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HomeMy WebLinkAboutHealth & Human Services 05-09-03 1 ESTHER WENTZ WILL REVIEW VOUCHERS AT 8:00 AM REVISED-05/06/03 ST. CROIX COUNTY REVISED 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: 05/09/03 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: 05/22/03 OR 06/13/03 ACTION ON PREVIOUS MINUTES: 04/11/03 ANNOUNCEMENTS APPOINTMENTS: UNFINISHED BUSINESS: NEW BUSINESS: 1. Election of Health and Human Services Board officers 2. Consideration of Claims and Vouchers 3. Financial Report 4. Program Reports a. Public Health b. Economic Support c. Family & Children's 5. Public beach safety monitoring policy 6. Resolution to termination Wisconsin Works (W-2) contract with State of Wisconsin 7. Health Insurance Portability and Accountability Act (HIPAA) Policy 8. Action to approval rental contract with Henk Van Dyk for County barn 9. Nursing Home downsizing plans 10.Capital Outlay plan update 11.Request to negotiate placement of two part-time Mental Health Technicians into bargaining unit 12.Review of offer from WISDOT for purchase of County land 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 09, 2003 The St. Croix County Health and Human Services Board met on May 09, 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 Ralph Swenson Esther Wentz MEMBERS ABSENT: none STAFF PRESENT: John M. Borup, Health and Human Services Director Carolyn L. Krieger, Nursing Home Administrator Ron Kiesler, AODA/Mental Health Coordinator Mary Squyer, Economic Support Supervisor Barbara Nelson, Public Health Supervisor-Health Officer Malva Berg, Secretary OTHERS PRESENT: Deb Kathan, Personnel Director Chuck Whiting, Administrative Coordinator 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 Thursday, May 22, 2003 at 8:30 AM. The following meeting is scheduled for Friday, June 13 at 8:30 AM. Olson will review vouchers at 8:00 AM. AGENDA: Motion: A motion was introduced by Bethke, seconded by Wentz, 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 04/11/03 Health and Human Services Board meeting be approved as distributed. APPOINTMENTS: Deb Rasmussen and Dr. Michael Kretz were introduced to the Board as the citizen-member appointments to the Health and Human Services Board. PERSONNEL ISSUES: Diane Northrup resigned from Economic Support. The Economic Support Unit is down three positions. ELECTION OF HEALTH AND HUMAN SERVICES BOARD OFFICERS: Dorsey turned the meeting over to Vice Chair Berenschot. Berenschot announced that the election of officers would take place. Berenschot asked for nominations for the position of chair. Dorsey was nominated for the Chair position. Berenschot called for other nominations for Chair three times. St. Croix County Health and Human Services Board Page 2 May 09, 2003 Motion: A motion was introduced by Swenson, seconded by Bethke, and unanimously adopted: That the nominations for Chair be closed and the Board cast a unanimous vote for Dorsey to be chair. Berenschot turned the meeting over to Chair Dorsey. Dorsey asked for nominations for the position of Vice Chair. Berenschot was nominated for the position of Vice Chair. Motion: A motion was introduced by Wentz, seconded by Olson, and unanimously adopted: That the nominations for Vice Chair be closed and the Board cast a unanimous vote for Berenschot to be vice Chair. Dorsey declared Berenschot to be the Vice Chair of the Health and Human Services Board. Dorsey asked for nominations for the position of Secretary. Bethke was nominated for the position of Secretary. Motion: A motion was introduced by Berenschot, seconded by Wentz, and unanimously adopted: That the nominations for Secretary be closed and the Board cast a unanimous vote for Bethke to be Secretary. Dorsey declared Bethke to be the Secretary of the Health and Human Services Board. CONSIDERATION OF CLAIMS: The following reports were distributed to the Board: April cash report, March unemployment report, and April fixed asset report. Health and Human Services Board member, Wentz, reviewed the following vouchers: HUMAN SERVICES: 18919: PATH Treatment Foster Homes, $3,170.76, treatment