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HomeMy WebLinkAboutHealth & Human Services 10-08-04 ESTHER WENTZ AND LINDA LUCKEY WILL REVIEW VOUCHERS AT 7:45 AM NOTE: Action on Minutes from past two meetings. REVISED: 10/01/04 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: 10/08/04 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: 11/12/04 (tentative 10/28/04) ACTION ON PREVIOUS MINUTES: 09/10/04 ANNOUNCEMENTS APPOINTMENTS: UNFINISHED BUSINESS: 1. Resolution to make County properties and grounds tobacco free 2. Updates to 2005 Health and Human Services /Nursing Home Budgets NEW BUSINESS: 1. Consideration of Claims and Vouchers 2. Financial Report 3. Program Reports a. Family & Children's b. Long Term Support C. Nursing Home 4. Request to increase Nursing Home Private Pay Rates effective December 1, 2004 5. Request to issue bids for Nursing Home generator 6. Closed session pursuant to Wis. Stats. Sec. 19.85 (1) (f), considering financial, medical, social or personal histories or disciplinary data of specific person, preliminary consideration of specific personnel problems or the investigation of charges against specific persons which, if discussed in public, would be likely to have a substantial adverse effect upon the reputation of any person referred to in such histories or data, or involved in such problems or investigations. Reconvene in open session. 7. Personnel Issues 8. Request to lease office space to U.W. Medical School 9. Discussion and action on setting time to sell two department fleet cars. 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 Ccktrc 10 -(S -�'-r ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD October 08, 2004 The St. Croix County Health and Human Services Board met on October 08, 2004 at the St. Croix County Health and Human Services /Health Center complex. MEMBERS PRESENT: Thomas Dorsey, Chair Lois Burri Tom Caflisch Dr. Michael Kretz Stan Krueger Linda Luckey Deb Rasmussen Ralph Swenson Esther Wentz MEMBERS ABSENT: None STAFF PRESENT: John M. Borup, Health and Human Services Director Judy Ziegler, Accounting Supervisor Carolyn L. Krieger, Nursing Home Administrator Fred Johnson, Family and Children's Supervisor Steve Kirt, Mental Health /AODA Clinical Services Supervisor Ron Lockwood, Long Term Support Coordinator Don Gillen, Corporation Counsel Kathy Leisch, Secretary OTHERS PRESENT: Elizabeth Coleman, Long Term Support Intern 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, November 12, 2004 at 8:30 AM. Swenson will review vouchers at 7:45 AM. AGENDA Motion A motion was introduced by Wentz, seconded by Swenson, 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 08/30/04 and 09/10/04 Health and Human Services Board meeting be approved. CLOSED SESSION PURSUANT TO WIS. STATS. SEC. 19.85 (1)(F), CONSIDERING FINANCIAL, MEDICAL, SOCIAL OR PERSONAL HISTORIES OR DISCIPLINARY DATA OF SPECIFIC PERSON, PRELIMINARY CONSIDERATION OF SPECIFIC PERSONNEL PROBLEMS OR THE INVESTIGATION OF CHARGES AGAINST SPECIFIC PERSONS WHICH, IF DISCUSSED IN PUBLIC, WOULD BE LIKELY TO HAVE A SUBSTANTIAL ADVERSE EFFECT UPON THE REPUTATION OF ANY PERSON REFERRED TO IN SUCH HISTORIES OR DATA, OR INVOLVED IN SUCH PROBLEMS OR INVESTIGATIONS Dorsey stated that Don Gillen, Corporation Counsel, would remain in meeting. Motion A motion was introduced by Wentz, seconded by Krueger, with a roll call vote: That the Board enter into closed session per Wisconsin Statute 19.85 (1)(f), considering financial, medical, social or personal histories or disciplinary data of specific person, preliminary consideration of specific personnel problems or the investigation of charges against specific persons which, if discussed in public, would be likely to have a substantial adverse St. Croix County Health and Human Services Board Page 2 October 08, 2004 effect upon the reputation of any person referred to in such histories or data, or involved in such problems or investigations. Roll call vote: Thomas Dorsey -yes Lois Burri -yes Thomas Caflisch -yes Dr. Michael