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HomeMy WebLinkAboutHealth & Human Services 08-12-05 TOM CAFLISCH WILL REVIEW VOUCHERS AT 7:45 AM REVISED 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: 08/12/05 TIME: 8:30 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: 08/25/05 ACTION ON PREVIOUS MINUTES: 07/15/05 ANNOUNCEMENTS: *Community Links Application Approval *Mona Flanum APPOINTMENTS: UNFINISHED BUSINESS: 1. Nursing Home Private Pay Rate Increase Request NEW BUSINESS: 1. Consideration of Claims and Vouchers 2. Financial Report a. WIMCR revenue 3. Program reports a. Nursing Home Report b. Economic Support c. Public Health 4. Personnel Issues a. Temp position to cover family leave in Family and Children's b. Temp position to cover family leave in Accounts Receivable ** 5. Donation Accounts -DHHS and Nursing Home 6. Initial planning for 2006 budget 7. Drug Court 8. Storm damage to power line by maintenance building ** 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 August 12, 2005 The St. Croix County Health and Human Services Board met on August 12, 2005 at the St. Croix County Health and Human Services /Health Center complex. MEMBERS PRESENT:' Thomas Dorsey, Chair Lois Burri Tom Caflisch Tom Dowd Dr. Michael Kretz Linda Luckey Ralph Swenson Esther Wentz MEMBERS ABSENT: Deb Rasmussen, excused STAFF PRESENT: Fred Johnson, Health and Human Services Director Jennifer Pempek, Financial Manager Carolyn Krieger, Nursing Home Administrator Malva Berg, Secretary OTHERS PRESENT: Larry Lester, Wipfli Chair Dorsey 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 Friday, September 9, 2005 at 8:00 AM. 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 Swenson, seconded by Wentz, and unanimously adopted: That the minutes of the 07/15/05 Health and Human Services Board meeting be approved eliminating the fourth sentence in the fourth paragraph on page 6 to read: APPLICATION OF FUND BALANCE At the completion of the audit, the Nursing Home fund balance was approximately $479,000 to the good and Health and Human Services was approximately $327,000 deficit. Auditor Tracey recommended a fund balance of working capital of 30 to 60 days. It was also recommended to have cash flow on hand to cover payroll. Johnson asked for clarification on how the board wished to handle fund balance, positive or negative. ANNOUNCEMENTS St. Croix Industries will be holding a picnic at the Blue Moon at 12:30 today. Several Board members will be attending. Johnson said Mona Flanum of Five Loaves has viewed the area available for the food shelf. Five Loaves declined the offer to utilize the space viewed for the food shelf. The Nursing Home picnic was on August 4 It was well attended and well organized. . A total of 47 baskets were sold and $1,737.50 was raised for resident donation account. Deb Lindemann was awarded the Florence Nightingale award in August through 1� �, x-01 St. Croix County Health and Human Services Board Page 2 August 12, 2005 ' Public Health. PRIVATE PAY INCREASE REQUEST Krieger requested an increase in private pay rates for ISN and ICF from $165 and $155 respectively to $185 and $160 effective October 1, 2005. Also an increase in private pay SNF rates from $160 to $165 effective October 1, 2005. Krieger indicated this increase is under the average of the competition and that Medicaid allows 30% over the Medicaid rates for private pay rates. Based on the 2004 Medicaid cost report, the overall cost per resident per day is $221. Krieger indicated if we charged that rate, no private pay residents would come to the Nursing Home and we are trying to obtain a rate that will not price us out of the market. Krieger said there are currently 17 private pay residents. She said four facilities have been compared for nursing home staff hours per resident day. Also, a charge of $12 per day is made for private rooms and is common in long term care. A $75 state imposed bed tax was also approved May 1, 2005, which is $2.50 per day. The Nursing Home has 16 private rooms some of which are filled with Medicaid residents due to dementia, behavior problems or clinical needs. Dr. Kretz indicated a need to eliminate.the structural deficit in private pay rates. The County does not limit the number of Medicaid residents admitted. St. Croix County takes residents no matter the pay source. Some for - profit facilities limit the number of Medicaid admissions. Currently 75% of the residents in the Nursing Home are Medicaid. There is no planned increase for Medicaid or Medicare for 2006, which means no increase in Nursing Home revenues for next year. Lester indicated a large demand for private rooms. The Nursing Home census today is 72. Motion A motion was introduced