foster home. Treatment foster home expense for one month. Treatment foster homes offer special services for abused children with special needs. Motion: A motion was introduced by Wentz, seconded by Berenschot, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book: Human Services voucher 18872, dated April 10, 2003 in the amount of $410.00. Human Services vouchers 18873 through 18950, dated April 17, 2003 in the amount of $198,629.96. Human Services vouchers 18951 through 18994, dated April 24, 2003 in the amount of $199,236.63. Human Services vouchers 18995 through 19052, dated May 01, 2003 in the amount of $19,749.13. Human Services vouchers 19128 through 19273, dated May 09, 2003 in the amount of $237,256.15. St. Croix County Health and Human Services Board Page 3 May 09, 2003 Human Services vouchers 19053 through 19127, dated May 09, 2003 in the amount of $65,331.23. Human Services vouchers 19274 through 19333, dated May 09, 2003 in the amount of $47,735.42. Nursing Home vouchers 2660 through 2673, dated April 17, 2003 in the amount of $14,774.36. Nursing Home vouchers 2674 through 2677, dated April 24, 2003 in the amount of $436.96. Nursing Home vouchers 2678 through 2690, dated May 01, 2003 in the amount of $24,450.38. Nursing Home vouchers 2691 through 2740, dated May 09, 2003 in the amount of $45,140.47. Human Services and Nursing Home vouchers 230 through 260, dated May 06, 2003 in the amount of $200,206.44. Human Services, Workshop, Public Health, Social Services vouchers 227 through 256, dated May 06, 2003 in the amount of $329,172.57. Human Services and Nursing Home vouchers 199 through 229, dated April 22, 2003 in the amount of $185,600.58. Human Services, Workshop, Public Health, Social Services vouchers 198 through 226, dated April 22, 2003 in the amount of $332,578.40. Human Services and Nursing Home vouchers 169 through 198, dated April 08, 2003 in the amount of $190,166.53. Human Services, Workshop, Public Health, Social Services vouchers 168 through 197, dated April 08, 2003 in the amount of $333,217.76. FINANCIAL REPORTS: The following financial reports through March were distributed to the Board. Rod Paulson, CPA, distributed the Nursing Home Audit report and highlighted several areas of the report. Paulson said the worker's compensation is higher at St. Croix Health Center when compared to other facilities and may want to look at this issue, whether to remain self-insured or go to a private carrier. Krieger said there were three large settlements dating back to 2000 in the last year. Paulson distributed a worksheet that reflects how costs compare to what the Nursing Home is actually reimbursed per day. He recommended a similar report be generated monthly and will bring an Excel disk when he returns for the Health and Human Services audit. He said the facility needs to look at what is being spent and what the facility is taking in. Paulson said it would be to the Nursing Home's advantage to find an alternate use for the space vacated by the Nursing Home. Paulson will return in June for the Health and Human Services audit. A copy of the Wipfli and Keefe report will be forward to Dr. Kretz and Deb Rasmussen. St. Croix County Health and Human Services Board Page 4 May 09, 2003 ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD 01/01/03 THROUGH 03/31/03 NURSING HOME 1st OUARTER Cash Balance 03/31/03 $481,269.48 Add: Accounts Receivable, 03/31/03 Private Pay $45,376.41 Medicare $201,337.56 Medicaid $236,567.53 General $0.00 Accounts Payable-03/31/03 ($204,004.29) Net Current Items, 03/31/03 $760,546.69 2003 Revenue Recorded through 03/31/03 $1,539,011.74 Includes Allocations of Anticipated Revenues 2003 Expenses Recorded through 03/31/03 $0.00 Includes Allocations of Expected Expenses Net Revenues over Expenses $0.00 St. Croix County Health and Human Services Board Page 5 May 09, 2003 HEALTH AND HUMAN SERVICES - 2003 SUMMARY Total OF REVENUES Jan.