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HomeMy WebLinkAboutHealth & Human Services 07-20-11 Berenschot will review vouchers. Revised 07/18/2011 NOTICE OF MEETING AND AGENDA ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD DATE AND TIME: July 20, 2011 at 8:30 AM LOCATION.• (Board Room, St Croix County DHHS Building, 1445 N. Fourth Street, New Richmond WI) CALL TO ORDER ROLL CALL APPROVAL OF MINUTES OF PREVIOUS MEETING - 06/15/11 and 06/15/11 Open Hearing DATE OF NEXT MEETING – 08/17/11 at 8:30 a.m. OLD AND NEW BUSINESS 1. Consideration of Claims and Vouchers and appoint member to review vouchers at next meeting 2. Financial Report a. Monthly financial and staffing report for Nursing Home, Health and Human Services and St. Croix Industries b. aged receivable report 3. Nursing Home Administrator's Report 4. Health Center Environmental Survey 5. 2012 Budget timeline and guidelines 6. 2011 Departmental Operational Goals—Health Center 7. Ordinance amending Chapter 40—Lodging and Food Protection 8. Annual Open Hearing on the Budget 9. * *Family Care Caps —State waitlist policy 10. 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. 7/18/2011 8:11 AM ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD July 20, 2011 The St. Croix County Health and Human Services Board met on July 20, 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 Deb Rasmussen Alfred Schrank MEMBERS ABSENT: Dr. Lisa Ramsay, excused STAFF PRESENT: Fred Johnson, Health and Human Services Director Frank Robinson, Nursing Home Administrator Wendy Kramer, Public Health Officer/Public Health Coordinator Malva Sirek, Clerical Supervisor OTHERS PRESENT: Pat Thompson, County Administrator Daryl Standafer, County Board Chair Art Tobin, Building Services Director Kim Dupre, Information Systems Analyst Norm Matzek 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, August 17, 2011 at 8:30 AM. AGENDA Motion A motion was introduced by Schrank, seconded by Marzolf, and unanimously adopted: That the agenda be approved as distributed. MINUTES Motion A motion was introduced by Marzolf, seconded by Schrank, and unanimously adopted: That the minutes of the 06/15/11 Health and Human Services Board meeting and Open Hearing be approved with revisions noted by Marzolf. St. Croix County Health and Human Services Board Page 2 July 20, 2011 CONSIDERATION OF CLAIMS All check registers for June for funds 205, 225, 230, 600 and 625 were reviewed by Health and Human Services (HHS) Board member Berenschot. All questions were answered satisfactorily. Motion A motion was introduced by Berenschot, seconded by Rasmussen, and unanimously adopted: To approve the June vouchers. Johnson said there is a need for consistent financial and budget reports between the committees. He distributed a sample of a budget report which included expenditures for the month, year to date and what has been budgeted. The report includes the five funds under Health and Human Services. The transition to the new reports will probably occur in August. Board members will not continue to review detail vouchers monthly; however, the voucher reports will be made available if requested. Johnson indicated any member can review vouchers at any time but there will be no formal monthly approval of vouchers. FINANCIAL REPORTS The following financial report for Health and Human Services through June, 2011 was distributed. Johnson indicated the County appropriations for the year have been applied to the Health and Human Services (HHS) financial report. He indicated financial staff are being cross trained so staff can file monthly reports to the State. He indicated in previous years the State would forward revenue in advance; now the State forwards up to 25% of the revenue until July and then actual revenue is sent. St. Croix County Health and Human Services Board Page 3 July 20, 2011 Health S Human Sendem - Fund 225 JMe 2iUll Annual .krM Budget % of Romnue by Service Budget Aduals Balance DwW Adrrmistration S 5,624,119 S 4,600,855 S 1,023,264 81.8% AODA Services 696,880 323,518 373,352 46.4% Mental Health 2,561,597 930,094 1,631,503 36.3% Family 8 teen's 1,501,668 114,965 1,386,703 73% Pubic Health 1,127,707 829,027 298 73.5% FemonicSWpod 814,943 249,431 565,512 30.6% General Relief - - - 0.0% Doordnated SeruiceslSED 3,644,207 1,089,429 2,554,778 29.9% Service Rerenue $ 15.971.121 $ 8.137.319 $ 7,833,802 51.0% Annual .krre Budget % of