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Thomas Dorsey WILL REVIEW VOUCHERS AT 7:30 AM.
.ST. CROIX COUNTY
NOTICE OF COMMITTEE MEETING
TO: Clarence Malick, Chairman
St. Croix County Board
FROM: Tom Dorsey
(Fred Johnson, 246 -8223)
COMMITTEE TITLE: St. Croix County Health and Human Services Board
DATE: 02/10/06
TIME: 8 :00 a.m.
LOCATION: St. Croix County Health and Human Services Complex, New Richmond
CALL TO ORDER
ROLL CALL
ADOPTION OF AGENDA
DATE OF NEXT MEETING: 03/20/06
ACTION ON PREVIOUS MINUTES: 01/13/06
ANNOUNCEMENTS:
APPOINTMENTS:
UNFINISHED BUSINESS:
NEW BUSINESS:
1. Consideration of Claims and Vouchers
2. Financial Report
a. WIMCR update
3. Program reports
a. Nursing Home Report
b. Public Health
c. Long Term Care Reform update
4. Personnel Issues
ANNOUNCEMENTS & CORRESPONDENCE
POSSIBLE AGENDA ITEMS FOR NEXT MEETING:
ADJOURNMENT
(Agenda not necessarily presented in this order)
SUBMITTED BY: Fred Johnson
DATE:
COPIES TO: COUNTY BOARD OFFICE
COUNTY CLERK
NEWS MEDIA /NOTICE
* *ADDITIONS /CHANGES /CORRECTIONS
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ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD
February 10, 2006
The St. Croix County Health and Human Services Board met on February 10, 2006
at the St. Croix County Health and Human Services /Health Center complex.
MEMBERS PRESENT: Thomas Dorsey, Chair
Lois Burri
Tom Caflisch
Tom Dowd
Linda Luckey
Ralph Swenson
Esther Wentz
MEMBERS ABSENT: Dr. Michael Kretz, excused
Deb Rasmussen, excused
STAFF PRESENT: Fred Johnson, Health and Human Services Director
Jennifer Pempek, Financial Operations Manager
Ron Kiesler, Mental Health /AODA Coordinator
Ron Lockwood, Long Term Support Coordinator
Wendy Kramer, Lead PHN
Geralyn Karl, Health Educator
Bill Vanofferen, Nursing Home Administrator
Malva Berg, Secretary
OTHERS PRESENT: Chuck Whiting, Administrative Coordinator
Jay Shrader, Program Coordinator, Western Region
Partnership for Public Health Preparedness
Jill Kreiling, RN, UW Green Bay BSN completion program
Chair Dorsey called the meeting to order at 8:00 AM noting the meeting was
properly and legally publicized.
NEXT MEETING The next Health and Human Services Board meeting is scheduled
for Monday, March 20, 2006 at 1:00 PM. Wentz will review vouchers.
AGENDA Motion A motion was introduced by Swenson, seconded by Wentz, and
unanimously adopted: That the agenda be approved as circulated.
MINUTES Motion A motion was introduced by Wentz, seconded by Burri, and
unanimously adopted: That the minutes of the 01/26/06 Health and Human
Services Board meeting be approved as circulated.
ANNOUNCEMENTS Johnson introduced Bill Vanofferen, contracted Nursing Home
Administrator.
Johnson announced the Child Welfare Continuous Quality Review would take
place the full week of February 13. This state and county review team is
part of Wisconsin's Program Enhancement Plan. This plan is the result of
needs identified in the Federal Children and Family Services Review (CFSR).
The audits are being done in conjunction with court improvement project and
will be redone every three to five years. Board members were invited to the
kickoff on Monday and exit review on Friday.
The Governor will be in Chippewa County on February 16 to talk on
methamphetamines as a result of a paper submitted by Steve Kirt on behalf of
the meth consortium. Board members were asked to contact Johnson or Kirt if
any are interested in attending as more details will follow.
St. Croix County Health and Human Services Board
Page 2
February 10, 2006
Johnson announced the final report from Wipfli on the nursing home
operational assessment is in the Board packets.