-March. Budget Balance % Administration 183,214.55 763,412.00 580,197.45 24.0% AODA Services 103,933.19 440,846.00 336,912.81 23.6% Long Term Support 3,104,359.18 12,731,125.00 9,626,765.82 24.4% Mental Health 386,100.38 2,381,245.00 1,995,144.62 16.2% Family & Children's 645,631.71 2,648,969.00 2,003,337.29 24.4% Economic Support 223,027.99 1,025,999.00 802,971.01 21.7% General Relief 1,176.23 18,663.00 17,486.77 6.3% REVENUES HUMAN SERVICES PROGRAMS 4.647.443 23 20.010.259.00 1 6 815 77 23_2% Public Health 314 287 09 1 347 443.00 1,033,195 91 23_3% TOTAL REVENUES HEALTH AND HUMAN SERVICES 4 61 730 3 1 57 70 00 16,399 71 68 2_2% SUMMARY Total OF EXPENDITURES Jan.-March. Budget Balance % Administration 156,149.06 763,412.00 607,262.94 20.5% Alcohol-Drug Abuse 99,067.37 440,846.00 341,778.63 22.5% Long Term Support 2,905,399.61 * 12,731,125.00 9,825,725.39 22.8% Mental Health 557,552.72 2,381,245.00 1,823,692.28 23.4% Family & Children's 527,177.86 * 2,648,969.00 2,121,791.14 19.9% Economic Support 248,938.61 1,025,999.00 777,060.39 24.3% General Relief 1,761.51 18,663.00 16,901.49 9.4% Accrued Payroll 366,475.60 0.00 (366,475.60) 0.0% EXPENDITURES HUMAN SERVICES PROGRAMS 4,862,522.34 20,010,259.00 15,147,736.66 24.3% Public Health 282.793.24 1,347 443 00 1.064.649.76 21.0% TOTAL EXPENDITURES HEALTH AND HUMAN SERVICES 5.145 315.58 21.357.702.00 16.212.386.42 24.1% To be on budget, percentage should be 25.0% St. Croix County Health and Human Services Board Page 6 May 09, 2003 ST CROIX HEALTH CENTER OPERATIONS REPORT JAN THROUGH MARCH 2003 JAN-MARCH BUDGET ACTUAL DIFFERENCE % CENSUS 88 84 4 4.50% OPERATING REVENUE: MEDICARE $ 1,254,708.00 $ 245,326.89 $ 1,009,361.11 19.66% MEDICAID $ 2,929,061.00 $ 723,316.93 $ 2,205,744.07 24.69% PRIVATE PAY $ 1,025,316.00 $ 191,214.52 $ 834,101.48 18.65% ALL OTHER SOURCES $ 1,117.00 $ 586.40 $ 530.60 62.50% TOTAL OPERATING REVENUE $ 5,210,202.00 $ 1,160,444.74 $ 4,049,757.26 22.27% OPERATING EXPENSES: DAILY PATIENT SERVICES $ 4,252,427.00 $ 958,939.51 $ 3,293,487.49 22.55% SPECIAL SERVICES $ 300,748.00 $ 74,373.69 $ 226,374.31 24.73% GENERAL SERVICES $ 1,279,983.00 $ 285,131.60 $ 994,851.40 22.28% ADMINISTRATIVE SERVICES $ 507,779.00 $ 112,923.65 $ 394,855.35 22.24% UNASSIGNED: DEPRECIATION(%BASED) $ - $ 46,542.00 $ (46,542.00) 0.00% OTHERS $ 367,926.00 $ 90,077.94 $ 277,848.06 24.46% TOTAL OPERATING EXEPNSES $ 6,708,863.00 $ 1,567,988.39 $ 5,140,874.61 23.37% NET FROM OPERATIONS $ (407,543.65) NON-OPERATING ITEMS: REVENUE FROM RATE APPEALS $ 14,808.00 $ 3,702.00 $ 11,106.00 25.00% ITG FUNDS (%BASED) $ 798,386.00 $ 203,499.00 $ 594,887.00 25.49% CO ALLOCATION (%BASED) $ 685,467.00 $ 171,366.00 $ 514,101.00 25.00% TOTAL NON-OPERATING ITEMS $ 1,498,661.00 $ 378,567.00 $ 1,120,094.00 25.26% NET FROM ALL SOURCES $ $ (28,976.65) PERCENT SHOULD BE FUND BALANCE 01/01103 AUDITED $ 1,684,566.10 PRIOR OPERATIONS $ (28,976.65) CASH REPLENISHMENT(%$250,000) $ 62,500.00 FUND BALANCE END OF PERIOD $ 1,716,089.45 NURSING HOME: The current census in the Nursing Home is 85. If the census is down to 72, it will lessen the use of the elevators and ramps. Krieger outlined tentative plans to revamp the Nursing Home such as revamping the dining room, eliminate the chapel and beauty shop in the basement. Krieger said a time study was done and it takes 302 minutes of staff time for each meal to serve residents meals three times a day. Dr. Kretz asked if it was necessary to serve residents three meals a day. Krieger said there are strict Federal regulations establishing the amount of time allowed between meals and portion size and residents must have three meals a day. Krieger said the downsizing has two factors: environmental downsizing and staff downsizing. Kathan said it is more efficient to eliminate positions St. Croix County Health and Human Services Board Page 7 May 09, 2003 when downsizing rather than cutting hours, as it is not cost effective to cut hours. Kathan said we will proceed slowly with downsizing staffing due to the make up of resident needs. Staffing is done according to case mix and resident needs. This will be an ongoing process. Downsizing will begin by opportunity, such as attrition. She said it is too early to make decisions on any large lay offs. She said all employees are in the unions, which are operating under contracts for 2002 