $ 348,785.00 $ 198,690.00 64% 3.51 RATE APPEALS - ACTUAL 14,824.00 _$ -. $ _._.._. 14,B24.00 • 0% IGT FUNDS - ACTUAL $ 377,000.00. $ - $ 377,000.00 _.,..._ . ALL OTHER SOURCES`** $ 220,453.00: $ 103,425.13: $ 117,027.87 47%% 1.04 TRANSFER FROM CONTINGENCY $ - $ - 0 TOTAL OPERATING, REVENUE $ 4,396,991.12 1,003,701.42: $ 2,595,289.70 41W 18.16 ~ OPERATING EXPENSES: 'DAILY PATIENT SRVICES $ 3,363,410.47 $ $ 2,019,582.82 40W 13.54 SPEC IAL - SERVICES $ 274,458.35 _ $ 103,932.26 GENERAL SERVICES $ 1,169,758.41 .$ 495,764.21. $ 673,994.20 42% 4.99 ADMINISTRATIVE SERVICES $ 527,734.,19. $ 210,412.56 $ 317,321 ..: _ ; UNASSIGNED: $ _ . 0.00 DEPRECIATIONMASED �, -_....$........ .. '._... ..:, �.....__ 0 . 00 _._..__' - OTHERS: (INS-WC- CAP ITAL-UTIQ $ 373,372.00 $ 304,929.12 $ 66,442.86 82%4 3.07 TOTAL OPERATING EXPENSES $ 5,708,733.42 2,458,865.80 $ 3, 249,867.62 _ 43% w 24.77 NET FROM OPERATIONS $. __.. - $ (655,164.38) (COST OF DOING BUSINESS PRIOR TO APPLYING LEVY a OUTSTANDING REV) EXTRAORDINARY REVENUES OUTSTANDING RATE APPEAL REV $ 14,824.00 $ - $ 14,824.00. 0% % OF OUTSTANDING IGT REV $ 377,000.00 $ - $ 377 ,000.00 ; 0% CO ALLOCATIONS( %BASED) : $ 1 ,309,742.30 ' $ 545,725.95 $ 764,016.35 42%-: TOTAL OUTSTANDING $ 1,701,566.30 ; $ 545,725.95 $ 1,155,840.35 i .. _... . NET FR6M ALL S06kCESM "...... _._4 $ 0 4 PERCENTAGE SHOULD BE 41.65 Pote ntial Salary (licf eases ._.__ : __.__._ u _ $16.856 - $50,567 annual projection; Unassigned includes WOFkers Comp: $190,000_ ..._.___..._.. _..._.. ,___.____..._._ Finance will be notified of both of these transfers. NURSING HOME The Nursing Home subcommittee compared the average per patient day (PPD) for the last six months of 2005 to the first six months of 2006. The projected savings are significantly lower than the WIPFLI estimate as the St. Croix County Health and Human Services Board Page 7 July 19, 2006 WIPFLI estimate is for a full year and the projected savings used is for six months given implementation timing. If annualized, the savings would be very close to the WIPFLI estimates. No reductions were needed in housekeeping and laundry. Discussions are continuing with maintenance and staffing levels in activities are being reviewed. The remaining departments were fully implemented as of June, 2006. Maintenance will have one maintenance person in the Nursing Home as a three to four week pilot. Roles and responsibilities of maintenance will be clarified and addressed as a 2007 staffing /budget issue. The current case mix does not discriminate based on level of care or pay source. Screening reviews if the resident's needs can be met in the Nursing Home. The Nursing Home cannot discriminate admissions on pay type. All WIPFLI recommendations have been fully implemented. Staff continue to assess that all departments are operating effectively and efficiently without jeopardizing the care to residents. All department heads in the Nursing Home have received training in PPD scheduling and benchmarks and are able to monitor costs within their respective departments daily. Staff will work on continued efficiencies. More training on MDS will take place on August 2, 2006 with another training to occur later. Efforts will continue to maximize Medicare reimbursement and MDS reimbursement. Issues will continue to be brought to the Board. - - -- - Van Offeren reported that one of the cites went from a Level - D to a G. The State has verified we are doing what we are supposed to do. This is a Class B cite with a possible forfeiture of up to $5,000 per day. There is an option - to appeal the cite. Nothing-more -has been received and staff will continue to update the Board as information is received. The Nursing Home uses the Kronos system for payroll. With updates, this system could be used for scheduling which would cut staff time and make the payroll and staffing more efficient. The cost of this update is approximately $14,900 and would include multi -user training. This update is not budgeted as a specific line item but is a crucial item for the Nursing Home. Motion A motion was introduced by Caflisch, seconded by Burri, and unanimously adopted: That the Board approves purchasing the update for Kronos at a cost not to exceed $14,900. Wentz will notify Finance of the above purchase. Luckey questioned giving a full report regarding the Nursing Home to the County Board in August. It was the consensus the report should be delayed until September. FAMILY AND CHILDREN'S SERVICES REPORT Dunlap reported there are currently 27 children in placement, which does not include children in Kinship Care. As a comparison, Eau Claire County, which is similar in size to St. Croix County, has over 150 children in out of home care. Staff work hard to keep kids at home. In a recent state audit staff were highly commended for the positive numbers and results of fewer out of home placements. Dunlap said Coordinated Family Services (CFS) has been developed as a partnership with the schools. Families and other significant people in the child's life are also included in the program. St. Croix County is the only county that has developed this program as a partnership with the schools. St. Croix County Health and Human Services Board Page 8 July 19, 2006 LONG TERM SUPPORT -LONG TERM CARE REFORM CONSORTIUM Johnson said the consortium will hold a meeting tomorrow and he will have more updates after that meeting. There has been no new information and implementation has been put on hold at this time due to funding questions. CAPITAL OUTLAY Board members were given copies of the capital outlay plan. He indicated the telephone system numbers may change. The current plan includes a $50,000 upgrade. After further evaluation, the cost may be closer to $200,000 to get a system to meet our needs. Johnson requested consulting with Elert and Associates to get a full evaluation of our phone system and what direction should be taken to update it. Motion A motion was introduced by Kretz, seconded by Burri, and unanimously adopted: That the Board approves contracting with Elert and Associates at a cost of $3,600 to study and evaluate our phone system needs. Johnson will forward capital outlay plan to Whiting with a note regarding the phone system. HEALTH AND HUMAN SERVICES GOVERNING BODY BY -LAWS REVIEW Will be delayed until the August - meeting. BARN /FARM LEASE UPDATE Johnson announced closing out of the barn lease with Van Dyk is not going quickly. He indicated the pit is full of manure and the RFP did not include draining the pit. He also indicated the new leaser is requesting a change in how maintenance costs are handled so increase from the - barn lease .could be reduced. Cost for draining the pit is not known at this time. The leaser is proposing the leaser pay for repairs up to $100 and after the $100 all repairs be 50/50 split. Caflisch said the barn should be torn down. Johnson will continue to work on the lease transition. Wentz asked if there were any other issues to bring before the Board. Wentz announced the annual Nursing Home picnic is scheduled for Thursday, July 27 at 5:00 PM. She said there is also a basket social with over 75 baskets being offered for silent auction bids. She encouraged all Board members to attend. Wentz adjourned the meeting. Time: 1:05 PM Chair: Attest: (Secretary)