HomeMy WebLinkAboutHealth & Human Services 12-12-03
ESTHER WENTZ WILL REVIEW VOUCHERS AT 8:00 AM
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: 12/12/03
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: 01/09/04
ACTION ON PREVIOUS MINUTES: 11/14/03
ANNOUNCEMENTS
APPOINTMENTS:
UNFINISHED BUSINESS:
1. Nursing Home Admission/Discharge Policy
NEW BUSINESS:
1. Consideration of Claims and Vouchers
2. Financial Report
3. Personnel Issues
4. Program Reports:
a. Abandoned wells program-Bob Heise, Land and Water Conservation
b. Economic Support
C. Nursing Home
5. Action to develop Psychiatric Mental Health/AODA Inpatient Diversion Program
6. Fence for Health Center community garden
7. Approval of Public Health Community Needs Assessment
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
Health and Human Services Board - December 12, 2003 Page 2 of 7
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
COUNTYCLERK
NEWS MEDIA/NOTICE
MINUTES
HEALTH AND HUMAN SERVICES 130ARD
DECEMBER 12, 2003
The St. Croix County Health and Human Services Board met on December 12, 2003 at the St.
Croix County Health and Human Services/Health Center complex.
MEMBERS PRESENT: Thomas Dorsey, Chair
Leon Berenschot
Chris Bethke
Lois Burri
Mary Louise Olson
Deb Rasmussen
Ralph Swenson
Esther Wentz
MEMBERS ABSENT: Dr. Michael Kretz, excused
STAFF PRESENT: John M. Borup, Health and Human Services Director
Carolyn L. Krieger, Nursing Home Administrator
Judy Ziegler, Accounting Supervisor
Barbara Nelson, Public Health Supervisor-Health Officer
Ron Lockwood, Long Term Support
Ron Kiesler, Mental Health/AODA Coordinator
Steve Kirt, Mental Health/AODA Clinical Services Supervisor
Becky Ruka, Accounts Receivable Supervisor
Mary Squyer, Economic Support Supervisor
Wendy Kramer, Public Health Nurse
Malva Berg, Secretary
OTHERS PRESENT: Bob Heise, Land and Water Conservation Department
Chair Dorsey called the meeting to order at 8:3o AM noting the meeting was properly and legally
publicized.
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NEXT MEETING: The next Health and Human Services Board meeting is scheduled for Friday,
January o9 at 8:3o AM.
AGENDA: Motion: A motion was introduced by Wentz, seconded by Bethke, and unanimously
adopted: That the agenda be approved as circulated.
ANNOUNCEMENTS: Ayres bids are about two weeks later than anticipated. If the bidding
documents come in there may possibly be a need for a second meeting in December.
It was the consensus of the Board that Health and Human Services meetings will continue to be
held the second Friday of the month unless the Board decides differently at a later date.
MINUTES: Motion: A motion was introduced by Burri, seconded by Swenson, and unanimously
adopted: That the minutes of the 11/14/03 Health and Human Services Board meeting be
approved with the following changes:
Delete the following sentence from page two: "It was the consensus of the Board to delete the last
sentence of the statement and replaced with: The St. Croix Health Center will decide whether a
resident is appropriate for placement depending upon the nursing care needs." Also, it was
requested that additional revenue figures be added to Nursing Home report on page four and the
Nursing Home Operations report on page six be replaced.
APPOINTMENTS: Dorsey appointed Swenson and Wentz to a Building Committee for the
Nursing Home. Another member will be added to this committee hopefully by December 23,
2003.
NURSING HOME ADMISSION/DISCHARGE POLICY: After reviewing the admissions/
discharge policy, Timmerman offered suggestions for the policy. Discussion followed on
suggestions. Will ask Timmerman to review the policy again and bring the policy back to the
Board at the January 9th meeting.
Motion: A motion was introduced by Swenson, seconded by Berenschot and unanimously
adopted: That the Board approves the policies unless there are final revisions by Timmerman and
if there are revisions, the policies will be brought back before the whole Board in January.
ABANDONED WELLS PROGRAM: Heise said residents of municipalities and villages do not
qualify for Land and Water Conservation well help. He said they will cost share with well help for
township residents in St. Croix County. He said some municipalities already have regulations in
place so he is only looking at the rural section to provide ground water protection and protect
public resources. He said the abandoned well program is a voluntary effort, it is not mandatory.