by Swenson, seconded by Wentz, and unanimously adopted: That the Board approves the Private Pay rate increase request for ISN and ICF from $165 and $155 respectively to $185 and $160 and also an increase in private pay SNF rates from $160 to $165 effective October l 2005 and to come back to the Board with a recommended rate increase per day for private rooms. Dr. Kretz questioned whether it was easier to go to the taxpayer and request extra monies rather than the person receiving the service. Lester explained most rural hospitals threatened to close and the fix was for Medicare to pay costs in the hospitals. Residents receiving the exact same care in the hospital as in nursing homes will receive approximately $900 /day compared to $353.69/day in the nursing home. Nursing home Medicare utilization is down due to this. This is a Federal issue. The nursing home is funded $79.07 /day for Medicaid residents and 75% of the Nursing Home residents are Medicaid. There is no anticipated increase in State dollars in 2006. Strategic planning is needed for the nursing home and should go out at least five years. Johnson said strategic planning is not in the budget for this year. Lester said information can be provided for different scenarios for the nursing home as far as possibly decreasing the population, changes in staffing, adult care program, contracting for various services, and then actions will need to be taken with that information. It would cost approximately $15,000 to $20,000 to develop a strategic plan and the decisions that have to be made from that plan would not be easy decisions. It is anticipated that if we make no modifications in the Nursing Home, that the levy request will double within the next five years. St. Croix County Health and Human Services Board Page 3 August 12, 2005 CONSIDERATION OF CLAIMS Health and Human Services Board member Caflisch reviewed the vouchers. Motion A motion was introduced by Caflisch, seconded by Wentz, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book: Human Services voucher 54358, dated July 28, 2005 in the amount of $1,243.40. Human Services vouchers 55596 through 55762, dated August 12, 2005 in the amount of $97,294.70. Human Services vouchers 55808 through 55819, dated August 12, 2005 in the amount of $70,951.22. Human Services vouchers 55054 through 55208, dated August 12, 2005 in the amount of $109,347.98. Human Services and Nursing Home vouchers 53739 through 53795, dated July 21, 2005 in the amount of $39,523.40. Human Services and Nursing Home vouchers 53796 through 53827, dated July 21, 2005 in the amount of $63,373.01. Human Services and Nursing Home vouchers 54035 through 54144, dated July 28, 2005 in the amount of $454,821.32. Human Services and Nursing Home vouchers 54598 through 54680, dated August 04, 2005 in the amount of $114,621.49. Nursing Home vouchers 55763 through 55807, dated August 12, 2005 in the amount of $12,672.57. Human Services, Workshop, Public Health, Social Services vouchers 416 through 445, dated July 26, 2005 in the amount of $338,450.38. Human Services, Workshop, Public Health, Social Services vouchers 446 through 477, dated August 09, 2005 in the amount of $93,796.91. Human Services and Nursing Home vouchers 469 through 500, dated July 28, 2005 in the amount of $181,792.23. Human Services and Nursing Home vouchers 459 through 468, dated July 19, 2005 in the amount of $7,723.68. Human Services and Nursing Home vouchers 501 through 533, dated August 11, '2005 in the amount of $176,036.31. Workshop vouchers 19 through 24, dated July 26, 2005 in the amount of $9,315.86. Workshop vouchers 25 through 30, dated August 09, 2005 in the amount of $8,741.69. The Board recessed from 10:25 to 10:30 AM. ECONOMIC SUPPORT Squyer informed the Board that second party reviews are being done on Food Share. The process takes about an hour and a half. This St. Croix County Health and Human Services Board Page 4 August 12, 2005 ' will increase staff workload but also protect the agency from a Federal fine if the case(s) are reviewed. She also mentioned that Long Term Care Reform is being put into the Economic Support system. She said that free and reduced lunches for school children is also now on line. Approximately 50% of St. Croix County cases have been converted and the switch should be completed by 08/22/05. After 01/01/06, clients will not come in -house to apply for assistance; access to applications will be on -line. Effective 10/06, the Medical Assistance grace period will be -eliminated. There has been a one -month grace period for MA clients for a long time but this grace period ends 10/06. Effective 01/01/06, SSI and Food Stamp applications will be a combined application; however