HomeMy WebLinkAboutHealth and Human Services 12-18-06 .
Revised 12/11/06
NOTICE OF MEETING AND AGENDA
ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD
December 18, 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 - 11/20/06
DATE OF NEXT MEETING — 01/17/07
OLD AND NEW BUSINESS
1. Consideration of Claims and Vouchers
2. Financial Report
a. Update on Auditor report
3. Health and Human Services Governing Body By -laws Review
4. Updated Job Descriptions
5. Program Reports
a. Nursing Home RFP and Program Report
b. St. Croix Industries Program Report
c. Health and Human Services Facility Planning **
6. Long Term Support-Long Term Care Reform/ADRC
7. Resolution in Response to Surgeon General's Report
8. Economic Support Program Review
9. Farm Land Lease
10. Animal Shelter
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. **
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.
12/11/2006 7:53 AM
ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD
December 18, 2006
The St. Croix County Health and Human Services Board met on December 18, 2006
at the St. Croix County Health and Human Services /Health Center complex.
MEMBERS PRESENT: Gordon Awsumb
Leon Berenschot
Lois Burri
Tom Caflisch
Dr. Michael Kretz
Linda Luckey
Deb Rasmussen
MEMBERS ABSENT: Ronald Troyer, excused
Esther Wentz, excused
STAFF PRESENT: Fred Johnson, Health and Human Services Director
Jennifer Pempek, Accountant /Fiscal Manager
Bill Van Offeren, Nursing Home Administrator
Ron Lockwood, Long Term Support Coordinator
Steve Kirt, Mental Health /AODA Clinical Services Supervisor
Ron Eichstaedt, Director, St. Croix Industries
Geralyn Karl, Public Health
Charlotte Sortedahl, Public Health Coordinator
Malva Berg, Secretary
OTHERS PRESENT: Kjersti Duncan, Director, Department on Aging
Sharon Elliot, St. Croix Animal Friends
Vice Chair Berenschot called the meeting to order at 8:30 AM noting the
meeting was properly and legally publicized.
ANNOUNCEMENTS
NEXT MEETING The next Health and Human Services Board meeting is scheduled
for Wednesday, January 17, 2007 at 8:30 AM. Berenschot will review December
vouchers.
AGENDA Motion A motion was introduced by Caflisch, seconded by Burri, and
unanimously adopted: That the agenda be approved as circulated.
MINUTES Motion A motion was introduced by Caflisch, seconded by Burri,
and unanimously adopted: That the minutes of the 11/20/06 Health and Human
Services Board meeting approved as circulated.
Dr. Kretz brought up a concern regarding the October minutes regarding
information reported on Larry Lester's presentation. He will contact Larry
Lester and bring back amended wording at a future meeting.
CONSIDERATION OF CLAIMS Health and Human Services Board member Rasmussen
reviewed the vouchers.
Motion A motion was introduced by Rasmussen, seconded by Dr. Kretz, 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
December 18, 2006
Human Services voucher 87899, dated November 10, 2006 in the amount of
$1,140.00.
Human Services vouchers 88324 through 88328, dated November 10, 2006 in the
amount of $38,258.56.
Human Services vouchers 89131 through 89157, dated December 06, 2006 in the
amount of $50,592.83.
Human Services and Nursing Home vouchers 87903 through 88004, dated November
10, 2006 in the amount of $104,816.40.
Human Services and Nursing Home vouchers 88005 through 88039, dated November
10, 2006 in the amount of $14,001.71.
Human Services and Nursing Home vouchers 88330 through 88434, dated November
21, 2006 in the amount of $222,087.64.
Human Services and Nursing Home vouchers 88503 through 88620, dated November
29, 2006 in the amount of $344,877.37.
Human Services and Nursing Home vouchers 88943 through 89094, dated December
06, 2006 in the amount of $78,307.45.
Human Services and Nursing Home vouchers 88838 through 88942, dated December
06, 2006 in the amount of $244,927.01.
Human Services and Nursing Home vouchers 89745 through 89847, dated December
13, 2006 in the amount of $245,853.74.
Human Services and Nursing Home vouchers 89888 through 90002, dated December
13, 2006 in the amount of $196,940.47.
Nursing Home vouchers 88836 through 88837, dated December 06, 2006 in the
amount of $532.44.