for wages and benefits. Negotiations have gone to arbitration. She said arbitration staff have been downsized also and chances are not good for a settlement before 2004. The Board toured the Nursing Home from 10:10 to 10:30 AM. Discussion was held regarding changing bedrooms into a dining room on the floors. Robole said cost is about $1.80/square foot to demolish walls, but will need to commission a structural engineer or architect to verify that the area can be opened up. Staff will need to weigh the cost of the structural change to the building versus the payback of the 302 minutes of staff time to bring residents for meals, activities, etc. Swenson said there is no need to defer hiring a structural engineer to Finance Committee if it is just a one- time service. Motion: A motion was introduced by Berenschot, seconded by Bethke, and unanimously adopted: That the Board give Ralph Robole authority to secure a consulting engineer to explore if remodeling desired in the Nursing Home can be done. ECONOMIC SUPPORT: W-2 is a non-mandated program. With the results of the first quarter Random Moment Time Study, administration feels it would not be cost efficient for us to remain in the W-2 business and anticipate a net loss of approximately $33,000 in 2002 and 2003. Three staff have left the program and these positions will not be filled. If passed, the resolution would go to the full County Board on 05/20/03 and we could possibly be out of the W-2 program by 09/28/03. Motion: A motion was introduced by Swenson, seconded by Berenschot, and unanimously adopted: That the Board adopts the following resolution: ST. CROIX COUNTY RESOLUTION TERMINATING WISCONSIN WORKS (W-2) CONTRACT WITH STATE OF WISCONSIN RESOLUTION WHEREAS, 1995 Wisconsin Act 289 amended Chapter 29 of the Wisconsin Statutes to replace the Aid to Families with Dependent Children (AFDC) Program with the Wisconsin Works Program and to include he Wisconsin Works (W-2) Program as part of the Food Stamp Program and Medical Assistance Program, and WHEREAS, on August 20, 1996 the St. Croix County Board of Supervisors authorized the St. Croix County Department of Health and Human Services (DHHS) the authority to contract with the State of Wisconsin to be the W-2 Agency in St. Croix County, and WHEREAS, said resolution also required the Health and Human Services Board to review the benefits of W-2 Program administration, and St. Croix County Health and Human Services Board Page 8 May 09, 2003 WHEREAS, the State of Wisconsin has changed the method for funding the W-2 program in Wisconsin resulting in losses to many Wisconsin counties, including St. Croix County. NOW, THEREFORE, be it resolved that the St. Croix County chooses to exercise language in the 2002-2003 W-2 Contract terminating the contract with 120-day written notice. Dated this 9th day of May, 2003. Offered by: St. Croix County Health and Human Services Board. The W-2 caseload consists of about 130 cases, however all of these cases are receiving Medical Assistance and Food Stamps and those two programs will remain with the County. Squyer said caseloads are climbing approximately 150 cases/month and the unit will be extremely chaotic until October. We will not actually lose any cases; we will just have less work to do on the cases we continue to have. The eligibility portion of the Child Care Program will go with the W-2 Program, however, the authorization portion of the Child Care Program will remain with the County. Unfortunately the authorization portion of the program is the most time consuming. ACTION TO APPROVE RENTAL CONTRACT WITH HENK VAN DYK: A request was received for a one-year extension on the barn rental contract. Motion: A motion was introduced by Bethke, seconded by Berenschot, and adopted with Kretz abstaining from voting: That the Board approvals the barn rental contract with Henk Van Dyk for $750.00 per month for one year effective June 1, 2003 through May 31, 2004. PUBLIC HEALTH: Dr. Kretz gave a presentation on the Tobacco Free Coalition activities. The coalition's goals are to prevent tobacco use in children, reduce exposure to second-hand smoke