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HomeMy WebLinkAboutHealth & Human Services 05-14-04 LOIS BURRI WILL REVIEW VOUCHERS AT 8:00 AM REVISED - 04/29/04 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: 05/14/04 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: 05/27/04 (5:00 PM) ACTION ON PREVIOUS MINUTES: 04/12/04 ANNOUNCEMENTS APPOINTMENTS: UNFINISHED BUSINESS: 1. Health and Human Services Governing Body By -laws update NEW BUSINESS: 1. Election of Health and Human Services Board Officers 2. Consideration of Claims and Vouchers 3. Financial Report 4. Program Reports a. Mental Health /AODA Inpatient Update b. Nursing Home 5. Discussion of Springsted Study 6. Update General Relief Policy 7. Capital Outlay Plan Update 8. 2003 Nursing Home and Health and Human Services Department Audit Report 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 May 14, 2004 The St. Croix County Health and Human Services Board met on May 14, 2004 at the St. Croix County Health and Human Services /Health Center complex. MEMBERS PRESENT: Thomas Dorsey, Chair Lois Burri Thomas Caflisch Dr. Michael Kretz Stan Krueger Linda Luckey Deb Rasmussen Ralph Swenson Esther Wentz MEMBERS ABSENT: Deb Rasmussen, excused STAFF PRESENT: John M. Borup, Health and Human Services Director Judy Ziegler, Accounting Supervisor Ron Kiesler, Mental Health /AODA Coordinator Mary Squyer, Economic Support Supervisor Malva Berg, Secretary OTHERS PRESENT: Buck Malick, County Board Chair Michelle Pietrick, Finance Director Rod Paulson, CPA, Tracey and Thole 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 May 27, 2004 at 4:30 PM, followed by the Open Budget Hearing, which is required by Wisconsin Statutes at 6:00 PM at St. Croix Industries. The following meeting is scheduled for June 11, 2004 at 8:30 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 Burri, seconded by Kretz, and unanimously adopted: That the minutes of the 04/12/04 Health and Human Services Board meeting be approved as circulated. ANNOUNCEMENTS Borup indicated an invitation in Board packets to WALHDAB update on June 16, 2004 from 10:00 AM to 3:00 PM in Eau Claire. Members were asked to notify Barb Nelson if they planned to attend. 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, seconded by Kretz. Swenson called for other nominations for Chair three times. Motion A motion was introduced by Wentz, seconded by Krueger, and unanimously adopted: That the nominations for Chair be closed and the Board cast a unanimous vote for Dorsey to be chair. St. Croix County Health and Human Services Board Page 2 May 14, 2004 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, seconded by Burri. Dorsey called for other nominations for Vice Chair three times. Motion A motion was introduced by Krueger, seconded by Wentz, and unanimously adopted: That the nominations for Vice Chair be closed and the Board cast a unanimous vote for Swenson to be Vice Chair. Dorsey declared Swenson to be the Vice Chair of the Health and Human Services Board. Dorsey asked for nominations for the position of Secretary. Burri nominated Wentz, seconded by Kretz, for the position of Secretary. Dorsey called for other nominations for Secretary three times. Motion A motion was introduced by Krueger, seconded by Swenson, and unanimously adopted: That the nominations for Secretary be closed and the Board cast a unanimous vote for Wentz to be Secretary. Dorsey declared Wentz to be the Secretary of the Health and Human Services Board. Dorsey welcomed the new Board members and said it is a busy time for this Board with the remodeling construction of the Nursing Home. HEALTH AND HUMAN SERVICES GOVERNING BODY BYLAWS Borup said the final document is not available and this item will be scheduled for the June meeting. 2003 NURSING HOME AND HEALTH AND HUMAN SERVICES DEPARTMENT AUDIT REPORT Rod Paulson presented the 2003 audit reports for the Nursing Home and Health and Human Services. The Nursing Home balance is $297,221. Paulson said the Nursing Home downsized from 102 to 72 beds in 2003. He said there were changes in ITP accrual funds and changes in PTO accrual. He said there were reductions in PTO accrued amounts of approximately $59,000 due to long term employees leaving employment. He said this is a non - recurring item. This will not have an affect on cash, but will reduce expenses on the operating statement. Paulson indicated Medicare and Private Pay resident counts were down in 2003 due to downsizing. Paulson said the Nursing Home did well on controlling numbers considering the impact downsizing had. He said the value of net property and plant has decreased, which is not a