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HomeMy WebLinkAboutHealth & Human Services 06-10-05 RALPH SWENSON AND DEB RASMUSSEN WILL REVIEW VOUCHERS AT 7:45 AM Revised: 06/03/05 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: 06/10/05 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: 07/15/05 (06/23/05 meeting tentative) ACTION ON PREVIOUS MINUTES: 05/13/05 ANNOUNCEMENTS APPOINTMENTS: UNFINISHED BUSINESS: 1. Velocity Wireless contract negotiation NEW BUSINESS: 1. Election of Health and Human Services Board Officers 2. Consideration of Claims and Vouchers 3. Financial Report 4. Capital Outlay 5. Health and Human Services Audit Report a. Fund Balance b. Policy regarding application of year end funding c. Billing cut off 6. Program reports a. Nursing Home Report b. Public Health Program Report /Update c. HFS 140 Review (June 9) d. Waiting lists 7. Personnel Issues 8. New Position Request 9. Department Strategic Planning 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 n � * *ADDITIONS /CHANGES /CORRECTIONS o� ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD June 10, 2005 The St. Croix County Health and Human Services Board met-on June 10, 2005 at the St. Croix County Health and Human Services /Health Center complex. MEMBERS PRESENT: Thomas Dorsey, Chair Tom Caflisch Tom Dowd Linda Luckey Deb Rasmussen Ralph Swenson Esther Wentz MEMBERS ABSENT: Lois Burri, excused Dr. Michael Kretz, excused STAFF PRESENT: Fred Johnson, Health and Human Services Director Jennifer Pempek, Financial Manager Ron Kiesler, Mental Health /AODA Coordinator Steve Kirt, Mental Health /AODA Clinical Services Supervisor Kristie Tellijohn, Director of Nursing- Nursing Home Barbara Nelson, Public Health Supervisor - Health Officer Kathy Dunlap, Family and Children's Coordinator Malva Berg, Secretary OTHERS PRESENT: Michelle .Pietrick, Finance Director Steve Tracey, Auditor, Tracey and Thole CPA 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, July 15, 2005 at 8:30 AM. Wentz and Dowd will review vouchers at 7:45 AM. ANNOUNCEMENTS Johnson said he appreciated the full Board's attendance at the Open Hearing. The Board questioned if a letter was received from Patty Draxler from the.Family Resource Center and Johnson will investigate this. Johnson thanked Rasmussen and Burri for attending the Public Health 140 Review on 06/09. Johnson informed the Board that a County Department Head meeting will be held at St. Croix County Health and Human Services on June 24, 2005. Budget instructions will be distributed at that meeting. AGENDA Motion A motion was introduced by Wentz, seconded by Rasmussen, and unanimously adopted: That the agenda be approved as circulated. MINUTES Motion A motion was introduced by Swenson, seconded by Caflisch, and unanimously adopted: That the minutes of the 05,/13/05 Health and Human Services Board meeting be approved as circulated. VELOCITY WIRELESS CONTRACT NEGOTIATION Johnson reported there are no new updates to the Velocity contract negotiations and will report back to the Board when more information is available. �i 3o - o�' r r St. Croix County Health and Human Services Board Page 2 June 10, 2005 ELECTION OF HEALTH AND HUMAN SERVICES BOARD OFFICERS Dorsey turned the meeting over to Swenson. Swenson announced that the election of officers would take place: Swenson asked for nominations for the position of chair. Wentz nominated Dorsey for the Chair position. Caflisch requested to close nominations for Chair. Swenson requested a unanimous vote be cast for Dorsey to be Chair. Swenson turned the meeting over to Chair Dorsey. Dorsey asked for nominations for the position of Vice Chair. Wentz nominated Swenson for the position of Vice Chair. Caflisch requested to close nominations for Vice Chair. Dorsey requested a unanimous vote be cast for Swenson to be Vice Chair. Dorsey asked for nominations for the position of Secretary. Caflisch nominated Wentz for the position of Secretary. Rasmussen and Swenson requested to close the nominations for Secretary. Dorsey requested a unanimous vote be cast for Wentz to be Secretary. CONSIDERATION OF CLAIMS Health and Human Services Board members, Swenson and Rasmussen, reviewed the vouchers; the following vouchers were pulled for discussion: HUMAN SERVICES: 49941: Wisconsin Early Autism Project, $17,500.80, LTS purchased services. 