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HomeMy WebLinkAboutHealth & Human Services 10-19-11 REVISED: 10/17/11 NOTICE OF MEETING AND AGENDA ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD October 19, 2011- 8:30 A.M. Board Room, St Croix County DHHS Building 1445 N. e Street, New Richmond Wisconsin L CALL TO ORDER II. ROLL CALL III. APPROVAL OF MINUTES OF PREVIOUS MEETING: 09/21/2011 IV. BUSINESS ITEMS 1. Financial Report for Nursing Home and Health and Human Services 2. Nursing Home Administrator's Report 3. Health Center Plan of Correction timeline 4. 2011 Departmental Operational Goals-St. Croix Industries 5. Community Rehabilitation Programs petition 6. Tour of St. Croix Industries-Day Services new program space 7. **Public Health Accreditation Grant 8. **2012 Nursing Home budget 9. **Concealed Carry V. ANNOUNCEMENTS & CORRESPONDENCE VI. ADJOURN DATE OF NEXT MEETING: 11/16/11 at 8:30 A.M. REVIEWED AND APPROVED BY: Committee Chair and County Administrator DATE APPROVED: 10/07/2011 A quorum of the St. Croix County Board of Supervisors (County Board) may he 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. 10/17/2011 ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD October 19, 2011 The St. Croix County Health and Human Services Board met on October 19, 2011 at the St. Croix County Health and Human Services/Health Center complex. MEMBERS PRESENT: Esther Wentz, Chair Leon Berenschot Roger Larson Linda Luckey Richard Marzolf Dr. Lisa Ramsay Deb Rasmussen Alfred Schrank MEMBERS ABSENT: Frederick Horne STAFF PRESENT: Fred Johnson, Health and Human Services Director Cindy Anderson, Nursing Home Administrator Wendy Kramer, Health Officer/Public Health Coordinator Clark Schroeder, St. Croix Industries Administrator Connie Sarauer, Nursing Home Director of Nursing Malva Sirek, Clerical Supervisor OTHERS PRESENT: Pat Thompson, County Administrator Art Tobin, Building Services Director Kim Dupre, Information Systems Analyst Tammy Funk, Human Resource Janet Smith Katie Thurmes Pam Benson Dave Osness Dan Hansen Art Juchno Shaila Liebfried Norm Matzek Jeff Holmquist, New Richmond News 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, November 16, 2011 at 8:30 AM. St. Croix County Health and Human Services Board Page 2 October 19, 2011 MINUTES: Motion: A motion was introduced by Berenschot, seconded by Larson, and unanimously adopted: That the minutes of the 09/21/11 Health and Human Services Board meeting be approved as distributed. FINANCIAL REPORT FOR NURSING HOME AND HEALTH AND HUMAN SERVICES: The following financial report for Health and Human Services, Nursing Home, St. Croix Industries, Aging and ADRC through September, 2011 was distributed. Johnson indicated all figures are up to date. Health and Human Services does lag behind due to billing. Johnson reported ADRC expenses are higher due to payment made to the State of Wisconsin to participate in the Long Term Care Program. The Nursing Home expenses are at 70.4%, which includes September bills. The Nursing Home census has been lower than budgeted, which equals less expense and staffing levels have been adjusted according to census. Finance reported that all Nursing Home revenues have now been recorded through September. The levy has been fully allocated; however, IGT funds have not been fully allocated. If the financial trend continues as is, there is a projected short fall that could be as much as $400,000 for the Nursing Home. Thompson questioned what changes are being considered to control expenses, which will be covered later in the meeting. ~R?4 Annual Aduals Budget % of Revenues Budget s To Date RaLime Budget Heakh 8 Hinman SenAces S 15,971,121 S 598,671 S 9,600,083 S 6,371,038 60.1% St Croix tdm ies 418182 9B,452 1,754,9D1 663 281 726% Aging 943,362 24,422 769,321 174,041 81.6% ADRC Z274,599 59,833 200041 74,558 96.7% Nursi Home 6,499,631 721,780 4,165,149 Z334482 641% TOW Prognarn Revenue S 28.10G AN S 1,503,156 $ 18,4 ,494 $ 9,617,401 65.8% Exes Heakh 8 Hinman Services S 15,975,121 S 1,383,185 S 10,141,772 S 5,833,349 63.5% St Croix tdm ies 2,418,182 242,451 1,687,509 730,673 69.8% Aging 943,362 96,631 671,776 271,586 71.2% ADRC 2,274,599 92,932 2,010,734 263,865 88.4% Nursing Home 6,499,631 592,749 4,575,774 1,923,857 70.4% TOW Progam Expenrihses S 2%110 AN S 2,407,948 S 19,067,565 S 9,023,330 679% R"U"LAes ONW(Unnlav Evomffhoes S ,791 S 598,071 Ejp-kdP 75.8% NURSING HOME ADMINISTRATOR'S REPORT: The average monthly census for September was 60, with 7 Medicare, 38 Medicaid, 1 Family Care and 14 private pay residents. The Medicare average daily rate paid was $571.00 for September compared to the budgeted amount of $485.00. Acuity rates continue to be higher than budgeted Anderson reported marketing being done for the Nursing Home. The New Richmond Chamber is having a conference on Friday and St. Croix Health Center is providing brochures and items to be placed in the bags that will be distributed at the conference. The therapy department has been interviewed by the local radio station to highlight the Nursing Home. These short pieces are aired Monday through Friday at approximately 7:30 AM. St. Croix County Health and Human Services Board Page 3 October 19, 2011 In follow up of questions that