COMMUNITY HEALTH NEED ASSESSMENT: Nelson said WI Statute Ch. 251.05 mandates that
local health departments "regularly and systematically collect, assemble, analyze and make
available information on the health of the community, including statistics on health status,
community health needs and epidemiologic and other studies of health problems". The
assessment process has incorporated a review of past community assessment; analysis of
demographic, economic and health status information; focus groups; and public input surveys.
Over the past six months, a core team of community stakeholders has been meeting to share in
the direction of the assessment process, priority health issue determination and final
recommendations. Nelson presented a PowerPoint presentation of the process. Nelson said the
assessment is useful in identifying and gaining insight into major health issues. She said this is
not the end of the process but rather the starting point for developing a current local health
improvement plan.
Motion: A motion was introduced by Burri, seconded by Wentz and unanimously adopted: That
the Community Health Needs Assessment was presented and accepted by the Board.
The Board recessed from 9:55 to 10:05 AM.
CONSIDERATION OF CLAIMS: The following reports were distributed to the Board: November
cash report, October and November unemployment report, and November fixed asset report. The
advanced IGT monies of $231,000 lump sum payment was received in December. It is projected
there will be a $2o,ooo deficit in the Nursing Home at year-end.
Swenson questioned cabling costs of $8,274 in the Nursing Home and why not bid. These costs
are tied to office moves and electronic software. Krieger and Borup both underestimated costs
and expressed disappointment with the total cost.
Health and Human Services Board member, Wentz, reviewed the following vouchers:
HUMAN SERVICES:
1o8o8": Skoglund Oil Company, Inc. $263.16, gas and diesel. Fuel oil to heat the maintenance
shop. The shop is not hooked up to the main heating plant for the 1974 building.
Motion: A motion was introduced by Wentz, seconded by Burri, and unanimously adopted: That
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the following vouchers be approved and be made a part of the supplemental minute book:
Human Services voucher 9290, dated November 18, 2003 in the amount of $15o.oo.
Human Services vouchers 9409 through 9527, dated November 20, 2003 in the amount of
$317215.61.
Human Services voucher 9540, dated November 21, 2003 in the amount of $3,193.00.
Human Services vouchers 9545 through 959o, dated November 26, 2003 in the amount of
$237,194.02.
Human Services vouchers 9602 through 9607, dated December 03, 2003 in the amount of
$27,438.75•
Human Services vouchers 10028 through 10104, dated December 04, 2003 in the amount of
$134,824.29•
Human Services vouchers 1o871 through 1o892, dated December 05, 2003 in the amount of
$21,632.41.
Human Services vouchers 10474 through 10628, dated December 12, 2003 in the amount of
$224,8o1.55•
Human Services vouchers 1o7o8 through 10807, dated December 12, 2003 in the amount of
$158,694.32.
Nursing Home vouchers 9405 through 94o8, dated November 20, 2003 in the amount of
$748.16.
Nursing Home vouchers 9541 through 9544, dated November 26, 2003 in the amount of $164.80.
Nursing Home vouchers 1o629 through 10707, dated December 12, 2003 in the amount of
$35,992.83•
Human Services, Workshop, Public Health, Social Services vouchers 623 through 651, dated
November 14, 2003 in the amount of $333,499.70•
Human Services and Nursing Home vouchers 643 through 671, dated November 18, 2003 in the
amount of $168,832.31.
Human Services, Workshop, Public Health, Social Services vouchers 651 through 68o, dated
December 02, 2003 in the amount of $328,605.45•
Human Services and Nursing Home vouchers 672 through 702, dated December 02, 2003 in the
amount of $167,854.09.
FINANCIAL REPORTS: The following financial reports through October were distributed to the
Board.
ST. CROIX COUNTY HUMAN SERVICES BOARD
FINANCIAL SUMMARIES
FOR THE PERIOD 01/01/03 THROUGH 10/31/03
NURSING HOME 10/31/2003
Cash Balance 10/31/03 $455,040.22
Add:
Accounts Receivable, 10/31/03
Accounts Receivable $313,519.39
Accounts Payable-10/31/03 ($258,545.41)
Net Current Items, 10/31/03 ($510,014.20)
2003 Revenue Recorded through 10/31/03
Includes Allocations of Anticipated Revenues $5,117,841.99
2003 Expenses Recorded through 10/31/03
Includes Allocations of Expected Expenses $5,145,838.39
Net Revenues over Expenses ($27,996.40)
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HEALTH AND HUMAN SERVICES - au
SUMMARY Total
OF REVENUES Jan -October Budget Balance
Administration 710.872.59 763.412 00 52.539.41 93 1%
AODA Services 400.888 72 440.846.00 39 957.28 90 9%
Long Term Support 10,526 230 86 12,731 12S 00 2.204 894 14 82 71".
