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HomeMy WebLinkAboutHealth & Human Services 07-11-03 CHRIS BETHKE WILL REVIEW VOUCHERS AT 8:00 AM REVISED 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: 07/11/03 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: 07/24/03 OR 08/08/03 ACTION ON PREVIOUS MINUTES: 06/26/03 ANNOUNCEMENTS APPOINTMENTS: UNFINISHED BUSINESS: 1. Nursing Home Engineering Report NEW BUSINESS: 1. Consideration of Claims and Vouchers 2. Financial Report 3. Program Reports a. Family & Children's b. Long Term Support c. Nursing Home 4. Personnel Issues a. Springsted Personnel Study update 5. Health and Human Services 2002 Audit Report (Presented by Steve Tracey) 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 July 11, 2003 The St. Croix County Health and Human Services Board met on July 11, 2003 at the St. Croix County Health and Human Services/Health Center complex. MEMBERS PRESENT: Thomas Dorsey, Chair Leon Berenschot Chris Bethke Lois Burri Dr. Michael Kretz Mary Louise Olson Deb Rasmussen Esther Wentz MEMBERS ABSENT: Ralph Swenson, excused STAFF PRESENT: John M. Borup, Health and Human Services Director Carolyn L. Krieger, Nursing Home Administrator Judy Ziegler, Accounting Supervisor Kathy Dunlap, Family and Children's Supervisor Fred Johnson, Family and Children's Supervisor Ralph Robole, Facilities Manager Malva Berg, Secretary OTHERS PRESENT: Clarence Malick, County Board Chair Steve Tracey, 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 Friday, August 08 at 8:30 AM. Wentz will review vouchers at 8:00 AM. Berenschot asked to be excused from the August meeting. 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 Berenschot, seconded by Bethke, and unanimously adopted: That the minutes of the 06/26/03 Health and Human Services Board meeting and Open Hearing be approved with the correction that Olson was excused from the meeting. ANNOUNCEMENTS: Mark Campbell from the Bureau of Family and Children's Services and representing the Governor's office attended to present an award on behalf of Jim Doyle to Fred Johnson for his leadership skills in a collaborative relationship of state, local and county governments to work together for improvement of services that benefit Wisconsin's children and families in the development of ongoing Standards and Guidelines for Child Protective Services in Wisconsin. Johnson has set a positive example for his colleagues by actively demonstrating a strong commitment to a statewide partnership that benefits Wisconsin's children and families. St. Croix County Health and Human Services Board Page 2 July 11, 2003 CONSIDERATION OF CLAIMS: The following reports were distributed to the Board: June cash report, May unemployment report, and June fixed asset report. Health and Human Services Board member, Bethke, reviewed the following vouchers: HUMAN SERVICES: 20011: Pamida, Inc., $125.00 Restitution. We collect court ordered restitution payments from juvenile offenders and pay the money over to the victims. In this case, some vandalism was done to the Pamida store and the judge ordered restitution as part of the sentencing. 20084: Farm Plan, $132.48, maintenance expense. Farm Plan is the name of the company that performs billing work for Polfus Implement in New Richmond. The maintenance department purchases parts and supplies for the lawn tractors and mowers from Polfus. 