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HomeMy WebLinkAboutHealth & Human Services 04-12-04 ESTHER WENTZ WILL REVIEW VOUCHERS AT 8:00 AM REVISED - 04/07/04 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: 04/12/04 (Monday) 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: 05/14/04 (04/22/04 tentative) ACTION ON PREVIOUS MINUTES: 03/12/04 ANNOUNCEMENTS APPOINTMENTS: UNFINISHED BUSINESS: 1. Fence for Health Center Community Garden 2. Health and Human Services Governing Body By -laws update NEW BUSINESS: 1. Consideration of Claims and Vouchers 2. Financial Report 3. Program Reports a. Public Health b. Long Term Support C. Nursing Home 4. Presentation of 2003 Annual Report 5. Action on bids to purchase bussette for St. Croix Industries 6. Setting date for 2005 Open Budget Hearing 7. Valley Health Plan Contract Proposal 8. Discussion of Springsted Study 9. Action to approve rental contract with Henk Van Dyk for County barn. 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 April 12, 2004 The St. Croix County Health and Human Services Board met on April 12, 2004 at the St. Croix County Health and Human Services /Health Center complex. MEMBERS PRESENT: Thomas Dorsey, Chair Chris Bethke Lois Burri Dr. Michael Kretz Mary Louise Olson Deb Rasmussen MEMBERS ABSENT: Leon Berenschot, excused Ralph Swenson, excused Esther Wentz, excused STAFF PRESENT: John M. Borup, Health and Human Services Director Carolyn L. Krieger, Nursing Home Administrator Judy Ziegler, 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 Wendy Kramer, PHN Ron Eichstaedt, St. Croix Industries Supervisor Malva Berg, Secretary OTHERS PRESENT: None 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, May 14 at 8:30 AM. Burri will review vouchers at 8:00 AM. The following meeting will be May 27, 2004 at 5:00 PM, followed by the Open Budget Hearing at 6:00 PM. AGENDA Motion A motion was introduced by Olson, seconded by Burri, and unanimously adopted: That the agenda be approved as circulated. MINUTES Motion A motion was introduced by Burri, seconded by Bethke, and unanimously adopted: That the minutes of the 03/12/04 Health and Human Services Board meeting be approved as circulated. Borup will present the annual report to the County Board on April 20. FENCE FOR HEALTH CENTER COMMUNITY GARDEN Borup said this issue will need to be tabled as there are no possible funding sources for a fence at this time and there are no monies in the budget for a fence. Borup is waiting on written confirmation on ownership of pheasant pens. He is reluctant to start dismantling the pens without permission. CONSIDERATION OF CLAIMS The following reports were distributed to the Board: March fixed asset report and March cash report. Health and Human Services Board member, Burri, reviewed the vouchers, the following voucher were pulled for discussion: St. Croix County Health and Human Services Board Page 2 April 12, 2004 18655: MN Bureau of Criminal Apprehension, $15.00, purchased services alternate care recruitment. Cost of criminal background check for prospective foster parents. Depending on length of residency, we may do a criminal background check through the State of their previous address. 18956: Camp St. Croix /YMCA, $30.00, juvenile restitution fund. We collected money from a juvenile ordered to pay restitution to their victim by the court. Once the money has been collected, we are notified by the social worker to pay the victim. 18971: M. Foster, $90.35, MA transportation. This State program reimburses family members or volunteers who transport people with MA to doctor /hospital/ lab appointments. The program is "sum sufficient" -the State reimburses the County for all transportation costs. Motion A motion was introduced by Burri, seconded by Olson, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book: Human Services voucher 18464 through 18494, dated March 18, 2004 in the amount of $14,914.50. Human Services voucher 18402 through 18463 dated March 18, 2004 in the amount of $37,720.60. Human Services voucher 18612 through 18729, dated March 25, 2004 in the amount of $228,074.38. Human Services vouchers 18741 through 18744, dated March 25, 2004 in the amount of $17,928.29. Human Services vouchers 18940 through 19047, dated April 01, 2004 in the amount of $88,896.71. Human Services voucher 18746, dated April 01, 2004 in the amount of $5,655.00. Human Services vouchers 19049 through 19055, dated