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HomeMy WebLinkAboutHealth and Human Services 03-20-06 s ESTHER WENTZ WILL REVIEW VOUCHERS REVISED 03/15/06 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: 03/20/06 TIME: 1 : 0 0 P . M. (NOTE TIME CHANGE) LOCATION: St. Croix County Health and Human Services Complex, New Richmond CALL TO ORDER ROLL CALL ADOPTION OF AGENDA DATE OF NEXT MEETING: 04/17/06 ACTION ON PREVIOUS MINUTES: 02/10/06 ANNOUNCEMENTS: APPOINTMENTS: UNFINISHED BUSINESS: NEW BUSINESS: 1. Consideration of Claims and Vouchers 2. Financial Report a. WIMCR update b. Year -end closeout 3. Program reports a. Nursing Home Report b. Family and Children's Report 4. Personnel Issues 5. 2006 DHHS meeting schedule 6. Set date of 2007 Open Public Hearing 7. 2005 Annual Report planning 8. DHHS Strategic Planning 9. Polk County Adult Development Center letter 10.Award of renewable State - funded Methamphetamine Treatment Grant ($60,000) 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 ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD March 20, 2006 The St. Croix County Health and Human Services Board met on March 20, 2006 at the St. Croix County Health and Human Services /Health Center complex. MEMBERS PRESENT: Thomas Dorsey, Chair Lois Burri Linda Luckey Deb Rasmussen Esther Wentz MEMBERS ABSENT: Tom Caflisch, excused Tom Dowd Dr. Michael Kretz, excused Ralph Swenson, excused STAFF PRESENT: Fred Johnson, Health and Human Services Director Jennifer Pempek, Financial Operations Manager Ron Kiesler, Mental Health /AODA Coordinator Kathy Dunlap, Family and Children's Coordinator Malva Berg, Secretary OTHERS PRESENT: None Chair Dorsey called the meeting to order at 1:00 PM noting the meeting was properly and legally publicized. NEXT MEETING The next Health and Human Services Board meeting is scheduled for Monday, April 17, 2006 at 1:00 PM. Wentz will review vouchers. AGENDA Motion A motion was introduced by Wentz, seconded by Burri, and unanimously adopted: That the agenda be approved as circulated. MINUTES Motion A motion was introduced by Burri, seconded by Wentz, and unanimously adopted: That the minutes of the 02/09/06 Health and Human Services Board meeting be approved as circulated. ANNOUNCEMENTS Johnson said the WCHSA Spring Conference will be held May 17 through 19 and invited Board members to attend. Johnson will be attending. New Richmond Utilities has filed an application with the Public Service Commission of Wisconsin ( PSC) to increase electric rates. The adjustment is necessary to offset increased operation and maintenance expenses and to build a new substation. The last electric rate increase was approved in January 2002. CONSIDERATION OF CLAIMS Health and Human Services Board member Wentz reviewed the vouchers. Motion A motion was introduced by Burri, 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 69150 through 69151, dated February 16, 2006 in the amount of $12,408.55. Human Services voucher 69751, dated February 27 and 28, 2006 in the amount of $2,728.92. St. Croix County Health and Human Services Board Page 2 March 20, 2006 Human Services vouchers 69764 through 69768, dated February 27 and 28, 2006 in the amount of $32,041.28. Human Services vouchers 69863 through 69871, dated March 01, 2006 in the amount of $56,231.73. Human Services vouchers 70322 through 70355, dated March 10, 2006 in the amount of $52,716.94. Human Services vouchers 70667 through 70711, dated March 10, 2006 in the amount of $6,664.87. Human Services and Nursing Home vouchers 69128 through 69149, dated February 16, 2006 in the amount of $96,289.68. Human Services and Nursing Home vouchers 69013 through 69127, dated February 16, 2006 in the amount of $128,436.88. Human Services and Nursing Home vouchers 69152 through 69169, dated February 16, 2006 in the amount of $3,611.30. Human Services and Nursing Home vouchers 69567 through 69571, dated February 22, 2006 in the amount of $7,533.58. Human Services and Nursing Home vouchers 69572 through 69626, dated February 22, 2006 in the amount of $382,520.48. Human Services and Nursing Home vouchers 69769 through 69843, dated March 01, 2006 in the amount of $148,083.23. Human Services and Nursing Home vouchers 69997 through 70142, dated March 10, 2006 in the amount of $217,511.48. Human Services and Nursing Home vouchers 70143 through 70279, dated March 10, 2006 in the amount of $87,495.63. Nursing Home vouchers 69844 through 69862, dated March 01, 2006 in the amount of $6,419.49. Nursing Home vouchers 70280 through 70321, dated March 10, 2006 in the amount of $13,548.11. Human Services, Workshop, Public Health, Social Services vouchers 104 through 133, dated February 21, 2006 in the amount of $353,465.19. Human