Nursing Home vouchers 89095 through 89130, dated December 06, 2006 in the
amount of $17,617.04.
Nursing Home vouchers 89848 through 89887, dated December 13, 2006 in the
amount of $26,165.95.
Human Services, Workshop, Public Health, Social Services vouchers 653 through
682, dated November 14, 2006 in the amount of $346,276.64.
Human Services, Workshop, Public Health, Social Services vouchers 683 through
712, dated November 28, 2006 in the amount of $306,118.42.
Human Services, Workshop, Public Health, Social Services vouchers 713 through
744, dated December 12, 2006 in the amount of $367,430.21.
Human Services and Nursing Home vouchers 712 through 743, dated November 16,
2006 in the amount of $150,517.59.
Human Services and Nursing Home vouchers 744 through 765, dated November 30,
2006 in the amount of $122,152.49.
Human Services and Nursing Home vouchers 766 through 797, dated December 14,
2006 in the amount of $162,640.07.
St. Croix County Health and Human Services Board
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December 18, 2006
Workshop vouchers 133 through 138, dated November 14, 2006 in the amount of
$10,867.97.
Workshop vouchers 139 through 144, dated November 28, 2006 in the amount of
$10,332.10.
Workshop vouchers 145 through 150 dated December 12, 2006 in the amount of
$10,737.21.
FINANCIAL REPORT Pempek distributed the following Health and Human Services
financial report for January through October. Pempek noted SED (Severely
Emotionally Disturbed) revenue is higher than anticipated due to CLTS, Autism,
MH (Mental Health) , and DD (Developmentally Disabled) now being included in a
grouping. The percentages will need to be recalculated and funds will be
redistributed between Long Term Support and SED programs. Awsumb questioned if
some of these monies could be utilized to take clients off the waiting list.
Johnson indicated this would be utilizing short term funding to fund long term
care needs.
St. Croix County Health and Human Services Board
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December 18, 2006
HEALTH AND HUMAN SERVICES - 2006
SUMMARY Total
OF REVENUES Budget Jan - October Balance %
,administration 925,134.00 1,087,972.68 (162,838.68) 117.6%
AO DA Services 649,146.01 562,171.03 86,974.98 86.6%
Long Term Support 17,542,262.00 15,856,885.44 1,685,376.56 90.4%
Mental Health 2,909.086.00 2,532,717.94 376.368.06 87.1%
Family & Children's 3,120,265.00 2,869,910.42 250,354.58 92.0%
SED 216,000.00 337,417.26 (121,417.26) 156.2%
Public Health 1,537,680.00 1,265,185.00 272,495.00 82.3%
Economic Support 1,010,360.00 810,055.43 200,304.57 80.2%
General Relief 15,000.00 12,500.00 2,500.00 83.3%
Coordinated Services 260,403.00 126,609.18 133,793.82 48.6%
REVENUES HUMAN
SERVICES PROGRAMS 28,185,336.01 25.461,424.38 2,723,911.63 90.3%
SUMMARY Total
OF EXPENDITURES Budget Jan - October Balance %
Administration 925,134.00 810,046.18 115,087.82 87.6%
Alcohol -Drug Abuse 649,146.01 571,396.98 77,749.03 88.0%
Long Term Support 17,542,262.00 14,105,899.44 3,436,362.56 80.4%
Mental Health 2,909,086.00 2,419,143.70 489,942.30 83.2%
Family & Children's 3,120,265.00 2,291,962.30 828,302.70 73.5%
SED 216,000.00 197,982.24 18.017.76 91.7%
Public Health 1,537,680.00 1,274.379.98 263,300.02 82.9%
Economic Support 1,010,360.00 840,423.71 169,936.29 83.2%
General Relief 15,000.00 573.06 14,426.94 3.8%
Coordinated Services 260,403.00 129,543.72 130,859.28 49.7%
EXPENDITURES HUMAN
SERVICES PROGRAMS 28,185,336.01 22,641,351.31 5,543,984.70 80.3%
Excess Rev over Expenses ! 2.820.073.07
Percentage of Budget: 83.333
`WIMCR revenues recorded
$ 2,820,073.07
Revenues above include state
advances Jan - Aug 06
$ 2,820,073.07
Pempek distributed the following Nursing Home report for January through
October. Pempek noted the average census through October was 61, below the
budgeted amount but there has been a shift to more residents covered under
Medicare and private pay. She noted additional IGT monies have been received
and will be reflected on the December financial report.