Mental Health 2.092 748 74 2.381.245 00 286.496 26 87 9%
Family & Children's 2,185,155.73 2,648.969 00 463.813.27 82 S2
Economic Support 942.821 2S 1,029,999.00 83.177 7S 91 9%
General Relief 7.937 04 18.663 00 10 72S 96 42 S%
REVENUES HUMAN
SERVICES PROGRAMS 16.866 694 93 20 010 'S9 no 3.143 604.07 84 1%
Public Health 1 19o J17.5b 7 3d7 443 ,U1! 157 225 4d R8 a~.
TOTAL REVENUES HEALTH
AND HUMAN SERVICES 18.056 97".49 ?1 57 70' 0 0 3 300 pig St 84 S':
SUMMARY Total
OF EXPENDITURES Jan.-October Budget Balance
Administration 609.990 99 763 412 00 153 421 01 79 9%1
Alcohol-Drug Abuse 371.763.56 440.846.00 69,082.44 84 3%
Long Term Support 11,339.6322 39 s 12,731.125 00 1,391,492 61 89 1%
Mental Health 2,222.282 45 2 381 245 00 158 962 5S 93 P.
Family & Children's 2 136 864 03 + 2.648.969 00 512.104.97 80 7%
Economic Support 914 513.11 1,025.999.00 111.485.89 89 1%
General Relief 9.597 28 18 663 00 9 06S.72 S1 4/
EXPENDITURES HUMAN
SERVICES PROGRAMS 17,604.643.81 20,010 259 00 2,405.615.19 88 01:
Public Health 1-1211..9' .1 347 4420 22G_519_.58 83_26
TOTAL EXPENDITURES HEALTH
AND HUMAN SERVICES 18 729 S67 13 21 ';S7 702 00 2.63' 134.87 87 7;:
To be on budget percentage should be 7S,O%
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ST CROIX HEALTH CENTER
OPERATIONS REPORT
JANUARY THROUGH OCTOBER JAN-OCT
am BUDGET A0_1J6L DIFFERENCE %
CENSUS 88 804 76 9136%
OPERATING REVENUE
MEDICARE $ 1,254,708 00 $ 653,747 47 $ 600,960.53 5210%
MEDICAID $ 2,929,061 00 $ 2305,017 30 $ 424,043 70 D5 52%
PRIVATE PAY $ 1,025,316.00 $ 676.34666 S 348,969.34 6596%
ALL OTHER SOURCES $ 1,11700 $ 20,840 56 $ (19,72356) laU 76
TOTAL OPERATING REVENUE $ 5,210 202.00 $ 3,855,951 99 $ 1,354,250.01 7401%
OPERATING EXPENSES
DAILY PATIENT SERVICES $ 4,252,427.00 $ 3.096.098 55 $ 1,156,328 45 7281%
SPECIAL SERVICES $ 300,748 00 $ 236,71388 S 64,034.12 7871%
GENERAL SERVICES $ 1,279,983 00 $ 934,152 95 $ 345,830 05 7298%
ADMINISSTRA.TIVE SERVICES $ 507,77900 $ 427,851 54 $ 79,927.46 384260000%
UNASSIGNED- $ -
DEPRECIATION(°/oBASED) $ - $ 155,14000 $ (155,140.00) 000%
OTHERS $ 367,926.00 $ 295,881 47 $ 72,04453 SCIA2%
TOTAL OPERATING EXEPNSES $ 6,7108,863 00 $ 5.145.838 39 $ 1,563,024 61 7670%
NET FROM OPERATIONS
NON-OPERATING ITEMS
REVENUE FROM RATE APPEALS $ 14,808 00 $ 12,340 CIO $ 2,468-00 8333%
ITG FUNDS (%BASED) $ 798,386 00 $ 676,330 00 $ 120,056.00 8496%
CO ALLOCATION (%BASED) $ 685,467 00 $ 571,220 CIO $ 114 247 00 8333%
TOTAL NON-OPERATING ITEMS $ 1,498,661.00 $ 1,261,890.00 $ 236,771.00 84 20%
MA BED REDUCTION EST FUNDS
NET FROM ALL SOURCES $ $ (27,996 40)
PERCENTAGE SHOULD BE 83
FUND BALANCE ONU1N3 AUDITED $ 1,684,556.10
PRIOR OPERATIONS $ (27,996 40)
CASH REPLENISHMENT(%$250.000) $ 208,32500
FUND BALANCE END OF PERIOD $ 1.864 894 70
PERSONNEL ISSUES: Borup informed the Board of the following personnel changes: Paula
Brandt, CSP Receptionist, posted into the Economic Support Specialist position vacated by Sherry
Bonte (moved to Menomonie). Wanda Sather, Economic Support Receptionist, has posted into
Paula's old position. He said Geralyn Karl accepted the LTE Health Educator position with Public
Health. This full time LTE position was approved with the 2004 budget and is scheduled to start
January 1, 2004. It will involve tobacco control/prevention activities, a role with preparedness,
and education associated with any and all of our programs. It is possible this position will become
a permanent position in the future, depending on funding and Board action.