Services, Workshop, Public Health, Social Services vouchers 134 through 165, dated March 07, 2006 in the amount of $357,082.47. Human Services and Nursing Home vouchers 109 through 140, dated February 24, 2006 in the amount of $164,478.86. Human Services and Nursing Home vouchers 141 through 172, dated March 09, 2006 in the amount of $175,847.60. Workshop vouchers 19 through 24, dated February 21, 2006 in the amount of $12,647.24. St. Croix County Health and Human Services Board Page 3 March 20, 2006 Workshop vouchers 25 through 30, dated March 07, 2006 in the amount of $13,542.92. FINANCIAL REPORTS The following financial reports through January, 2006 were distributed to Board members. Year -end closeout numbers are not ready yet. It is hoped reports will be ready by the April meeting. Pempek indicated revenue advances through March have been received so reports reflect three months of revenue in State advances and one month expenditures, which will inflate January revenues. The nursing home will attempt to portray budgeted and actual per patient day (PPD) costs on future reports. PPD has also been introduced to Nursing Home management staff. IGT monies of $189,000 for six months of 2006 have been received. ST CROIX HEALTH CENTER OPERATIONS REPORT JANUARY 2006 JANUARY 2006 BUDGET ACTUAL DIFFERENCE _6 CENSUS 66 64 -2 0.97 OPERATING REVENUE_ : MEDICARE $ 629,623.05 1 73,695.69 $ 555,927.36 0.117 MEDICAID $ 2,609,616.07 $ 181,624.52 $ 2,427,991.55 0.07 PRIVATE PAY 547 ,475.00 $ 62 ,913.06 $ 484 ,561.94 0.115 RATE APPEALS - ACTUAL $ 14,824.00 $ - $ 14,824.00 0 IGT FUNDS - ACTUAL $ 377,000.00 $ 189,000.00 $ 188,000.00 0.501 ALL OTHER SOURCES* * $ 220,453.00 $ 22,379.24 $ 196,073.76 0.102 TRANSFER FROM CONTINGENCY TOTAL OPERATING REVENUE $ 4,398,991.12 $# 523,612.51 $ 3,869,378.61 0.12 OPERATING EXPENSES: DAILY PATIENT SRVICES $ 3,363,410.47 $ 257,947.35 $ 3,105,463.12 0.077 SPECIAL SERVICES $ 274,458.35 $ 21,433.63 $ .253,024.72 0.078 GENERAL SERVICES $ 1,169,758.41 $ 91,176.49 $ 1,078,581.92 0.078 ADMINISTRATIVE SERVICES $ 527,734.19 $ 39,882.04 $ 487,852.15 0.076 UNASSIGNED: $ DEPRECIATION( %BASED) OTHERS: (INS -WC- CAPITAL -UTIL) $ 373,372.D0 $ 55,692.50 $ 317,679.50 0.149 TOTAL OPERATING EXPENSES $ 5,708,733.42 $ 466,132.01 $ 5,242,601.41 0.082 NET FROM OPERATIONS $ - $ 63,480.50 (COST OF DOING BUSINESS PRIOR TO APPLYING LEVY 8 OUTSTANDING REV) ,OUTSTANDING REVENUES OUTSTANDING RATE APPEAL REV $ 14,824.00 $ - $ 14,824.00 0 % OF OUTSTANDING IGT REV $ 168,000.00 $ - $ 188,000.00 0 CO ALLOCATIONS( %BASED) $ 1,309,742.30 $ 109,145.20 $ 1,200,597.10 O.D83 TOTAL OUTSTANDING $ 1,512,566.30 $ 109,145.20 $ 1,403,421.10 NET FROM ALL SOURCES $ 172,625.70 PERCENTAGE SHOULD BE 8.33 St. Croix County Health and Human Services Board Page 4 March 20, 2006 At the last meeting information was given to Board members of information received at the Financial Managers' meeting that the state was done taking back WIMCR monies for 2005. A week later St. Croix County had a reduction in BCA of $224,000 contrary to what the state had previously indicated. DHHS had a similar experience in 2004 but was told it was a one -time occurrence. HEALTH AND HUMAN SERVICES - 2006 SUMMARY Total OF REVENUES Budget January Balance % Administration 925,134.00 39,234.94 885,699.06 4.2% AODA Services 584,307.00 56,953.26 527,353.74 9.7% Long Term Support 17,542,262.00 2,890,707.07 14,651,554.93 16.5% Mental Health 2,909,086.00 351,476.14 2,557,609.86 12.1% Family & Children's 3,120,265.00 399,921.33 2,720,343.67 12.8% SED 216,000.00 141,494.00 74,506.00 65.5% Public Health 1,537,680.00 125,138.31 1,412,541.69 6.1% Economic Support 1,010,360.00 132,073.07 878,286.93 13.1% General Relief 15,000.00 1,250.00 13,750.00 8.3% Coordinated Services 260,403.00 31,580.10 228,622.90 12.1% REVENUES HUMAN SERVICES PROGRAMS 28.120,497.00 4169 828.22 23,950.668.78 14.82i SUMMARY Total OF EXPENDITURES Budget January Balance % Administration 925,134.00 76,155.62 848,978.38 8.2% Alcohol -Drug Abuse 584,307.00 40,782.57 543,524.43 7.0% Long Term Support 17,542,262.00 1,188,755.85 16,353,506.15 6.8% Mental Health 2,909,086.00 226,387.26 2,662,698.74 7.8% Family & Children's 3,120,265.00 230,155.50 2,890,109.50 7.4% SED 216,000.00 0.00 216,000.00 0.0% Public Health 1,537,680.00 132,076.35 1,405,603.65 8.6% Economic Support 1,010,360.00 96,556.25 913,803.75 9.61 General Relief 15,000.00 467.41 14,532.59 3.1% Coordinated Service/SED 260,403.00 4,535.39 255,867.61 1.7% EXPENDITURES HUMAN SERVICES PROGRAMS 28,120,497.00 1,995,872.20 26,124,624.80 7.1% Excess Rev over Expenses S 2.173.956.02 Percentage of Budget 8.33 "'WIMCR not recorded $ 2,173,956.02 Revenues above include state advances Jan - March 06 $ 2,173,956.02 NURSING