CONSIDERATION OF CLAIMS Health and Human Services Board member Dorsey
reviewed the vouchers.
Motion A motion was introduced by Dorsey, seconded by Wentz, and
unanimously adopted: That the following vouchers be approved and be made a
part of the supplemental minute book:
Human Services vouchers 66774 through 66782, dated January 19, 2006 in the
amount of $76,570.59.
Human Services voucher 67020, dated January 19, 2006 in the amount of
$715.99.
Human Services vouchers 68001 through 68120, dated January 09, 2006 in the
amount of $76,086.30.
Human Services vouchers 68147 through 68177, dated January 09, 2006 in the
amount of $40,232.16.
Human Services vouchers 67852 through 68000, dated February 09, 2006 in the
amount of $204,158.28.
Human Services and Nursing Home vouchers 66693 through 66773, dated January
19, 2006 in the amount of $93,653.86.
Human Services and Nursing Home vouchers 66783 through 66818, dated January
19, 2006 in the amount of $15,501.51
Human Services and Nursing Home vouchers 67035 through 67085, dated January
26, 2006 in the amount of $61,653.53.
Human Services and Nursing Home vouchers 67086 through 67120, dated January
26, 2006 in the amount of $267,106.64.
Human Services and Nursing Home vouchers 67531 through 64595, dated February
O1, 2006 in the amount of $65,513.25.
Human Services and Nursing Home vouchers 67596 through 67634, dated February
01, 2006 in the amount of $54,702.99.
Human Services and Nursing Home vouchers 68178 through 68254, dated February
09, 2006 in the amount of $68,906.32.
Nursing Home vouchers 67848 through 67849, dated February 01, 2006 in the
amount of $644.00.
Nursing Home vouchers 68121 through 68146, dated February 09, 2006 in the
amount of $21,227.75.
Human Services, Workshop, Public Health, Social Services vouchers 42 through
71, dated January 24, 2006 in the amount of $358,389.02.
Human Services, Workshop, Public Health, Social Services vouchers 72 through
103, dated February 07, 2006 in the amount of $352,726.55.
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St. Croix County Health and Human Services Board
Page 3
February 10, 2006
Human Services and Nursing Home vouchers 42 through 73, dated January 26,
2006 in the amount of $176,746.01.
Human Services and Nursing Home vouchers 77 through 108, dated February 09,
2006 in the amount of $168,339.72.
Workshop vouchers 7 through 12, dated January 24, 2006 in the amount of
$12,613.66.
Workshop vouchers 13 through 18, dated February 07, 2006 in the amount of
$11,719.32.
FINANCIAL REPORTS The following reports through December were distributed to
Board members. Pempek noted the differences /updates in the reports to more
accurately reflect current balances. Pempek noted the generator was put into
an asset account for the Nursing Home and Health and Human Services. Private
pay estimates fell short but came back at the end of the year. Updating on the
reporting for the Nursing Home continues to give more clarity for current
balances. Johnson emphasized Mental Health and Family and Children's staff
have worked hard to recoup more waiver dollars.
WIMCR UPDATE An overpayment of $264,000 was made by the state. Part of the
overpayment is the result of more overhead found to claim in the cost report
from 2002 and amendments made by Pempek to receive more monies than was
originally paid in the claims. These monies would not normally be received
until 2006 but were received in December, 2005. It is recommended that these
monies be moved to 2006 as 2005 revenue predictions were met and the payment is
not usually received until 2006. If this is not done, there may be a "hole" in
the budget as historically payments are made in the following year. The
$264,000 will be set aside and held in a separate account in 2006.