50807: Pines II, Inc., $1,000, AODA purchased services. For three clients receiving AODA treatment. 50696: Heartview, Inc., $28,198.94, LTS purchased services. Motion A motion was introduced by Swenson, seconded by Rasmussen, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book: Human Services voucher dated May 19, 2005 in the amount of $3,390.00. Human Services vouchers 49953 through 49958, dated May 26, 2005 in the amount of $45,493.60. Human Services vouchers 50952 through 50983, dated June 10, 2005 in the amount of $49,398.63. Human Services vouchers 50739 through 50900, dated June 10, 2005 in the amount of $150,970.01. Human Services vouchers 50577 through 50738, dated June 10, 2005 in the amount of $195,449.43. Human Services and Nursing Home vouchers 49406 through 49447, dated May 19, 2005 in the amount of $43,115.06. Human Services and Nursing Home vouchers 49448 through 49480, dated May 19, 2005 in the amount of $6,253.08. Human Services and Nursing Home vouchers 49830 through 49952, dated May.26, 2005 in the amount of $475,375.89. St. Croix County Health and Human Services Board Page 3 June 10, 2005 Human Services and Nursing Home vouchers 50219 through 50283, dated June 2, 2005 in the amount of $65,588.27. Nursing Home vouchers 50901 through 50951, dated June 10, 2005 in the amount of $24,764.27. Human Services, Workshop, Public Health, Social Services vouchers 321 through 353, dated June 01, 2005 in the amount of $389,503.33. Human Services, Workshop, Public Health, Social Services vouchers 300 through 330, dated May 17, 2005 in the amount of Human Services and Nursing Home vouchers 339 through 371, dated June 02, 2005 in the amount of $173,743.70. Human Services and Nursing Home vouchers 307 through 338, dated May 19, 2005 in the amount of $176,534'.76. HEALTH AND HUMAN SERVICES AUDIT REPORT Steve Tracey from Tracey and Thole, CPAs, presented the Nursing Home Statement of Net Assets, which was previously the Balance Sheet. He reported the Nursing Home has no outstanding debt except for employee leave. He said the Nursing Home had a budgeted loss of $1,176,000 without the County levy but the actual loss was $875,000 without the County levy. He said the working capital availability and the assets of the Nursing Home have also increased. Tracey recommended the Nursing Home have working capital of 30 to 60 days of operations. He said the Nursing Home is in a good financial position right now with 30 to 45 days of working capital. He also reported the net income loss for the Nursing Home is less than budgeted. Tracey informed the Board that the Nursing Home is an enterprise fund whereas Human Services is a special revenue fund. Tracey said ITP funds of $564,000 were budgeted but $706,000 was realized. He said ITP has been a consistent allocation and Tracey is comfortable with how it is allocated. Tracey reported Health and Human Services has outstanding debt. He said the actual fund balance at the end of 2004 was ($367,283). He reported $200,000 was budgeted to carryover from 2003 to 2004 but $200,000 was not available to carryover at the end of 2003. He said the County received $800,000 WIMCR monies in January and February, however only realized $300,000 because $500,000 was taken back by the State. Tracey recommended the deficit in Human Services be addressed. He said Health and Human Services revenues are reported by program, not by source; the County reports by source. Pietrick said the County closed the 2004 books on 05/01/05 but is looking at moving that date up in the future. Tracey issued the management letter from the audit. He offered to reissue his 1994 letter regarding fund balance recommendations for Health and Human Services. Tracey stated he is very pleased with the positive audit and the work Pempek has done. The Board recessed from 9:40 to 9:50 AM. UPDATE ON MENTAL HEALTH DIVERSION Kiesler updated the Board on the RFP for diversion facility. Bids received from the RFP were too high so a notice of no award was issued by Dana Baker. Kiesler stated Baker was instrumental