it is not clear who will administer the application process, Social Security or Economic Support. Mail - in applications will be put through a scanner to apply. It is a question as to who will be responsible for errors. Senior Care applications are scheduled to be added to Economic Support 05/06. PUBLIC HEALTH There is no report on the Public Health 140 review. Dowd left the meeting at 11:00 a.m. FINANCIAL REPORT The Nursing Home received the balance of the IGT funds for the entire year in June, which amounted to $26,000 more than what was budgeted. The Nursing Home is currently $186,786.41 to the positive after the County levy is applied. The Human Services Department is also showing a positive balance due to a WIMCR payment of $464,484 but staff are still working with the State for a formula or report to make sure this amount is accurate. Contracts require the Department to follow guidelines but that doesn't mean the monies will be the same as in the contract as the State has been "taking back" monies. The following reports through June plus reports on Nursing Home and Human Services budget trends for past years were distributed to the Board: St. Croix County Health and Human Services Board Page 5 August 12, 2005 ST CROIX HEALTH CENTER ... .. ..... ... . I-— ...... ........... ....... .... OPERATIONS REPORT JANUARY THROUGH JUNE i JAN - JUNE 20 BUDG ACTUAL DIFFERENCE % ..... ....... .......... !CENSUS 70: 69 -0.5; 0.9857143 (OPERATING REVENUE: D 743,498.00 $ 445,080.50 $ 298,417.50 0.5986304 ME $ 2,642.397.00 $1,307,282.63 $ 1,335,114.37 0.4947336. PRIVATE PAY $ 817,926.00 $ 28056.28 $ 533,069.72 0.3482666 'R I ATE - AP . P . EALS A $_ 17,652.0 $ 14.824.00 $ 2. 0. * 8397915 ,G � FUNDS - ACTUAL $ 450,000.00 $ 476.007.DO $ (26.007. 1.0577933 ­* ALL OTHER SOURCES*** 9,4B4.00 $ 19,775.30 $ (10,291.30)= 2.0851223 TRANSFE FR OM ' $ $ 8 $ 0,600. TOTAL OPERATING REVENUE 1$ 4,680,957.00 2,556,425.71 $ 2,124,531 .29 0.5461331. ;OPERATING EXPENSES: .. .... ..... .. - .. ... .... .. I .......... ....... ...... IDAILY PATIENT SRVICES $ 3,411,487.50 $ 1,741.427.13 1,670,060.37 0.5104598 �SPECIAL SERVICES $ 266 $ 130,599.96 135,910.46Y 35,910.46 0.490037 GENERAL SERVICES $ 1111.184.21' 7 1 - - 4' 89.' 436 ...... .......... . . .. ..... . ... . .. .. . ....... .. ... ,.41 621747.80 0.4404639 ADMINISTRATIVE SERVICES 539,734.15 $ 320,566.38 $ .. 219,167.77: _ 0.5939338; A § - S - 1 b `N D: 'DEPRECIATION(%BASED) OTHERS: (INS-WC-CAPITAL-UTIL) !$ 255.835.007$ 196,361.41 59,473.59 . 0.7675315 ' jf0_tA_[_0`PERXf_fN_GEXPENSES $ 5,584,751.2R $ 2.878,391.29 .. ......... .... ... .. . NET FROM OPERATIONS I$ (321.965M) `(COST OF DOING BUSINESS PRIOR TO , APPLYING LEVY & OUTSTANDING REV) ... ....... . ..... .. :OUTSTANDING REVENU !OUTSTANDING RATEAPPEALREV i$ 2,828.00 $ .00 0:: [ OUTSTANDING IOT REV 1 4.771. $ 314,771.00 -4-- 0 jCO ALLOCATIONS(% BASED) j $ 1,017,504.00 $ 508,752.00 $ 5_08,75_2 .5 TOTAL OUTSTANDING $ 1,335 ,103.00 $ 508,752.D0 $ ry 826.351.00 ........ .... .. . .. ............ . ..... ... .... . ........ . ............ .... ... ....... .. .. . . ...... . .. ... NET FROM ALL SOURCES 186,786.42 .. .. ...... ...... . ... .. .... .. . . .... . .. .............. . ................. ... . .. ... ......... .. IPERCENTAGE SHOULD BE 49.98: !NHJUNEFINANCIAL REPORT . . . . ..... ... .................... . .......... . Depreciation Expense Removed 'ErioLy ment of 1$12,185.61 rec'd 4/05 .... .... ........ . . ...................... . ......... ... ..... ...... . St. Croix County Health and Human Services Board Page 6 August 12, 2005 HEALTH AND HUMAN SERVICES - 2005 SUMMARY Total OF REVENUES Budget Jan -June Balance Administration 11020,399.92 423,012.24 597,387.68 41.5% AODA Services 473,948.78 245,876.47 228,072.31 51.9% Long Term Support 17,299,811.93 8.131,7136.138 9,168,025.05 47.0% Mental Health 3,006,239.35 1,239,888.52 1,766,350.83 41.2% Family & Children's 3,059,580.00 1,591,706.1 B 1,467,873.82 52.0% Public Health 1,471,999.17 761,771.00 710,228.17 51.0 Economic Support 927,622.06 463,520.75 464,101.31 50.0% General Relief 14,1332.45 7,500.00 7,332.45 50.6% Coordinated Services/ED 380,509.80 342,136.24 38,373.56 89.9% REVENUES HUMAN SERVICES PROGRAMS 27.654.943.46 13.207.1913.213 14.447.745.1 B 473% SUMMARY Total OF EXPENDITURES Budget Jan.