HomeMy WebLinkAbout07-08-2014 Health & Human Services Minutes MINUTES
HEALTH & HUMAN SERVICES BOARD
July 8, 2014 5:30 PM
County Board Room - Government Center
1101 Carmichael Road, Hudson, Wisconsin
CALL TO ORDER
Health and Human Services Board Chair Dr. Chris Babbitt called the meeting to order at 5:30
PM on July 8, 2014
ROLL CALL
Attendee Name Organization Title Status Arrived
Christopher Babbitt St. Croix County Supervisor Present
Howard Novotny St. Croix County Supervisor Present
Chris Kilber St. Croix County Supervisor Absent
Ron Kiesler St. Croix County Supervisor Present
Paulette Anderson St. Croix County Supervisor Present
Shaela Leibfried St. Croix County Supervisor Present
Leon Berenschot St. Croix County Board Member Present
Lisa Ramsay St. Croix County Board Member Absent
Deb Rasmussen St. Croix County Board Member Present
Health and Human Services (HHS) Director Fred Johnson, County Administrator Pat Thompson,
Corp Counsel Scott Cox, Human Resources Director Tammy Funk, Financial Director Tabatha
Hanson, Fiscal Manager Beata Haug, Social Services Director Lisa Leahy, Director of Nursing
& Interim Nursing Home Administrator Sandy Hackenmueller, ADRC Administrator Brad
Beckman, Children Services Administrator Kathy Dunlap,Children Services Manager Julie
Krings Economic Support Administrator Ronda Brown-Anderson, Public Health Administrator
Deb Lindemann, Public Health Supervisor Sharon Reyzer, Public Health Staff Laurie Diab y-
Gassama, several other County employees, and community members.
APPROVAL OF MINUTES
1. June 10, 2014 5:30 PM
A correction was noted to the June 10th, 2014 meeting minutes. The minutes stated that Howard
Novotny was recommended to be a member of the HHS Board Nursing Home Sub-Committee, it
should actually have stated Deb Rasmussen.
Supervisor Kiesler made a motion to approve the June 10th minutes as amended.
Supervisor Anderson seconded the motion.
Minutes were approved as amended. Corrections will be made.
RESULT: APPROVED AS AMENDED [UNANIMOUS]
MOVER: Ron Kiesler, Supervisor
SECONDER: Paulette Anderson, Supervisor
AYES: Christopher Babbitt, Howard Novotny, Ron Kiesler, Paulette
Anderson, Shaela Leibfried, Leon Berenschot, Deb Rasmussen
ABSENT: Chris Kilber, Lisa Ramsay
PUBLIC COMMENT*
No Public Comment at this time.
BUSINESS ITEMS
Chair Babbitt informed the Board and those in attendance that some items will be taken out of
order due to other obligations of staff.
1. Financial Reports
Fiscal Manager Beata Haug presented the financials to the Board.
HHS, Aging, and ADRC a variance mainly due to the receipt of tax levy in January of
2014. Also, the WIMCR payment has not come in yet and some additional program
funding and state allocations should be coming in later in the year. The claims shown are
through April, it takes quite some time to get a payment. On the expense side, the
operating costs are through April.
Nursing Home revenue is looking good as Census remains high and the increased
Medicare Part B being collected for client Speech, Occupational, and Physical Therapies.
On the expense side at the Nursing Home we are also showing operating costs through
April.
St. Croix Industries variance in the revenue is due to the surplus applied and also some
pending collections. No changes with the expenses, however variances are mainly due to
severance pay outs and the continued decline in operating costs.
Fiscal Manager Haug shared that she welcomes any of the Board members to call or
come in to see her with questions regarding the financial reports.
2. Nursing Home Report
Nursing Home Administrator Sandy Hackenmueller updated the Board regarding the
Census and current admissions. Things are going well and they continue to make
improvements.