F3powlilure by Service Budget Acksaft Balance DLKW AdrrYtistrabon $ 1,337,034 S 663,648 S 673,386 49.6% Alcolwl-DnigAbuse 797,658 336,106 462,552 420% Mental Health 3,516,766 1,494,324 2,022,442 425% F 8 ten's 3,030,817 1,212,678 1,827,139 39.9% Pubic Health 2,112,632 901,721 1,210,911 427% FemonwSWpod 1,187,786 549,489 638 46.3% [general Relief 1,500 500 1,000 33.3% DoordnatedSenimSED 3,977,928 1,169,508 2,80B 29.4% Service Fxpowkknes $ 15.971.121 $ 6.325.974 $ 9,644,147 39.6% 1aMWNMr9sOWWAft9 y EqWWRff&ffVS $ 1.810.345 P&vmd ofBbVet 50.0% The following financial report for St. Croix Industries through June, 2011 was distributed. St. Croix Industries expenses are better than budgeted. St. Croix Industries has had some contractual adjustments so some adjustments will be seen in the financial reports over time. St. Croix County Health and Human Services Board Page 4 July 20, 2011 SL Croix Industries - Fund 525 JMW 2011 Arux" JUM Rudgqt % of PIOVCWNKM Budget teals Balance Budget WS Opetabons $ 1,496,000 $ 721,559 $ 774,441 48.2% WS Production 321,482 219,624 101,858 68.3% WS H Hands 116,700 80,061 36,639 68.6% WS 10,500 6,736 3,764 64.1% WS Vocational RaceMMI 365,500 181,331 184,169 49.6% WS Om m Based Day Prog 1n8,0on 54,042 53,958 5+0.0% Total Rovenue $ 2.415.182 $1 X3.353 $ 1.154.829 522% Annual JUM Budget % of teals Balance Rudga WS Opembom $ 1,407,854 $ 6n4,M $ 802,908 43.096 WS Production 324,778 207,017 117,761 633% WS Hdoing Hands 86,250 52,588 33,663 61-96 WS Popfflanding 10,500 2,349 8,151 22.4% WS Vocational Ptaceraml 421,630 158,861 262,769 373% WS Om m Based Day Prog 167,170 66,359 100,811 393% Total EWen&l res $ 2.418.182 $1.M2.120 $ 1.326.E 452% 14l revs Orar [ ridsrJ $ 171 Ejpac&d FhrcmtofBkmWI W O% The following financial report for the Nursing Home through June, 2011 was distributed. Johnson noted there was a contractual adjustment in the outpatient therapy line for the Nursing Home as the actual figure needed to be revised. The Nursing Home census has been lower and staffing levels have been adjusted to the lower census, which results in lower operating expenses. St. Croix County Health and Human Services Board Page 5 July 20, 2011 St CnAk Health Center - Fund 600 June Mil Operatrrg Revenue: Budget Actuift 11311fiamnce of Budget Medicare S 1 S 765 S 880 46.5% Medicaid Z178 1040 650 1 47.8% Pmrate Pay 1 928 955 38.3% Revenm - IGT Finds 463 217 246 266 469% out PatientThuapy 20 (4 325) 24 -21.6% Al 00rer Sources 18 8 10 44.7% Cafe Revenue $0.00 5 ( 589 0.0% Total Operatrrg Revenue S 5,875 49 $ 2,625,965 S 3",M 44.79E erg Exp- DwIly Patient Services S 3 S 1774 351 $ Z 112 , 972 45.6% Spea alSerAces 277 12!) 147 46.7% General Services 1 5 190 687 45.4% Administrative Ser Aces 690 260 429 378% Cafe $0.00 4 486 0.0% Sub Total S 6,114,805 S 2,742,014 S 3,372,791 44.8% Unassigrea: ation other UtiitiPs S 169 S 67 S 101 400% WorkersComp CwpulerTedi 160 ass 105 54 66.0% kf rance 55 74 19 465 1354% Unassigned Sub Total $ 384826 S 248,004 S 136822 64.4% Total OpmA g F es S 6,499,631 S 2,990,018 S 3,509,813 46A% Rommu es Dater firm Op ff- S (364,153) County Revenues bmuran mDividend- iww .rpededrevmmnotresufo[Oporafians S 9,000 $ 1,855 S 7,145 20.6% Co Vocations - L 369 369 S - 100.0% Nwang Horne Carry Over 246 246 0.0% TOW 0U13ftndrg S 624,382 S 370,874 $ 253,500 59.40% Rleraerx�es Omer (llr�darJ EIrieres ►� Corar►}r Corr6►7irilAVrts $ 6,721 Eipmded Parcantaef BUV& 50.0% AGED HEALTH AND HUMAN SERVICES RECEIVABLES REPORT: The aging Accounts Receivable report for Health and Human Services through May was briefly reviewed. Accounts Receivable staff are working on providing detail to create projections for 2012 budget revenue for collections. Johnson indicated the report reflects HHS collections only. It was the consensus of the Board to review this report quarterly versus monthly. NURSING HOME ADMINISTRATOR'S REPORT Robinson said the average monthly census for June was 56, with 6 Medicare, 36 Medicaid, and 13 private pay residents. The Medicare average daily rate paid was $548.25 for June compared to the budgeted amount of $485.00. Acuity rates continue to be higher than budgeted. Robinson indicated the Nursing Home has experienced a lower census, which seems to be consistent with other facilities in the area, although St. Croix Health Center census occupancy has been higher than competitors in the area. St. Croix County Health and Human Services Board Page 