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HomeMy WebLinkAboutHealth & Human Services 01-10-03 X CHRIS BETHKE WILL REVIEW VOUCHERS AT 8:00 AM 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: 01/10/03 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: 02/14/03 ACTION ON PREVIOUS MINUTES: 12/12/02 ANNOUNCEMENTS APPOINTMENTS: UNFINISHED BUSINESS: NEW BUSINESS: 1. Consideration of Claims and Vouchers 2. Financial Report 3. Personnel Issues 4. Program Reports a. Public Health b. Birth to Three Program c. Nursing Home 5. Review of WIPFLI Report 6. Request approval for Nursing Home software change 7. Review and action on bids for 20-passenger bussette for St. Croix Industries - 9:30 a.m. 8. Request to apply for Otto Bremer Foundation Grant 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 January 10, 2003 The St. Croix County Health and Human Services Board met on January 10, 2003 at the St. Croix County Health and Human Services/Health Center complex. MEMBERS PRESENT: Thomas Dorsey, Chair Leon Berenschot Chris Bethke Lois Burri Fern Johnson-Schmidt Mary Louise Olson Ralph Swenson Esther Wentz MEMBERS ABSENT: James Craig, excused STAFF PRESENT: Carolyn L. Krieger, Nursing Home Administrator Judy Ziegler, Accounting Supervisor Ron Eichstaedt, St. Croix Industries Supervisor Barbara Nelson, Public Health Supervisor-Health Officer Deb Lindemann, Public Health Nursing Geralyn Karl, Tobacco Prevention & Control Specialist Laurie Cameron, Family & Children's Social Worker Norma Vrieze, Early Intervention Director Malva Berg, Secretary OTHERS PRESENT: Chuck Whiting, Administrative Coordinator 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, February 13 at 8:30 AM. The January 23rd meeting will not be held unless important agenda items arise. Olson, Johnson-Schmidt, and Swenson asked to be excused from the February 13th meeting. AGENDA: Motion: A motion was introduced by Bethke, seconded by Berenschot, and unanimously adopted: That the agenda be approved as circulated. MINUTES: Motion: A motion was introduced by Wentz, seconded by Bethke, and unanimously adopted: That the minutes of the 12/12/02 Health and Human Services Board meeting be approved as circulated. REQUEST TO APPLY FOR OTTO BREMER FOUNDATION GRANT: Laurie Cameron, Family and Children's Social Worker, requested approval from the Board to apply for a $5,000 grant from the Otto Bremer Foundation to fund a "revolving" housing security deposit fund. Independent Living youth between the ages of 18 and 21 would be able to access the fund when obtaining housing. Cameron would work with youth to maintain the rental unit and leaving it in good condition upon leaving the rental agreement to better ensure return of the deposit to the revolving fund. Youth would need to provide the first month's rent at the time the deposit would be released. Money is received from the Federal Government to fund the Independent Living program but the funds are used to cover salary and benefits and there are no monies left over to fund St. Croix County Health and Human Services Board Page 2 January 10, 2003 additional programming. Human Services is mandated to provide services to Independent Living youth until their 21St birthday. Motion: A motion was introduced by Wentz, seconded by Olson, and unanimously adopted: That the Board approves applying for the $5,000 grant from the Otto Bremer Foundation to fund a revolving housing security deposit fund. Olson requested follow up information on this project. CONSIDERATION OF CLAIMS: The following reports were distributed to the Board: December cash report and November financial report. Health and Human Services Board member, Bethke, reviewed the following vouchers: HUMAN SERVICES: 16959: Beebe Mortuary, $2,880.00, funeral expense. This funeral expense will be reimbursed in full by the State contract. No County dollars are required for this contract item. 17289: Shopko Pharmacy, $218.75, LTS client expense. This expense is for a Long Support client in the Community Options Program. These people stay in the community and utilize the stores most convenient to them. NURSING HOME: 12742: Sundance Rehabilitation, $1,452.94, physical therapy services/November, 2002. The Nursing Home contracts with this company to provide therapy services to residents of the Nursing Home. The therapy staff have work areas in the Nursing Home building so residents don't have to leave the premises to receive services. 