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HomeMy WebLinkAboutHealth & Human Services 12-10--04 STAN KRUEGER 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: 12/10/04 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: 01/14/05 (tentative 12/23/04) ACTION ON PREVIOUS MINUTES: 11/12/04 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. Closed session pursuant to Wis. Stats. §19.85 (1) (e) to discuss labor negotiation strategies. This is a joint session with the Personnel Committee. 4. Reconvene in open session 5. Program Reports a. Family and Children's b. Economic Support C. Nursing Home d. Mental Health /AODA 6. Personnel Issues 7. Nursing Home remodeling project closure. 8. American Association of Homes and Services for the Aging Commitment to Quality Approval 9. Resolution authorizing Health and Human Services Board the authority to apply for Aging and Disability Resource Center Grant 10.Resolution for Reinstatement of State of Wisconsin Financial Support for the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) 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 December 10, 2004 The St. Croix County Health and Human Services Board met on December 10, 2004 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: Linda Luckey, excused Dr. Michael Kretz, excused STAFF PRESENT: John M. Borup, Health and Human Services Director Judy Ziegler, Accounting Supervisor Carolyn L. Krieger, Nursing Home Administrator 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 Ralph Robole, Facilities Manager Mary Squyer, Economic Support Supervisor Fred Johnson, Family and Children's Supervisor Becky Ruka, Accounts Receivable Supervisor Malva Berg, Secretary OTHERS PRESENT: Deb Kathan, Personnel Director Richard King, Personnel Committee Daryl Standafer, Personnel Committee Cindy Leonard, Personnel Committee 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, January 14, 2005 at 8:30 AM. Caflisch 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 Swenson, seconded by Wentz, and unanimously adopted: That the minutes of the 11/12/04 Health and Human Services Board meeting be approved as circulated. ANNOUNCEMENT Borup announced a potluck will be held for Judy Ziegler for her retirement on January 5, 2005. Nelson announced the next Legislative breakfast is scheduled for 01/17/05 from 9:00 - 11:00 AM at the Health Center. F , St. Croix County Health and Human Services Board Page 2 December 10, 2004 RESOLUTION FOR REINSTATEMENT OF STATE OF WISCONSIN FINANCIAL SUPPORT FOR THE SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC) Nelson reviewed the resolution. She said the resolution will not go to the full County Board, only to the Health and Human Services Board. The resolution is requesting a reinstatement of funds to better accommodate increased caseload demands. Motion A motion was introduced by Swenson, seconded by Wentz and unanimously adopted: That the Board approve the following resolution: Reinstatement of State of Wisconsin Financial Support for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Whereas, the WIC Program serves nearly 1 of every 2 infants and nearly 1 of every 4 children in Wisconsin; and, Whereas, the Wisconsin WIC Program, including St. Croix County, has experienced a growth in participation of 8% over the last two years, Whereas, the WIC Program currently improves the nutritional status and health of 888 St. Croix County women and children, an increase over the average of 731 in 2002 and 652 in 2001; and, Whereas, for every dollar spent on WIC services, $1.92 - $4.21 in Medicaid savings is realized for participating newborns and their mothers; and, Whereas, in 2003, the incidence of low birth weight was only 4.9% when women participated in the WIC Program for 7 -8 months during their pregnancies, compared to a 10.6% incidence of low birth weight if the women did not participate in WIC during pregnancy and WIC served nearly 33,000 pregnant women in 2003; and, Whereas, 67% of St. Croix County WIC Program participants receive their health care coverage from Wisconsin Medical Assistance or Healthy Start; and, Whereas, St. Croix County WIC Program vendors received $421,780 from the redemption of WIC drafts for the year of 2003; and, Whereas, available federal funds only cover 90% of the costs associated with participant enrollment, nutrition counseling and distribution of WIC supplemental food; and, Whereas, in 1999 the State of Wisconsin provided 4% of the funding for the Wisconsin WIC Program; and, Whereas, in 2000 the Wisconsin WIC Program provided 79.7% of all available nutrition services administration federal funding to local county health departments and non - profit organizations to enroll applicants into the WIC Program; and, Whereas, this funding has been declining each year since 2000, and will be reduced to 72% in 2005; and, Whereas, 55 of 69 local WIC