6 July 20, 2011 The annual Health Department Survey resulted with one deficiency for hand washing. The plan of correction was submitted, a desk audit was performed by the State, and the plan of correction was approved. HEALTH CENTER ENVIRONMENTAL SURVEY The Life Safety Code Survey took place on June 27 2011. An Engineer from the State spent the entire day reviewing policy and procedure and touring the building. The average number of deficiencies issued to facilities in Wisconsin by the Engineer is 12. The St. Croix Health Center received three deficiencies, which included: • Fire drills are to be held at unexpected times under varying conditions at least quarterly on each shift; the Nursing Home had the required number of fire drills but the times of the drills did not vary enough. The schedule will be changed to correct this issue. • The main fire alarm control panel located in the boiler room had a heat detector but not a smoke detector. This was a change in code since the building was built. This will be corrected by this afternoon. • The basement plenum issue was reissued and will have to reapply to the State for a waiver, as needs to be done every year. Robinson reported the Resident/Family Picnic for the Nursing Home will be August 18 with music beginning at 4:30 and supper starting at 5:00 PM. There will also be a basket social with silent auction beginning on August 1 This year the picnic will have a Hawaiian theme. Board members were invited to attend. Marzolf thanked Robinson for the leadership he has provided and for the financial reports that have been consistently in the black. Tobin reported the loading dock project will be done within a week. He also reported the hot water issue is also being resolved and that he is pursuing grant monies from Focus on Energy to repair the exterior doors in the Nursing Home. 2011 DEPARTMENTAL OPERATIONAL GOALS—HEALTH CENTER A Department will be highlighted each month to help guide the Board with policy decisions. Robinson highlighted areas of the 2011 -2015 St. Croix Health Center (SCHC) strategic plan. Robinson repeated the SCHC mission statement: "Our residents don't live in a facility... We work in their Home." He reported staff give residents respect and they are treated as if this is their home. He reported the Nursing Home is now a 5 -Star facility, which is the highest rating nursing homes can receive. SCHC is one of the top 50 nursing homes in Wisconsin for the past two years. Robinson reported a family survey is sent upon resident discharge. The goal is to receive 95% customer satisfaction and the surveys returned indicate closer to 100% customer satisfaction in the last year. Another goal on the plan is no survey deficiencies at Level "G" or higher and that has not happened in the last five years. St. Croix County Health and Human Services Board Page 7 July 20, 2011 Robinson indicated the financial accountability goal is to have zero county levy required to fund operations by 2015. He anticipates with the union concessions recently made it is possible the Nursing Home will be off the County levy by the 2012 budget cycle. Robinson said staff do things right everyday, not just when the state survey team is here. He said there will be a monthly audit regarding hand washing for the next year to correct the deficiency received. Robinson indicated there may be a burden on the County if retroactive Medicaid pay is eliminated. Placements may not be funded possibly as long as 90 days and the County could have to pay for these placements. It is not certain from the information received from the Department of Health Services where the $500 million in Medicaid cuts will be made, but the elimination of retroactive payment could be an option. A committee consisting of Frank Robinson, Ron Kiesler, Brad Beckman, Connie Sarauer, and Lisa Leahy has been formed to discuss behavioral health client placements. The committee hopes to provide a recommendation by October. The top priority is to keep all other residents safe from behavioral health clients and to keep all residents safe. Johnson highlighted that currently all protectively placed clients are not coming to the county; however, with caps in Family Care and no retroactive MA, that could change and impact the county. Robinson said a new MDS procedure has been in place since October, 2010. The Nursing Home now receives a new rate every quarter based on acuity