good thing. Items are depreciated out quicker than net property and plant are replaced and this in turn affects the rates. Paulson recommended that general services area is a good area to look to see if possible cuts could be made compared to other nursing homes in the area. Health and Human Services is a special revenue fund of the County. Paulson reviewed the Health and Human Services audit report. The Health and Human Services balance is ($33,998). Several factors impacted this number including unexpected Mental Health /AODA inpatient costs (emergency detentions, court orders, etc.), $150,000 in 2003 billings was late due to HIPAA and software problems (these monies are anticipated in 2004), and the State's mid - contract change in the W -2 program resulted in a loss to the County of $41,168. In Paulson's management letter he indicated in the receipting of collections with a restrictive endorsement is not made until checks are deposited. He said checks should be endorsed and deposited immediately when received and at least daily. He recommended all inventory details should be on an excel spreadsheet so there is less room for human error on inventory extensions. Paulson St. Croix County Health and Human Services Board Page 3 May 14, 2004 recommended consolidating Health and Human Services donation funds and setting a minimum amount in the accounts, for example, $5000 minimum. The Board recessed from 10:10 to 10:20 AM. MENTAL HEALTH PROGRAM REPORT Borup indicated an article from the Wisconsin Counties Magazine regarding inpatient costs, court orders, etc. and articulates well that this is an unfunded mandate and how it affects property tax expense and encouraged Board members to read the article. Kiesler indicated approximately 95% of clients hospitalized are taken to an inpatient setting by law enforcement. He said it is rare for law enforcement to contact MH /AODA when a client is in crisis, other than to help them find a facility. He said the way the State Statutes read law enforcement would be liable if they did not emergency detain an individual in crisis and that individual ended up hurting themselves or someone else. Kiesler said law enforcement is doing their job. Kiesler informed the board members that for the first time in his tenure with St. Croix County he is being regularly invited to the bi- monthly Police Chief's /Sheriff's meetings. He hopes that this will lead to increased collaboration between law enforcement in the county and the Mental Health /AODA unit. Kiesler distributed a Mental Health Crisis Flow Chart depicting possible routes taken if a client is in crisis. He hopes in the future there will be a line representing communication from law enforcement to the Mental Health /AODA on -call worker during a crisis. He also included five different grids to help inform the Board on the financial status of the Mental Health /AODA contracts. Swenson asked for additional data to be included in future updates to the board. Kiesler stated he is committed to making whatever change is necessary to keep the board better informed. Kiesler stated that the current data indicates that through April we are approximately $47,000 under budget with the MH /AODA contracts. However, Kiesler also footnoted the fact that we currently have an individual who was committed by the courts who is placed at Winnebago State Institute. The commitment is for six months, which would compromise the MH /AODA budget significantly if we cannot find a less costly placement. This client is currently on a waiting list at Trempealeau County IMD, a placement that would be a third the cost. UPDATE GENERAL RELIEF POLICY The Health & Human Services Board resolved at the September 28 1995 meeting to limit the General Relief Program effective 1996 to provide: 1. Medical Relief for life threatening, or soon to be life threatening medical conditions, or to enable an individual to return to immediate employment. 2. Non - Medical Relief to those individuals with pending Social Security Supplemental Income determinations and the homeless, to prevent a threat to their health and safety. 