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TOM CAFLISCH WILL REVIEW VOUCHERS AT 7:45 AM
ST. CROIX COUNTY
NOTICE OF COMMITTEE MEETING
TO: Clarence Malick, Chairman
St. Croix County Board
FROM: Tom Dorsey
(John Borup, 246 -8223)
COMMITTEE TITLE: St. Croix County Health and Human Services Board
DATE: 01/14/05
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: 02/11/05 (tentative 01/27/05)
ACTION ON PREVIOUS MINUTES: 12/10/04
ANNOUNCEMENTS
APPOINTMENTS:
UNFINISHED BUSINESS:
NEW BUSINESS:
1. Consideration of Claims and Vouchers
2. Financial Report
3. Program Reports
a. Long Term Support
b. Mental Health /AODA
C. Family and Children's
d. Nursing Home
4. Medical Evaluations Inc. (MEI) request to periodically lease space for
medical exams
5. Request to issue bids for (wheelchair lift equipped) 14 passenger bussette
for St. Croix Industries
6. Personnel Issues
7. Action on Resolution supporting referendum on State versus County funding
for State - mandated human services
ANNOUNCEMENTS & CORRESPONDENCE
POSSIBLE AGENDA ITEMS FOR NEXT MEETING:
ADJOURNMENT
(Agenda not necessarily presented in this order)
SUBMITTED BY: John M. Borup
DATE:
COPIES TO: COUNTY BOARD OFFICE
COUNTY CLERK
NEWS MEDIA /NOTICE
r
ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD
January 14, 2005
The St. Croix County Health and Human Services Board met on January 14, 2005
at the St. Croix County Health and Human Services /Health Center complex.
MEMBERS PRESENT: Thomas Dorsey, Chair
Lois Burri
Tom Caflisch
Stan Krueger
Linda Luckey
Deb Rasmussen
Ralph Swenson
Esther Wentz
MEMBERS ABSENT: Dr. Michael Kretz, excused
STAFF PRESENT: John M. Borup, Health and Human Services Director
Ron Kiesler, Mental Health /AODA Coordinator
Ron Lockwood, Long Term Support Coordinator
Barbara Nelson, Public Health Supervisor- Health Officer
Fred Johnson, Family and Children's Supervisor
Wendy Kramer, PHN
Laurie Cameron, Family and Children's Social Worker
Ron Eichstaedt, St. Croix Industries Supervisor
Malva Berg, Secretary
OTHERS PRESENT:
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, February 11, 2005 at 8:30 AM. Krueger will review vouchers at
7:45 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 Wentz, seconded by Swenson, and
unanimously adopted: That the minutes of the 12/10/04 Health and Human
Services Board meeting be approved with the correction that Luckey was
absent.
ANNOUNCEMENT Borup said Health and Human Services will be open on 01/17/05
with the exception of Public Health. He said the holiday schedule will be
different for the Human Services union and Nursing Home union. GSS union
will be the same as non -union staff.
Borup announced the next Legislative breakfast is scheduled for 01/17/05 from
9:00 - 11:00 AM at the Health Center.
CONSIDERATION OF CLAIMS The following reports were distributed to the
Board: January fixed asset report, December cash report, and November
financial report.
Health and Human Services Board member, Caflisch, reviewed the vouchers.
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St. Croix County Health and Human Services Board
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January 14, 2005
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 vouchers 38050 through 38055, dated December 13, 2004 in the
amount of $6,511.00.
Human Services and Nursing Home vouchers 38331 through 38413, dated December
16, 2004 in the amount of $204,911.63.
Human Services and Nursing Home vouchers 38414 through 38442, dated December
16, 2004 in the amount of $8,997.95.
Human Services vouchers 38446 through 38451, dated December 17, 2004 in the
amount of $41,831.70.
Human Services and Nursing Home vouchers 38452 through 38575, dated December
21, 2004 in the amount of $62,681.71.