arose at the County Board meeting, St. Croix Health Center has had 97 admissions from January 1, 2011 through October 4, 2011. There are currently 35 counties in Wisconsin with County nursing homes; however, some counties have more than one home and the total County nursing home count in Wisconsin is approximately 40. Anderson reported Deerfield had groundbreaking for a 61 unit nursing home, which is projected to be completed mid-year of 2012. Osceola is opening a new facility in November, 2011 and currently has a waiting list. There is currently no nursing home in Osceola so a lot of the admissions from that area have been coming to St. Croix Health Center, which may impact the Nursing Home's census when the Osceola facility opens. Anderson reported private pay rates are being studied. St. Croix Health Center has the highest private pay rate in the area and some admissions have been lost because of the high private pay rates. Johnson is not recommending an increase in private pay rates at this time. HEALTH CENTER PLAN OF CORRECTION (POC) TIMELINE: A resolution to fund repairs indicated in the Plan of Correction was passed at the last County Board meeting. Tobin distributed a list of repairs needed, approximate costs associated with the repairs, waivers needed, and timeline to complete each item. Tobin indicated repairs listed in category 1 will be/have been completed by Building Services staff. Repairs listed in category 2 will involve a contractor. This work involves changing fire walls/fire stop in four rooms and it is anticipated this work will be done in the next week. Repairs listed in category 3 will also involve a contractor. The bid specs for this project, which involves changing doors and door hardware, will be completed this month. This project involves adding card swipes to replace using door locks. The bid process for exterior lighting and walk areas has been started and work will be completed as weather permits. Tobin indicated the entire Nursing Home building will need to be fully sprinkled by the end of the POC timeline. Tobin reported the notice of award has been received for the waiver for the basement plenum issue. The waiver is renewable every year. If the waiver is not renewed, there will be a cost associated to remedy the issue of approximately $250,000 to $300,000. Tobin reported Building Services staff is trying to do as many of the repairs as possible with in- house staff/resources. Building Services staff has been shifted from other facilities to get the work done. Priorities have been set with the focus on k-tag issues. PUBLIC HEALTH ACCREDITATION GRANT: Public Health had the opportunity to receive a $12,000 CDC Infrastructure Grant to be used between January 1, 2011 and September 30, 2011. The grant was used to develop a quality improvement plan that will be ongoing for 2012. A performance management plan was also developed. Staff training also took place for both plans. The performance management document identifies five key indicators to monitor and report progress in Public Health. This corresponds well with the Public Health strategic plan and program objectives to meet state and federal guidelines. An additional CDC Infrastructure Grant has been made available by the State. This grant will run from January 1, 2012 through September 29, 2012 and awards are up to $10,000. If awarded, the grant would be used to expand performance St. Croix County Health and Human Services Board Page 4 October 19, 2011 management and implement performance plans and would demonstrate work towards voluntary national public health accreditation. An additional NACCHO Accreditation Support Initiative for Public Health Departments in the amount of $5,000 to $40,000 can be applied for. These monies would be used to contract with an individual to be the Accreditation Coordinator, assemble documentation to meet specific Public Health Accreditation Board measures, and/or offsetting the cost of accreditation fees. Motion: A motion was introduced by Marzolf, seconded by Schrank, and unanimously adopted: That the Board approves applying for the $10,000 CDC Infrastructure Grant and the monies from NACCHO Accreditation Support Initiative. Johnson indicated the quality improvement measures and the county strategic planning should be consistent. Public Health is one of the units that will participate in ROWE (Results Only Work Environment). The results component of ROWE and accreditation should also align well. CONCEALED CARRY: Concealed carry was on the Administration Committee agenda. The Administration Committee meeting date was before the Health and Human Services Board meeting, thus the reason concealed carry is on the Health and Human Services agenda. This issue was discussed at the Administration Committee with the result of the Committee determining the entire Government Center building fits the definition of a courthouse and, thus falls under the new concealed carry law weapons are prohibited in the entire facility; however, there was no approval to prohibit firearms for other St. Croix County government owned facilities. If the resolution prohibiting firearms in the Health and Human Services campus buildings is approved by the Health and Human Services Board, then the