11029: Centuria Commercial Laundry, $114.50, laundry expense. Cost of supplies used by staff for residents' laundry. We contract with this company to wash the bedding and towels but do personal laundry in-house. Motion: A motion was introduced by Bethke, seconded by Wentz, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book: Human Services vouchers 16866 through 16953, dated December 19, 2002 in the amount of $359,116.53. Human Services vouchers 16954 through 16980, dated December 27, 2002 in the amount of $49,515.78. Human Services vouchers 16981 through 17025, dated January 02, 2003 in the amount of $77,805.56. Human Services vouchers 17035 through 17199, dated January 10, 2003 in the amount of $189,626.57. Human Services vouchers 17200 through 17354, dated January 10, 2003 in the amount of $125,096.28. Nursing Home vouchers 2430 through 2438, dated December 19, 2002 in the amount of $7,378.87. . St. Croix County Health and Human Services Board Page 3 January 10, 2003 Nursing Home vouchers 2439 through 2441, dated December 27, 2002 in the amount of $15,203.82. Nursing Home vouchers 2442 through 2485, dated January 10, 2003 in the amount of $54,318.56. Human Services and Nursing Home vouchers 671 through 699, dated December 17, 2002 in the amount of $208,598.09. Human Services, Workshop, Public Health, Social Services vouchers 714 through 743, dated December 17, 2002 in the amount of $317,612.26. Human Services, Workshop, Public Health, Social Services vouchers 744 through 773, dated December 27, 2002 in the amount of $317,022.50. Human Services and Nursing Home vouchers 700 through 729, dated January 02, 2003 in the amount of $192,111.09. FINANCIAL REPORTS: The following financial reports through November were distributed to the Board: ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD 01/01/02 THROUGH 11/30/02 NURSING HOME 11/30/02 Cash Balance 11/30/02 $36,989.64 Add: Accounts Receivable, 11/30/02 Private Pay $47,581.17 Medicare $174,997.51 Medicaid $225,296.68 General $0.00 Accounts Payable-11/30/02 ($307,207.08) Net Current Items, 11/30/02 $177,657.92 2002 Revenue Recorded through 11/30/02 $6,308,185.88 Includes Allocations of Anticipated Revenues 2002 Expenses Recorded through 11/30/02 $5,923,568.75 Includes Allocations of Expected Expenses Excess Revenues over Expenses $384,617.13 St. Croix County Health and Human Services Board Page 4 January 10, 2003 HEALTH AND HUMAN SERVICES - 2002 SUMMARY Total OF REVENUES Jan.-Nov. Budget Balance Administration 751,055.59 786,486.00 35,430.41 95.5% AODA Services 389,782.65 434,703.00 44,920.35 89.7% Long Term Support 10,202,369.78 12,358,744.00 2,156,374.22 82.6% Mental Health 2,229,768.71 2,297,343.00 67,574.29 97.1% Family & Children's 2,333,123.22 2,519,843.00 186,719.78 92.6% Economic Support 1,019,281.14 1,095,090.00 75,808.86 93.1% General Relief 24,441.59 13,494.00 (10,947.59) 181.1% REVENUES HUMAN SERVICES PROGRAMS 16,949,822.68 19,505,703.00 2,555,880.32 86.9% Public Health 1,194,510.51 1,256,677.00 62,166.49 95.1% TOTAL REVENUES HEALTH AND HUMAN SERVICES 18,144,333.19 20,762,380.00 2,618,046.81 87.4% SUMMARY Total OF EXPENDITURES Jan.-Nov. Budget Balance % Administration 657,275.87 786,486.00 129,210.13 83.6% Alcohol-Drug Abuse 338,020.93 434,703.00 96,682.07 77.8% Long Term Support 10,815,801.47* 12,358,744.00 1,542,942.53 87.5% Mental Health 2,092,536.31 2,297,343.00 204,806.69 91.1% Family & Children's 2,265,148.32* 2,519,843.00 254,694.68 89.9% Economic Support 921,073.68 1,095,090.00 174,016.32 84.1% General Relief 18,359.07 13,494.00 (4,865.07) 136.1% Accrued Payroll 478,377.91 0.00 (478,377.91) 0.0% EXPENDITURES HUMAN SERVICES PROGRAMS 17,586,593.56 19,505,703.00 1,919,109.44 90.2% Public Health 1,063,610.54 1,256,677.00 193,066.46 84.6% TOTAL EXPENDITURES HEALTH AND HUMAN SERVICES 18,650,204.10 20,762,380.00 2,112,175.90 89.8% To be on budget, percentage should be 91.67% NURSING HOME OPERATIONS REPORT JAN-OCT NOVEMBER TOTAL OPERATING REVENUES 3,895,890.40 4,251,702.88 St. Croix County Health and Human Services Board Page 5 January 10, 2003 OPERATING EXPENSES: DAILY PATIENT SERVICES 3,346,901.51 3,660,249.43 SPECIAL SERVICES 232,577.14 255,012.59 GENERAL SERVICES 951,363.49 1,042,631.25 ADMINISTRATIVE SERVICES 431,252.93 472,088.04 UNASSIGNED: DEPRECIATION % BASED 167,500.00 184,250.00 OTHER 274,809.21 309,337.44 TOTAL OPERATING EXPENSES 5,404,404.28 5,923,568.75 ET FROM OPERATIONS 1,508,513.88 1,671,865.87 ON-OPERATING ITEMS: REVENUE FROM RATE APPEALS 15,000.00 16,500.00 WAGE PASSTHROUGH REVENUE - - INTERGOVERNMENTAL TRANSFER IGT % BASED 785,390.00 863,929.00 CO. ALLOCATION % BASED on OPS. LEVY OF $1,282,965 1,069,140.00 1,176,054.00 TOTAL NON-OPERATING ITEMS 1,869,530.00 2,056,483.00 EXCESS of REVENUES OVER EXPENSES 6.12 384AI713 TERFUND