Human Services and Nursing Home vouchers 38577 through 38628, dated December
29, 2004 in the amount of $680,187.58.
Human Services vouchers 38963 through 38964, dated January 03, 2005 in the
amount of $61,980.00.
Human Services and Nursing Home vouchers 38965 through 39073 and 39079, dated
January 03, 2005 in the amount of $211,201.07.
Human Services vouchers 39072 through 39729, dated January 13, 2005 in the
amount of $58,147.70.
Human Services vouchers 39730 through 39863, dated January 13, 2005 in the
amount of $76,135.78.
Human Services vouchers 39864 through 40023, dated January 13, 2005 in the
amount of $149,162.01.
Nursing Home vouchers 40024 through 40082, dated January 13, 2005 in the
amount of $16,554.71.
Human Services and Nursing Home vouchers 40024 through 40082, dated January
13, 2005 in the amount of $39,914.32.
Human Services, Workshop, Public Health, Social Services vouchers 740 through
770, dated December 15, 2004 in the amount of $350,054.74.
Human Services, Workshop, Public Health, Social Services vouchers 771 through
795, dated December 28, 2004 in the amount of $348,009.52.
Human Services and Nursing Home vouchers 778 through 808, dated December 14,
2004 in the amount of $188,712.75.
Human Services and Nursing Home vouchers 809 through 832, dated December 28,
2004 in the amount of $170,694.59.
FINANCIAL REPORT The following financial reports through November were
distributed to the Board. Borup noted that the revenue column includes accrued
numbers. He said IGT numbers for the nursing home were stronger than
anticipated. Board members questioned how to judge the numbers on the cash
St. Croix County Health and Human Services Board
Page 3
January 14, 2005
report to put the numbers into context as to where they should be. Borup
indicated the auditors will be here soon to close 2004 books.
SST CROIX HEALT C
OPERA REP ORT
(SUMMARY FOR 2004
; JAN -NOV
'TOTAL O ..... _....... _........._- .....__._... .....__._ ..._.__..._....... _ ....... _.._....
:OPERATING EXPENSE » $ 5,210,949.76
:NET FROM OPERATIONS $ (1,425,748.17)
s =
=NON- OPERATING ITEMS $ 1,394,910.00
.... ....... ....._....... ...... _.._.._:........_....._.... ....._. ...... _.__ ........ - - .....
£
NET FROM ALL SOURCES $ (30,838.17)
St. Croix County Health and Human Services Board
Page 4
January 14, 2005
HEALTH AND HUMAN SERVICES 2004
SUMMARY Total
OF REVENUES Jan.- Nov. Budget Balance %:
Administration 627,395.12 873,534.97 46,139.85 94.7%
AODA Services 422,032.51 469,152.15 47,119.64 90.0%
Long Term Support 14,474,717.65 14,616,574.52 141,856.87 99.0%
Mental Health 2,296,814.29 2,745,667.40 448,853.11 93.7%
Family & Children's 2,S72,946.22 2,844,524.50 271,576.28 90.5%
Public Health 1,392,935.82 1,420,079.06 27,143.24 98.1%
Economic Support 896,529.06 957,504.B5 60,975.79 93.6%:
General Relief 1,911.30 19,212.68 17,301.36 9.9%
REVENUES HUMAN
SERVICES PROGRAMS 22.885.283.97 23.946.250.13 1 060-966-16 95.6%
SUMMARY Total
OF EXPENDITURES Jan.- Nov. Budget Balance %
Administration 790,865.06 873,534.97 82,669.91 90.5%
Alcohol -Drug Abuse 449,023.44 469,152.15 20,128.71 95.7%
Long Term Support 14,273,823.04 - 14,616,574.52 342,751.48 97.7%
Mental Health 2,378,133.32 2,745,667.40 367,534.08 86.6%
Family & Children's 2,671,032.19 * 2,844,524.50 173,492.31 93.9%
Public Health 1,278,590.88 1,420,079.06 141,488.16 90.0%
Economic Support 865,008.68 957,504.BS 92,496.17 90.3%
General Relief 11,633.92 19,212.69 7,578.76 60.6%:
EXPENDITURES HUMAN
SERVICES PROGRAMS 22,718,110.53 23,946,250.13 1,228,139.60 94.9%
Excess Rev over Expenses 167 173 44
To be on budget, percentage should be 91.67
St. Croix County Health and Human Services Board
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January 14, 2005
ST CROIX HEALTH CENTER
O R'b06 Rf
I JANUAR THROUGH _NOVEMBER ' ACTUAL JA N -NOV DIFFERENCE %
2004
BUDGET
' CENSUS 70.5 70.64
-57114 100.2 %`
OPERATING REVENUE:
WEbf6ARff' ' 1_,226.9_72 _ 00
660,819-88; 546,152.12 55.5
MEDICAID $ 2,135,B04.00 2,349.485.03 i $ (213,681.03)! 11q.