3. Nursing Home 2013 Audit Presentation
Nursing Home Administrator Hackenmueller introduced Trent Fast, CPA from
CliftonLarsonAllen who did the 2013 Audit and will be presenting the results. Mr. Fast
gave an overview of what they've included in the Power Point. He shared that the
documents show some of the required communication and financial items included when
doing an audit. They take the numbers that they compile and then look at historical
trends to put meaning to some of the numbers. Also included is information that looks at
the state of the industry. Comparisons were made with 35 facilities of similar size and
revenue, though some of these are not governmental entities. He emphasized the
improving numbers reflect the continued work and positive changes that have been made
over the past years. The attached Power Point was then reviewed with the Board and
those in attendance. Questions were encouraged.
4. Presentation of Marketing study results for the Health Center by Larry Lester, Partner
from Wipfli LLP
Nursing Home Administrator Sandy Hackenmueller introduced Larry Lester a partner
with the Wipfli accounting firm. He presented the attached Power Point regarding the
results of the Health Center Market Study. They looked at four different areas; the
business of skilled nursing that we are in today , the need for additional assisted living in
this area, the Dementia Crisis demand, and Adult Day Care needs.
* Over the next few years there will be less of a need for Nursing Home beds,
but as the Baby Boomer population ages the need will again increase. They also
considered that currently occupancy is high in this area and feel that if a new St. Croix
Health Center is built the utilization will likely remain high.
* Assisted Living can be provided via a couple different models. The
Community Based Residential Facilities (CBRF) for the most frail, those with memory
loss, and potentially those with behavior issues or via a Residential Care Apartment
Complex (RCAC) which is more apartment type living. Because of the way our current
building is set up and would convert easily to a 40 bed CBRF. It would make sense to
consider this at the time of remodel/build. People are looking for alternatives to the
Nursing Home setting. It seems that if a percentage of the beds are filled by Family Care
residents it should not be difficult to fill these beds, unless other projects are built within
the area.
* Dementia Crisis care demands are difficult to estimate, but at this time there
are no dementia crisis CBRF beds available within the County. A small 5-10 bed
Dementia Care and Mental Health Crisis CBRF would likely remain full. This would go
hand in hand with the State dementia care redesign.
* Lester suggested there is a need for an Adult Day Care drop in center for
respite. Caregiver's are trying to keep family members in their homes longer but this
service would meet the potential high demand for respite. Transportation would be key in
making this accessible to all that may use it.
Lester fielded several questions from the Board and further discussion was had.
5. Resolution Placing Health Care Advisory Referendum on the November 4, 2014 St.
Croix County Ballot
Health and Human Services (HHS) Director Johnson informed the Board that a copy of
an Advisory Referendum Resolution was received by the County Board Chair at their
June meeting and then was referred to the HHS Board .
This resolution came to our attention after Eau Claire County made an advisory
referendum, to encourage the State to accept the Federal money offered by the Affordable
Care Act for expansion of Medicaid and Badger Care. With this Boards approval this
resolution would go to the County Board of Supervisors for consideration of this
Advisory Referendum for the Nov. 4, 2014 ballot.
Further discussion was had. Supervisor Schactner provided the HHS Board with some
supporting documents.
A Motion was made by Kiesler to move this resolution on to the County Board for
approval and was seconded by Anderson.
RESULT: APPROVED [UNANIMOUS]
MOVER: Ron Kiesler, Supervisor
SECONDER: Paulette Anderson, Supervisor
AYES: Christopher Babbitt, Howard Novotny, Ron Kiesler, Paulette
Anderson, Shaela Leibfried, Leon Berenschot, Deb Rasmussen
ABSENT: Chris Kilber, Lisa Ramsay
6. St. Croix County Substance Abuse Prevention Coalition Report
Behavioral Health staff Sara Sedahl and Kristin Deprey to gave an update regarding the
Substance Abuse Prevention Coalition. Sedahl, an Alcohol and Other Drug Addictions
(AODA) Counselor, summarized some of the current activities with the Coalition and
how it got it's start. The Coalition has 3 Primary areas of focus; Community Awareness,
Prevention and Treatment.