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St. Croix County Health and Human Services Board
Page 4
February 10, 2006
HEALTH AND HUMAN SERVICES - 2005
SUMMARY Total Aver
OF REVENUES Budget Jan - December Balance %
(Bold = WIMCR Adi)
Administration 1,020,399.92 1,825,922.62 (605,522.70) 178.9%
AODA Services 473,940.78 500,825.32 (26,876.54) 105.7%
Long Term Support 17_299,811.93 16,104,469.45 1,195,322.40 93.1%
Mental Health 3.006,239.35 2,506,151.22 500,08B.13 83.4%
Family & Children's 3,059,5B0.00 3,071,032.06 (11,452.06) 100.4%
Public Health 1,471,999.17 1,492,923.78 (20,924.61) 101.4%
Economic Support 927,622.06 920,860.29 6,761.77 99.3%
General Relief 14,632.45 14,832.45 0.00 100.0%
Coordinated Services/ED 380,509.80 380,509.00 0.00 100.0%
REVENUES HUMAN
SERVIGES PROGRAMS 27.654.943.46 26.817,546.99 837,396.47 97.0%
SUMMARY Total
OF EXPENDITURES Budget Jan.- December Balance %
Administration 1,020,399.92 939,614.00 80,785.92 92.1%
Alcohol -Drug Abuse 473,946.78 519,006.43 (45,057.65) 109.5%
Long Term Support 17,299,811.93 16,6B8,086.58 611,725.35 96.5%
Mental Health 3,006,239.35 2,555,900.36 450,338.99 85.0%
Family & Children's 3,059,580.00 3,244,874.59 (185,294.59) 106.1%
Public Health 1,471,999.17 1,471,01B.46 980.71 99.9%
Economic Support 927,622.06 999,069.19 (71,447.13) 107.7%
General Relief 14,832.45 0.00 14,832.45 0.0%
Coordinated Service /SED 380,509.80 56,016.63 324,493.17 14.7%
EXPENDITURES HUMAN
SERVICES PROGRAMS 27,654,943.46 26,473,586.24 1,181,357.22 95.7%
Excess Reis over Expenses S 343,960.75
Percentage of Budget: 100%
WIMCR Adjustment: MH 3 (414,039.75)
Ll S (129,530.00)
F S (5,000.00)
AD S 546,569.75
NURSING HOME REPORT Current census in the Nursing Home is 72 with two in the
hospital and a waiting list has been started. Vanofferen gave some of his
background in the nursing home business. Changes in the nursing home have been
discussed but no implementation in changes has happened as yet. Attempts to
reduce the levy will be made without affecting resident care. Operational
Assessment and needs will be discussed on a routine basis at the Health and
Human Services meetings.
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St. Croix County Health and Human Services Board
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February 10, 2006
ST CROIX HEALTH CENTER
OPERATIONS REPORT
Est Yearend based on 121'30,05 aauals JAN-DECEMBER
2005 BUDGET ACTUAL DIFFERENCE %
CENSUS 70 66 -4 0
`OPERATING REVENUE:
MEDICARE $ 743 ,498. DO $ 768 ,019.09 $ (24 ,521.09) 1.032980707 .
MEDICAID $ 2,642,397.00 $ 2,551,485.88 $ 90,911.12 0.965595208
PRIVATE PAY _...........$....817,926.00 $ 760,477.76 $ 37,448.24 0.954215614
RATE APPEALS - ACTUAL $ 17,652.00 $ 14,824.00 $ 2,828.00 0.839791525
IGT FUNDS - ACTUAL $ 450,000.00 $ 476,007.00 $ (26,007.00) 1.057793333
ALL OTHER SOURCES"` _._. $._.....9,484.00 $ 36,658.15 , $ (27,174.15) 3.865262547
TRANSFER FROM CONTINGENCY $ - $ 8,600.00 $ (8,600.00)
?TOTAL OPERATING REVENUE $ 4,680,957.00 g 4,635,071.08 , $ 44,865.12 , 0.990411123
:OPERATING EXPENSES:
.DAILY PATIENT SRVICES $ 3,411,487.50 $ 3,404,555.41 $ 6,932.09 0.997968015
SPECIAL SERVICES $ 266,510.42 $ 249,959.92 $ 16,550.50 0.937899239
GENERAL SERVICES $ 1,111,184.21 $ 1,071,040.42 $ 40,143.79 0.963872966
ADMINISTRATIVE SERVICES $ 539734.15 , $ 497,075.80 $ 42,658.35 1 0.920964145
UNASSIGNED:
-
OTHERS: (INS -WC- CAPITAL- UTIL) $ 255,835.00 $ 320,536.67 $ (64,701.67) 1.252903903
TOTAL OPERATING EXPENSES $ 5,584,751.28 $ 5,5:113,16822 $ 41,583.06 0.992554179
NET FROM OPERATIONS $ $ (907,096.34)
(COST OF DOING BUSINESS PRIOR TO
APPLYING LEVY & OUTSTANDING REV)
OUTSTANDING REVENUES