3. Burials All three categories of General Relief are subject to St. Croix County residency requirements and the application and financial requirements. If the County runs out of money in the program, it can quit the program. with less revenue for all programs, we are questioning payments for burials. It is Administration's opinion that the cost of a funeral has nothing to do with the health and safety of our customers and it is Administration's recommendation to remove burial from the General Relief policy to maximize state monies to be applied to medical needs. It was the consensus of the Board to invite funeral directors to the open hearing. St. Croix County Health and Human Services Board Page 4 May 14, 2004 Motion A motion was introduced by Kretz, seconded by Burri and unanimously adopted: That the Board set the amount paid for a burial to $500 total and to re- evaluate this policy in 2005. NURSING HOME Borup said the census is 71 today. Borup reviewed the cites received from the State survey team. Most cites required a change in the system to achieve compliance. A State Class B cite was received because of the remodeling construction. Mag locks were installed for safety. Borup has sent a letter to the architect, contractor and Corporate Counsel that the nursing home will not assume the financial cost of the cite. The fine attached to this cite could be $5,000. Board members suggested deducting the fine cost from the contractor's final payment. CONSIDERATION OF CLAIMS The following reports were distributed to the Board: March and April unemployment reports, April fixed asset report, April cash report and March financial reports Health and Human Services Board member, Burri, reviewed the vouchers; the following vouchers were pulled for discussion: HUMAN SERVICES: 20547: Curves for Women, $39.00, Long Term Support purchased services. Monthly cost for a membership for a CIP IB waiver client. This membership was recommended by the client's medical doctor as part of a weight management plan. 20583: Friendship Ventures, $1,043.00, Long Term Support purchased services. Friendship Ventures is located in Annandale, Minnesota and runs Camp Friendship for handicapped children and the Eden Wood Center. The check was for a person receiving services under the CIP IB waiver to attend camp. Motion A motion was introduced by Burri, seconded by Wentz, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book: Human Services vouchers 20535 through 20652, dated April 15, 2004 in the amount of $283,458.07. Human Services vouchers 20675 through 20699, dated April 15, 2004 in the amount of $4,742.17. Human Services voucher 20708, dated April 20, 2004 in the amount of $1,575.00. Human Services vouchers 20711 through 20716, dated April 22, 2004 in the amount of $31,754.07. Human Services voucher 20717, dated April 22, 2004 in the amount of $3,240.52. Human Services vouchers 20883 through 20984, dated April 22, 2004 in the amount of $105,471.89. Human Services vouchers 20994 through 21065, dated April 29, 2004 in the amount of $206,535.53. St. Croix County Health and Human Services Board Page 5 May 14, 2004 Human Services voucher 21721, dated May 06, 2004 in the amount of $6,097.97. Human Services vouchers 21725 through 21836, dated May 06, 2004 in the amount of $210,684.81. Human Services vouchers 22351 through 22428, dated May 14, 2004 in the amount of $41,906.89. Human Services vouchers 22429 through 22487, dated May 14, 2004 in the amount of $16,796.51. Human Services voucher 22513, dated May 14, 2004 in the amount of $6,600.00. Human Services vouchers 22488 through 22512, dated May 14, 2004 in the amount of $43,911.39. Human Services vouchers 22514 through 22683, dated May 14, 2004 in the amount of $235,582.02. Nursing Home vouchers 20653 through 20674, dated April 15, 2004 in the amount of $12,397.30. Nursing Home vouchers 20700 through 20703, dated April 15, 2004 in the amount of $1,390.07. Nursing Home voucher 20710, dated April 20, 2004 in the amount of $10,080.61. Nursing Home vouchers 20718 through 20728, dated April 22, 2004 in the amount of $16,000.72. Nursing Home vouchers 20900 through 20993, dated April 29, 2004 in the amount of $698.80. Nursing Home vouchers 21722 through 21724, dated May 06, 2004 in the amount of $45,178.56. Nursing Home vouchers 22273 through 22350, dated May 14, 2004 in the amount of $49,831.26. Human Services, Workshop, Public Health, Social Services vouchers 221 through 250, dated April 15, 2004 in the amount of $350,226.92. Human Services, Workshop, Public Health, Social Services vouchers 251 through 281, dated May 04, 2004 in the amount of $352,723.17. Human Services and Nursing Home vouchers 236 through 266, dated April 20, 2004 in the amount of $263,148.51. Human Services and Nursing Home vouchers 267 through 297, dated May 06, 2004 in the amount of $171,859.98. FINANCIAL REPORTS The following financial reports for March, 2004 were distributed to Board members. St. Croix County Health and Human Services Board Page 6 May 14, 2004 ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD 01/01/04 THROUGH 03/31/04 NURSING HOME March_ 2004 Cash Balance 03/31/04 $1,716,874.19 Add: Accounts Receivable 03/31/04 $269,019.58 Account Payable 03/31/04 ($346,459.08) Net Current Items 03/31/04 $1,639,434.69 2004 Revenue Recorded through 03/31/04 $1,413,407.99 Includes Allocations of Anticipated Revenues . 