Hudson and St. Croix County (SCC) as a whole began to notice the Heroin increase in
the Spring of 2013, with overdose deaths. In July 2013 there was a Community Forum in
Hudson, where 100's of people were in attendance. Sedahl took this opportunity to
present information about forming a Coalition on Substance Abuse and Substance Abuse
Prevention in St. Croix County. An informational meeting was set up for Sept. 2013
where they had 33 people sign up. Community forums have since been held in other
Communities.
Through collaboration they started doing a presentation called "What's in your Medicine
Cabinet." Data shows that 60% of heroin users in treatment indicate they started with
prescription drugs and they are also the most commonly abused drugs by 12 and 13 year
olds. The promotions of the medication collection program have been greatly supported
in St. Croix County.
Our next project is the Candidate education sessions through the WI Alliance for Youth.
These sessions allow 3 members of the community about 20 minutes to share with the
candidates what we are concerned with and experiencing here in our county. The
Coalition members would focus on substance abuse issues during these sessions.
Deprey added that we need to keep in mind that alcohol continues to be the largest
service need. Continued prevention efforts around all substances is necessary.
HHS Director Johnson shared there are increased costs within the AODA Dept. and will
need to be looked at in the 2015 budget. Also, the County Board approved the
Community Justice Collaborating Council and 2 of their priority areas are Mental Health
Services and Drug Abuse. They will be looking to collaborate and work across different
disciplines as well.
7. Behavioral Health Nurse Position Request
HHS Director Johnson informed the Board that in the 2014 budget process positions were
adjusted to include 20 hrs. per week for a Nurse in Behavioral Health.
Jody Frick Foremiller from Human Resources shared information on the recruitment for
this position. They found that a part time position didn't seem to meet the need of many
candidates and through all their efforts are having no success in filling the position as it
is. In addition a professional placement service was also pursued and this agency was
unable to provide a candidate as well.
Johnson recommended this position be a full time, benefited position and that this
adjustment be completed yet this year. This is budget neutral for 2014 but will have a
financial impact in 2015. There will also be reduced hours in 2015 from our current nurse
for her continuing education.
Administrator Thompson reiterated the need and is looking to the HHS Board to support
a budget amendment that would then be placed on the Administration Committee agenda
and on to County Board.
Discussion was had regarding what programs this position will be billing, and what level
education is needed to fill the position. Additional fiscal impact for 2015 will also be
completed.
A Motion was made by Kiesler to move this request to the Administration Committee for
consideration and was seconded by Novotny.
All yes none opposed
At this time Chair Babbitt asked for a short recess. Reconvene @ 7:35
RESULT: APPROVED [UNANIMOUS]
MOVER: Ron Kiesler, Supervisor
SECONDER: Howard Novotny, Supervisor
AYES: Christopher Babbitt, Howard Novotny, Ron Kiesler, Paulette
Anderson, Shaela Leibfried, Leon Berenschot, Deb Rasmussen
ABSENT: Chris Kilber, Lisa Ramsay
8. Food and Nutrition Service Management Evaluation of the Wisconsin Women, Infants
and Children Program
Director Johnson shared that recently we had the opportunity to participate in a WIC state
review. Johnson introduced 3 staff from Public Health, Administrator Deb Lindemann,
Supervisor Sharon Reyzer, and Ruth Lehmann.
Reyzer gave a brief overview of the WIC program. WIC promotes and maintains health
for pregnant women, infants, and children under 5. They serve 850-900 clients in our
County.
On April 9-10th the audit took place. Reyzer reported that the WIC program had no
findings(a corrective action) and 5 observations. The observations included that we only
displayed one "And Justice for all" poster and need more, we could do better with
Hispanic literature by having more variety available. It was also recommended that we
look at more of the reports out there and how we can use them for outreach. At the time
of the review our breast pumps were in closet within a locked office, after the review they
are now locked in cabinet within a locked office. They also suggested looking at other
ways to improve outreach. Overall the audit went very well and the observations made
were acted upon so to continue to support best practice.
Chair Babbitt shared that this seems like an extremely positive report for an audit.
Lindemann added that St. Croix County should be very proud of the WIC program, they
do a great job and are very professional.