projects have experienced an increase in the numbers of participants identified with one or more high nutritional risk factors since 2002, requiring individualized nutrition counseling with the WIC Registered Dietitian and funding to local projects to provide this counseling has not kept pace with need. r St. Croix County Health and Human Services Board Page 3 December 10, 2004 Now, therefore, be it resolved, that the St. Croix County Health and Human Services Board does hereby encourage the State of Wisconsin to make $1.5 million annually in the 2005 -2007 biennium available to provide the WIC services necessary to enroll all interested, eligible families in the program, provide the nutrition counseling needed to encourage healthy lifestyles and to assure the distribution of WIC supplemental foods the estimate of which, based on current caseload, would be $11,830 additional funding to St. Croix County; and, Be it further resolved that this Resolution be sent to Senator Sheila Harsdorf, Representatives Kitty Rhoades, Andy Lamb and Mark Pettis and Governor James Doyle and the Wisconsin Counties Association to encourage efforts to support State supplemental funding for the Special Supplemental Nutrition Program for Women, Infants and Children in Wisconsin. RESOLUTION TO MAKE COUNTY PROPERTIES AND GROUNDS TOBACCO FREE There would be basically four points of gain from passing this resolution: go from smoke free to tobacco free, 25' rule imposed at doorways, improved public health conditions for majority (non- tobacco users), and presenting public image as cleaner /healthier to employees and community. A survey of County departments was performed. Of 429 employees, the number of tobacco users is 109. A total of 14 departments responded to the survey and results were shared with the Board. It was felt that enforcement of the resolution would be a problem. It was the consensus of the Board that this issue was political in nature and there are larger items to address at the County. Motion: A motion was introduced by Swenson, seconded by Wentz, and unanimously adopted: That the Board approves tabling the Tobacco -free Resolution for at least six months. Caflisch indicated he would like to hear from someplace that has the tobacco - free policy in place that does work. Borup said it is the role of Public Health to bring the tobacco -free resolution forward. Nelson reported there have been 12 confirmed cases of influenza in Wisconsin but none in St. Croix County. She said vaccine has been made available to health care workers, people age 50 to 64 and household contacts of eligible candidates that are high risk. Nelson also reported there have been 18 positive cases of Pertussis in St. Croix County. She said follow up time on these cases is very labor intensive with up to 180 hours /month logged. UPDATES ON 2005 HEALTH AND HUMAN SERVICES /NURSING HOME BUDGETS Krieger stated we will get more IGT monies than was budgeted for 2004 -2005, and the latest projection from Brian Schoeneck is $644,671. The IGT budgeted for 2004 -05 was $450,000. There is an additional $4 million available statewide which increased the amount. From information received at a recent county homes meeting, IGT monies should be available in years to come for county homes. Judy Ziegler reported that the nursing home will receive $706,991 in IGT monies by December for fiscal year 2004. It is anticipated that mileage will go to 40.5 in 2005. Greg Timmerman recommends the fine received during the remodeling be deducted from the final payment made to the contractor. St. Croix County Health and Human Services Board Page 4 December 10, 2004 CONSIDERATION OF CLAIMS The following reports were distributed to the Board: November fixed asset report, November cash report, November unemployment report and October financial report. Health and Human Services Board member, Wentz, reviewed the vouchers; the following vouchers were pulled for discussion: HUMAN SERVICES: 36538: Wellhaven Apartments, $795.00, Long Term Support client expense. The Wellhaven apartments are located in River Falls. This was the monthly rent for one CIP II client. This apartment is shared by two Long Term Support clients. Motion A motion was introduced by Wentz, seconded by Burri, 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 36010 through 36178, dated November 18, 2004 in the amount of $186,102.84. Human Services and Nursing Home vouchers 36179 through 36204, dated November 18, 2004 in the amount of $18,962.74. Human Services and Nursing Home vouchers 36408 through 36463, dated November 23, 2004 in the amount of $232,914.12. Human Services vouchers 36468 through 36477, dated November 29, 2004 in the amount of $50,750.25. Human Services and Nursing Home vouchers 36493 through 36542, dated December O1, 2004 in the amount of $57,910.50. Human Services and Nursing Home vouchers 37598 