2004 Expenses Recorded through 03/31/04 $1,401,909.74 Includes Allocations of Expected Expenses Excess Revenues over Expenses $11,498.25 St. Croix County Health and Human Services Board Page 7 May 14, 2004 HEALTH AND HUMAN SERVICES 2004 SUMMARY Total OF REVENUES Jan.- March Budget Balance % Administration 222,810.44 873,534.97 650,724.53 25.5% AODA Services 123,397.08 469,152.15 345,755.07 26.3% Long Term Support 3,776,986.42 14,616,574.52 10,839,588.10 25.8% Mental Health 603,160.48 2,745,667.40 2,142,506.92 22.0% Family & Children's 684,948.27 2,844,524.50 2,159,576.23 24.1% Public Health 336,498.65 1,420,079.06 1,083,580.41 23.7% Economic Support 254,227.90 957,504.85 703,276.95 26.6% General Relief 3,197.43 19,212.68 16,015.25 16.6% REVENUES HUMAN SERVICES PROGRAMS 6.005 226.67 22 946.290 12 17 941 023 46 25_1% SUMMARY Total OF EXPENDITURES Jan.- March Budget Balance % Administration 215,339.92 873,534.97 658,195.05 24.7% Alcohol -Drug Abuse 121,490.04 469,152.15 347,662.11 25.9% Long Term Support 3,763,050.51 * 14,616,574.52 10,853,524.01 25.7% Mental Health 625,794.94 2,745,667.40 2,119,872.46 22.8% Family & Children's 674,900.05 * 2,844,524.50 2,169,624.45 23.7% Public Health 330,449.08 1,420,079.06 1,089,629.98 23.3% Economic Support 222,660.54 957,504.85 734,844.31 23.3% General Relief 7,868.75 19,212.68 11,343.93 41.0% EXPENDITURES HUMAN SERVICES PROGRAMS 5,961,553.83 23,946,250.13 17,984,696.30 24.9% Excess Rev over Expenses 43.672.84 To be on budget, percentage should be 25.00. St. Croix County Health and Human Services Board Page 8 May 14, 2004 ST CROIX HEALTH CENTER OPERATIONS REPORT JANUARY THROUGH MARCH JAN -MARCH 2004 BUDGET ACTUAL DIFFERENCE % CENSUS 70.5 71 0.5 100.7 OPERATING REVENUE: MEDICARE $ 1,226,972.00 $ 232,428.41: $ 994,543.59 18.9% MEDICAID $ 2,135,804.00 $ 655,534.61 $ 1,480,269.39 30.7% PRIVATE PAY $ 1,074,462.00 $ 160,679.91 $ 913,782.09 15.0% ALL OTHER SOURCES $ 6,706.00 $ 15,624.27 $ (8,918.27) 233.0% TOTAL OPERATING REVENUE $ 4,443,944.00 $ 1,064,267.20 $ 3,379,676.80 23.9% OPERATING EXPENSES: DAILY PATIENT SRVICES $ 3,607,389.85 $ 841,431.13 $ 2,765,958.72 23.3% SPECIAL SERVICES $ 267,452.94 $ 65,860.79 $ 201,592.15 24.6% GENERAL SERVICES $ 1,173,975.87 $ 258,266.82 $ 915,709.05 22.0% ADMINISTRATIVE SERVICES $ 501,036.96 $ 122,799.35 $ 378,237.61 24.5% UNASSIGNED: DEPRECIATION( %BASED) $ 178,000.00 $ 44,499.00 $ 133,501.00 25.0% OTHERS $ 302,423.05 $ 69,052.65 $ 233,370.40 22.8% TOTAL OPERATING EXPENSES $ 6,030,278.67 $ 1,401,909.74 $ 4,628,368.93 23.2% NET FROM OPERATIONS NON - OPERATING ITEMS: REVENUE FROM RATE APPEALS $ 17,650.00 $ 4,413.00 $ 13,237.00 25.0% IGT FUNDS ( %BASED) $ 564,705.00 $ 141,177.00 $ 423,528.00 25.0% CO ALLOCATIONS( %BASED) $ 815,480.00 $ 203,550.79 $ 611,929.21 25.0% TOTAL NON - OPERATING ITEMS $ 1,397,835.00 $ 349,140.79 $ 1,048,694.21 25.0% NET FROM ALL SOURCES $ 11,498.25 PERCENTAGE SHOULD BE 25 FUND BALANCE 01/01/04 $ 1,911,092.35 OPERATIONS $ 11,498.25 FUND BALANCE END OF PERIOD $ 1,922,590.60 Report does include an accrual of wages for 2004. Wages still being paid at the 2002 rate for union staff. DISCUSSION OF SPRINGSTED STUDY Yearly updates are requested for this study and updates are due to Chuck Whiting by June. Borup said there are a few minor changes and the last revision date is indicated at the bottom of the reports. It was the consensus of the Board to reschedule this discussion to the May 27 meeting. CAPITAL OUTLAY PLAN UPDATE Borup distributed updated capital outlay plans for Health and Human Services, St. Croix Industries and building services. Discussion held on various line items in the plans, no changes were made. St. Croix County Health and Human Services Board Page 9 May 14, 2004 Motion A motion was introduced by Wentz, seconded by Caflisch, and unanimously adopted: That the Board approves the capital outlay plans as presented and they be forwarded to the Finance Committee. It was the consensus of the Board to change the meeting time for the May 27 meeting to 4:30 PM. Dorsey asked if there were any other issues to bring before the Board. Swenson informed the Board there would be tighter screening for new positions for the 2005 budget. He indicated the county levy will not exceed the percent of new construction in the county, which was 6W in 2003. Motion A motion was introduced by Wentz, seconded by Krueger, and unanimously adopted: that the meeting be adjourned. Time: 12:15 PM Chair: Attest: (Secretary)