OUTSTANDING RATEAPPEALREV $ 2,826.00 $ - $ - p
% OF OUTSTANDING IGT REV $ - $ $ - p
.CO ALLOCATIONS(%BASED) $ 1,017,504.00 $ 1,017,504.00 $ - 1
TOTAL OUTSTANDING _
_.. _ _._ ; .$.. 1 , 020 ,332.00. $ 1,017 ,504.00 $ 2,828.00
NET FROM ALL SOURCES _ $ - 110,407.66
PUBLIC HEALTH A guide for public health preparedness was distributed to Board
members. St. Croix County is part of a nine county consortium with Polk County
being the fiscal agent for the consortium. Jay Shrader, Program Coordinator,
Western Region Partnership for Public Health Preparedness, was introduced and
gave a powerpoint presentation on public health preparedness. Shrader said
Wisconsin is a `Home Rule State' which means the chief elected official is
responsible in the event of an incident. Shrader reviewed the Public Health
Preparedness System which was formed in 2003 with CDC and Homeland Security
Funds. Shrader reviewed past and future preparedness planning efforts of the
consortium and presented an emergency scenario in the guide to demonstrate
how the public health community would respond.
It was the consensus of the Board to discuss with the County Board Chair
bringing this presentation to the full County Board after the elections,
possibly in May.
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St. Croix County Health and Human Services Board
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February 10, 2006
Dowd left the meeting at 9:20 AM.
The Board recessed from 9:35 to 9:42 AM.
LONG TERM CARE REFORM UPDATE Long Term Support is working in collaboration
with nine other counties in the region to implement Long Term Care Reform.
The nine counties are partnering with the Community Health Partnership, Inc.,
the Management Group, and Group Health Cooperative of Eau Claire. The State
agreed to provide $250,000 to implement a managed care approach to providing
support services to persons with long term care needs financed by Medicare
and Medicaid. The main advantage to "the reform would be the ability to serve
all persons currently on waiting lists for MA Waiver services with the goal
to eliminate waiting lists in five years. Use of informal and existing caring
systems would be reinforced with funding streamed through one major managed
care entity. Lockwood presented a powerpoint presentation on the West Central
Wisconsin -Care Management Collaborative. He said 75% of MA dollars go to meet
the needs of people with long term care needs. Lockwood indicated it will be
easier to implement for the elderly and younger physically disabled but would
be a huge commitment by the county in services in the developmental
disability and mental health /substance abuse area. Community Health
Partnership is currently operating in Eau Claire, Dunn and Chippewa Counties
serving the elderly and younger physically disabled. Efforts to expand these
services to St. Croix and Pierce counties and pilot a program for the
consortium is planned to be implemented by September of 2006. It was
discovered when piloted in LaCrosse and Milwaukee area there needs to be
linkage with Economic Support or financial issues could arise. In addition,
the consortium has questions about how all of this reform will be funded and
Board approval will be sought as more detail about the governance structure,
risk sharing, etc. are developed.
PERSONNEL ISSUES Kristin DePrey began as an AODA Counselor. She is at the
jail four days per week and in New Richmond one day per week.
Dorsey asked if there were any other issues to bring before the Board.
Motion A motion was introduced by Swenson, seconded by Wentz, and
unanimously adopted: That the meeting be adjourned.
Time: 10:37 AM
Chair:
Attest:
(Secretary)