through 37624, dated December 09, 2004 in the amount of $48,700.32. Human Services and Nursing Home vouchers 37625 through 37804, dated December 09, 2004 in the amount of $85,711.04. Human Services and Nursing Home vouchers 37856 through 38049, dated December 09, 2004 in the amount of $308,579.96. Nursing Home voucher 36205, dated November 18, 2004 in the amount of $250.00. Nursing Home vouchers 37805 through 37855, dated December 09, 2004 in the amount of $22,208.23. Human Services, Workshop, Public Health, Social Services vouchers 679 through 709, dated November 16, 2004 in the amount of $351,722.63. Human Services, Workshop, Public Health, Social Services vouchers 710 through 739, dated December 01, 2004 in the amount of $309,821.90. Human Services and Nursing Home vouchers 716 through 746, dated November 16, 2004 in the amount of $171,511.09. Human Services and Nursing Home vouchers 747 through 777, dated December 01, 2004 in the amount of $144,862.05. St. Croix County Health and Human Services Board Page 5 December 10, 2004 FINANCIAL REPORTS The following financial reports through October were distributed to the Board. Ziegler noted the land rent for the farm was received in December. She said a transfer of $67,500 will be transferred from the farm account to Health and Human Services in December. Borup noted an increase in out -of -home expenses for Family and Children's with out of home costs continuing to rise this fall. ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD 01/01/04 THROUGH 10/31/04 NURSING HOME OCTOBFR $693,102.59 Cash Balance 10/31/04 Add: $410,133.35 Accounts Receivable 10/31/04 ($275,775.25) Account Payable 10/31/04 $827,460.69 Net Current Items 10/31/04 2004 Revenue Recorded through 10/31/04 $4,693,156.03 Includes Allocations of Anticipated Revenues 2004 Expenses Recorded through 10/31/04 $4,721,858.22 Includes Allocations of Expected Expenses Excess Revenues over Expenses ($28,702.19) • 0 St. Croix County Health and Human Services Board Page 6 December 10, 2004 HEALTH AND HUMAN SERVICES 2004 SUMMARY Total OF REVENUES Jan. - Oct. Budget Balance % Administration 745,147.61 873,534.97 126,387.36 65.3% AODA Services 385,944.11 469,152.15 83,208.04 82.3% Long Term Support 13,229,823.06 14,616,574.52 1,386,751.46 90.5% Mental Health 2,080,756.63 2,745,667.40 664,910.77 75.8% Family & Children's 2,343,586.30 2,844,524.50 500,938.20 82.4% Public Health 1,272,194.34 1,420,079.06 147,884.72 89.6% Economic Support 792,558.58 957,504.65 164,946.27 82.8% General Relief 1,905.49 19,212.68 17,307.19 9.9% REVENUES HUMAN SERVICES PROGRAMS 20.851.916.12 23 946 2S0 13 3.094.334.01 87 SUMMARY Total OF EXPENDITURES Jan.- Oct. Budget Balance % Administration 728,566.93 873,534.97 144,968.04 83.4% Alcohol -Drug Abuse 399.204.78 469,152.15 69,947.37 85.1% Long Term Support 13,067,673.92 * 14,616.574.52 1,548,900.60 89.4% Mental Health 2,151,890.62 2,745,667.40 593,776.78 78.4% Family & Children's 2,397,453.35 - 2,844,524.50 447,071.15 84.3% Public Health 1,159,682.24 1,420,079.06 260,396.82 81.7% Economic Support 791,738.04 957,504.85 165,766.81 82.7% General Relief 11,129.20 19,212.68 8,083.48 57.9% EXPENDITURES HUMAN SERVICES PROGRAMS 20,707,339.08 23,946,250.13 3,238.911.05 86.5% Excess Rev over Expenses 144 577.64 To be on budget, percentage should be 83.33. St. Croix County Health and Human Services Board Page 7 December 10, 2004 ST CROIX HEALTH CENTER OPERATIONS REPORT F JANUARY THROUGH OCTOBER JAN -OCT 2004 BUDGET ACTUAL DIFFERENCE % CENSUS _. 70.5 70.7 0.2 100.3 ° f° OPERATING REVENUE: MEDICARE $ 1,226,972.00 $ 621,050.00 $ 605,922.00 50.6° MEDICAID $ 2,135,804.00 $ 2,148,261.73 $ (12,457.73) 100.6'x° PRIVATE PAY $ 1,074,462.00 $ 650,199.08 $ 424,262.92 60.5% ALL OTHER SOURCES $ 6,706.00 $ 23,951.22 $ (17,245.22) 357.2 °!° ;TOTAL OPERATING REVENUE $ 4,443,944.00 $ 3,443,462.03 $ 1,000,481.97 77.5% OPERATING EXPENSES: $ _ 'DAILY PATIENT SRVICES $ 3,607,389.85 $ 2,836,482.57 $ 770,907.28 78.6% SPECIAL SERVICES _ __.._ .. ..... ;. $ 267 ,452.94 $ 212 ,154.91 $ 55 ,298.03 ' 79.3% :GENERAL SERVICES $ 1,173,975.87 $ 875,848.79 $ 298,127.08 74.6% =ADMINISTRATIVE SERVICES $ 501,036.96 $ 418,600.09 $ 82,436.87 83.5% UNASSIGNED: _ DEPRECIATION( °f°BASEQ) $ 178,000.00 $ 148,330.00 $ 29,670.00 83.3% 'OTHERS $ 302,423.05 $ 230,441.66 $ 71,981.19 76.2% TOTAL OPERATING EXPENSES $ 6,030,278.67 $ 4,721,858.22 $ 1,308,420.45 78.3% ;NET FROM OPERATIONS $ (1,278,396.19) NON- OPERATING ITEMS: REVENUE FROM RATE APPEALS $ 17,650.00. $ 14,710.00 $ 2,940.00 83.3% :IGT FUNDS ( %BASED) .. __... $ 639 ,500.00 $ 555 ,414.00 $ 84 ,086.00 86.9% ;CO ALLOCATIONS(%BASED) $ 815,480.00 $ 679,570.00 $ 135,910.00 83.3 % TOTAL NON- OPERATING ITEMS $ 1,472,630.00 $ 1,249,694.00 $ 222,936.00 84.9% NET FROM ALL SOURCES $ (28,702.19) 'PERCENTAGE SHOULD ' BE 83.33 FUND BALANCE 010104 $ 1,911,092.35 ; OPERATIONS $ (28,702.19} :FUND BALANCE END OF PERIOD $ 1,882,390.16 MENTAL HEALTH /AODA PROGRAM REPORT Kiesler estimated ($72,691) deficit in Mental Health /AODA contracted services through November and approximately $80,000 to $90,000 deficit by year -end. Furthermore, he said lagging revenues has played a factor in increasing the total deficit for Mental Health /AODA. Kiesler projects the total deficit to be about $150,000 when combining the lagging revenues with MH /AODA contracted services deficits.