Kretz -yes Stan Krueger -yes Linda Luckey -yes Deb Rasmussen -yes Ralph Swenson -yes Esther Wentz -yes Nine yes, motion passed. The Board went into closed session at 8:45 AM. Motion A motion was introduced by Caflisch, seconded by Wentz, with a roll call vote: That the Board reconvene into open session per Wisconsin Statute 19.85 (2). Roll call vote: Thomas Dorsey -yes Lois Burri -yes Thomas Caflisch -yes Dr. Michael Kretz -yes Stan Krueger -yes Linda Luckey -yes Deb Rasmussen -yes Ralph Swenson -yes Esther Wentz -yes Nine yes, motion passed. The Board entered into open session at 9:25 AM. ANNOUNCEMENTS Borup introduced Elizabeth Coleman, a social work student doing her internship in Long Term Support. Caflisch stated he would be leaving the meeting at 10:00 AM. UPDATES ON 2005 HEALTH AND HUMAN SERVICES /NURSING HOME BUDGETS Borup stated that Administration's budget presentation to Finance on 09/23/04 resulted in the following changes: Health and Human Services Department: • $100,000 deduction from Mental Health inpatient. • $10,000 deduction from Capital Outlay for vans at St. Croix Industries. • $6,000 decrease in Economic Support. Remove the $6,000 training expense and reduce County Appropriations by $6,000. Borup stated he is optimistic that we can recruit an employee with training (most probable). • $35,800 increase in Economic Support revenue and decrease County Appropriations by $35,800. • $1,732 increase in WIC revenue from the State grant and decrease County Appropriations by $1,732 for Public Health. • $14,082 decrease in expenses from Tobacco Control grant results in $14,082 decrease in County Appropriations for Public Health. St. Croix County Health and Human Services Board Page 3 October 08, 2004 Cuts per Finance: $167,614 Items adjusted since Finance meeting: • $15,000 for workshop air conditioning is removed from capital budget. Cost to be covered by workshop earnings, County Appropriations reduced by $15,000. • St. Croix Industries budget incorrectly included $6,000 in depreciation, amount to be billed to the State and removed from the budget resulting in a County Appropriation reduction of $6,000. These adjustments result in additional County Appropriation reduction of $40,500. Grant total reduction of $208,114. Nursing Home Capital Outlay Plan reduced per Finance as follows: $18,000 Fire Doors $ 3,000 Chairs $21,000 Total Reduction Borup stated we are still waiting for anticipated changes in health insurance numbers. Kretz questioned why the decrease was made from the Tobacco Control grant. Borup stated that the program would continue with no County dollars. Swenson explained why the decision was made by Finance. Borup stated that Nelson was a part of that process and was comfortable with the decision. Kretz asked if these numbers were final. Borup stated these numbers are final for now but the Finance Committee and the County Board can alter any numbers on 10/28/04 when they have the final vote on the budget. Caflisch left the meeting at 10:00 AM. CONSIDERATION OF CLAIMS The following reports were distributed to the Board: September fixed asset report, September cash report and August financial reports. Health and Human Services Board members, Wentz and Luckey, reviewed the vouchers; the following vouchers were pulled for discussion: HUMAN SERVICES: 31670: S &C Bank, $30.69, HS petty cash. Money was taken out of the Mental Health CSP donation fund to purchase item for a CSP client. 