in leading the four County consortium through the RFP process. All four counties are working together to try to get something affordable that will meet our needs. It continues to be a work in progress. St. Croix County Health and Human Services Board Page 4 June 10, 2005 DISCUSSION OF MENTAL HEALTH /AODA TREATMENT OPTIONS RELATED TO THE JAIL Judge Lundell requested Human Services consider providing treatment services in the jail. Currently Mental Health provides psycho - educational services to the jail. Kirt and Kiesler informed the judge the request for those services would need to come from the Jail and its parent committee, Public Protection. Supervisor Denise Gunderson, who was a part of the meeting this discussion came out of, invited Kirt and Kiesler to the Public Protection Committee to discuss jail needs and honor Lundell's request to look at this possibility. The treatment may be ordered by the court or inmates may be offered incentives to enroll. At this time, just alcohol treatment is being looked at. The staff resources needed would have to be reprioritized within AODA unit if we were to provide the additional treatment services to the jail. This meeting is intended to be a dialog as a preliminary step as to what is expected as it is not clear what will be expected. The Mental Health contract report was distributed to the Board. Johnson said this is a very thorough report and staff are working on consolidating purchased services reports rather than reporting on only one department. Family and Children's and Long Term Support also do a significant amount of contracting and including that information will give a better handle on contract costs. On the Mental Health report there was a jump from $57,622 to $143,550 of possible outstanding liability in one month due to inpatient psychiatric stays. FINANCIAL REPORT The financial reports are still a work in progress to try to get into a more user friendly format. No fund balance is included in the report. The Health and Human Services report includes some County allocations as allocations are built into program areas as the programs need county match to get program revenue. There is a 30 to 60 day lag to bill the state and another 30 to 60 day lag in the state paying. St. Croix County Health and Human Services Board Page 5 June 10, 2005 ;._... ST CROIX HEALTH CENTER_...... OPERATIONS REPORT JANUARY THROUGH APRIL � � �� JAN -APRIL 2005 BUDGET ACTUAL DIFFERENCE % '.CENSUS 70. _- _.......__ 6 . _._ . -0.5, 0.9787234 `OPERATING REVENUE: MEDICARE S 743,498.Q0 $ 266,900.47 = $ 476,597.53 ' 0.3589794 _- .. .. ..._.._..__ _ .............___ .._._ _ _ _ _.._. ......_- _._.._.. _. ,59 ._. MEDICAID $- 2,642,397.00 $ 885,070.71 ; $ 1,757,326.29. 0.3349499 _ ..$,.__..817,926.00 $ 184,387.75 $ 633,538.25 0.2254333 RATE APPEALS - ACTUAL I $ 17,652.00 ° .$ ..... $ 17,652.00: 0 IGT FUNDS - ACTUAL $ 450,000.00 $ SOURCES*** 135,299.00 t $ 314,701.00 _ 0.3006644 ,ALL_OTHER - _.- - _.._.___..__.. _.. _$, 9 484.00 $ 16,840.14 E . S (7,356.14) 1.7756369 TRANSF C ER FROM ONTINGENCY ' $ ..._ ..__ $ 8,600.00$ (8,600.00) gTOTAL OPERATING REVENUE $ 4,680,957.00 $ 1,497,098.07 ; $ 3,183,858.93 ' 0.3198273 _. _._ . ;OPERATING 'DAILY PATIENT SRVICES 3,411,487.50 $ 1,128,261.54 $ 2,283,225.96 0.3307242 !SPECIAL SERVICES $ 266,510.42 $ 84,547.41 $ 181,963.010.3172387 ;GENERAL SERVICES ...._.._..._,... . __.....__ .......__._;...$.. 1,111,184.21 364,292.63: $ 746,891.58 ; 0.3278418 ADMINISTRATIVE SERVICES _ ; $ 539,734.15: $ 175,680 Y $ „364,054.08 ' 0.3254937 ° UNASSIGNED: DEPRECIATIO NQ; BASED) _ _ _ $_ 1 $ 51,497.60: $ 66,674.40: 0.4357851 ?OTHERS: (INS -WC- CAP UT IL) 1 255,835.00 ,44 rvM 1526.27 ' S 103,388.73 0.5958773 " ;TOTAL OPERATING EXPENSES $ 1,956,725.52 ; $ 3,746,197.76 i 0.3431092 'IONS ----- ----- - NET FROM OPERAT.._._.__.__ '(COST OF DOING BUSINESS PRIOR TO =APPLYING LEVY & OUTSTANDING REV) " LOUISTANDING REVENUES OUTSTANDING RATE APPEAL REV _ $ _ 17,652.00 $ 5,884.00 $ 11,768.00 , 0.333 3333 A OF OUTSTANDING IGT $ 314 ,771.00 $ _37,500.00 1 $ 277,271.00: 0.1191342 t CO AL166 ATI0NS(%BABED) $ 1,017,504.00 $ 339,168.00 ; $ 678 0.3333333 TOTAL OUTSTANDING $ 1,349,927.00 $ 382,552.00 - i $ 967,375.00 NET FROM ALL SOURCES E $ (77,075.45) _ ........ . ...... ._.. -.- _..... ...... . .__....__... ....... .._. _ ........_ _ 'PERCENTAGE SHOULD BE 33.32 r NHAPRILFINANCIAL REPORT - mm W µmm M _........... _......... _._... _.... _ _..... ="Private PaV revenues runnifi __._.,..........._ X08,252 under its proj amount ; i ' Prior years dividend payment of i ;$12,185.61_ recd 4105 .......... _.._ ..... ..... _...... ...._....__._......._......_,.. . St. Croix County Health and Human Services Board Page 6 June 10, 2005 HEALTH AND HUMAN SERVICES - 2005 SUMMARY Total OF REVENUES Budget Jan -April Balance % Administration 1,020,399.92 261,891-.23 758,508.69 25.7% AODA Services 473,948.78 149,598.08 324,350.70 31.6% Long Term Support 17,299,811.93 4,730,141.29 12,569,670.64 27.3/ Mental Health 3,006,239.35 733,362.36 2,272,876.99 24.4% Family & Children's 3,059,580.00 1,057,034.97 2,002,545.03 34.5% Public Health 1,471,999.17 475,966.79 996,032.38 32.3 Economic Support 927,622.06 221,934.80 705,687.26 23.9% General Relief 14,832.45 5,000.00 9,832.45 33.7% Coordinated Services /ED! 380,509.80 211,102.24 169,407.56 55.5° REVENUES HUMAN SERVICES PROGRAMS 27,654A43.46 7.846.031.76 19.808.911.70 2 .4 SUMMARY Total OF EXPENDITURES Budget Jan.-April. Balance % Administration 1,020,399.92 304.508.45 715,891.47 29.6% Alcohol -Drug Abuse 473,948.78 181,732.61 292.216.17 38.3% Long Term Support 17,299,811.93 4,874,231.20 12,425,580.73 28.2% Mental Health 3,006,239.35 793,493.48 2,212,745.87 26.4% Family & Children's 3,059,560.00 996,201.87 2,063,378.13 32.6% Public Health 1,471,999.17 485,714.29 986,284.88 33.0% Economic Support 927,622.06 326,341.76 601,280.30 35.2% General Relief 14,832.45 100.98 13,031.0 12.1 V. Coordinated Service /SED 380.509.80 4,228.05 376,281.75 1.1 % EXPENDITURES HUMAN SERVICES PROGRAMS 27,654,943.46 7,968,252.69 19.686,690.77 28.8% Excess Rev over Expenses (122.220.93) CAPITAL OUTLAY Updated capital outlay plan was distributed to Board members. It was questioned if there was more on this year's 2006 capital outlay than last year's 2006 capital outlay and the answer was yes. Swenson requested due to a possible levy freeze that there be a tighter estimate for 2007 capital outlay. Board members questioned if a cost analysis has been done recently on doing laundry in -house versus sending it out. Johnson will investigate this. Motion A motion was introduced by Caflisch, seconded by Rasmussen: That the Board approves the capital outlay plan as presented unless Johnson finds changes that may be needed. Rasmussen withdrew the second to the motion; Caflisch removed the motion., It was the consensus of the Board to delay capital outlay until the July meeting. Luckey mentioned she has a problem approving something for aesthetics for the Nursing Home if the Nursing Home is in a deficit. Wentz questioned'architect fees listed on the Nursing Home capital outlay. The t St. Croix County.Health and Human Services Board Page 7 June 10, 20Q5 updated capital outlay will be mailed to Board members prior to the next meeting. NURSING HOME REPORT Tellijohn said the Nursing Home census today is. 70 with one admission and one discharge today. A report regarding Nursing Home levels of care, daily rates and definitions was distributed to Board members. This report explains how Nursing Home budgeting is determined for resident mix. Swenson requested a budget created on most probable census. WAITING LISTS Information on waiting lists in each unit was provided to the Board per request. Public Health, Economic Support, Birth to Three and.. Family and Children's have no waiting list. There are waiting lists in Long Term Support, Mental Health /AODA, and St. Croix Industries. Waiting lists will be discussed further under strategic planning. PUBLIC HEALTH PROGRAM REPORT /UPDATE Nelson announced that Dr. Sheri Johnson is the new Administrator of the Division of Public Health as of July 11, 2005. Board members received the agent (licensing and inspection) newsletter. She said fees may now be paid on -line with no cost to the Department and no fee to the County.,Nelson also referenced the change in enforcement components being added to the restaurant program. This is not