ECONOMIC SUPPORT: Squyer said caseloads continue to climb. Caseloads should be at
approximately 200 per worker and the current caseloads are running around 575 to 6oo. She said
the economy is not doing well. St. Croix County's unemployment is higher than other counties in
the area.
Squyer said the ceiling for Badger Care has been exceeded and there is no money in the program.
She said the premium to customers will be increased and the premium is based on household
income.
Squyer reported on the Venison Project. She said 16 animals were received from bow hunting and
six more were received this week. With the venison distributed, a paper on safe handling of
venison and a paper on CWD is also included. She said Westcap is working on a grant to purchase
another freezer and also to pay for more processing.
MENTAL HEALTH/AODA PSYCHIATRIC INPATIENT DIVERSION PROGRAM: Mental Health
staff has continued to explore the options and feasibility of creating a mental health inpatient
diversion program. This program would include the following components: psychiatric care,
residential care, and mobile crisis services. Administration stated that the outcome of the
diversion program is to control the escalating number of psychiatric inpatient admissions and in
turn the escalating drain on the County levy. Kiesler said this change could impact a staff person
in the department and is creating some anxiety. He said Phase 1 involves re-looking at psychiatry
namely, whether we want to upgrade the psychiatric nurse to an Advanced Practice Nurse
Practitioner with prescriptive abilities, hire a full-time Psychiatrist or both. If the full-time
Psychiatrist option is chosen, there would have to be a new pay grid, which would probably
require full County Board action. Kiesler said we need to do one or the other, but not necessarily
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both.
Motion: A motion was introduced by Berenschot, seconded by Rasmussen, and unanimously
adopted: That the Board approves the first part of Phase i of the Mental Health Psychiatric
Inpatient Diversion Program which is re-evaluate and restructure psychiatric nursing services
and all of Phase 2, which is re-evaluate and restructure crisis mental health residential services,
re-evaluate and restructure long term mental health residential services, and evaluate and
develop mental health diversion facility.
Swenson commended Kiesler for his planning and creativity.
FENCE FOR HEALTH CENTER COMMUNITY GARDEN: Bethke distributed information on
costs to raise the community garden fence from five foot to nine foot to keep deer out. Materials
will cost approximately $6oo. It was the consensus of the Board to table this issue until after the
first of the year and research other sources for the monies.
Dorsey asked if there were any other issues to bring before the Board.
Swenson said he would like the Building Committee to be able to approve the concept before the
bid process is started. He would like the Committee to approve and sign off on the blueprints and
no other changes may be made unless there is a legal change on the contract. Timmerman will be
asked to evaluate the contracts when the bids are awarded to meet legal requirements. It is
anticipated that Cindy Campbell and Ralph Robole will also be a part of this Committee. Borup
said there are no monies left in the contingency fund to pay the Ayres bill. Krieger said the
Nursing Home has a remodeling donation account and will check into that for paying this bill.
Borup said next year will be tight for capital outlay items.
Motion: A motion was introduced by Berenschot, seconded by Bethke, and unanimously
adopted: that the meeting be adjourned.
Time: 12:05 PM
Chair:
Attest:
n0i CARMW1IAEL RO\h ` III'lNON W1,540Ib
'1 i~:j8t"'1000
LAst PI)AXE' Oct L 2010
DN'CLACNILR
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