HOME REPORT The Nursing Home census is 69 with possible admissions and several inquiries. St. Croix County Health and Human Services Board Page 5 March 20, 2006 The Governor announced a 2.8% rate increase over the next two years, or 1.40 each year, from the Medicaid program so quality services can continue to Wisconsin seniors in nursing homes. VanOfferen said the 35t /patient day increase is marked for fuel costs and increases in wages are not reimbursable by the state. Operational Assessment: Wipfli forwarded a written report on the status of the operational assessment (12/13/05 report), which Bill Van Offeren reviewed. Copies of the report were given to Board members. Consideration to downsizing to 50 beds is not an option the Board approved, so this is deferred. Development of a behavioral program within the facility has not occurred at this time. Priority has been placed on nursing recommendations. Work on the behavioral program will be reviewed, but due to maintaining 90 -95o capacity with traditional nursing home residents, this programming may also be deferred or addressed on a limited basis. Operation of 25 beds for behavioral residents and 25 for traditional long term care residents is deferred at this time. He said the areas are not conducive to set up such a program at this time. Staffing has been reduced in the nursing area and the nursing home is operating within the benchmarks of a long term care setting. Some reductions in the management area are being made and overtime is under control at this time. He said the Director of Nursing time is not part of direct care time and is not considered a `working nurse' according to regulations. Office changes are being considered to possibly implement making more private rooms available. The five -meal service plan has been postponed until fall. Barb Gunderson and Mary Jo Graham will consult with nursing home staff until the end of April and Van Offeren is encouraging staff to utilize their skills and knowledge while they are here. Van Offeren said the benefit and wage package in the nursing home is very good compared to the market. Resident care is not in jeopardy with the modifications being made. Van Offeren said the new schedule should be in place by April 1. MDS training has begun and should be completed by the end of March. Weekend housekeeping was started in December, 2005. Housekeeping supervision is in the process of being reallocated. Van Offeren offered high praise for Barb Williams in Medical Records for her knowledge and efforts. Tools for ongoing monitoring of payroll, staffing and budget variances have been developed by Wipfli and are in the process of being implemented. AWARD OF RENEWABLE STATE - FUNDED METHAMPHETAMINE TREATMENT GRANT ($60,000): Kiesler said $250,000 was received from Doyle in this grant. The funds were allocated as follows: $60,000 to Polk County, $20,000 to Burnett County, $60,000 to Barron County, $60,000 to St. Croix County and $50,000 to be used in the prevention /intervention area. This grant is for meth clients only and while the State allows us some flexibility as to the position's role within the county, the funding will only be renewable based on success so counties will need to develop a plan to show measurable results. The inflexibility of the county system for new positions in this instance causes limitations for implementing a position and capturing these grant monies. The expectation from the State is that we have a contracted position in place for 2006 by May 1 to provide case management /wraparound services. The position likely will be filled by a candidate with an Associate or Bachelor's degree and will have no benefits. The position would potentially interact with drug court and would be part of a wrap around type system with our outpatient clinic. St. Croix County Health and Human Services Board Page 6 March 20, 2006 PERSONNEL ISSUES Kiesler announced two new staff will begin in CSP; Heather Gillen is scheduled to begin 03/27/06 and Kimberly McDonald on 04/03/06. FAMILY AND CHILDREN'S REPORT A state quality service review was conducted the week of February 13 through 17 in Family and Children's. This review checks safety and best practice for well being and permanency. Kathy Dunlap reviewed a PowerPoint presentation that was used by the State in their exit conference. The review found a low child welfare staff turnover, positive working conditions and was impressed with the workers and quality of work. Frontline staff are well trained and stable. More foster homes are needed but the ones in place are strong and reliable. The survey team really liked the Coordinated Family Services (CFS) project and encouraged its operation. One issue that arose from the