a statutory change, only a local program change. Nelson distributed a smoke -free dining guide for St. Croix and Pierce County which was created through a collaborative headed by the Pierce /St. Croix Tobacco Free Coalition. The printing costs were paid by the WWMA (Western WI Medical Associates) and the four hospitals. HFS 140 REVIEW The HFS 140 review was completed on June 9th. Nelson thanked Rasmussen and Burri who joined the review process and stayed the entire time. She said the department was approved as a Level I (minimum requirement) and it will be determined at a latef time by the State as to Level II or III - classification. Rasmussen gave input on her experience stating it was a good learning experience. Nelson said it will take approximately one month to receive the official feedback from the review and she will update the Board when that documentation is received. NEW POSITION REQUEST Nelson requested to expand a current Public Health Nurse position from half time to.full time. The primary responsibilities would include communicable disease services. She said there may be some funding sources and some grants available to cover expenses of this position but this is just speculative at this time. Nelson left the meeting to calculate staff cost. Johnson said there is no agency -wide process to track recertifications. He requests one day a week of inservice coordinator time to address Health and Human Services inservice needs. He said one day per week would be approximately $12,000,.. =in staff time. There is no county -wide initiative on coordination of new staff and inservice training that Johnson is aware of so this responsibility is placed on individual departments. There is a need for coordination of ongoing- training for staff certification and licensing. Wentz will bring the issue up at' the Personnel Committee meeting as it is a larger county -wide issue. Nelson returned to the meeting. The nurse position is a Grade 7. position and. St. Croix County Health and Human Services Board Page 8 June 10, 2005 to add the additional half -time position would cost $35,650, which includes insurance of $7,500. Motion A motion was introduced by Wentz, seconded by Caflisch, and unanimously adopted: That the Board approves increasing the Public Health Nurse position from half time to full time and forward the request to the Personnel Committee with the correct position costs. Independent living skills is a mandated service for youth placed in alternate care. Youth must be in care for a certain lengths of time and age 15 and older to qualify for this service. Currently we receive $15,932 to fund this service but that amount can change yearly. This service does not have to be provided by a social worker and could be provided by a Mental Health Technician, which would be more cost effective. This would be cost neutral for Mental Health and the independent living skills funds would go to Mental Health rather than Family and Children's. The social worker position in Family and Children's would be maintained at full time to address juvenile justice caseload responsibilities. The social worker position would also work collaboratively with the Coordinated Family Service Project to capture more SED waiver dollars. The Board supported the collaboration between units and would like this transition highlighted in the budget process. Dunlap informed the Board that Family and Children's cannot have a waiting list. DEPARTMENT STRATEGIC PLANNING Johnson said the open hearing will be utilized for strategic planning for a longer range plan to set priorities. He said Long Term Support had a higher representation at the open hearing than other departments. Department staff are meeting as a group to discuss budget needs and strategic plan long range. Luckey asked if we are paying for "frills" in Long Term Support. Johnson said that type of issue will be investigated, but limiting some services alone will by be enough to address the waiting list. Dorsey asked if there were any other issues to bring before the Board. Barb Nelson and Steve Kirt have been appointed to an Ad Hoc Meth Committee. Dorsey adjourned the meeting. Time: 12:20 PM Chair: Attest: (Secretary)