L
PRI IVATE PAY 1,074,462. 00 $ 729,759.46 $ 344,702.54 67.97.
!ALL OTHER SOURCES q
6,706.00 25,137.22 $ (1 8,431.22) 374.8%
TOTAL OPERATING REVENUE 4 $ 3,765,201.59 $ 658.742.41 65.296!
OPERATING EXPENSES: Tm
!DAILY PATIENT SRVICES 3,607,389.85: $ 3,127,010.69 _ 480,379.16 86.7%
,SPECIA SERVICES 2157,452.§471 _ 3_4_'___'__
.233.22 87.2%1
, GENERAL SERVICES $ 1,173,975.87 1$ 968.311.72 205.664.15 82,5% j
ADMINISTRATIVE SERVICES $ 501,036.96 466,454.03 $ 34,582.93 93.1 %
'UNASSIGNED:
- 3.00 $ 14,837.0 O� 91.796
.. ..... ... .. .. . . . . . ......... ..
zOTHERS $ jbj ,423.05 . . .. . 262,790.60 $ 49 6 . 32 4 5 83.6 %
.. . ........ . . ......... . .. .. .......
TOTAL OPERATING EXPENSES $ 6,030,278.67 i $ 5,210,949.76 _.._$._.._._.. 86.4%,
.. .. . .. .. .......
NET FROM OPERATIONS $(1,425,748.17)
NON—OPERATING ITE MS: z
, REVENUE FROM RATE APPEALS .$ 17,650.00 $ 16.181.00 1.469.00 91.7%
IGT FUNDS(%BASED) $ .500.00 $ 631.202.00 28.00
.. ... ..... . 8,9 98.7%1
..
$
.. . ... . .. .... . ...
CO ALLOCATIONS(%BASED) 815,460.00 $ 747,527.00 $ 67,953.00 91.7%;
TOTAL NON-OPERATING ITEMS $ 1,472,630.00 $ 1,394,910.00 $ 77,720.00 94.7%4
............
,NET FROM ALL SOURCES (30.838.17).
.. ...... . ... . ........ ... .
'PERCENTAGE SHOULD BE
FUND BALANCE 01,V1104 1,911,092.35
OPERATIONS $
D
:
:FUND bKL)KNC END OF PERIOD $ — 1,880,254.18
.... ... . . .. .... ......... . .... ... . .....
*We have not received our Medicaid
,rates that are retro to 01101/2004. This
WII be shown as 2004 revenue by the _,
;auditors when it is available.