St. Croix County Health and Human Services Board
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December 18, 2006
ST C:ROIX HEALTH CENTER
OPERATIONS REPORT
Jan - Oct 2006 Jan - Oct
2006 BUDGET ACTUAL DIFFERENCE %
CENSUS 66 61 1
OPERATING REVENUE:
MEDICARE $ 629,623.06 $ 872,369.99 $ (242,746.94) 139%
MEDICAID $ 2,609,616.07 $ 1,644,781.47 $ 964,834.60 63%
PRIVATE PAY ` "` $ 647,475.00 $ 866,592.66 $ (308,117.66) 156%
ALL OTHER SOURCES"** $ 220,453.00 $ 195,969.11 $ 24,483.89 89%
TRANSFER FROM CONTINGENCY $ - $ - $
TOTAL OPERATING REVENUE $ 4,007,167.12 $ 3,568,713.23 $ 438,453.89 89%
OPERATING EXPENSES:
DAILY PATIENT SRVICES $ 3,363,410.47 $ 2,707,028.52 $ 656,381.95 80%
SPECIAL SERVICES $ 274,458.35 $ 201,866.50 $ 72,591.85 74%
GENERAL SERVICES $ 1,169,758.41 $ 868,835.73 $ 300,922.68 74%
ADMINISTRATIVE SERVICES $ 527,734.19 $ 527,962.85 $ (228.66) 100%
UNASSIGNED: $ -
DE PRE CIATION( °BASED) $ - $ - $ -
$ 373,372.00 $ 373,372.00 0%
Utilities $ 102,429.93
Workers Comp, Computer Tech $ 194,415.98
Insurance $ 63,013.58
OTHER EXP: $ 359,859.49
TOTAL OPERATING EXPENSES $ 5,706,733.42 $ 4,665553.09 $ 1,043,180.33 82%
NET FROM OPERATIONS $ - $ )1.096,839.86)
(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 ALLOCATIONS( %BASED) $ 1,309,742.30 $ 1,087,950.00 $ 221,792.30 83%
TOTAL OUTSTANDING $ 1,701,566.30 $ 1,276,020.00 $ 425,546.30
NET FROM ALL SOURCES $ 179,180.14
PERCENTAGE SHOULD BE 83.33 °4,
Potential Salary hicreases:
$16.856 - $50,567 annual Projection.
"IGT Aw,7rrl bid liilf in the artri
of $196 11 $7070 over bdgt
Tonal IGT Award $384070
St. Croix County Health and Human Services Board
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December 18, 2006
ANIMAL SHELTER Sharon Elliot from Saint Croix Animal Friends was present to
investigate the possibility of utilizing the county barn as an option for an
animal shelter and possibly involve clients from St. Croix Industries sheltered
workshop with the shelter. Currently, there is no facility in St. Croix County
for animals; however, there are some kennels. Woodbury does provide services
to St. Croix County community but the concern is that they will soon be full.
Saint Croix Animal Friends has a three -year goal to have a shelter. The
shelter would be run on contributions, donations, grants, etc. The group
started in February 2006 and they are currently working on a strategic plan and
business plan and will be patterned after the Woodbury shelter. Elliot
mentioned property is the largest expense for the project. This group has no
connection to the former shelter in River Falls and will just cover St. Croix
County. The goal is to have a green space with buildings being both heated and
air conditioned. There has been a reluctance on the part of towns, cities and
villages to fund this project. Luckey expressed concern if the facility was
located at the county, the county would be expected to fund the project. Dr.
Kretz said pets are part of our quality of life and are a major issue in terms
of public health and animal .control. Dr. Kretz volunteered to give a
presentation to Saint Croix Animal Friends regarding an animal shelter. Saint
Croix Animal Friends will attempt to schedule at town board meetings to solicit
support. They will investigate if the county barn is practical and meets their
needs and come back to the Board if the facility is satisfactory. Johnson
offered to view the barn with the group and coordinate with St. Croix
Industries for possible placement for St. Croix Industries client workers if
requested. Elliot questioned amount of property available with the building to
utilize for dog runs, etc.