TRANSFERS: - TRANSFERS FROM OTHER FUNDS - TOTAL INTERFUND TRANSFERS - TOTAL OPERATING, NON-OPERATING & TRANSFERS FUND BALANCE 2002 AUDITED NUMBER 1,506,067.69 1,506,067.69 PERIOD OPERATIONS 361 016.12 384,617.13 CASH REPLENISHMENT % BASED on $250,000 for YEAR 208 330.00 229 167.00 FUND BALANCE, END of PERIOD 2,075,413.81 2,119,851.82 The facility notes that several positions were cut in March in order to decrease expenses by $99,702 for the last ten months of 2002. ACTUAL IGT AWARD FOR 2001-2002 IS $942,471. REVIEW OF WIPFLI REPORT: The final report from Wipfli was distributed to Board members. The information in the final report is essentially unchanged however does include three new appendices. A report from Krieger regarding follow up to the Nursing Home management audit review was also distributed to the Board. The "template" received from Wipfli does not compare two equal time periods, however, Ziegler developed a new report comparing the appropriate time periods. Swenson said the changes to the report that were St. Croix County Health and Human Services Board Page 6 January 10, 2003 requested aren't seen in the final report. Whiting said Wipfli has only been paid half of their fee and have not received the final bill for the audit. The report prepared by Krieger emphasizes the cost per patient day by dollars and hours. The study felt that the facility was overstaffed and management did not have good control of the staff to resident care ratio. Adjustments have been made in the Nursing Home staffing that resulted in cost savings in the 2002 budget and will continue into 2003. Krieger prepared a report comparing the first six months of 2001 and 2002. She questioned pulling out the overtime, orientation/training time hours to give a true picture of the hours worked on the floor to provide patient care. The 2003 budget was prepared using a census of 88. The census today is 94 with two admissions pending for tomorrow. Krieger said the Nursing Home budget has eight less FTE in 2003 from 2002. Krieger said the nursing home has experienced admissions of many younger people than it has ever had before and many of these admissions have no pay source. She said residents are accepted only if the Nursing Home can provide their clinical care and work with financial resources. Some areas not addressed in the final report include the gradual reduction in staff, CMI-protectively placed population, adjustments made in the nursing department to try to lessen workload. The five dining areas in the Nursing Home were criticized by the study but was also cited by the State surveyors in the survey process as the increased number of residents in wheelchairs has caused overcrowding in the dining room. Krieger said the private pay rates were increased in December rather than January. Board members questioned if private pay rates could be increased further. Krieger surveyed other facilities in the area and the nursing department structure in the Nursing Home is pretty much staffed like the other facilities in the area. It is difficult to know how well the Nursing Home is doing by the financial reports generated. Loney will be working with Borup, Krieger and Ziegler to make needed changes to generate a financial statement with needed information. Berenschot requested that all County Board members receive copies of the Wipfli report and receive copies of the follow up presentation from Krieger. REQUEST APPROVAL FOR NURSING HOME SOFTWARE CHANGE: The Nursing Home transitioned to the windows version of the Horizon software in September due to the company's non-support on December 31, 2002. The new version is not an integrated product, which is unacceptable. Krieger is recommending the purchase of American Data because it is an integrated program that works. It is in 12 County nursing homes and over 140 other Wisconsin nursing homes. Tom Boron and Jim Williams have been involved in this project and share the opinion to move to American Data. Motion: A motion was introduced by Berenschot, seconded by Wentz, and unanimously adopted: That the Board approves the software change to American Data. REVIEW AND ACTION ON BIDS FOR 20-PASSENGER BUSSETTE FOR ST. CROIX INDUSTRIES: Eichstaedt said 12 bid requests were sent out and seven bids were received. Eichstaedt reviewed the spreadsheet outlining bids received. He said the motors and the frames in the bussettes are Ford while the bodies are assembled by a separate company. There is no one in the immediate area that is familiar with our vehicles. If service is needed on a bussette, an issue St. Croix County Health and Human Services Board