31563: Cemstone Ready Mix, Inc., $2,970.00. Replaces check #583796. The original check was reported lost. The Treasurer issued a stop payment with the bank and we re- issued the new check. Motion A motion was introduced by Wentz, seconded by Luckey, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book: Human Services and Nursing Home vouchers 31556 through 31651, dated September 16, 2004 in the amount of $290,718.66. St. Croix County Health and Human Services Board Page 4 October 08, 2004 Human Services and Nursing Home vouchers 31652 through 31677, dated September 16, 2004 in the amount of $18,825.36. Human Services vouchers 31811 through 31820, dated September 16, 2004 in the amount of $51,859.90. Human Services and Nursing Home vouchers 31824 through 31925, dated September 23, 2004 in the amount of $302,569.60. Human Services and Nursing Home vouchers 32099 through 32160, dated September 30, 2004 in the amount of $47,698.91. Human Services vouchers 32292 through 32428, dated October 07, 2004 in the amount of $191,709.25. Human Services voucher 32801, dated October 07, 2004 in the amount of $430.00. Human Services vouchers 32802 through 32969, dated October 07, 2004 in the amount of $148,546.54. Nursing Home vouchers 32970 through 33028, dated October 07, 2004 in the amount of $25,791.41. Human Services vouchers 33029 through 33051, dated October 07, 2004 in the amount of $39,397.08. Human Services and Nursing Home vouchers 33418 through 33420, dated October 08, 2004 in the amount of $848.09. Human Services, Workshop, Public Health, Social Services vouchers 551 through 581, dated September 21, 2004 in the amount of $346,307.37. Human Services, Workshop, Public Health, Social Services vouchers 582 through 614, dated October 05, 2004 in the amount of $350,019.11. Human Services and Nursing Home vouchers 589 through 619, dated September 21, 2004 in the amount of $180,246.20. Human Services and Nursing Home vouchers 620 through 651, dated October 05, 2004 in the amount of $174,195.70. St. Croix County Health and Human Services Board Page 5 October 08, 2004 FINANCIAL REPORTS The following financial reports through August were distributed to the Board. ST. CROIX COUNTY HUMAN SERVICES HOARD FINANCIAL SUMMARIES FOR THE PERIOD 01/01/04 THROUGH 09/31/04 NURSING HOME AUGUS Cash Balance 09/31/04 $905,771.91 Add: Accounts Receivable 08/31/04 $326,199.21 Account Payable 08/31/04 ($225,949.30) Net Current Items 09/31/04 $1,006,021.72 2004 Revenue Recorded through 08/31/04 $3,724,067.51 Includes Allocations of Anticipated Revenues . 2004 Expenses Recorded through 08/31/04 $3,762,554.01 Includes Allocations of Expected Expenses Excess Revenues over Expenses ($38,486.50) ti St. Croix County Health and Human Services Board Page 6 October 08, 2004 HEALTH AND HUMAN S:SERVICES 2004 SUMMARY Total OF REVENUES Jan.- AUGUST Budget Balance % Administration 588.905.45 873,534.97 284,629.52 67.4% AODA Services 316,639.32 469,152.15 152,512.83 67.5; Long Term Support 10,559,362.48 14,616,574.52 4,057,212.04 72.2% Mental Health 1,645,034.33 2,745,667.40 1,100,633.07 59.9% Family & Children's 1,872,778.04 2,844,524.50 971,746.46 65.8% Public Health 1,025,801.74 1,420,079.06 394,277.32 72.2: Economic Support 664,421.73 957,504.85 293,083.12 69.4% General Relief 1,602.48 19,212.68 17,610.20 8.3% REVENUES HUMAN SERVICES PROGRAMS 16 674 545 7 23 946 2sn 13 7.271 - 704.56 SUMMARY Total OF EXPENDITURES Jan.- AUGUST Budget Balance % Administration 584,069.11 873,534.97 289,465.86 66.9% Alcohol -Drug Abuse 322,799.05 469,152.15 146,353.10 68.8% Long Term Support 10,395,923.39 * 14,616,574.52 4,220,651.13 71.1% Mental Health 1,716,610.11 2,745,667.40 1,029,057.29 62.5% Family & Children's 1,972,446.46 * 2,844,524.50 872,078.04 69.3% Public Health 917,952.93 1,420,079.06 502.126.13 64.6% Economic Support 631,828.45 957,504.65 325,676.40 66.0% General Relief 10,167.91 19,212.68 9,044.77 52.9% EXPENDITURES HUMAN SERVICES PROGRAMS 16,551,797.41 23,946,250.13 7,394,452.72 69.1% Excess Rev over Expenses 1 22 748 To be on budget, percentage should be 66.67. �I St. Croix County Health and Human Services Board Page 7 October 08, 2004 ST CROIX HEALTH CENTER OPERATIONS REPORT JANUARY THROUGH AUGUST JAN -AUG 2004 BUDGET ACTUAL DIFFERENCE % CENSUS 70.5 71 -0.5 100.7% OPERATING REVENUE: 'MEDICARE $ 1,226,972.00 $ 487,847.67 $ 739,124.33 ' 39.8% MEDICAID $ 2,135,804.00 f $ 1,729,218.41 $ 406,585.59 81.0% PRIVATE PAY $ 1,074,462.00 $ 503,623.86 $ 570,838.14 46.9% ALL OTHER SOURCES $ 6,706.00 $ 21,619.57 $ t`14,913.57)z 322.4 %. TOTAL OPERATING REVENUE $ 4,443,944.00 $ 2,742,309.51 $ 1,701,634.49 61.7% OPERATING EXPENSES: DAILY PATIENT SRVICES $ 3,607,389.85 $ 2,267,334.28 $ 1,340,055.57 62.9% SPECIAL SERVICES $ 267,452.94 $ 171,876.83 $ 95,576.11 64.3°x'0 GENERAL SERVICES $ 1,173,975.67 $ 694,239.30 $ 479,736.57 59.1% ADMINISTRATIVE SERVICES $ 501,036.96 $ 326,709.54 $ 174,327.42 65.2% UNASSIGNED: DEPRECIATION( %BASED) $ 178,000.00 ` $ 118,664.00 $ 59,336.00 66.7°% OTHERS $ 302,423.05 $ 183,730.06 $ 118,692.99 60.8 TOTAL OPERATING EXPENSES $ 6,030,278.67 $ 3,762,554.01 $ 2,267,724.66 62.4% NET FROM OPERATIONS $ (1,020,244.50) NON- OPERATING ITEMS: REVENUE FROM RATE APPEALS $ 17,650.00: $ 11,768.00 $ 5,882.00 66.7% IGT FUNDS (%' BASED) $ 639,500.00 $ 426,334.00. $ 213,166.00 66.7% - CO ALLOCATIONS( %BASED) $ 815,480.00 $ 543,656.00 $ 271,824.00 66.7% TOTAL NON- OPERATING ITEMS $ 1,472,630.00 _ 981,758.00. $ 490,872.00 66.7% ,NET FROM ALL SOURCES $ (38,486.50) 'PERCENTAGE SHOULD BE 66.67 FUND BALANCE 01101/04 $ 1,911,092.35 OPERATIONS $ (38,486.50) FUND BALANCE END OF PERIOD $ 1,872,605.85 NH JANTHROUGHAUGUST2004FINANCIALREPORT St. Croix County Health and Human Services Board Page 8 October 08, 2004 LONG TERM SUPPORT Lockwood stated that the Long Term Support Unit is becoming more efficient in the delivery of community long term care services by consolidating scattered -site living situations into four to eight bed residential care facilities. Unit staff is encouraged by the cooperation being pledged by all four residential care providers in meetings held during the past four weeks. Residential care providers say that developing more congregate service options will make it easier for them to recruit and maintain support staff as well as reducing daily operating costs per program participant. Reducing turnover in support staff should improve service quality and dependability. During August, Brotoloc Corporation created a four bed Adult Family Care facility to replace two 2 person supported apartments, reducing daily per person costs by 150. Aurora Residential Alternatives, Inc. and Eeartview, Inc. have consolidation projects scheduled before year -end. REM is developing plans for improved cost effectiveness. The Northern Wisconsin Center downsizing is progressing. Two persons are now living in community settings and the remaining five persons will be moving to the community during November and December. Long Term Support staff and the residential care providers are working closely with guardians to assure that all health and safety needs are met during the community placement process. Lockwood stated that with increased service demands, it is our goal to "break even" financially at year's end. Lockwood stated they are participating in a survey of dental health care for persons on the waiver program. Clients are having trouble getting dental care if they are on medical assistance. Lockwood stated they are exploring the possibility of a resource center concept along with the Office on Aging. Lockwood stated there is a grant application to support this concept. The grant provides $55,000 for start -up costs and $100,000 ongoing costs per year. The Board recessed from 10:15 to 10:35 AM. FAMILY & CHILDREN'S Johnson informed Board of a juvenile that was committed to a juvenile correction facility at the cost of $175.00 per day. Johnson stated this is an unusual circumstance where Family & Children's was not a part of the process and were informed after the juvenile was committed. Usually when a juvenile is committed to a juvenile correction facility, Family & Children's is assigned the case and follow up on it. The cost then comes out of the Family & Children's allocation. Wentz asked if this was going to be a long -term commitment. Johnson stated that they would know more after the 30 -day intake process was completed. Johnson provided an update on foster home recruitment activities that have taken place since the last report to the Board, which was in March of this year. Unfortunately, these activities have not produced a significant change in the