MENTAL HEALTH/AODA PROGRAM REPORT: Kiesler distributed a grid showing
facility/vendor contracts for 2004. He said worst-case scenario would be a
loss of $124,790 but hopes it will be less than that by the time the 2004
books are closed. He said bills are still coming in from February of 2004 so
it is extremely difficult to give a closer estimate. He said there was a
placement at Trempealeau County in December and that bill has not yet
arrived. He said revenues for AODA and CSP are on target. There will be a
1
St. Croix County Health and Human Services Board
Page 6
January 14, 2005
shortfall in Mental Health Outpatient due to more clients being on MA, more
indigent clients and less privately insured clients. Kiesler stated he is
working with the MH OPS Staff to develop strategies to correct for the
changing market. Kiesler stated he plans on reporting to the Board in April
on strategies developed for Board approval.
FAMILY AND CHILDREN'S
Swenson left the meeting at 9:10 AM.
A foster care client read a statement regarding the policy that children in
foster care are not allowed to get their driver's licenses while they are in
foster care until they are 18. A policy was established that minors in foster
care must be 18 before obtaining their driver's license.
Swenson returned to the meeting at 9:15 AM.
LONG TERM SUPPORT Lockwood reported the State received our application for
the Aging and Disability Resource Center grant before the deadline. He said
the grant if awarded and accepted would develop an Aging and Disability
Resource Center (ADRC) to improve access for individuals with disabilities of
all ages to have greater control over their lives by improving their ability to
make informed choices. The county may need to give oral testimony in early
February if the contract is awarded. A decision about awarding the grant will
be made by the end of February. He said five grants will be awarded and the
grant amount will be determined by the county size. There are nine counties in
Wisconsin that currently have a resource center, five of which are associated
with Family Care. The long -term plan is to have a resource center in every
county. The first year of the grant is Federal money for program development.
The second year and thereafter, there will be a minimum of $200,000 for
operating an Aging and Disability Resource Center. The county is not required
to provide this service and can opt out at any time. The resource center will
be separate from the county and have no county employees. The county will
purchase services from the St Croix Family Resource Center and will not be
employing anyone to implement the ADRC. The object of the resource center is
about helping people regarding long -term care. The resource center would be a
central intake point for long term care.
Lockwood reported on the financial projections for 2004. Depending on waiver
dollars of $50,000 to - $150,000, it is most likely the balance will be
breakeven. The state and federal supplemental allocations over the last six
years have resulted in average county cost reductions of $160,000 per year.
The Board recessed from 9:40 to 9:50 AM.
REQUEST TO ISSUE BIDS FOR (WHEELCHAIR LIFT EQUIPPED) 14 PASSENGER BUSSETTE FOR
ST. CROIX INDUSTRIES Eichstaedt said he has contacted Dana Baker regarding the
bidding process. It was the consensus of the Board to follow previous practice
of opening the bids before the meeting and preparing a spreadsheet regarding
bid results for presentation to the Board.
Motion A motion was introduced by Wentz, seconded by Rasmussen, and
unanimously adopted: That the Board approves issuing bids for a wheelchair
lift equipped 14- passenger bussette for St. Croix Industries.
FAMILY AND CHILDREN'S Johnson said there was approximately $100,000 in
alternate care expenses in December. He said $60,000 was budgeted in Family
and Children's for collections and $51,571 has come in. He said in two cases
the county was able to bill insurance so we were able to recoup monies for
.St. Croix County Health and Human Services Board
Page 7
January 14, 2005
care. This insurance payment helped to make budget on revenues for
collections. Also, two youth were approved for waiver slots and we are working
with Long Term Support to recoup approximately an additional $10,000 to cover
expenses that have already been incurred. He anticipates we will receive a
total of approximately $30,000 in unbudgeted revenues.
ACTION ON RESOLUTION SUPPORTING REFERENDUM ON STATE VERSUS COUNTY FUNDING FOR
STATE - MANDATED HUMAN SERVICES
Motion A motion was introduced by Caflisch, seconded by Krueger, That the
Board approves the Resolution supporting Referendum on State versus County
funding for State - mandated human services.
Krueger withdrew the seconded; Caflisch withdrew the motion.