118: Glenwood City Cemetery, $250.00, funeral expense. The Economic Support Unit pays funeral expenses for those who qualify. These expenses are reported to the State and the County is reimbursed in full. 338: Nobles Tire Service, $246.55, workshop van expense. We purchase van tires and repairs for the workshop fleet at Nobles Tire Service in New Richmond. Nursing Home: 2867: Dean Foods North Central, Inc. $1756.33, food. This is the dairy products vendor for the Nursing Home. This contract is put out for bids each year. Motion: A motion was introduced by Bethke, seconded by Berenschot, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book: Human Services vouchers 19961 through 20065, dated June 19, 2003 in the amount of $205,028.92. Human Services vouchers 20066 through 20138, dated June 26, 2003 in the amount of $229,651.96. Human Services voucher 20139, dated July 01, 2003 in the amount of $1,512.18. Human Services vouchers 20141 through 20202, dated July 03, 2003 in the amount of $88,865.05. Human Services vouchers 1 through 185, dated July 11, 2003 in the amount of $314,574.48. Human Services vouchers 285 through 516, dated July 11, 2003 in the amount of $108,378.36. Nursing Home vouchers 2867 through 2890, dated June 19, 2003 in the amount of $27,733.45. Nursing Home vouchers 2895 through 2897, dated June 26, 2003 in the amount of $894.93. St. Croix County Health and Human Services Board Page 3 July 11, 2003 Nursing Home vouchers 2899 through 2901, dated July 03, 2003 in the amount of $691.00. Nursing Home vouchers 186 through 284, dated July 11, 2003 in the amount of $48,812.20. Human Services and Nursing Home vouchers 323 through 353, dated June 17, 2003 in the amount of $198,023.28. Human Services, Workshop, Public Health, Social Services vouchers 316 through 344, dated June 17, 2003 in the amount of $324,069.73. Human Services and Nursing Home vouchers 354 through 384, dated July 01, 2003 in the amount of $192,096.74. Human Services, Workshop, Public Health, Social Services vouchers 345 through 374, dated July 01, 2003 in the amount of $328,024.61. HEALTH AND HUMAN SERVICES 2002 AUDIT REPORT: Steve Tracey distributed the 2002 Audit report and highlighted the three-year comparison report and balance sheet. A planned $45,000 transfer was made from the Farm account to Health and Human Services. He said previous year's funds were used to balance the budget. He said $575,000 was applied from previous operations and there will be approximately $293,000 to apply for the 2004 budget. Borup reminded the Board that a few years ago the County Board took one million dollars away from Health and Human Services for the County general fund resulting in a declining fund balance for Health and Human Services. A final settlement will be received from the State in June but it is not relevant to accrue numbers until the final settlement is paid from the State. The amount received relies on how many apply for the MA deficit dollars. Tracey discussed accounts receivables. If turn around on accounts is longer than 90 days he suggested negotiating with the client, going to collection agencies or going to small claims court. Borup stated these steps are taken by collections. Ruka will be invited to attend the next meeting to explain the accounts receivable process. He said there is a good segregation of duties and that Judy Ziegler does a good job. NURSING HOME ENGINEERING REPORT: Estimated construction costs for the entire project for the nursing home for structural modifications not including interior finishes or required mechanical and electrical revisions/ modifications is $96,500 from Ayres Associates. Robole indicated there are not a lot of mechanical changes needed. Krieger has been and will be meeting with Nursing Home staff and architects to see how to finish the area. A bid document will be prepared. Motion: A motion was introduced by Kretz, seconded by Berenschot, and unanimously adopted: That the Board approves Ayres working with Krieger, Robole and staff to draft a credible document for bids including the nursing station. The roofing project for the nursing home was completed at the end of June and looks good. The mobile shelving for Medical Records is in and is what was expected. St. Croix County Health and Human Services Board Page 4 July 11, 2003 Krieger said the Nursing Home loses money with Medicaid admissions. With