April 06, 2004 in the amount of $80,770.24. Human Services vouchers 19056 through 19081, dated April 06, 2004 in the amount of $41,888.92. Human Services vouchers 20119 through 20305, dated April 12, 2004 in the amount of $122,193.22. Human Services vouchers 19979 through 20118, dated April 12, 2004 in the amount of $147,757.83. Nursing Home vouchers 18395 through 18401, dated March 18, 2004 in the amount of $14,622.91. Nursing Home vouchers 18730 through 18740, dated March 25, 2004 in the amount of $2,227.71. Nursing Home vouchers 18936 through 18939, dated April 01, 2004 in the amount of $861.01. St. Croix County Health and Human Services Board Page 3 April 12, 2004 Nursing Home vouchers 19935 through 19978, dated April 12, 2004 in the amount of $13,432.49. Human Services, Workshop, Public Health, Social Services vouchers 160 through 189, dated March 22, 2004 in the amount of $344,603.50. Human Services, Workshop, Public Health, Social Services vouchers 190 through 220, dated April 01, 2004 in the amount of $346,967.23. Human Services and Nursing Home vouchers 175 through 204, dated March 23, 2004 in the amount of $169,415.24. Human Services and Nursing Home vouchers 205 through 235, dated April 08, 2004 in the amount of $174,339.41. FINANCIAL REPORTS The following financial report for February, 2004 was distributed to Board members. Ziegler said the reports reflect the settlement of the union contracts and the wages will come through as accurate expenses. The General Relief Policy needs to be updated as we are questioning the priority of the General Relief Burial Policy as opposed to the General Relief Medical and Shelter Policy. This item will be on the May agenda. ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD 01/01/04 THROUGH 02/29/04 NURSING HOME January. 2004 February. 2004 Cash Balance 02/29/04 $1,550,427.35 $1,481,520.67 Add: Accounts Receivable 02/29/04 $337,778.21 $392,561.11 Account Payable 02/29/04 ($284,320.61) {$226,608.36} Net Current Items 02/29/04 $1,603,884.95 $1,647,473.42 2004 Revenue Recorded through 02/29/04 $513,897.68 $918,549.54 Includes Allocations of Anticipated Revenues 2004 Expenses Recorded through 02/29/04 $474,031.00 $882,819.24 Includes Allocations of Expected Expenses Excess Revenues over Expenses $39,866.68 $35,730.30 St. Croix County Health and Human Services Board Page 4 April 12, 2004 HEALTH AND HUMAN SERVICES 2004 SUMMARY Total OF REVENUES Jan.- February Budget Balance % Administration 145,639.61 873,534.97 727,895.36 16.7% AODA Services 83,461.25 469,152.15 385,690.90 17.8% Long Term Support 2,395,149.13 14,616,574.52 12,221,425.39 16.4% Mental Health 396,972.57 2,745,667.40 2,348,694.83 14.5% Family & Children's 502,937.10 2,844,524.50 2,341,587.40 17.7% Public Health 219,750.45 1,420,079.06 1,200,328.61 15.5% Economic Support 123,435.43 957,504.85 834,069.42 12.9% General Relief 2,465.62 19,212.68 16,747.06 12.8% REVENUES HUMAN SERVICES PROGRAMS x.869.Bit I. 23 946-2;n-lq 20.076.438.97 16_2% SUMMARY Total OF EXPENDITURES Jan.- February Budget Balance % Administration 146,643.05 873,534.97 726,891.92 16.8% Alcohol -Drug Abuse 73,393.01 469,152.15 395,759.14 15.6% Long Term Support 2,468,648.67 * 14,616,574.52 12,147,925.85 16.9% Mental Health 401,458.17 2,745,667.40 2,344,209.23 14.6% Family & Children's 387,591.96 * 2,844,524.50 2,456,932.54 13.6% Public Health 215,670.10 1,420,079.06 1,204,408.96 15.2: Economic Support 141,442.36 957,504.85 816,062.49 14.8% General Relief 4,797.04 19,212.68 14,415.64 25.0% EXPENDITURES HUMAN SERVICES PROGRAMS 3,839,644.36 23,946,250.13 20,106,605.77 16.0% Excess Rev over Expenses 30.166.80 St. Croix County Health and Human Services Board Page 5 April 12, 2004 ST CROIX HEALTH CENTER OPERATIONS REPORT JANUARY THROUGH JANUARY JAN - 2004 BUDGET ACTUAL DIFFERENCE % CENSUS 70.5 72 1.5 100.2 OPERATING REVENUE: MEDICARE $ 1,226,972.00 $ 143,953.47 $ 1,083,018.53 11.7% MEDICAID $ 2,135,804.00 $ 436,860.21 $ 1,698,943.79 20.5% PRIVATE PAY $ 1,074,462.00 $ 102,137.51 $ 972,324.49 9.6% ALL OTHER SOURCES $ 6,706.00 $ 2,876.06 $ 3,829.95 42.9% TOTAL OPERATING REVENUE $ 4 $ 686,827.24 $ 3,758,116.76 15.4% OPERATING EXPENSES: DAILY PATIENT SRVICES $ 3,607,389.85 $ 527,032.03 $ 3,080,357.82 14.6% SPECIAL SERVICES $ 267,452.94 $ 42,458.46 $ 224,994.48 15.9% GENERAL SERVICES $ 1,173,975.87 $ 153,166.69 $ 1,020,809.18 13.0% ADMINISTRATIVE SERVICES $ 501,036.96 $ 82,109.79 $ 418,927.17 16.4% UNASSIGNED: DEPRECIATION( %BASED) $ 178,000.00 $ 29,666.00 $ 148,334.00 16.7% OTHERS $ 302,423.05 $ 48,386.27 $ 254,036.78 16.0% TOTAL OPERATING EXPENSES $ 6,030,278.67 $ 882,819.24 $ 5,147,459.43 14.6% NET FROM OPERATIONS $ (196,992.00) NON - OPERATING ITEMS: REVENUE FROM RATE APPEALS $ 17,650.00 $ 2,942.00 $ 14,708.00 16.7% IGT FUNDS ( %BASED) $ 564,705.00 $ 135,662.30. $ 429,042.70 24.0% CO ALLOCATIONS( %BASED) $ 815,480.00 $ 94,118.00 $ 721,362.00 11.6% TOTAL NON - OPERATING ITEMS $ 1,397,835.00 $ 232,722.30 $ 1,165,112.70 16.6% NET FROM ALL SOURCES PERCENTAGE SHOULD BE 16.67 $ 35,730.30 FUND BALANCE 01/01/04 $ 1,911,092.35 OPERATIONS $ 35,730.30 FUND BALANCE END OF PERIOD $ 1,946,822.65 Report does include an accrual of wages for 2004. Wages still being paid at the 2002 rate for union staff. PUBLIC HEALTH PROGRAM REPORT Wendy Kramer, Lead PHN, shared that last week was National Public Health Week. News releases were sent to local newspapers and the Public Health Newsletter was issued. Staff displayed a proclamation from Governor Doyle declaring Public Health Week. The 2004 Friend of Public Health will be honored by department staff on April 23. Nelson said the WIC numbers are increasing. She said the use of food pantries is also increasing. St. Croix County Health and Human Services Board Page 6 April 12, 2004 Nelson announced that Teresa Kvan was hired as a full -time nutritionist for Public Health. Nelson said the TB dispensary plan budget for 2003 will be submitted to the State program this week. It is possible for Public Health to recoup some of the expenditures. The 2004 budget and MOU will be submitted to the state program in May. Nelson said the Legislative Event will be held Monday, April 19, 2004 from 9:00 AM to 11:00 AM in the DHHS Board Room. Upcoming conference materials in the packet were referenced including WPHA /WALHDAB in Stevens Point on May 18 -19, WI Public Health Law on June 2 in Madison, and NALBOH national conference in June. Nelson gave some information on Wisconsin preparedness and encouraged Board members to access more information at www.co.polk.wi.us /wrpphp. The Board recessed from 10:05 AM to 10:20 AM. MENTAL HEALTH PROGRAM REPORT Kiesler said Mental Health inpatient usage was up in 2003 and there are difficulties in collecting revenues. He said the Board approved the diversion program, however after further discussion with State officials who have decided that only Advanced Practice Nurse Prescribers who specialize in adult Mental Health will be allowed to work in mental health clinic, it will be very difficult to carry out the diversion program plan in St. Croix County. There are only 89 (of over 2400) APNPs certified in Adult Mental Health in the State. A letter was sent to each one and no response was received. Staff are now back to square one reconsidering how to put the program together. Kiesler also reported on inpatient psychiatric admissions. He said we know the number of inpatient days by the end of every month and we typically know the rate per day for inpatient by the beginning of the year, but, we cannot accurately determine which client are insured, which clients are uninsured and which clients insurances will refuse to pay for their inpatient stays. Kiesler referred to the data assembled for the facts sheet for this meeting entitled "MH /AODA Highlights to 2003 Year End Budget" on several occasions to reference the difficulty in assembling a budget for contracted services due to the unpredictable and crisis oriented clients served in the Mental Health /AODA unit and to put prior years surpluses /losses into perspective. Kiesler plans to provide the Board with more routine data regarding acute and long -term psychiatric inpatient admissions. This data will provide a data range and to attempt to anticipate the best /worst case scenario. Kiesler said so far this year we have had fewer inpatient admissions than we had last year at this time. However, because he believes the number of indigent clients are higher we may have incurred more cost in this specific line item this year compared to last year. Kirt said we are seeing more cases involving methamphetamine use. He said clients addicted to meth are among the most difficult clients to treat. ACTION ON BIDS TO PURCHASE BUSSETTE FOR ST. CROIX INDUSTRIES Eichstaedt said we received four responses to the bid requests, however only three eligible bids met the bid specifications. Motion