Loading...
HomeMy WebLinkAboutHealth and Human Services 11-20-06 Esther Wentz will review vouchers. REVISED - 11/15/06 NOTICE OF MEETING AND AGENDA ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD November 20, 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 - 10/19/06 DATE OF NEXT MEETING — 12/18/06 8:30 AM OLD AND NEW BUSINESS 1. Consideration of Claims and Vouchers 2. Financial Report 3. 2007 Routine Meeting Dates 4. Health and Human Services Governing Body By -laws Review 5. Mental Health/AODA Purchase Service Costs and Contracts ** 6. Nursing Home Report- Request for Proposal a. Health and Human Services Facility Planning ** 7. Surgeon General's Report Action 8. Family and Children's Purchase Service Costs 9. Economic Support Program Review ** 10. Public Health Program Report** a. Public Health Interim Pharmaceutical Stockpile Functional Exercise Report** b. Communicable Disease update ** 11. Personnel Issues a. Closed session pursuant to Wisconsin Statutes sec. 19.85(1) (f) considering financial, medical, social or personal histories or disciplinary data of specific persons. At the conclusion of the closed session, the board will reconvene in open session. 12. Long Term Support-Long Term Care Reform/ADRC 13. Closed session pursuant to Wisconsin Statutes sec. 19.85(1) (e) discussion of negotiation strategies with regard to union negotiations. At the conclusion of the closed session, the board will reconvene in open session. 14. Purchase of AED ** ADJOURN (Items may be taken in different order) ** Additions /Changes /Corrections Items for County Board approval must be submitted to the County Clerk's office by Wednesday morning preceding a County Board meeting. 11/15/2006 12:34 PM ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD November 20, 2006 The St. Croix County Health and Human Services Board met on November 20, 2006 at the St. Croix County Health and Human Services /Health Center complex. MEMBERS PRESENT: Esther Wentz, Chair Gordon Awsumb Lois Burri Tom Caflisch Linda Luckey Deb Rasmussen MEMBERS ABSENT: Dr. Michael Kretz, excused Ronald Troyer, excused Leon Berenschot, excused STAFF PRESENT: Fred Johnson, Health and Human Services Director Bill Van Offeren, Nursing Home Administrator Ron Lockwood, Long Term Support Coordinator Ron Kiesler, Mental Health /AODA Coordinator Steve Kirt, Mental Health /AODA Clinical Services Supervisor Kathy Dunlap, Family and Children's Coordinator Pat Haeny, Family and Children's Supervisor Malva Berg, Secretary OTHERS PRESENT: Buck Malick, County Board Chair Kjersti Duncan, Director, Department on Aging Rachel Dunn, UWRF student Beth Anez, UWRF student Dan Goodier, Christian Community Home Ruth Ann Richter, Christian Community Home Chair Wentz called the meeting to order at 8:35 AM noting the meeting was properly and legally publicized. ANNOUNCEMENTS NEXT MEETING The next Health and Human Services Board meeting is scheduled for Monday, December 18, 2006 at 8:30 AM. Rasmussen will review December vouchers. AGENDA Motion A motion was introduced by Rasmussen, seconded by Awsumb, and unanimously adopted: That the agenda be approved as circulated. MINUTES Motion A motion was introduced by Burri, seconded by Rasmussen, and unanimously adopted: That the minutes of the 10/19/06 Health and Human Services Board meeting approved as circulated. 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: St. Croix County Health and Human Services Board Page 2 November 20, 2006 Human Services vouchers 86690 through 86716, dated November 09, 2006 in the amount of $54,776.49. Human Services and Nursing Home vouchers 85991 through 86068, dated October 19, 2006 in the amount of $218,912.24. Human Services and Nursing Home vouchers 86069 through 86101, dated October 19, 2006 in the amount of $10,986.35. Human Services and Nursing Home vouchers 86140 through 86232, dated October 26, 2006 in the amount of $349,847.91. Human Services and Nursing Home vouchers 86419 through 86518, dated November 02, 2006 in the amount of $41,657.82. Human Services and Nursing Home vouchers 87363 through 87571, dated November 09, 2006 in the amount of $140,986.80. Human Services and Nursing Home vouchers 87156 through 87362, dated November 09, 2006 in the amount of $337,559.79. Nursing Home vouchers 87572 through 87605, dated November 09, 2006 in the amount of $35,095.10. Human Services, Workshop, Public