fewer admissions, there are decreased Medicare admissions, which is having a negative impact on our revenues. She said the community has expressed concerns regarding the downsizing of the nursing home. Kretz indicated the Board has made an effort to preserve the service by downsizing the Nursing Home. FINANCIAL REPORTS: The following financial reports through May were distributed to the Board. Krieger said she anticipates IGT funds but doesn't have definite numbers. Borup expressed concern with the Nursing Home deficits it will force Administration to make more cuts to match reduced census and revenues. Revenues are up in Health and Human Services and are close to being on schedule. ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD 01/01/03 THROUGH 05/31/03 NURSING HOME 5/31/2003 Cash Balance 05/31/03 $497,654.59 Add: Accounts Receivable, 05/31/03 Private Pay $0.00 Medicare $0.00 Medicaid $0.00 Accounts Receivable $503,391.17 Accounts Payable-05/31/03 ($187,860.20) Net Current Items, 05/31/03 ($813,185.56) 2003 Revenue Recorded through 05/31/03 $2,626,897.41 Includes Allocations of Anticipated Revenues 2003 Expenses Recorded through 05/31/03 $2,680,442.63 Includes Allocations of Expected Expenses Net Revenues over Expenses ($53,545.22) St. Croix County Health and Human Services Board Page 5 July 11, 2003 HEALTH AND HUMAN SERVICES - 2003 SUMMARY Total OF REVENUES Jan.-May. Budget Balance % Administration 408,813.60 763,412.00 354,598.40 53.6% AODA Services 206,642.29 440,846.00 234,203.71 46.9% Long Term Support 5,431,987.92 12,731,125.00 7,299,137.08 42.7% Mental Health 879,519.68 2,381,245.00 1,501,725.32 36.9% Family & Children's 1,260,820.36 2,648,969.00 1,388,148.64 47.6% Economic Support 524,393.52 1,025,999.00 501,605.48 51.1% General Relief 1,642.60 18,663.00 17,020.40 8.8% REVENUES HUMAN SERVICES PROGRAMS 8 71 R19 97 20.010 99 00 It- 296 4 0 43 9 Public Health S42 901 99 1_347.443.00 804 541 0] 403 TOTAL REVENUES HEALTH AND HUMAN SERVICES 2S6 721 96 1 397 70 00 1100 980 04 43 3% SUMMARY Total OF EXPENDITURES Jan.-May. Budget Balance % Administration 323,487.95 763,412.00 439,924.05 42.4% Alcohol-Drug Abuse 189,064.54 440,846.00 251,781.46 42.9% Long Term Support 5,377,198.45 * 12,731,125.00 7,353,926.55 42.2% Mental Health 1,051,636.46 2,381,245.00 1,329,608.54 44,2% Family & Children's 1,057,085.53 * 2,648,969.00 1,591,883.47 39.9% Economic Support 481,125.46 1,025,999.00 544,873.54 46.9% General Relief 2,869.50 18,663.00 15,793.50 15.4% Accrued Payroll 0.00 0.00 0.00 0.0% EXPENDITURES HUMAN SERVICES PROGRAMS 8,482,467.89 20,010,259.00 11,527,791.11 42.4% Public Health 547.288 45 1.347.443.00 800 5] S9 40 6% TOTAL EXPENDITURES HEALTH AND HUMAN SERVICES 9.029.756 34 21.357 702.00 12.327 945.66 42_3% To be on budget, percentage should be 41.66% St. Croix County Health and Human Services Board Page 6 July 11, 2003 ST CROIX HEALTH CENTER OPERATIONS REPORT JAN THROUGH MAY 2003 JAN-MAY BUDGET ACTUAL DIFFERENCE CENSUS 86 2 2.27% OPERATING REVENUE: MEDICARE $ 1,254,708.00 $ 397,191.38 $ 857,516.62 31.66% MEDICAID $ 2,929,061.00 $ 1,210,194.18 $ 1,718,866.82 41.32°f° PRIVATE PAY $ 1,025,316.00 $ 301,866.10 $ 723,429.90 29.44°9/6 ° ALL OTHER SOURCES $ 1,117.00 $ 19,760.24 $ (18,643.24) 1769.05% TOTAL OPERATING REVENUE $ 5,210,202.00 $ 1,929,031.90 $ 3,281,170.10 37.02% OPERATING EXPENSES: DAILY PATIENT SERVICES $ 4,252,427.00 $ 1,632,848.18 $ 2,619,578.82 38.40%' SPECIAL SERVICES $ 300,748.00 $ 122,637.50 $ 17$,110.50 40.78% GENERAL SERVICES $ 1,279,983.00 $ 488,210.52 $ 791,772.48 38.14% ADMINISSTRATIVE SERVICES $ 507,779.00 $ 204,190.50 $ 303,588.50 40.21% UNASSIGNED: DEPRECIATION(%BASED) $ - $ 77,570.00 $ (77,570.00), #DIV/01 OTHERS $ 367,926.00 $ 154,985.93 $ 212,940.07 42.12% TOTAL OPERATING EXEPNSES $ 6,708,863.00 $ 2,680,442.63 $ 4,028,420.37 39.95% NET FROM OPERATIONS $ (751,410.73) NON-OPERATING ITEMS: REVENUE FROM