resolution will be forwarded to the full County Board for action. Johnson indicated the resolution has been reviewed by Corporation Counsel and Finance. Motion: A motion was introduced by Larson, seconded by Berenschot, and unanimously adopted: That the Board approves adopting the following resolution: RESOLUTION PROHIBITING FIREARMS IN HEALTH AND HUMAN SERVICES CAMPUS BUILDINGS Resolution No. St. Croix County, Wisconsin WHEREAS, effective November 1, 2011, Wisconsin Statutes § 175.60(2g) permits any properly licensed person to carry a concealed weapon anywhere in this state except as provided in other statutes; and WHEREAS, "weapon" means a handgun, as defined in Wisconsin Statutes § 175.60(1)(bm), an electric weapon, as defined in Wisconsin Statutes § 941.295(lc)(a), a knife other than a switchblade knife under Wisconsin Statutes § 941.24, or a billy club (Wisconsin Statutes §175.60(1)0)); and St. Croix County Health and Human Services Board Page 5 October 19, 2011 WHEREAS, Wisconsin Statutes § 175.60(16)(a) prohibits any person properly licensed to carry a concealed weapon from knowingly carrying a concealed weapon, a weapon that is not concealed, or a firearm that is not a weapon in certain places, including any portion of a building that is a sheriff s office, a jail, or a county courthouse; and WHEREAS, Wisconsin Statutes § 175.60(16)(b) exempts from the prohibitions contained in § 175.60(16)(a): (1) a weapon in a courthouse or courtroom if a judge who is a licensee is carrying the weapon or if another licensee or out-of-state licensee, whom a judge has permitted in writing to carry a weapon, is carrying the weapon; and (2) a weapon in a courthouse or courtroom if a district attorney, or an assistant district attorney, who is a licensee is carrying the weapon; and WHEREAS, Wisconsin Statutes § 943.13(lm)(c)4. recognizes the right of the state or any local governmental unit - including counties - to prohibit any person carrying a firearm from entering or remaining in any building or portion of a building that is owned, occupied, or controlled by the state or any local governmental unit; and WHEREAS, "firearm" means a weapon that acts by force of gunpowder (Wisconsin Statutes § 167.31(1)(c)); and WHEREAS, in order to prevent disturbances to employees and members of the public and disruption in services, it is in the County's best interest to prohibit persons carrying firearms from entering or remaining in any building owned, occupied or controlled by the County; and WHEREAS, a person is guilty of a Class B forfeiture (a forfeiture not to exceed $1000) if he or she, while carrying a firearm, enters or remains in any part of a building that is owned, occupied, or controlled by the state or any local governmental unit, if the state or local governmental unit has notified the person not to enter or remain in the building while carrying a firearm (Wisconsin Statutes § 943.13(lm)(c)4.); and WHEREAS, the state or a local governmental unit has "notified" a person not to enter or remain in that part of the building while carrying a firearm if the state or the local governmental unit has posted a sign that is at least 5 inches by 7 inches and is located in a prominent place near all of the entrances to the part of the building to which the restriction applies and any individual entering the building can be reasonably expected to see the sign (Wisconsin Statutes § 943.13(2)(bm)). THEREFORE, BE IT RESOLVED by the St. Croix County Board of Supervisors that no person that is carrying a firearm may enter or remain in any building at the Health and Human Services Campus in New Richmond. FURTHER, BE IT RESOLVED that the prohibition established by this resolution does not apply to active duty law enforcement officers. St. Croix County Health and Human Services Board Page 6 October 19, 2011 FURTHER, BE IT RESOLVED that signs complying with the statutory requirements shall be posted at the entrances to every building at the Health and Human Services Campus in New Richmond. Johnson indicated cost impact of the resolution is under $1,000. Dupre questioned the incongruence of managing employee health by banning tobacco in the facility, but not addressing employee safety by not prohibiting concealed carry. It was the consensus of the Board that the Board members be advocates with other supervisors for the safety of fellow employees. The Board recessed from 9:20 - 9:27 AM. 2011 DEPARTMENTAL OPERATIONAL GOALS-ST. CROIX INDUSTRIES: Johnson reminded Board members that a different Department will be highlighted each month to help guide the Board with policy decisions. Schroeder reported work has gone into the 2012 strategic plan and budget. A business survey was planned for St. Croix Industries but that was delayed due to changes made at the State level as to what services the State will purchase. In addition to the changes at the State level, local provider rates were reduced. Consequently, the survey was delayed, but will now be completed in 2012. Marketing efforts for St. Croix Industries continue increase the public understanding of what services are provided. The St. Croix Industries Facebook page is updated regularly and membership has also expanded to the New Richmond and Hudson chamber of