9. Communicable Disease Report
Director Johnson asked Public Health (PH) Administrator Lindemann and Supervisor
Reyzer to be here to give us an update from PH. One of the recent issues was the illness
outbreak in New Richmond Schools. Lindemann reported on the investigation that took
place and that within 3 days had identified the cause as Norovirus. Norovirus is highly
contagious and was likely spread due to the vomiting that occurred at the school.
The school was cleaned immediately and field trips cancelled. The school did a great job
in controlling this and contained it to the Middle School. No other cases were reported
after the initial outbreak.
Lindemann added that this was a good example to highlight as one of the mandated
services of Public Health is to monitor communicable diseases, their surveillance,
prevention, and control.
10. Grant County Wisconsin Resolution Opposing Decreased Local Authority
HHS Director Johnson received a copy of this resolution through the County Clerks
office and was placed on the agenda for input from the HHS Board to consider a similar
resolution.
Public Health Administrator Deb Lindemann shared that she has talked with Jeff Kindrai,
the Health Officer with Grant County. Their resolution was initiated by their zoning
department and though they have only 1 small frac sand mine in their county they were
concerned by the issues around the state and passed this resolution.
Lindemann also spoke in regards to a Health Impact Assessment study. The Institute for
WI Health is offering a $100,000 grant over a 18 month period to study the health
impacts of frac sand mining. The purpose of the study is to inform people and help guide
policy around frac sand mining.
Board Chair Babbitt reminded everyone that frac sand mining was a previous agenda
item and this is the follow up information. The Grant County Resolution also points out
the intent to undermine local authority in several matters. Babbitt wanted to bring this to
the Board for discussion and consider making our own resolution in the near future.
A draft resolution will be presented at the next HHS Board meeting.
11. Children's Long-Term Support Waiver Program Capacity Building Funding
The Health and Human Services Board previously supported a budget amendment for
Children's Long Tem Support. Additional county capacity building funds are available
and a review of the St. Croix County application was completed. If the state approves
this application as presented, Children Services could receive an additional $146,000.
Kiesler made a motion to pass this along to the Administration Committee to apply for
this grant. This was Seconded by Rasmussen.
RESULT: APPROVED [UNANIMOUS]
MOVER: Ron Kiesler, Supervisor
AYES: Christopher Babbitt, Howard Novotny, Ron Kiesler, Paulette
Anderson, Shaela Leibfried, Leon Berenschot, Deb Rasmussen
ABSENT: Chris Kilber, Lisa Ramsay
12. Wisconsin County Human Service Association Redesign Report
Director Johnson shared that the Wisconsin County Human Services Association
(WCHSA) is a professional organization to provide a statewide voice from a County
prospective. Johnson reported on the WCHSA redesign options and the St. Croix County
vote in this process.
At the July 10th WCHSA meeting there will be a final vote taken and Johnson will keep
the Board appraised of the results.
13. Health and Human Services 2014-2016 Strategic Planning
HHS Director Johnson reminded the Board that these documents were reviewed at last
meeting and have not been changed. We are coming here to ask the Board to support and
endorse this Strategic Plan so we can take the next steps. We will bring this back to the
Board quarterly for updates.
Motion by Berenschot to move this forward to the County Board and was Seconded by
Anderson.
RESULT: APPROVED [UNANIMOUS]
MOVER: Leon Berenschot, Board Member
SECONDER: Paulette Anderson, Supervisor
AYES: Christopher Babbitt, Howard Novotny, Ron Kiesler, Paulette
Anderson, Shaela Leibfried, Leon Berenschot, Deb Rasmussen
ABSENT: Chris Kilber, Lisa Ramsay
ANNOUNCEMENTS & CORRESPONDENCE
For the upcoming WALDAB Board of Health event on Aug. 6th , we are on the agenda to
present and are now seeking a Board member, that was part of the Accreditation process, to
attend with our PH staff. Paulette Anderson and Deb Rasmussen volunteered to attend.
Reminder of the Open House at the new facility on July 15th.
ADJOURN
Meeting was adjourned by Chair Babbitt at 8:29 PM
DATE OF NEXT MEETING
Tuesday August 12, 2014 @ 5:30 PM