Page 7 January 10, 2003 arises whether it is a problem Ford should repair or if it is a problem the body company should repair. Service is an issue. Motion: A motion was introduced by Olson, seconded by Johnson-Schmidt, and unanimously adopted: That the Board approves bid #3 for $42,560 from Minnesota Body and Equipment in Shakopee, Minnesota. Borup will send a letter to Finance regarding a loan for these vehicles requesting an "internal loan" be obtained from the Finance Committee for this vehicle with a payment schedule set up over four years. Berenschot left the meeting at 10:00. The Board recessed from 10:00 to 10:10. BIRTH TO THREE PROGRAM REPORT: Vrieze reported the Birth to Three Program has been mandated since 1987. She said the program has received between 100- 110 referrals per year but not all are enrolled in the program. She outlined referral sources, age at time of referral and diagnosis/description of clients in the program. She also distributed a comparison study of the program comparing 1994 to 2001. In 2001 there were 64 clients enrolled in the Birth to Three Program. Wentz announced that she is on the Long Term Support Committee and complimented the help the Birth to Three Program provides to the parents of St. Croix County for the children in this program. PUBLIC HEALTH PROGRAM REPORT: Lindemann and Karl reported on the Wisconsin WINS Program. This program started in November and the goal is to try to reduce sale of tobacco products to minors. A chart was distributed outlining the outcome of tobacco compliance investigation in St. Croix and Pierce County. One supervisor and two youth visited establishments in these two counties that sold tobacco products. The minors attempted to purchase tobacco products. If the sale was not completed, the establishment was rewarded for following the law. If the sale was completed, the establishment was reminded of the law that it is illegal to sell tobacco products to minors and offered additional training. This project established positive relationships with both retailers and law enforcement. The Wisconsin Youth Tobacco Survey results were recently released and show a definite decline in tobacco use in high school and middle school students. A letter from David Gunderson, Wisconsin Tobacco Control Board, was distributed to Board members. Clean indoor air policy goals to be achieved by 2005 were outlined as follows: ❑ 100 percent of municipal government buildings will be smoke-free; ❑ 100 percent municipalities will pass smoke-free restaurant ordinances; ❑ 90 percent of all workplaces will be smoke-free; and ❑ 70 percent of homes will be voluntarily smoke-free. If the County does not work on the policies as outlined above, there will be no funding. There are currently no municipal ordinances mandating smoke-free restaurants in St. Croix County. The Board questioned if smoking was allowed on County property. Borup said there is no smoking allowed in County buildings. St. Croix County Health and Human Services Board Page 8 January 10, 2003 Public Health is still providing nursing services on a month-to-month basis as the sheriff has not hired personnel. Interviews are scheduled for the end of January. The agenda for the January 20th, 2003, Legislative Event was distributed to Board members. Nelson gave a communicable disease update. She said Pertussis has been seen throughout the State; St. Croix County had its first case this week. She reported there have been no recent local cases of E coli. Influenza has been at normal levels this year. She said there was one reported episode of measles in a 22-year-old person in Wisconsin who was not vaccinated for measles and had returned from India. There will be a pandemic follow-up tabletop exercise with Baldwin community members the end of February at the BAMC. Nelson invited Board members to be evaluators for this process. Nelson said there are nine counties in the bioterriorism consortium. She said no money was given to Polk County or any other county to have the consortium. There is no stand-alone money for the consortium, there is only money if the county is part of a consortium and the money is shared by all the counties in the consortium. There are 12 consortiums in the state. Funding received last year by the health department for bioterrorism preparedness has been used for education, training and consortium development. Dorsey asked if there were any other issues to bring before the Board. Motion: A motion was introduced by Wentz, seconded by Bethke, and unanimously adopted: that the meeting be adjourned. Time: 11:40 AM Chair: Attest: (Secretary)