levels. Work has been done with consultant Theresa Lange to document correctly for enhanced reimbursement. Robinson indicated the Nursing Home is getting better reimbursement for work that is being done through rehab nursing. Work is being done to develop a training module as ECS does not have a training feature. The SCHC is second in the nation for utilizing ECS. Wentz congratulated Robinson on doing a great job and expressed appreciation for the work he has done. The Board recessed from 9:35 — 9:45 AM. ORDINANCE AMENDING CHAPTER 40—LODGING AND FOOD PROTECTION Kramer reported the State has updated their administration code and presented an Ordinance Amending Chapter 40 — Lodging and Food Protection. Motion A motion was introduced by Rasmussen, seconded by Berenschot, and unanimously adopted: That the Board approves the following ordinance: St. Croix County Health and Human Services Board Page 8 July 20, 2011 ORDINANCE AMENDING CHAPTER 40 – LODGING, RECREATION FACILITIES AND FOOD PROTECTION Ordinance No. St. Croix County, Wisconsin WHEREAS, County Code Chapter 40 was created in March, 2002, with the enactment of Ordinance No. 612(2002) to authorize the Public Health Division of the St. Croix County Department of Health and Human Services to obtain agent status from the State of Wisconsin Department of Health Services to pre- inspect, inspect and investigate vending operations, hotels, restaurants, tourist rooming houses and other recreational establishments; and WHEREAS, the State of Wisconsin Department of Health Services (DHS) changed the Administrative Code chapter name from "HFS" to "DHS" to correctly reflect the current department name; and WHEREAS, to be accurate and current Chapter 40 has been updated to reflect the change. THEREFORE, the St. Croix County Board of Supervisors does ordain as follows: Section 40.02 Regulations and enforcement of Chapter 40 – LODGING, RECREATION FACILITIES AND FOOD PROTECTION is amended as attached changing "HFS" to "DHS." 2012 BUDGET TIMELINE AND GUIDELINES Johnson distributed a schedule of the 2012 budget timeline, which will begin with a department head meeting on July 28 Johnson briefly reviewed the schedule. ANNUAL OPEN HEARING ON THE BUDGET Johnson reported Health and Human Services is required by Department of Health Services and Department of Family and Children's to conduct an annual open hearing to solicit input on the budget. Johnson reported documents regarding the open hearing were sent to the State on July 8 Board members commented that attendance at the open hearing was down this year. A possible reason is that wait lists are less this year with the implementation of Family Care. Other areas that presented at the open hearing were the Castle, which is a drop -in center for behavioral health clients, Positive Alternatives and the Family Resource Center. Both requested county monies to help with services. Johnson indicated there is a purchase of service contract when services are needed, but limited funding has been set aside for prevention for families that are not service connected. Johnson will review this item with Thompson. FAMILY CARE CAPS —STATE WAITLIST POLICY Johnson reported Family Care caps will go into effect 07/01/2011. Attempts were made to obtain additional slots before the 07/01/2011 deadline. More slots are gained through attrition and then the slots are filled from the wait list. Aging & Disability Resource Center manages the wait list and clients can be served St. Croix County Health and Human Services Board Page 9 July 20, 2011 in the slots due to crisis and chronic needs. A wait list policy is being developed and operational practices will be received from the state. St. Croix County is still reviewing the waitlist policy for budgetary projections. This process could impact the 2012 budget and will be considered as the 2012 budget is being developed. The Federal Government will have to approve the plan from the state regarding the caps in place. Johnson indicated from questions last month there is no way to separate client counts to have distinct counts in programs as there is some duplication in services in Economic Support between Food Share and MA. POSSIBLE AGENDA ITEMS FOR NEXT MEETING No items were brought up for discussion at the next meeting. Wentz asked if there were any other issues to bring before the Board. Wentz adjourned the meeting. Time: 10:12 AM Chair: Attest: (Secretary)