UPDATE ON AUDITOR REPORT Work has been done with the ECHO program to obtain a
true accounts receivable starting balance going into 2007. Modifications have
been made to obtain reports by date range, payment source, provider, etc. These
changes should meet auditor needs /requests.
HEALTH AND HUMAN SERVICES GOVERNING BODY BY -LAWS REVIEW Awsumb recommended
deleting ...'and support'... under Article V, Section A, number 4 and deleting
number 5 under Article V, Section B regarding the Board conducting twice yearly
inspections of Department facilities. Other changes include changing the name
of Mental Health and Alcohol /Drug Abuse Services to Behavioral Health Services
and adding St. Croix Industries
Motion A motion was introduced by Caflisch, seconded by Awsumb, and
unanimously adopted: That the Board approves the Bylaws as modified above.
SURGEON GENERAL'S REPORT ACTION The resolution authorizing creation of an
ordinance relating to secondhand smoke was presented and discussed. Awsumb
requested copies of other smoking ordinances. It was the consensus of the Board
that the resolution did not include specific enough detail and by itself would
raise questions that could be answered by just completing the ordinance. Work
will be done to propose an ordinance to maximize reduction of exposure to
secondhand smoke. A meeting with Dr. Kretz, Awsumb, Karl, Sortedahl, and
Johnson will be held on 12/21/06 from 2:00 PM to 4:00. Discussion will be held
on options /planning around a smoke -free ordinance. Additional information will
be gathered and brought back to the Board.
The Board recessed from 10:10 to 10:15 AM.
UPDATED JOB DESCRIPTIONS Two job description titles need to be changed based
on changes made in the Bylaws. The two descriptions affected are the Mental
Health /AODA Coordinator and Mental Health /AODA Clinical Services Supervisor
St. Croix County Health and Human Services Board
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December 18, 2006
positions. Kirt reported an organizational change has been made with a Social
Worker position in Community Support Program (CSP) to move to mobile crisis to
track emergency services. This position would also need to be re- titled
Behavioral Health Services Social Worker. This move reduces the liability to
the county as clients are diverted from the hospital and duties were shifted
due to needs in the department. He reported commitments are also tracked by
this position. The unit is working towards certification so the department is
eligible for reimbursement from Medicaid. There is no change in the budget due
to these changes.
Motion A motion was introduced by Caflisch, seconded by Burri, and
unanimously adopted: That the Board approves changes in the following three
job titles: Mental Health /AODA Coordinator to Behavioral Health Services
Coordinator, Mental Health /AODA Clinical Services Supervisor to Behavioral
Health Services Supervisor, one CSP Social Worker to Behavioral Health
Services Social Worker.
ST. CROIX INDUSTRIES PROGRAM REPORT Eichstaedt reported St. Croix Industries
has provided vocational habilitation and rehabilitation programs to county
residents who are developmentally disabled and /or have mentally health issues
for over 32 years. Many clients have dual diagnoses but developmentally
disabled is the primary diagnosis. In 2006 193 clients were served.
Eichstaedt reported all clients live in the community either independently,
with family, with some help or with a paid caregiver. There is no public
transportation in St. Croix County so St. Croix Industries provides
transportation to over 100 persons per day for over 600 miles per day.
St. Croix Industries operates as a social service agency, which includes
day services, community employment services, and work services, as well as
production. At the end of 2006 there will be six individuals on the waiting
list for services for community employment and 11 for work services.
St. Croix Industries is certified annually by the State of Wisconsin and the
U.S. Department of Labor to employ disabled individuals. Time studies and
prevailing wage studies are done. Work is provided in three areas:
production, rest area maintenance project (RAM), Helping Hands. Helping Hands
is a community employment service used to provide paid community work
experiences. It is also available to provide work opportunities to allow
MAPP (Medicaid Purchase Plan) eligible clients to receive Wisconsin Medical
Assistance (MA) which allows the client to afford needed medication and
treatment through the MA Program.
LONG TERM SUPPORT -LONG TERM CARE REFORM A meeting with Board members and
consumers was held on 12/13/06 with presentation on Long Term Care Expansion
presented by Tim Sheehan, Center for Independent Living for Western Wisconsin,
Inc., and Paul Cook, Community Health Partnership. Discussion of the meeting
occurred.