RATE APPEALS $ 14,808.00 $ 6,170.00 $ 8,638.00 41.67% ITG FUNDS (%BASED) $ 798,386.00 $ 339,165.00 $ 459,221.00 42.48% CO ALLOCATION (%BASED) $ 685,467.00 $ 285,610.00 $ 399,857.00 41.67%' TOTAL NON-OPERATING ITEMS $ 1,498,661.00 $ 630,945.00 $ 867,716.00 42.10%1 MA BED REDUCTION EST FUNDS $ 66,920.51 NET FROM ALL SOURCES $ - $ (53,545.22) PERCENTAGE SHOULD BE 41.65 FUND BALANCE 0101103 AUDITED $ 1,684,566.10 PRIOR OPERATIONS $ (53,545.22) CASH REPLENISHMENT(%$250,000) $ 104,125.00 FUND BALANCE END OF PERIOD $ 1,735,145.88 FAMILY AND CHILDREN'S: Three years ago an agreement was reached with the District Attorney's office to contract for termination of parental rights legal services with a local private law firm. In the past this has been a relatively small line item in the Department's budget, but this year the expenses have been higher due to current caseload issues. $2,000 has been budgeted and $12,000 to $13,000 has been spent already this year. While costs may be up in legal fees, there are some costs that are ultimately saved when a TPR is completed as the Department no longer is responsible for alternate care costs. These are cases that are typically very complex and time consuming from both a legal and service perspective. There are three active cases in this area currently. It is anticipated that two will be completed St. Croix County Health and Human Services Board Page 7 July 11, 2003 soon and one is still in process. Staff will keep the Board informed on the status of the settlement of the termination of parent rights cases. Staff are looking at a grant application that may cover the legal services for this year. It may be possible to use some of the District Attorney salary costs as match money in writing the grant. It was the consensus of the Board to apply for the grant. Alternate care expenses for 2003 are budgeted at $871,700 and we are $16,000 over at mid-point in the year. $58,200 was budgeted for correctional placements for 2003 and we have not had one correctional placement so far this year. There is a good staff to client caseload ratio currently. Internal resources are utilized effectively. St. Croix County works with a family focus and meetings are held with families as a group, but the bottom line is to ensure safety. The success rate is better when family is involved. Staff attend regional meetings with other counties to share ideas/ concepts. The Board recessed from 10:00 to 10:15. NURSING HOME: The current census of the Nursing Home is 79. It is hoped to have the census in the mid 70's in August and down to 72 after Labor Day. Krieger said there has been much community reaction regarding the downsizing. She has received calls from doctors regarding turning down admissions. The Board reinforced that downsizing is a way to preserve the nursing home service. Krieger said IGT funds received were $45,492 over what was budgeted and appeals received were $3,500 over what was received last year. Krieger received the statement from Ayres and questioned where the money to pay this should come from. Motion: A motion was introduced by Berenschot, seconded by Wentz, and unanimously adopted: That the funds to pay Ayres should come from the contingency fund. SPRINGSTED PERSONNEL STUDY UPDATE: The Springsted Study was distributed to the Board and will be discussed at the August meeting. Borup said the study needs Board approval and returned to Whiting by August 22. The study is intended to standardize and make things more even across all departments. It is possible this study could substitute for the Hay Committee in the future. Dorsey asked if there were any other issues to bring before the Board. Kretz gave a brief summary of the 2003 Youth Tobacco Survey. Motion: A motion was introduced by Wentz, seconded by Berenschot, and unanimously adopted: that the meeting be adjourned. Time: 10:40 AM Chair: Attest: (Secretary)