- He said there are fewer clients with insurance coverage this year as compared to last year. He informed the Board that Mendota and Trempealeau costs currently are one -third of what it was last year at this time. Kiesler indicated indigent clients are the most concerning, relating to the Board there are more indigent clients and less clients with insurance. He said the State has frozen the amount received from Medicaid clients. Different ways are being considered to run the clinic to lessen the strain financially. He said one way being considered to lessen costs is to run more group format treatment versus individual treatment. Efficiencies and cost sharing around St. Croix County Health and Human Services Board Page 8 December 10, 2004 emergency services are being explored with Pierce, Dunn and St. Croix County. FAMILY AND CHILDREN'S Johnson announced that the OJA grant request for Coordinated Family Services (CFS) was fully funded at $87,955. This money will be applied to cover costs for an additional social worker intended to help us reduce out of home costs. This position was approved (with a sunset clause) in the 2005 budget. This plan includes the schools, law enforcement also. The program has been successful in other counties to avoid or shorten placements. Borup thanked Johnson, Dunlap, Huston, Kiesler, and Kirt for their efforts. The Board recessed from 9:30 to 9:40. Motion A motion was introduced by Wentz, seconded by Krueger, that the Board enter closed session pursuant to Wis. Stats. §19.85 (1) (e) to discuss labor negotiation strategies. This is a joint session with the Personnel Committee. 9:40 AM Roll call vote: Thomas Dorsey -yes Lois Burri -yes Tom Caflisch -yes Michael Kretz- absent Stan Krueger -yes Linda Luckey- absent Deb Rasmussen -yes Ralph Swenson -yes Esther Wentz -yes Seven yes, two absent, motion passed. Motion A motion was introduced by Swenson, seconded by Burri, and unanimously adopted that the Board reconvene in open session. 10:40 AM FAMILY AND CHILDREN'S Johnson updated the Board that there is a trend toward a diminishing ability for clients to pay for placements. Johnson reported alternate care expenses are 97.9 expended through October. He anticipates alternate care costs through the end of the year will be approximately $1,093,000 and $906,000 was budgeted for 2004. He said the trend for alternate care program is to be busier through the holidays and into March. Johnson reported the good news is that costs are down $50,000 in other program areas. He said the SED waiver revenue was not included in the budget and the Department will receive approximately $21,000 by the end of the year due to this waiver. ECONOMIC SUPPORT Squyer reported on the CARES worker web. She explained that training is offered on line rather than traveling to Eau Claire for training. There will be five courses in May and June with a Learning Assessment at the end. If unable to pass the Assessment, attendance will be required at a review lab in Eau Claire, after which the assessment will be retaken. If the assessment isn't passed, the result will be revocation of the CARES /worker web access. The program will require 19" monitors, of which four have been budgeted for Economic Support for 2005. Once the CARES Worker Web is being used, we will have paperless files. This program has been piloted in LaCrosse County. The words they used to describe the program is labor intensive. They hired two clerical persons to work with the scanning of the paperwork. The State will provide one scanner for the St. Croix County Health and Human Services Board Page 9 December 10, 2004 county. All documents needed for the case file will be coded and then scanned. There will be no money for the administration of the coding and scanning. Squyer said WHEAP (Wisconsin Home Energy Assistance Program) began October 1, 2004. Today there are 571 approved cases, which is up 41.7% from last year at this time and payments have increased $22,269 or 49.3% from last year. Squyer said General Relief is over budget by $527 for 2004. She asked approval to pay $175 to O'Connell's Funeral Home for a cremation expense. It was the consensus of the Board to pay $175 to O'Connell's. NURSING HOME REMODELING PROJECT CLOSURE The certificate of substantial completion has been received but there are still details remaining. Sterling still has minor details to complete such as air