and reduce tobacco use in adults. He said River Falls is considering a smoke-free dining city ordinance, which will be confined to businesses that are 50% or more food. Nelson distributed a policy on Public Beach Safety Monitoring for approval by the Board. Nelson said this is a policy only, not an ordinance. State Statute Ch. 254 specifies that "the local health department shall close or restrict swimming, diving, and recreational bathing if a human health hazard exists in any area used for those purposes on a body of water and on associated land and shall require the posting of the area." This issue was cited on the HFS 140 Public Health Review in 1999. This policy needs to be implemented in order to fulfill our statutory requirement and definitely want it in place before we go through the review again. Nelson said ten public beaches have been identified in St. Croix County. Board members were concerned that the policy was not an ordinance and thus not enforceable with no citation authority. Nelson said technically the policy doesn't need Board approval but has to be done by Statute. REQUEST TO NEGOTIATE PLACEMENT OF TWO PART-TIME MENTAL HEALTH TECHNICIANS (MHT) INTO BARGAINING UNIT: Kiesler said two MHT positions are in the union and they do both job coaching and ADLs. Another two MHT positions are not in the union and do only ADLs with clients. With two different classifications even though they have similar duties, it is difficult to mix and match job duties to positions. With the increase in needed services, it is even more St. Croix County Health and Human Services Board Page 9 May 09, 2003 important to be able to efficiently distribute work between the paraprofessional positions. This issue was brought before the Personnel Committee who approved it if it came to the Health and Human Services Board for approval. Motion: A motion was introduced by Berenschot, seconded by Rasmussen, and adopted with Swenson and Olson voting no: That the Board approve Deb Kathan to negotiate in the best interest of the County the two Mental Health Technician positions into the union. CAPITAL OUTLAY PLAN UPDATE: Whiting requested an update on the Capital Outlay Plan by the end of May for planning for the 2004 budget process. Borup said costs in the Nursing Home capital outlay plan are based on the Keefe study and may have more accurate estimates after Robole hires an engineer. Swenson questioned if software updates were included for the Nursing Home for 2004 and 2005 and suggested monies be included for the updates. Motion: A motion was introduced by Berenschot, seconded by Wentz, and unanimously adopted: That the Board approves postponing the Nursing Home capital outlay plan until the next meeting on 05/22/03. Swenson said the loan request for the bussette was approved unanimously at the Finance Committee. In 2004 Health and Human Services will be required to provide the entire cost of new vehicles and the loan window will not be open. Motion: A motion was introduced by Swenson, seconded by Olson, and unanimously adopted: That the Board approves submitting St. Croix Industries, Building Services and Health and Human Services capital outlay plans to Whiting. REVIEW OF OFFER FROM WISDOT FOR PURCHASE OF COUNTY LAND: Borup said Highway 64 road expansion is coming from the east. WISDOT has offered $93,500 for 23.3 acres of County farmland. The County may obtain a second appraisal of the land before July 3, 2003. Schottler's contract to rent the farmland runs through December, 2006 and will need to be adjusted. When negotiating with the State for this land, negotiations for crop loss should also occur. Borup received a letter from Star Prairie Fish and Game to request permission to provide special hunts for disabled hunters and youth in our area. Borup said this item is not on the agenda and he will speak with Corporation Counsel and Schottler on this matter. Dorsey asked if there were any other issues to bring before the Board. Motion: A motion was introduced by Bethke, seconded by Wentz, and unanimously adopted: that the meeting be adjourned. Time: 12:05 AM Chair: Attest: (Secretary)