- June. Balance % Administration 1,020,399.92 495,729.47 524,670.45 48.6% Alcohol -Drug Abuse 473,948.78 286,84B.13 187,100.65 60.5% Long Term Support 17,299,811.93 8,043,953.73 9,255,658.20 46.5% Mental Health 3,006,239.35 1,315,674.90 1,690,564.45 43.8% Family & Children's .0 1, ,485.73 1,402,094.27 54.2% Public Health , 7 76 ,716.26 709,282.91 51.8% Economic Support 92 , 13 ,154.17 795,467.89 14.2% General Relief 14,832.4 2,858.92 11,973.53 19.3% Coordinated Service /SED 380,509.80 7,856.13 372,653.67 2.1% EXPENDITURES HUMAN SERVICES PROGRAMS 27,654,943.46 12,70$,277.44 14,949,666.02 45.9% Excess Rev over Expenses 501.920.84 Percentage of Budget: 49.9B May Human Service Total $ (301,791.40) Total revenue swing from May to June $ B03.712.24 WIMCR Revenues $ 464, 484.60 Late Allocations $ 427,233.00 ($ earned in prior month but rec'd June 2B, 2005) Total- - - - - -- $— 891.717.60 ----------------------- TEMPORARY POSITION TO COVER FAMILY LEAVE IN FAMILY AND CHILDREN'S: Discussion was held with Deb Kathan on how to cover this position during a family leave. Kathan recommended a short term contract. Staff are requesting to enter a short -term contract with a qualified certified social worker to provide ongoing case management services in the Juvenile Supervision unit. This position has a caseload of 41 and it' is not feasible to allocate that many cases to other social workers in the unit. St. Croix County Health and Human Services Board .Page 7 August 12, 2005 Motion A motion was introduced by Caflisch, seconded by Kretz, and unanimously adopted: That the Board approves entering a short -term contract with a qualified certified social worker to provide ongoing case management services in the Juvenile Supervision unit to cover a family medical leave. TEMPORARY POSITION TO COVER FAMILY LEAVE IN ACCOUNTS RECEIVABLE Staff person in Accounts.Receivable will be on a 12 -week medical leave. Motion A motion was introduced by Caflisch, seconded by Burri, and unanimously adopted: That the Board approves. hiring staff to cover a 12 -week medical leave in Accounts Receivable. 2006 BUDGET HIGHLIGHTS Health and Human Services and Nursing Home preliminary budget highlights will be reviewed by the Board.. It was the consensus of the Board strategic planning costs should be included in the budget and as an item on the next agenda. Discussion held around date of next meeting. Consensus of the Board was there will not be a meeting on August 25 and the next meeting will be held September 9, 2005 with a start time of 8:00 a.m. Information on the budget will be forwarded to Board members prior to the September 9th meeting. Motion A motion was introduced by Kretz, seconded by Caflisch, and unanimously adopted: That the Board approves Tom Dorsey reviewing and approving the vouchers according to Corp Council's recommendations when the vouchers are completed. STORM DAMAGE TO POWER LINE BY MAINTENANCE BUILDING Johnson reported on July 23r a tree fell on a power line near the maintenance building. A temporary fix was completed on- July 24 An estimate for repair was received but several concerns regarding overhead wiring were identified by the electrician such as the wire not being high enough, wire was strung around the building and there were more than two points of entry. Maintenance reviewed the safety concerns /code violations with Risk Management, Administration and DHHS Board Chair. It was the consensus of all to proceed with the repairs to the damaged power line as well as the other identified problems. It was the consensus of the Board to pay the low bid of $22,893 and work with Kristen and Finance as to where the monies for this project will come from, either administration or the liability fund. DRUG COURT A major change has occurred with the timeline for drug court as the judges are not able to get drug court up and running with their current caseload. It is anticipated the drug court will now be able to happen by 2007 on a limited basis with full implementation in 2008 contingent upon a fourth judge. However, there will be increased services in the jail with a full time AODA counselor. Services will be provided in eight -week group cycles and would be available to approximately 192 individuals in a year's time. DONATION ACCOUNTS -DHHS AND NURSING HOME It was the consensus of the Board to postpone discussion of this item until the November or December meeting. Johnson said there is currently $5,163.27 in a miscellaneous administrative account. He recommended using those.monies to purchase chairs for the Board room and then closing that account. Motion A motion was introduced by Caflisch, seconded by Wentz, and unanimously adopted: That the Board approves using $5,163.27 in the Human Services miscellaneous donation account to purchase chairs for the Board room and to then close the account. St. Croix County Health and Human Services Board ' Page 8 August 12, 2005 ` Dorsey asked if there were any other issues to bring before the Board. Motion A motion was introduced by Wentz, seconded by Caflisch, and unanimously adopted: That the meeting be adjourned. Time: 12:15 PM Chair: Attest: (Secretary)