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HomeMy WebLinkAboutHealth & Human Services 02-11-05 STAN KRUEGER WILL REVIEW VOUCHERS AT 7:45 AM REVISED - 02/07/05 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: 02/11/05 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: 03/11/05 (tentative 02/24/05) ACTION ON PREVIOUS MINUTES: 01/14/05 ANNOUNCEMENTS APPOINTMENTS: UNFINISHED BUSINESS: NEW BUSINESS: 1. Consideration of Claims and Vouchers 2. Financial Report 3. Program Reports a. Public Health 1. Communicable disease 2. Community Health Needs Assessment Report b. Mental Health /AODA 1. Mental Health Functional Screen Grant 2. Mental Health Homeless Grant 3. Methamphetamine Consortium 4. Diversion RFP C. Nursing Home 1. Census Report 2. Pharmacy RFP Update 3. Request to Reclassify a Non union Grade4 (Administrative Secretary) to a Non union Grade 5 (Housekeeping /Laundry Supervisor) 4. Personnel Issues 5. Aurora Resident Alternatives 2004 Contract additional claims for service 6. Consideration of Joint Mental Health /AODA Emergency Services with Dunn County 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 ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD February 11, 2005 The St. Croix County Health and Human Services Board met on February 11, 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 Esther Wentz MEMBERS ABSENT: Dr. Michael Kretz, excused Deb Rasmussen, excused Ralph Swenson, excused STAFF PRESENT: John M. Borup, Health and Human Services Director Jennifer Pempek, Accounting Supervisor Ron Kiesler, Mental Health /AODA Coordinator Steve Kirt, Mental Health /AODA Clinical Services Supervisor Ron Lockwood, Long Term Support Coordinator Barbara Nelson, Public Health Supervisor - Health Officer Carolyn Krieger, Nursing Home Administrator 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, March 11, 2005 at 8:30 AM. Burri 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 Caflisch, and unanimously adopted: That the minutes of the 01/14/05 Health and Human Services Board meeting be approved as circulated. ANNOUNCEMENT Borup announced that the Nursing Home construction committee met and the final payment was made for the Nursing Home remodeling. The fine amount was deducted from the final payment. Borup introduced Jennifer Pempek as the new Accounting Supervisor. She is scheduled to attend a Regional Financial Managers meeting in Eau Claire today so will leave the meeting early. Borup reported that he is scheduled along with the Sheriff to give a community presentation regarding poverty and violence in the community at the request of a five - church ecumenical group from Hudson and River Falls on February 19 in Hudson. Borup informed the Board that there are critics of the program and wanted to make the Board aware of the situation. CONSIDERATION OF CLAIMS The following reports were distributed to the Board: January fixed asset report and December unemployment report. St. Croix County Health and Human Services Board Page 2 February 11, 2005 Health and Human Services Board member, Krueger, reviewed the vouchers and questioned the following vouchers: 39074: Best Buy Stores, $474.97, Client expense through Long Term Support. 40159: USA Northland, $804.00, AODA advertising in telephone directory. 40883: $1,873.29, replacement payroll check for employee. 41695: Rapid Cable, $49.40, Nursing Home resident cable expense. 42709: Great Wolf Lodge, $186.00, employee /staff training. 40991: Carpet Center, $4,267.00, carpet replacement. 41077: Tracey and Thole, SC, $7,800.00, audit expense. 41078: Verizon Wireless, $32.39, phone expense. 41639: Sign Me Up LLC, $750.00, education outreach. 42856: Ruth Lehman, $16.20, employee travel. 42893: Vonasek and Schieffer, Inc., $15,076.00, Nursing Home remodeling project. 40986: Xcel Energy, $324.20, gas energy. Motion A motion was introduced by Krueger, seconded by Wentz, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book with the exception of voucher #41639 in the amount of $1,873.29 due to needing clarification of the dates on the voucher: Human Services vouchers 39074 through 39078, dated January 03, 2005 in the amount of $2,347.40. Human Services and Nursing Home vouchers 40137 through 40164, dated January 13, 2005 in the amount of $7,216.08. Human Services and Nursing Home vouchers 40820 through 40879, dated January 20, 2005 in the amount of $331,917.83. Human Services and Nursing Home vouchers 40880 through 40914, dated January 20, 2005 in the amount of $17,402.16. Human Services vouchers 40915 through 40920, dated January 20, 2005 in the amount of $31,389.41. Human Services and Nursing Home vouchers 40987 through 41080, dated January 27, 2005 in the amount of $123,115.20. Human Services and Nursing Home vouchers 40941 through 40986, dated January 27, 2005 in the amount of $271,545.86. Human Services and Nursing Home vouchers 41615 through 41647, dated February 02, 2005 in the amount of $54,579.45. St. Croix County Health and Human Services Board Page 3 February 11, 2005 Human Services and Nursing Home vouchers 41648 through 41695, dated February 02, 2005 in the amount of $95,491.84. Human Services vouchers 42472 through 42613, dated February 11, 2005 in the amount of $66,562.52. Human Services vouchers 42751 through 42774, dated February 11, 2005 in the amount of $56,990.66. Human Services and Nursing Home vouchers 42820 through 42895, dated February 11, 2005 in the amount of $57,986.41. Human Services vouchers 42614 through 42750, dated February 11, 2005 in the amount of $123,388.22. Nursing Home vouchers 42775 through 42819, dated February 11, 2005 in the amount of $24,754.72. Human Services, Workshop, Public Health, Social Services vouchers 1 through 33, dated