Borup said he has rewritten the resolution to include only human service issues
and eliminate reference to the court system. Borup indicated he strongly
supports the resolution as he remains opposed to the State's authority to
mandate services and not address issues of inflation, the rapid growth of our
county, and increasingly complex programs that place more demands on county
government. Borup said if the programs are not funded, the work should be sent
back to the state.
Motion A motion was introduced by Caflisch, seconded by Krueger, and
unanimously adopted: That the Board supports the resolution regarding the
State of Wisconsin funding State - mandated human service programs and that the
question: Should the State of Wisconsin, not the county taxpayer, pay for the
cost of state mandated human services in St. Croix County? be placed on the
April ballot in the spring election as an advisory referendum question.
WHEREAS, county government acts in partnership with state government in
Wisconsin to provide programs and services for the citizenry; and
WHEREAS, state government requires county government to provide programs and
services that are not always funded by the state government; and
WHEREAS, a major funding source for county government is the county property
tax; and
WHEREAS, some mandated programs and services are not funded or fully funded
by the state, causing the county property taxpayer to supplement funding with
property tax dollars; and
WHEREAS, the public has an increased concern over how property tax dollars
are being expended; and
WHEREAS, two statewide commissions (Kettl and Sheehy) suggested that the
circuit court system and human services should not be funded by the property
tax; and
WHEREAS, Chapter 59.52 (25) of the State Statutes states "the board may
conduct a countywide referendum for advisory purposes or for the purpose of
ratifying or validating a resolution adopted or ordinance enacted by the
board contingent upon approval in the referendum. "; and
WHEREAS, the following advisory referendum question is an effective way to
determine how the citizenry believes human services should be funded.
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St. Croix County Health and Human Services Board
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January 14, 2005
Should the State of Wisconsin, not the county taxpayer, pay for the
cost of state mandated human services in St. Croix County?
NOW, THEREFORE, BE IT RESOLVED that St. Croix County will,place the above
mentioned question on the April ballot as advisory referendum question.
BE IT FURTHER RESOLVED that a copy of this resolution be sent to the
Wisconsin Counties Association.
MEDICAL EVALUATIONS INC. (MEI) REQUEST TO PERIODICALLY LEASE SPACE FOR MEDICAL
EXAMS The medical rou is requesting to lease exam space at
9 p q g 40.00 /exam. P $
There is suitable space available in Public Health and Nelson is comfortable
with this request.
Motion A motion was introduced by Wentz, seconded by Burri, and unanimously
adopted: That the Board approves negotiating a contract with fees with Medical
Evaluations Inc. and to include a termination clause.
NURSING HOME The Nursing Home census is 72. The 2004 census averaged 70.58;
budget was based on 70.5. The state is changing the reporting system for the
cost report beginning 01/01/05 and nursing homes will lose a management tool
due to this. Now an accounting firm is offering a web -based software to
track data to benchmark each facility as well as compare with other
facilities. Presently there is a $500 cost to set up the program and $275
monthly to subscribe, which may be lowered with help from WAHSA involvement.
The software will track all costs and hour per patient day (PPD) as well as
some accounts receivable and clinical data.
The Nursing Home just received $255 from Medicare for 2003, an example of the
adjustments that can be made up to three years later by Medicare. Luckily,
this adjustment was positive.
A letter has been sent to Econofoods indicating dissatisfaction with an
increased pharmacy error rate. The Nursing Home is working with Dana Baker to
RFP pharmacies this month.
It was again pointed out that if an item is not on the agenda, it cannot be
discussed at the meeting.
PERSONNEL ISSUES Jennifer Fitzmaurice is scheduled to start January 31. She
will be filling the position vacated by Judy Ziegler's retirement.
Dorsey asked if there were any other issues to bring before the Board.
Motion A motion was introduced by Caflisch, seconded by Burri, and
unanimously adopted: that the meeting be adjourned.
Time: 10:25 AM
Chair:
Attest:
(Secretary)