HomeMy WebLinkAboutHealth & Human Services 04-08-11 Revised 04/01/2011
NOTICE OF MEETING AND AGENDA
ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD
DATE AND TIME: April 08, 2011 at 8:30
LOCATION.• (Board Room, St Croix County DHHS Building,
1445 N. Fourth Street, New Richmond WI)
CALL TO ORDER
ROLL CALL
REVIEW OF AGENDA
CONSENT AGENDA
APPROVAL OF MINUTES OF PREVIOUS MEETING - 03/16/11
DATE OF NEXT MEETING — 04/20/11 at 8:30 a.m.
OLD AND NEW BUSINESS
' G etti 4 S -,4 es f r P afeft W r en fl e4 r,r e di 4; moved to 04/20/11 meeting
2. Budget Priority Planning
3. Updated Business Plan for St. Croix Health Center
4. "Personnel Issues:
a. * *Position requests
b. * *Health Center positions delayed for consideration at County Board
5. Possible agenda items for next meeting
NOTE: A quorum of the St. Croix County Board of Supervisors (County Board) may be present
at this meeting. Therefore, this notice also serves as notice of a meeting of the County Board for
the purpose of obtaining information relating to subjects listed above for use at future County
Board meetings.
ADJOURN
(Items may be taken in different order)
** Additions /Changes /Corrections
Items for County Board approval must be submitted to the County Clerk's office
by Wednesday morning preceding a County Board meeting.
4/1/2011 10:04 AM
ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD
April 08, 2011
The St. Croix County Health and Human Services Board met on April 08, 2011 at the St. Croix
County Health and Human Services/Health Center complex.
MEMBERS PRESENT: Esther Wentz, Chair
Leon Berenschot
Frederick Horne
Roger Larson
Linda Luckey
Richard Marzolf
Dr. Lisa Ramsay
Alfred Schrank
MEMBERS ABSENT: Deb Rasmussen, excused
STAFF PRESENT: Fred Johnson, Health and Human Services Director
Frank Robinson, Nursing Home Administrator
Malva Sirek, Clerical Supervisor
OTHERS PRESENT: Daryl Standafer, County Board Chair
Tammy Funk, Human Resource Coordinator
Kim Dupre, Information Systems Analyst
Jeff Holmquist, New Richmond News
Katie Korbel
Norm Matzek
Shirley Matzek
Richard Hesselink
Chair Wentz 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
Wednesday, April 20, 2011 at 8:30 AM. Rasmussen will review vouchers.
AGENDA Motion A motion was introduced by Berenschot, seconded by Marzolf, and
unanimously adopted: That the agenda be approved as distributed.
MINUTES Motion A motion was introduced by Schrank, seconded by Berenschot, and
unanimously adopted: That the minutes of the 03/16/11 Health and Human Services Board
meeting be approved as distributed
BUDGET PRIORITY PLANNING Johnson reported there is a County department head meeting
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April 08, 2011
scheduled at 10:00 AM today to discuss the structure of priority planning for the county so there is a
consistent format for all committees. Johnson will bring this information to the Health and Human
Services (HHS) Board in May or June, 2011.
PERSONNEL ISSUES POSITION REQUESTS Robinson reported two additional openings in
the Nursing Home: one 50% RN evening supervisor and one 80% cook position. The 50% RN
evening supervisor position is the compliment of the open 90% RN evening supervisor position.
Between the two positions, they are in charge every weekday after the Administrator and Director
of Nursing (DON) leave the building and on weekends.
Motion A motion was introduced by Berenschot, seconded by Marzolf, and unanimously adopted:
That the Board approves filling the 50% Nursing Home RN evening supervisor and one 80%
Nursing Home cook position and to bring to the Administration Committee for approval.
HEALTH CENTER POSITIONS DELAYED FOR CONSIDERATION AT COUNTY BOARD
It was the consensus of the Board that these positions should also be brought forward to the County
Board to be filled.
Johnson announced that Tonya Kusmirek, Financial Manager, has submitted her resignation.
Johnson will work with Pietrick on ways to cover the current duties, to look at options and to move
forward with alternatives.