review was the lack of consistent representation from the District Attorney's office in child welfare cases. This was reported by families, opposing attorneys, public defenders, GAL's, judges and workers during various focus groups that were held during the week review. Johnson has had conversations with District Attorney Eric Johnson on this issue and he reported that this is a resource issue due to cuts that have been made in his office. Johnson has proposed a preliminary plan to public protection to bring the juvenile prosecutor back to a full time status in St. Croix County and has also agreed to meet with DHHS administration to again look at options to addressing this issue. WiSACWIS improvement efforts are underway and the system will be changing again by the end of March. The system is not seen as user friendly and is still evolving. A new focus will be on improving accuracy of data entry for better utility. Many other counties have expressed concern about WiSACWIS data entry system as it forces staff to spend too much time in front of the computer and less in the field working with the clients. St. Croix County received favorable status on all cases that were reviewed. Family and Children's staff should receive well deserved praise and thanks for work done. ANNOUNCEMENT A CFS grant came up quickly and was applied for. It is a $50,000 school based grant for prevention services for kids at risk. The awards will be announced in mid - April. 2006 DHHS MEETING SCHEDULE There will be new appointments to the Board in May. This item will be delayed to the April meeting. SET DATE FOR 2007 OPEN PUBLIC HEARING The 2007 Budget Open Hearing date was set for Tuesday, June 13 at 6:00 PM. A Health and Human Services meeting will be held at 4:30 PM before the.open hearing. Johnson would like to give a brief powerpoint presentation on all services and then solicit consumer input at the hearing. 2005 ANNUAL REPORT PLANNING Johnson would like the annual report to be more concise. Staff will prepare the report in April, present to the Health and Human Services Board in May and present to the full County Board on June 20, 2006. DHHS STRATEGIC PLANNING Johnson reminded Board members that $15,000 was set aside in the budget for strategic planning. He would like the planning to be done in conjunction with the 2007 budget process. A RFP has been issued to vendors. An award date of April 11, 2006 has been established. Johnson St. Croix County Health and Human Services Board Page 7 March 20, 2006 requested at least one Board member participate in strategic planning with DHHS staff and the contracted provider. It was the consensus of the Board to appoint a member in April after the elections. POLK COUNTY ADULT DEVELOPMENT CENTER LETTER A letter from Polk County Adult Development Center was received notifying the Department of fraud that was discovered. Two St. Croix County clients received services from this agency and to date we have no reason to believe that the clients received a reduction in services or directly lost funds. It is our understanding the state will participate in this year's audit and if more information surfaces, the Board will be notified. The fraud was discovered when a board member questioned an expenditure, which is part of the normal internal control procedures of the Polk County Adult Development Center. Dorsey asked if there were any other issues to bring before the Board. Motion A motion was introduced by Wentz, seconded by Rasmussen, and unanimously adopted: That the meeting be adjourned. Time: 3:35 PM Chair: Attest: (Secretary) St. Croix County Health and Human Services Board Page 7 March 20, 2006 requested at least one Board member participate in strategic planning with DHHS staff and the contracted provider. It was the consensus of the Board to appoint a member in April after the elections. POLK COUNTY ADULT DEVELOPMENT CENTER LETTER A letter from Polk County Adult Development Center was received notifying the Department of fraud that was discovered. Two St. Croix County clients received services from this agency and to date we have no reason to believe that the clients received a reduction in services or directly lost funds. It is our understanding the state will participate in this year's audit and if more information surfaces, the Board will be notified. The fraud was discovered when a board member questioned an expenditure, which is part of the normal internal control procedures of the Polk County Adult Development Center. Dorsey asked if there were any other issues to bring before the Board. Motion A motion was introduced by Wentz, seconded by Rasmussen, and unanimously adopted: That the meeting be adjourned. Time: 3:35 PM Chair: Attest: (Secretary)