January 10, 2005 in the amount of $349,635.86. Human Services, Workshop, Public Health, Social Services vouchers 34 through 43, dated January 13, 2005 in the amount of $56,449.55. Human Services, Workshop, Public Health, Social Services vouchers 44 through 74, dated January 24, 2005 in the amount of $362,969.54. Human Services, Workshop, Public Health, Social Services vouchers 75 through 107, dated February 04, 2005 in the amount of $359,632.18. Human Services and Nursing Home vouchers 1 through 33, dated January 13, 2005 in the amount of $200,969.53. Human Services and Nursing Home vouchers 34 through 44, dated January 18, 2005 in the amount of $21,232.35. Human Services and Nursing Home vouchers 45 through 76, dated January 27, 2005 in the amount of $190,687.26. Human Services and Nursing Home vouchers 77 through 109, dated February 10, 2005 in the amount of $169,862.73. FINANCIAL REPORT Borup said year -end figures may be available by the next Health and Human Services meeting. Borup said he anticipates the audit will begin in March. He said out of home placement costs for Family and Children are running with some deficits and Kiesler will update Mental Health inpatient costs during his report. Borup said the State is trying to cut its deficit by reducing allocations to counties. Counties are expected to cover these cuts by earning more Federal MA dollars. Despite the State's "hold harmless" promise, the changing revenues for 2004 and 2005 may impact our revenues. Borup has concern over the accuracy of the State's numbers and will keep the Board updated. Borup reminded the Board that there was no carryover of funds in the amount of $200,000 into the 2004 budget from 2003. MENTAL HEALTH /AODA PROGRAM REPORT Kiesler distributed grids regarding Mental Health /AODA financial status with contracts for 2004 and January, 2005. He St. Croix County Health and Human Services Board Page 4 February 11, 2005 said it is difficult to determine the amount of the deficit due to when the books are closed. Krueger expressed that the revenues for the contracts should be applied to the appropriate year. Kiesler said the contracts require the hospitals to bill insurance twice before billing the County so it is difficult to determine when monies /billing may come in. Kirt said hospitalizations for the month of January, 2005 are up dramatically from previous years but more clients have had insurance. Kirt reported there have been years when there were a total of 13 commitments for the entire year but there were seven commitments in January, 2005. MENTAL HEALTH FUNCTIONAL SCREEN GRANT Kiesler informed the Board that he applied for a grant from the State for $5,034 to reimburse the County for the costs associated with training staff to use the State - developed web -based MH /AODA Screen to assess Comprehensive Community Services (CCS) and Community Support Program (CSP) clients. This screen is voluntary for CSPs but mandated for CCS programs, which we do not have. State officials have informed counties that the MH /AODA Functional Screen will be required for CSPs after the CSP administrative code rewrite /update is complete. With the grant, it would be no cost to the County. He said if we do not receive the grant, we will wait to implement the screen until the State mandates it for CSPs. MENTAL HEALTH HOMELESS GRANT Kiesler said there is a $48,000 pool for Homeless Grant and Mental Health applied for $25,000 of this grant to create housing options for the severe mentally ill homeless in St. Croix County. This would help in moving clients out of Atlas House sooner, thus leaving Atlas beds available to move clients out of more costly psychiatric hospital placements sooner. METHAMPHETAMINE CONSORTIUM To address the growing meth problem in this region, St. Croix County has joined Polk County, Pierce County and private agencies to develop a Coordinated Community Response (CCR) to Methamphetamine consortium. St. Croix County is one of twelve counties in the western region that has joined the State in applying for a grant from Substance Abuse & Mental Health Administration (SAMHSA) for $500,000 to develop treatment programming for methamphetamine users. Polk County has agreed to be the fiscal agent for this consortium. Kirt reported methamphetamine use is a growing concern in rural areas. Kirt indicates it takes a meth user anywhere from six months to a year to feel pleasure again and they are not able to process information. He said people should be in a safe place for three months and then start treatment to allow them a chance to regain their cognitive functioning and then start treatment to have successful results. Dave McQuillen, Special Methamphetamine Prosecutor for Pierce /Polk /St. Croix Counties, reports meth usage is at a critical /crisis stage due to signs of increased organization in trafficking suggesting that there may be outside mob connections. DIVERSION RFP Kiesler has been working with Dana Baker to develop a Request for Proposal to solicit bids for a mobile emergency services inpatient diversion program and the RFPs should be ready to send out by the end of the month. Discussion has begun with Polk, Pierce and Dunn County to begin this venture as Kiesler believes that a four county consortium will improve our ability to attract and negotiate with potential vendors. CONSIDERATION OF JOINT MENTAL HEALTH /AODA EMERGENCY SERVICES WITH DUNN COUNTY Dunn County does not currently have a emergency services system in place and are interested in joining with St. Croix County to create a shared system. Kiesler said the payback will be small but there is the potential for joint mental health emergency services. He requested permission and support to go