The Board requested more information on what other people have done elsewhere
for long term care reform. Board members questioned how long term care reform
is going in counties it has been implemented. Attempts will be made to have
State representatives at the January meeting. Board members were asked to
forward questions to Lockwood, Johnson or Duncan. The Department's goal is to
have a decision by the March meeting on how St. Croix county will proceed with
implementation and development of the ADRC.
NURSING HOME REPORT - REQUEST FOR PROPOSAL Awsumb requested a mailing list for
the RFP. One vendor attended the December 12 2006 information meeting. The
next information meeting is scheduled for January 3 2007 and it is
St. Croix County Health and Human Services Board
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December 18, 2006
anticipated more vendors will attend that meeting. Van Offeren distributed a
list of advertisement costs incurred thus far. Van Offeren will send out
additional RFPs per Board member request. A copy of current floor plans will be
provided to Board members. It was questioned how many assisted living beds are
in St. Croix County and current occupancy. Van Offeren will obtain and forward
that information.
Johnson will present information on the Nursing Home RFP to the entire County
Board on 12/19/06.
Van Offeren reported the current census is 62. He reminded Board members
changes in position descriptions were approved at the last meeting and those
description changes have been forwarded to Finance.
Van Offeren said the Federal civil penalty in the amount of $6,500 regarding
the July nursing home incident has been paid. No information regard penalties
have been received from the State.
Van Offeren reported Pathways will only have the Director of Nursing position
by the end of December. This contract position, along with the contract
Administrator position are anticipated to remain through the RFP process.
Nursing Home arbitration occurred this morning. The union approved a side
letter stating that staffing will be determined on a Per Patient Day (PPD)
basis. The Per Patient Day (PPD) calculations will be determined by using
information developed by the calculations received by the State of Wisconsin
from cost reports submitted by all nursing homes in the State of Wisconsin.
Management reserves the right to determine the Per Patient Day calculation
for all departments. Staff whose hours are reduced due to census decline will
maintain their current percentage of health insurance.
HEALTH AND HUMAN SERVICES FACILITY PLANNING Johnson met with a consultant from
Ayres and Associates regarding facility planning. He gave an estimate of
$20,000 to $28,000 of evaluate facility planning, which would include the
following:
1. Evaluate buildings at the Health and Human Services site for building
envelope conditions, plumbing systems, heating ventilating systems, and
electrical systems.
2. Estimate short term and long term costs of updating building
deficiencies.
3. Conduct a space needs survey of Health and Human Services Departments and
designated departments within the St. Croix County Government Center in
Hudson.
4. Prepare a concept and budget report including space needs summary,
concept plans, project cost estimate and project schedule.
After discussion, it was felt that items 1 and 2 could be eliminated which
would substantially reduce cost. Johnson will follow up with Ayres and
Associates to get an updated price quote for the study. Johnson requested that
if this were an issue, the Board would want to pursue after update price quotes
are obtained, that it be a consideration to connect this long range space study
with other departments currently doing a study on excess land.
ECONOMIC SUPPORT PROGRAM REVIEW This agenda item was postponed to the January
meeting.
FARM LAND LEASE A lease for the farm land was signed in November. This lease
was reviewed by Greg Timmerman.
St. Croix County Health and Human Services Board
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December 16, 2006
PERSONNEL ISSUES
Motion A motion was introduced by Kretz, seconded by Awsumb, Closed session
pursuant to Wisconsin Statutes sec. 19.85(1) (f) considering financial,
medical, social or personal histories or disciplinary data of specific
persons.
Roll call vote:
Esther Wentz- absent
Gordon Awsumb -yes
Leon Berenschot -yes
Lois Burri -yes
Tom Caflisch -yes
Dr. Kretz -yes
Linda Luckey -yes
Deb Rasmussen -yes
Ronald Troyer - absent
Six yes, three absent, motion passed.
The Board entered closed session at 12:05 PM.
Motion A motion was introduced by Awsumb, seconded by Caflisch, and
unanimously adopted: That the Board reconvene into open session per Wisconsin
Statute 19.85 (2).
The Board reconvened in open session at 12:30 PM.
Berenschot asked if there were any other issues to bring before the Board.
Berenschot adjourned the meeting.
Time: 12:30 PM
Chair:
Attest:
(Secretary)
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