Health, Social Services vouchers 591 through 620, dated October 17, 2006 in the amount of $347,833.82. Human Services, Workshop, Public Health, Social Services vouchers 621 through 652, dated November 01, 2006 in the amount of $356,290.07. Human Services and Nursing Home vouchers 648 through 679, dated October 19, 2006 in the amount of $145,049.93. Human Services and Nursing Home vouchers 680 through 711, dated November 02, 2006 in the amount of $145,982.93. Workshop vouchers 121 through 126, dated October 17, 2006 in the amount of $11,645.45. Workshop vouchers 127 through 132, dated November 01, 2006 in the amount of $12,919.20. LONG TERM SUPPORT -LONG TERM CARE REFORM /ADRC Lockwood lead a discussion on ADRCs (Aging and Disability Resource Centers) and reviewed a powerpoint presentation that highlighted roles and functions. The ADRC's at this point will be one -stop for information, assistance and help for adults. Some key services provided by the ADRC will include explanation of care options, prevention or postponement of public care and response to urgent care needs. Currently, the Department on Aging and the Department of Health and Human Services are working together on joint planning to develop an ADRC for St. Croix County. Strengths from both departments can be utilized to fill roles in the ADRC to meet the needs for St. Croix County adult residents. Veterans Services has been consulted as well to assist in service coordination. Much planning is still needed and a core group of staff representing both departments has developed a work group. As discussed in previous meetings, St. Croix County involvement in our local consortium planning for Long Term Care Reform is with the "Implementation A St. Croix County Health and Human Services Board Page 3 November 20, 2006 workgroup" which has focused efforts on a care management organization providing case management for long term care, acute and primary needs of eligible adults. This entity would receive the capitated rate for services and be the risk bearing entity should costs exceed the reimbursed rate for services. Access to the care management services would be provided by the county through the ADRC for those that meet both functional and financial eligibility screening. The ADRC must be running approximately two months prior to the care management organization, so St. Croix County will need to have this in place sooner as Implementation A (tentative) timelines are to request moving forward with Long Term Care Reform in early 2007. Caflisch suggested a special meeting just to discuss Long Term Care Reform as it is difficult to make a decision on this major issue. A joint meeting with Department on Aging Committee, Long Term Support Committee and Department of Health and Human Services Board is scheduled to be held December 13 from 1:00 to 2:30 in the community room at the Government Center to discuss Long Term Care Reform /ADRC. A meeting open to the general public regarding this matter will then be held from 3:00 to 4:30 after the joint meeting. PUBLIC HEALTH INTERIM PHARMACEUTICAL STOCKPILE (IPS)FUNCTIONAL EXERCISE REPORT The functional exercise took place on October 26, 2006. It went well and was an excellent experience for all participants. It took a lot of coordination to carry out and reinforced the need for coordinated efforts between county departments in order to successfully respond to public health emergencies. The Incident Command System was used and worked well. It was discovered more security and more floater positions were needed. Evaluators followed the exercise and commented St. Croix County's exercise was by far the best they had observed thus far. COMMUNICABLE DISEASE UPDATE Public Health received a report on 11/01/06 from an emergency room physician of a probable case of the mumps. Lab tests have not confirmed the diagnosis at this time. Public Health has followed up on the case. Staff have not been able to find the source to trace where the mumps came from. Sixty hours of staff time have been used to follow up on this case. The Board recessed from 10:00 to 10:15 AM. NURSING HOME REQUEST FOR PROPOSAL (RFP) : Dr. Kretz joined the meeting via conference call. A meeting regarding the RFP was held on 11/15/06. An issue that arose out of the 11/15 meeting was the need for Health and Human Services facility planning to be done in