commerce. Various areas have been explored to implement a new service or product for St. Croix Industries. Schroeder reported a successful fund raiser for St. Croix Industries took place on September 18tH Approximately 250 people attended with approximate result of $6,800 raised to be used for client activities such as summer picnic and Christmas party. Money may also be used to purchase more tables for clients and install new lockers for client use. Weekly meetings for St. Croix Industries staff occur to keep staff informed. There have been a lot of program changes and the length of time services are funded has changed. Thompson commented the County is lucky to have Schroeder in this position as he has a passion to do the j ob. COMMUNITY REHABILITATION PROGRAMS PETITION: Schroeder distributed a petition that is being distributed by Rehabilitation for Wisconsin (RFW). There is a movement to limit center-based employment such as St. Croix Industries and serve all clients in the community. This petition is to support clients to make their own informed choice as some want to be involved in center-based employment. St. Croix Industries does support client employment in the community if that is what the client wants. This petition was sent out to St. Croix Industries client guardians and already over 40 have been returned. Marzolf said St. Croix Industries provides dignity to clients. Schroeder reported there are approximately 101 clients currently attending St. Croix Industries' center based employment with approximately 16 attending the Day Services Program throughout the month. There are St. Croix County Health and Human Services Board Page 7 October 19, 2011 approximately 12 job coaches that serve 65 people per month that have jobs in the community. These are duplicate counts as clients may attend more than one program. Overall SCI serves over 130 people with disabilities. TOUR OF ST. CROIX INDUSTRIES-DAY SERVICES NEW PROGRAM SPACE: The Day Service Program moved into the old Head Start area. Board members will tour the area after the meeting. 2012 NURSING HOME BUDGET: The 2012 Nursing Home Budget has been reviewed. Finance is to do a more detailed review of current Nursing Home figures but it anticipated the Nursing Home will be over budget by year end. Review is focused on what can be done on the expense side with the current census. The census trend has been lower than anticipated and what was projected for the 2012 budget, which results in a Nursing Home shortfall. Johnson highlighted that management has looked at potential changes due to continued lower census. Sarauer reported that a wing on second floor was opened and staffed to care for Medicare residents. The projected Medicare numbers never reached projected levels and Medicare numbers have not held steady. The proposal is to close a wing and make staffing changes. This carries with it the potential for layoffs; however, it is anticipated this could be done with not filling empty positions and not filling some pending anticipated retirements. This will lower expenses, yet still provide the overall number of beds that is consistent with occupancy. We will need time to see if this impacts occupancy as there will be less beds available within the facility. The plan is not to decertify beds or reduce licenses at this time. The facility currently pays a bed tax of $170/month/bed. Also, when the facility is not at 94% occupancy, bedhold cannot be charged when a resident is admitted to the hospital and we have lost revenue due to low census. An adjustment in the number of licensed beds may be the next step. Low census in nursing homes has been the trend in the industry with assisted living facilities which was reported by LarsonAllen when the audit report was presented. Under Community Health Partners (CHP) clients are also eligible for services/funding for assisted living or for support services in their home, which can also impact census. When the wing is closed, the heat in that wing and the lights can be dropped down. This would not result in a great savings, but there would be some savings. Some daily operational expenses would also be cut as far as meals, meds, etc. The long range plan is look at reducing the number of nursing home licensed beds. The new nursing home in Osceola, plus the additional new nursing home in New Richmond is also expected to impact the census at St. Croix Health Center which may impact the number of licensed beds. Private pay rates are being examined. Private pay rates are a consideration when a decision is made on where an individual will receive care. St. Croix Health Center has lost potential admissions due to our private pay rates. St. Croix Health Center's private pay rates are above all the competitors in St. Croix County. Johnson recommends keeping private pay rates the same at this time. In September there were 14 private pay residents in the nursing home. Johnson will continue to update the Board on these operational changes and plans will move forward to close a wing on second floor. St. Croix County Health and Human Services Board Page 8 October 19, 2011 Wentz asked if there were any other issues to bring before the Board. Wentz adjourned the meeting. Time: 10:17 AM Chair: Attest: (Secretary)