number of St. Croix County licensed homes, and concern about available resources continues. Johnson stated in March there were 23 licensed homes and today there are 26 licensed homes. There are three families that were previously with the County, then went to a private agency and will be returning to the County. Johnson gave Bretl credit for how he handles and works with foster parents. Johnson stated that 80 % -90% of recent inquiries in regard to foster care for the County had not been responding to any type of advertisement. It was just something they had been planning to do and had made the phone call without seeing any type of advertisement. Johnson stated they are currently working with the ministerial associations in regard to St. Croix County Health and Human Services Board Page 9 October 08, 2004 recruitment for foster care families. Johnson stated they looking at programs that would provide health insurance to foster care families. Johnson invited Board members to a Foster Care banquet to be held at the Hudson Golf Club on October 28 An article titled "Regarding the Professionalizing of Foster Care" was provided to Board members prior to the meeting. NURSING HOME Krieger stated the census is 70. Krieger stated there had been an average of 16 client referrals in the month of September. Two referrals are pending for admission. Krieger stated that the use of the new dining rooms began at lunch on September 21 Krieger thanked Dorsey and his wife for coming to the first meal in the dining room. Krieger stated that activities received a grant for $1,200.00 from EMC Corporation to pay for speakers in the new dining rooms to play music and call bingo, etc. Krieger stated there have been items that were not in the architect's plans for the new dining rooms but were not part of an official collection to the plan. They are minor items such as telephones, clocks, curtains, locks for doors, etc. that Krieger expended money for and paid the bills already. The costs were taken out of administrative supplies. Board members requested that Krieger bring a list of items to the November 12 meeting that was spent above and beyond what was levied. Borup stated the Finance Committee removed $3,000 for dining room chairs and $18,000 for fire doors from the Nursing Home Capital Plan for 2005. Krieger stated that the State architect has approved the new dining rooms. REQUEST TO INCREASE NURSING HOME PRIVATE PAY RATES EFFECTIVE DECEMBER 1, 2004 Krieger stated it is time for the annual review of rates. Krieger requested approval of following nursing home private pay rates effective December 1, 2004. A 30 -day notice needs to be given to families before rates are increased. Swenson asked how the new rates were arrived at. Krieger stated she looked at a survey with area facilities for their private pay rates and looked at an article with the average high and low rates in the area. Current Private pay rates are: ISN $155 SNF $150 ICF $145 Level of Care description: ISN Intensive skilled care SNF Skilled care ICF Intermediate care Motion A motion was introduced by Wentz, seconded by Burri, and unanimously adopted: that the Board approves the following Nursing Home Private Pay rates effective December 1, 2004. The rates are as follows: ISN $165 SNF $160 ICF $155 ti St. Croix County Health and Human Services Board Page 10 October 08, 2004 REQUEST TO ISSUE BIDS FOR NURSING HOME GENERATOR Borup stated Robole is requesting authority to issue bid specifications for formal action. Borup requested approval of document pending Corp. Counsel's review and approval. Robole will be working to find a buyer for the old generator during the bidding process. Motion A motion was introduced by Swenson, seconded by Krueger, and unanimously adopted: that the Board approves issuing bids for Nursing Home generator subject to review and approval from Corp. Counsel. PERSONNEL Borup stated the Economic Support clerical position has been filled by Star Hanson. Interviews will be taking place for the Economic Support