forward to continue to investigate this venture. St. Croix County Health and Human Services Board Page 5 February 11, 2005 Motion A motion was introduced by Wentz, seconded by Burri, and unanimously adopted: That the Board approves Kiesler pursuing a partnership with Dunn County to create a shared emergency system. NURSING HOME Because of the downsizing the nursing home will receive a special rate from January 2004 to June 2004. A special cost report needed to be submitted for this but we have not received the rate. There will be another rate from July 2004 to December 2004. Krieger anticipates the nursing home will be slightly in the black at the end of 2004. The January average census for the nursing home was 71. She said there were 16 referrals with two admissions in January. PHARMACY RFP UPDATE The RFPs for pharmacy services have been sent and are due back by February 21, 2005 and will be awarded by February 28, 2005. Krieger said a team of five people will review the proposals. Krieger said Dana Baker has been very helpful and knowledgeable with the RFP process. She said there are multiple areas where the nursing home needs update /upgrade in technology services. If the local vendor does not get the bid, a 90 -day notice will terminate their contract. It was the consensus of the Board that Borup and Krieger go ahead and award the bid. Free legal counsel from WAHSA regarding pharmacy errors indicated that the nursing home could have liability issues with the state and federal regulations if the matter is not corrected. REQUEST TO RECLASSIFY A NON -UNION GRADE 4 (ADMINISTRTIVE SECRETARY) TO A NON- UNION GRADE 5 (HOUSEKEEPING/ LAUNDRY SUPERVISOR : Krieger said four administrative staff were laid off in the Nursing Home. The supervision of the housekeeping/ laundry unit was shifted to the maintenance lead worker who received an additional $1.27 /hour for the additional duties. After the budget process was completed and after approval by Ralph Robole, the lead worker resigned from the housekeeping/ laundry duties last November. Wentz and Krueger agreed this request is a reclass and reclasses may only be done one time a year for both union and non -union staff. A request will be made to personnel to ask for an exception to the reclass since the reclass took place after the reclass date and the nursing home has no housekeeping/ laundry supervisor at this time. The reclass would save the nursing home about $600 this year. It was the consensus of the Board that Krieger should supervise the housekeeping /laundry unit until a decision is made. Motion A motion was introduced by Krueger, seconded by Caflisch, and unanimously adopted: That the Board agrees to send the reclass request to the Personnel Committee. The Board recessed from 10:00 to 10:05. Krueger left the meeting at 10:05. AURORA RESIDENTIAL ALTERNATIVES 2004 CONTRACT ADDITIONAL CLAIMS FOR SERVICE Lockwood and Kiesler came before the Board because Aurora has asked for additional payments for 2004 because of vacant beds and MA personal care collections being lower than anticipated. Aurora has requested more monies at the end of the contract in past years. Aurora is a large provider of care and serves both the mental health and developmentally disabled population with their contract exceeding $3.5 million. Their contract has empty beds built into the rate but the 2004 empty beds and hospital stays exceeded that number. Lockwood said we have honored their requests in the past. Lockwood estimates the net cost to the county if the request is honored will be between $25,000 to St. Croix County Health and Human Services Board Page 6 February 11, 2005 $30,000 due to the Home and Community Based Waiver Program. 60% of the monies are Federal dollars and 40% is County with 7 -10% allowed for administration. Given the tight budget, Borup recommended making no commitment to pay anything pending the outcome of the 2004 audit. Borup anticipates Aurora will ask to renegotiate 2005 rates for their contract. Motion A motion was introduced by Caflisch, seconded by Burri, and unanimously adopted: That the Board approves paying $19,372.32 missed MAPC billing to Aurora and to not pay the 2004 empty bed and hospital amount of $60,766.83. PUBLIC HEALTH COMMUNITY HEALTH NEEDS ASSESSMENT REPORT Nelson distributed a copy of the St. Croix County Community Health Needs Assessment Report -- 2005 and Beyond. She said this brochure is being distributed throughout the county. Binders of the entire assessment process and local community health improvement plan have been placed in the public libraries. Nelson gave a power point presentation regarding the report. This is not a Public Health department only plan, rather a plan that requires public health partners involvement. Public Health is required, by statute, to collect and assemble data to analyze and bring forward an improvement plan. COMMUNICABLE DISEASE Nelson said there are currently 56 positive or probable cases of Pertussis in St. Croix County. 460 hours of staff time have been used to follow up on the disease and over $450 in treatment costs have been paid as Public Health has an obligation to control and prevent spread per statute. Nelson reported influenza rates are up. She said 95% of the cases isolated are Influenza A and 75% are Influenza B, which have components or closely related components of the vaccine given this year. Nelson briefly reported on the Avian influenza, which it is believed will cause the next pandemic episode. Dorsey asked if there were any other issues to bring before the Board. Motion A motion was introduced by Wentz, seconded by Luckey, and unanimously adopted: that the meeting be adjourned. Time: 10:50 AM Chair: Attest: (Secretary)