UPDATED BUSINESS PLAN FOR ST. CROIX HEALTH CENTER An updated business plan
from Trenton Fast, LarsonAllen, was distributed to the Board. Johnson separated the document
between detail and summary and explained how figures were obtained. He explained two scenarios
are displayed, one containing zero County levy and one containing up to $150,000 in County levy
by the year 2015.
Robinson outlined the assumptions that were applied to the scenarios. Robinson estimated 75% of
expenses are labor costs. Assumptions included:
• Assumed decrease in Supplemental Payment Program (IGT) Revenue with a reduction to 40
and 50 bed facilities.
• 25% one time increase in private pay revenue effective 01/01/2011.
• 1 -2% annual increases in payment rates from all payers in subsequent years.
• No increase in labor rates through 2012, with 1.5% increase in subsequent years. Johnson
explained the labor increase is not a given just projected on the current wage structure. Any
wage changes would have to go through the negotiating team. None of these scenarios
include the 5.8% employee contribution to Wisconsin Retirement.
• 2 -3% overall increases in non -labor operating expenses.
• Current assumption for 10% annual increase for health insurance costs based on industry
averages.
• Increase in occupancy to 93% in care center in scenarios with bed reductions.
• Increase in Medicare /short stay payer mix to 12 to 13 %.
These scenarios give the Board a targeted amount to continue nursing home operations. If expense
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April 08, 2011
improvements are reached and debt ratios and cash on hand are consistent with information in the
handout, then LarsonAllen may be willing to issue an examined forecast to build an assisted living
facility and nursing home.
Horne recommended holding an honest conversation with Nursing Home employees as wages and
fringes are higher at St. Croix Health Center than other facilities and if there is any way to
collaboratively make this a workable solution. Employees need to work with the County Board to
create a feasible solution. Wentz indicated the power to negotiate is not with the HHS Board but
with the negotiating committee. The HHS Board can tell the negotiating committee what the HHS
Board would like to have happen. Larson is on the negotiating committee.
There may be a possibility for concessions from the employees but the employees in turn would like
a commitment of the Board that the Nursing Home will stay in business. It was the consensus of the
Board that Nursing Home employee commitment and involving staff is huge to the Nursing Home.
Shirley Matzek questioned if the public opinion is still a consideration as decisions are made. The
public has spoken in the referendum in continuing to support the Nursing Home even though no
dollar amount was set.
Wentz questioned if a new nursing home and assisted living was built, what would be done with
Health and Human Services. Marzolf reported St. Croix County is one of the fastest growing
counties in the state, which speaks to the need for the Nursing Home.
St. Croix Health Center has a Five Star rating due to the staff. There is very little staff turnover.
Robinson reported staff turnover can cost approximately $12,000 to $15,000 per staff. Robinson
said everything that can be done operationally to downsize the facility has been done and the only
thing left is wage and fringes.
The Board will meet with the Committee of the Whole to discuss the updated business plan and
come up with recommendations. The Committee of the Whole will meet on April 14, 2011.
The business plan may need to occur in phases; for example, reducing from 72 bed nursing home to
50 bed nursing home with assisted living.
Marzolf requested an assisted living complex including child hospice services be considered for
future planning. It was the consensus of the Board this would be a more specialized program and if
it were to be considered, should be considered after the assisted living is in place. Having an assisted
living facility is imperative to make the Nursing Home successful and building one would offer a
commitment to the employees. It was the consensus of the Board that Johnson and Robinson will
have a resolution supporting the St. Croix Health Center business plan available at the 04/20/2011
HHS Board meeting.
Motion A motion was introduced by Larson, seconded by Horne, and unanimously adopted: That
the Board approves bringing forth planning documents to the Committee of the Whole at their
04/14/2011 meeting.
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April 08, 2011
POSSIBLE AGENDA ITEMS FOR NEXT MEETING
• Resolution regarding St. Croix Health Center business plan.
Wentz asked if there were any other issues to bring before the Board.
Wentz adjourned the meeting.
Time: 9:42 AM
Chair:
Attest:
(Secretary)
St. Croix County
Nursing Home Cost Ai