Income Maintenance position being vacated by Shirley Johnson at the end of the year. DISCUSSION AND ACTION ON SETTING TIME TO SELL TWO DEPARTMENT FLEET CARS Borup asked the Board for flexibility over the next couple of months to put the old vehicles up for sale. Borup stated he would like to sell the vehicles in a timely fashion. Borup asked for authority to put the two 1998 vehicles up for sale this fall at his discretion. These vehicles will be sold to the general public with closed bids. Borup will coordinate the sale of these vehicles so new vehicles can be purchased per 2005 capital outlay plan. We await County Board action on 10- 28 -04. Motion A motion was introduced by Kretz, seconded by Swenson, and unanimously adopted: that the Board approves giving Borup authority to sell two Ford Taurus vehicles at his discretion. REQUEST TO LEASE OFFICE SPACE TO U.W. MEDICAL SCHOOL Borup stated we have a unique opportunity to lease office space on a part -time basis to U.W. Medical Schools for $200 per month. Nelson stated this program would not be in conflict with any vision or mission of the Public Health Department. This would be an opportunity to get some funding into the department. The individual currently in the office space is a 100% LTE position. She is dropping down in the hours; she will be working in Public Health to the end of the year and at the end of the year she will no longer be in that position. She has taken a position with the University of Wisconsin Medical College. She will work 60% in Public Health and 50% with the other organization. Some of her work will be done outside of the office space during evening hours. Nelson stated that phone service would not be included in the $200 per month. Motion A motion was introduced by Wentz, seconded by Rasmussen, and unanimously adopted: that the Board approves leasing office space to U.W. Medical School for $200 per month for a six -month period to start October 1, 2004. RESOLUTION TO MAKE COUNTY PROPERTIES AND GROUNDS TOBACCO FREE Borup stated the resolution that was discussed a month ago met with considerable questions and concerns. Borup stated that administration was to bring forth a reasonable resolution that would either involve a 50 -foot perimeter away from main doorways or for County properties to create a designated smoking area for facilities with the exclusion of County fairgrounds. Borup distributed a resolution to reflect those issues. Nelson added the Public Health mission statement to the resolution. Discussion ensued with the Board requesting a copy of Eau Claire County's resolution. Borup will get a copy of Eau Claire St. Croix County Health and Human Services Board Page 11 October 08, 2004 County's resolution and bring to the November meeting. Borup asked if the Board would like the resolution altered in language to empower each building to set up their own designated smoking areas outside the 25 -50 foot area of the front entrances. Borup stated this building was made smoke -free in the late 80's and it has worked very effectively. Both employees and clients have respected it. Swenson stated he would like to see more discussion on this in November. Luckey requested a discreet survey to be done to find out what policies were in other departments. Borup stated he would check on the law enforcement vehicle policy. Borup stated he would put this on the November agenda with some flexibility so a county -wide as well as a Health Center resolution can still be pursued. Luckey asked that the issue be addressed as to whom has the authority to select the designated areas. Kretz remarked on the loss of $14,500 in revenue for tobacco control. Kretz stated this is not the way to go and it is very unfortunate that this was not a higher priority for the smokers in St. Croix County. Dorsey asked if there were any other issues to bring before the Board. Motion A motion was introduced by Wentz, seconded by Dorsey, and unanimously adopted: that the meeting be adjourned. Time: 12:32 PM Chair: Attest: (Secretary)