balancing, control settings, etc. but no additional costs are anticipated. The remodeling balance is set at $19,830.54, this includes $16,218.33 for furnishing costs and $3,000 for chairs approved on November 12. This also includes $6,067 for change orders #3 and #4. The project should close out late next week. A credit of $1,491 will be deducted due to the fine incurred due to construction as the fine was paid by the County. Swenson thanked Robole for all the work done in the Nursing Home. Also, a request to reinstate $8,680 that was removed from the nursing home's 2005 capital budget by Michelle Pietrick is being made. The amount was budgeted for maintenance to buy supplies for handrail replacement in the nursing home to be compliant and to avoid a citation. The state engineer indicated that the wooden handrails are an infection control issue. Wentz said this should be part of the remodel. This item will be added to the January 13 Finance Committee agenda to request reinstatement of the $8,680 to be paid either by the contingency fund or the remainder of the remodeling fund. Robole asked if the building committee would like to sit in with the closing with Ayres. Swenson asked if this meeting could be arranged close to the next Finance Committee meeting date /time. NURSING HOME The Nursing Home census is 71. Krieger reported on a new concept in nursing home /senior housing. She said it is a model that is being followed at Manitowoc County, who currently has a waiting list of 74. She said many nursing homes are planning for the future with assisted living facilities attached to the nursing home. The industry is also moving towards a "resident meal choice" plan that provides two large meals and two small meals throughout the day that is representative of a typical day in a senior's life. Krieger said Schindler Elevator announced a rate increase for 2005. The rate increase is 9.19% and 8.81% on each of the elevators. The Nursing Home has an agreement with UHF, another purchasing group. The Nursing Home may now choose between UHF and Amerinet to realize cost savings. AMERICAN ASSOCIATION OF HOMES AND SERVICES FOR THE AGING COMMITMENT TO QUALITY APPROVAL Krieger presented a statement regarding "Quality First ". She said this is a formal way to visualize what we have been doing forever, providing quality care in performance and expectations. The "Quality First" concept is promoted by the national nursing home groups. Motion A motion was introduced by Wentz, seconded by Rasmussen, and unanimously adopted: That the Board grants permission to sign the Quality 4 Z St. Croix County Health and Human Services Board Page 10 December 10, 2004 First Covenant to recognize the quality care given to our nursing home residents. This announcement will be published statewide and put in the local papers. LONG TERM SUPPORT Lockwood requested permission for Long Term Support to apply for a county -wide Aging and Disability Resource Center (ADRC) grant in collaboration with the Department on Aging. If awarded, the grant would offer the general public a single entry point for information and assistance on issues affecting older people, persons with disabilities, and their families. Grant funds include start -up funds of $55,000 from the U.S. Administration on Aging and the Center for Medicare and Medicaid Services and an ongoing State General Purpose Revenue of $200,000 per year. A program planner /manager and disability benefit specialist position is required. Lockwood said the resource center is a concept intended to improve access to community long term care services rather than having all services in one location. He said there are 25 to 30 counties applying for the grant and only five awards will be made, so St. Croix County's chances of being awarded the grant are limited. Full County Board approval is needed to apply for the grant and the grant needs to be submitted by the second week of January. Lockwood indicated there is no commitment on the County's part to accept the ongoing grant if it is awarded to St. Croix County. Lockwood said the grants are scheduled to be awarded by the end of February. Motion A motion was introduced by Wentz, seconded by Burri, and adopted with Caflisch voting no, That the Board approves applying for the grant with the understanding there will be a separate vote of the Health and Human Services Board and the full County Board whether to accept the grant if the grant is awarded. PERSONNEL Borup announced that Gail Casey has announced her retirement effective 01/22/05. He also informed the Board that Jo Osborne has accepted the Economic Support Receptionist position. Dorsey asked if there were any other issues to bring before the Board. Motion A motion was introduced by Wentz, seconded by Rasmussen, and unanimously adopted: that the meeting be adjourned. Time: 12:03 PM Chair: Attest: (Secretary)