A motion was introduced by Olson, seconded by Bethke, and unanimously adopted: That the Board approves Bid #1 from Minnesota Body & Equipment for a price with trade -in of $40,719.00. St. Croix County Health and Human Services Board Page 7 April 12, 2004 VALLEY HEALTH PLAN CONTRACT PROPOSAL It is time to renew the agreement with Valley Health Plan. Ruka said from this point on, the agreement would automatically renew each year unless either party decided to opt out. She said the fee schedule for Valley Health Plan is very attractive and most employer groups pay 100 %. She said from a billing standpoint, it is a very simple insurance plan to deal with. One drawback is that the Mental Health services may have to be provided to some out of county residents covered under this plan. Ruka said insurance companies do not recognize county borders. Administration recommends renewing this contract with a request to Valley Health Plan to change the "opt out" to 30 days written notice at anytime. Ruka said the clinic is currently four weeks out for mental health appointments, which is a deterrent for some clients coming here. Also, as with any other plan that requests we see clients from other counties, we would encourage them to seek services within their county first before coming here. Motion A motion was introduced by Burri, seconded by Olson and unanimously adopted: That the Board approves renewing the contract with Valley Health Plan. It was the consensus of the Board that staff may initiate future similar contracts and do not need to bring the contracts back to the Board. NURSING HOME REMODELING UPDATE Krieger reported the contractors have blocked off the hallways and are waiting for steel supports for the lower level. If all continues as it is, the project should be done by mid -June. Nursing Home census is 70 today, with no referrals in the last week. Krieger gave a brief synopsis of referrals /admissions to the nursing home for the last three months. In January there were 17 referrals with nine admissions and eight declined due to no bed available; in February there were 11 referrals with two admissions and nine declined due to no bed available; in March there were 15 referrals with five admissions and 10 declined due to no bed available. Krieger said Assembly Bill 842 was opposed and defeated this session. This Bill is not supported by many groups as it is felt it will take away from patient care. The Bill may come back next session as it is viewed by supporters as a punishment that actually takes away from quality of care. LONG TERM SUPPORT PROGRAM REPORT Lockwood reported on the children's waiver programs. There are three separate programs that serve physically disabled children, severe emotionally disturbed (SED) children, and developmentally disabled- autistic children. The Board voted in December to support the waiver and it went into effect January 1. The program provides $461,000 per year for serving 16 autistic children with severe impairment. Lockwood said all the monies come from State and Federal resources, there are no County dollars involved. He said this program is a three -year program so it is a time - limited program. He said we are also currently targeting SED children already being served by Family and Children's using County dollars already in the 2004 budget to leverage Federal revenue in the Children's Waiver Program. The matching ratio is 60% Federal to 40% County. SPRINGSTED STUDY Copies of the program mission statements were distributed to Board members in March. These documents will be updated with the Board in May and returned to Chuck Whiting in June. ACTION TO APPROVE RENTAL CONTRACT WITH HENK VAN DYK FOR COUNTY BARN Borup said the contract for leasing the land with Schottler runs through 2006. Van Dyk is requesting to renew the rental contract on the barn for one more year. St. Croix County Health and Human Services Board Page 8 April 12, 2004 Motion A motion was introduced by Bethke, seconded by Burri, and unanimously adopted: That the Board approves renewing the barn contract. The Board presented plaques of appreciation for service to the Board to Olson and Bethke and thanked the members for serving on the Board. Dorsey asked if there were any other issues to bring before the Board. Motion A motion was introduced by Bethke, seconded by Olson, and unanimously adopted: that the meeting be adjourned. Time: 11:30 AM Chair: Attest: (Secretary)