conjunction with the Nursing Home RFP. The Board reviewed the RFP. Caflisch expressed concern that the county not enter a partnership in which we would be in worse shape in five years than we are now. Questions of how far out does the surrounding county land go that would be considered in a proposal. Concern was expressed that the Health and Human Services Board not exceed their authority by including surrounding contiguous county land in the proposal and the proposal dropped the term undeveloped when referring to county land. Johnson did indicate that the DHHS facility needs did come up in strategic planning, but at this point strategic planning is just focusing on prioritization of issues raised. Johnson will address the facility issues at the next strategic planning workgroup, will address with the Administrative Coordinator and report back to the Board in December. This issue will be an agenda item at future meetings. St. Croix County Health and Human Services Board Page 4 November 20, 2006 Names and addresses to receive the Nursing Home RFP should be to Johnson by 11/27/06. The RFP will be posted on the County's website. An advertisement will go on the County Homes and for - profit homes websites. Suggestions were made to place in nursing home trade publications, American Health Care Association, Milwaukee, Madison, Twin City and Fox Valley newspapers and Wisconsin, Minnesota and Illinois real estate journals. Johnson indicated there are no funds allocated in the budget for advertising the Nursing Home RFP. It was the consensus of the Board advertising is a necessity to get positive results on the RFP. Funds will come out of the Nursing Home budget and if needed, a request to Finance can be made if there is not money at year end to cover costs. Motion A motion was introduced by Caflisch, seconded by Awsumb, and unanimously adopted: That the Board approves the RFP as amended and approves associated costs for advertising the RFP. Facility planning was further discussed. Kretz felt an in -depth assessment of the Health and Human Services facility needs should happen at the same time as the RFP process. This assessment would be an involved process with input needed from an architect and space planner to evaluate space. No funds have been designated in the budget for consultants/ studies. The Board requested preliminary information regarding possible consultants and approximate costs associated. Van Offeren reported the current Nursing Home census is 64. Van Offeren also reported on excess furniture in the basement of the Nursing Home. These items have been viewed by Dana Baker. Baker is working on disposal of this property. Malick left the meeting. The conference call with Kretz terminated. Mental Health /AODA Purchase Service Costs and Contracts Kiesler distributed a report indicating the status of purchase of service costs. He pointed out the credit of $59,889 for state institutes. With state institutes, the county is required to pay as the cost is incurred without taking into account possible insurance, Medicaid or Medicare coverage. If there is still a credit amount at year end, he will request a check be cut to St. Croix County for the remaining balance. Kiesler reported on a letter he received from Sacred Heart Hospital. Sacred Heart refuses to contract with St. Croix County even though St. Croix County wants to contract with Sacred Heart. Thus, St. Croix County has been paying Medical Assistance (MA) rates for any services Sacred Heart provides. Law enforcement determines where to bring emergency detention clients, not Health. and Human Services. The letter is demanding St. Croix County pay what was actually billed for services, not the MA rate. An example of the difference in costs, for one day of service the cost was $1,827.13 and the MA rate paid was $360.33. The response to Sacred Heart is to bill the client for the balance of the bill as St. Croix County will pay only MA rates. Johnson expressed concern for the long range status of contracting for services. Clinical issues have arisen with Miller Dwan. Kiesler outlined issues. Currently, staff are considering not re- contracting when the contract lapses at the end of December of 2006. Kiesler and Kirt gave an update on mobile crisis /diversion. They reported that of 102 opportunities, there were 61 contacts for mobile crisis, of the 61, 47 clients were diverted and only 14 clients were hospitalized. This is St. Croix County Health and Human Services Board Page 5 November 20, 2006 considered a great improvement. He said the Sheriff's Department has been working with mobile crisis 100% of the time. The Board congratulated Kiesler and Kirt on a good job working with mobile crisis /diversion. Family and Children's Purchase Service Costs A report on the status of Family and Children's purchase of service contracts was distributed to the Board. Dunlap reported purchase of services contracts currently have a positive balance. She credited Family and Children staff, mobile crisis and CFS (Coordinated Family Services) team for positively impacting this figure as they are excellent compliments to all services provided by Family and Children's and Mental Health. She indicated the SED budget will also be impacted due to less out of home placements. Dunlap reported on the YES program, which is a 12 -13 consortium of counties with the goal to keep children out of long term institutional placements and in community -based intervention. A monthly capitated rate is paid to YES and multiple services are provided at that cost, no matter what services are provided. Dunlap recently received notice of an award of $43,432 for CFS grant from the Office of Justice. Health and Human Services Governing Body By-laws Review Johnson reviewed some of the revisions made to the By -laws. Board members will review changes and address at the December meeting. 2007 Routine Meeting Dates Schedule of meeting dates for 2007 was distributed to members. One meeting per month will be held on the third Wednesday of the month with the exception of November, which will be the second Wednesday. Motion A motion was introduced by Caflisch, seconded by Burri, and unanimously adopted: That the Board approves the committee meeting dates for 2007 as presented. FINANCIAL REPORT Johnson distributed the following Nursing Home report for January through September. He reported 50% of IGT funds have been received and another payment is expected in December. Johnson indicated revenues are above projections due to pay source case mix but census has also been running lower than budgeted. St. Croix County Health and Human Services Board Page 6 November 20, 2006 ST C:ROIX HEALTH CENTER OPERATIONS REPORT Jan - Sept 2006 Jan - Sept 2006 BUDGET ACTUAL DIFFERENCE % CENSUS 66 64 1 OPERATING REVENUE: MEDICARE $ 629,623.05 $ 791,650.43 $ (162,027.38) 126 % MEDICAID $ 2,609,616.07 $ 1,486,408.55 $ 1 ,123,207.52 57`Yo PRIVATE PAY `` $ 547,475.00 $ 775,203.16 $ (227,728.16) 142% ALL OTHER SOURCES"*" $ 220,453.00 $ 195,969.11 $ 24,483.89 69% TRANSFER FROM CONTINGENCY $ - $ - $ - TOTAL OPERATING REVENUE $ 4 $ 3.244.231.25 $ 757 935.87 81% OPERATING EXPENSES: DAILY PATIENT SRVICES $ 3,3133.410.47 $ 2,486,690.53 $ 876,719.94 74% SPECIAL SERVICES $ 274,458.35 $ 181,319.96 $ 93,138.39 E,6% GENERAL SERVICES $ 1,169,758.41 $ 783,741.45 $ 386,016.96 67% ADMINISTRATIVE SERVICES $ 527,734.19 $ 467,048.29 $ 60,685.90 89% UNASSIGNED: $ - DEPRECIATION( %BASED) $ - $ - $ - $ 373,372.00 $ 373,37100 0% Utilities $ 99,250.93 Workers Comp, Computer Tech $ 191,283.12 Insurance $ 63,013.58 OTHER EXP: $ 356,434.49 TOTAL OPERATING EXPENSES $ 5,708,733.42 $ 4,275,234.72 $ 1,433,498.70 75% NET FROM OPERATIONS $ - $ (1.026.003.47) (COST OF DOING BUSINESS PRIOR TO APPLYING LEVY & OUTSTANDING REV) EXTRAORDINARY REVENUES OUTSTANDING RATE APPEAL REV $ 14,824.00 $ - $ 14 ,824.00 0% % OF OUTSTANDING IGT REV $ 377,000.00 $ 188,070.00 $ 188,930.00 50% CO ALLOCATI 0 N S(% BAS E D) $ 1,309,742.30 $ 979,155.00 $ 330,587.30 75% TOTAL OUTSTANDING $ 1,701,566.30 $ 1,167,225.00 $ 534,341.30 NET FROM ALL SOURCES $ 141,221.53 PERCENTAGE SHOULD BE 74.97% Potential Salary Increases: $16,856 - $54,567 annual projection St. Croix County Health and Human Services Board Page 7 November 20, 2006 Johnson distributed the following Health and Human Services financial report for January through September. HEALTH AND HUMAN SERVICES - 2006 SUMMARY Total OF REVENUES Budget Jan - September Balance % Administration 925,134.00 1,045,469,30 (123,335.30) 113.3% AODA. Services 649,146.01 500:475.14 140,670.87 78.3`.v Long Term Support 17,542,262.00 14,053,778.35 3,488.483.65 80.1% Mental Health 2,909,086.00 2:340:553.80 568,532.20 80.5,'::• Family & Children's 3.120,265.00 2,644,299.77 475,965.23 84.7%x. SED 216,000.00 300,693.25 (84,693.25) 139.2% Public Health 1,537,680.00 1,175 362,386.83 76.4% Economic Support 1,010,360.00 767,926.03 242,433.97 76.0% General Relief 15,000.00 11,287.00 3,713.00 75.2% Coordinated Services 260,403.00 120,237.08 140,165.92 46.2`> REVENUES HUMAN SERVICES PROGRAMS 28 185,336.01 22,971.012.89 5.214.32312 81 5% SUMMARY Total OF EXPENDITURES Budget Jan - September Balance % Administration 925,134.00 733,434.67 191,699.33 79.3% Alcohol -Drug Abuse 649,146.01 502,002.44 147,143.57 77.3 "•L. Long Term Support 17,542,262.00 12,753,868.41 4,788,.393.59 72.7`.:, Mental Health 2,909,086.00 2,199,982.91 709,103.09 75.6% Family & Children's 3,120,265.00 2,168,638.83 951,626.17 69.5% SE 216.000.00 102,254.00 113.746.00 47.3% Public Health 1,537,680.00 1,137,690.45 399,989.55 74.0 Economic Support 11010,360.00 753,189.78 257,170.22 74.5`t, General Relief 15,000.00 500.00 14,500.00 3.3% Coordinated Services 260,403.00 114,323.85 146,079.15 43.9",: EXPENDITURES HUMAN SERVICES PROGRAMS 28,185,336.01 20,465,885.34 7,719,450.67 72.6% Excess Rev over Expenses S 2.505.127.55 Percentage of Budget: 74.97 `WIMCR revenues recorded $ 2:505.127.55 Revenues above include state advances Jan -Aug 06 $ 2,505,127.55 Purchase of AED (Automated External Defibrillator : Johnson reported the Safety and Security Committee has been reviewing policies and procedures. One need identified was a need for a second AED for the Health and Human Services building. The one AED in the building has been relocated to the first floor lounge near the nurses' station in the Nursing Home. Shawn Demulling from the Sheriff's Department has located a refurbished unit similar to the unit we currently have for approximately $1,500. This item is not specifically identified for purchase in the budget but Johnson recommends purchasing out of administration funds. St. Croix County Health and Human Services Board Page 8 November 20, 2006 Motion A motion was introduced by Caflisch, seconded by Burri, and unanimously adopted: That the Board approves purchasing an AED for approximately $1,500. SURGEON GENERAL'S REPORT ACTION This item will be delayed as the resolution is not completed. PERSONNEL ISSUES Johnson announced two new hires. Susan Morrow has been hired in Family and Children's as a Social Worker. Carl Gaede has been hired as a Mental Health Therapist. Johnson presented two new job descriptions which were developed after some reorganization in the Nursing Home. Previously there were two administrative nurses, one on each floor. The proposal is to move to one nurse manager and one MDS /staff education nurse. He said the job descriptions and reorganization would be budget neutral; however, the job descriptions would have a new job title and updated duties. He said the positions would most likely be filled by people already on staff. The job descriptions, if approved, would need to be forward for Springsted evaluation. Motion A motion was introduced by Awsumb, seconded by Rasmussen, and unanimously adopted: That the Board approves the two new job descriptions as presented and that the job descriptions be forward for Springsted evaluation. Motion A motion was introduced by Caflisch, seconded by Awsumb, That the Board enter closed session per Wisconsin Statute 19.85 (1) (f) - considering financial, medical, social or personal histories or disciplinary data of specific persons and per Wisconsin Statutes sec. 19.85(1) (e) discussion of negotiation strategies with regard to union negotiations. Roll call vote: Esther Wentz -yes Gordon Awsumb -yes Leon Berenschot- absent Lois Burri -yes Tom Caflisch -yes Dr. Kretz- absent Linda Luckey -yes Deb Rasmussen -yes Ronald Troyer- absent Six yes, three absent, motion passed. The Board entered closed session at 12:40 PM. Motion A motion was introduced by Burri, seconded by Rasmussen, and unanimously adopted: That the Board reconvene into open session per Wisconsin Statute 19.85 (2). Motion A motion was introduced by Caflisch, seconded by Awsumb, and unanimously adopted: That the Board approve the request for a medical leave of absence for up to one year as requested by a county employee. Wentz asked if there were any other issues to bring before the Board. St. Croix County Health and Human Services Board Page 9 November 20, 2006 Wentz adjourned the meeting. Time: 1:12 PM Chair: Attest: (Secretary)