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HomeMy WebLinkAboutHealth & Human Services 10-10-03 X CHRIS BETHKE 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: 10/10/03 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: 10/23/03 ACTION ON PREVIOUS MINUTES: 09/18/03 ANNOUNCEMENTS APPOINTMENTS: UNFINISHED BUSINESS: NEW BUSINESS: 1. Consideration of Claims and Vouchers 2. Financial Report 3. Architect's Report on Nursing Home Remodeling-Mike Berg, Ayres & Associates - 9:00 AM 4. 2004 Budget Update 5. 2004 Child Day Care Rates 6. Approval of Nursing Home Private Pay Rates 7. Nursing Home Admission/Discharge Policy 8. Program Reports a. Mental Health/AODA Inpatient Diversion Program 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 October 10, 2003 The St. Croix County Health and Human Services Board met on October 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 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 Ralph Robole, Facilities Manager Ruth Lehman, Public Health Fred Johnson, Family and Children's Supervisor Malva Berg, Secretary OTHERS PRESENT: Mike Berg, Ayres and Associates 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, November 14 at 8:30 AM. Berenschot asked to be excused from the November 14th meeting. Burri will review vouchers in November. ANNOUNCEMENTS: Board members received an invitation to the Food Collaborative. Ruth Lehman gave a brief presentation on areas the Collaborative covers. AGENDA: Motion: A motion was introduced by Berenschot, seconded by Bethke, and unanimously adopted: That the agenda be approved as circulated. MINUTES: Motion: A motion was introduced by Swenson, seconded by Wentz, and unanimously adopted: That the minutes of the 09/11/03 and 09/18/03 Health and Human Services Board meetings be approved. CONSIDERATION OF CLAIMS: The following reports were distributed to the Board: September cash report, August unemployment report, and September fixed asset report. Health and Human Services Board member, Bethke, reviewed the following vouchers: HUMAN SERVICES: St. Croix County Health and Human Services Board Page 2 October 10, 2003 5576: Cox Motor Sales, Inc. $557.18, fleet car expense. Brake work and tune up on one Mental Health vehicle. 5737: O'Connell Family Funeral Home, $2,500.00, funeral expense. We are reimbursed in full by the State on this bill. 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 voucher 4909, dated September 12, 2003 in the amount of $357.00. Human Services vouchers 4936 through 4997, dated September 18, 2003 in the amount of $201,273.99. Human Services vouchers 5186 through 5250, dated September 25, 2003 in the amount of $279,923.80. Human Services vouchers 5457 through 5519, dated October 02, 2003 in the amount of $44,144.40. Human Services vouchers 5525 through 5772, dated October 10, 2003 in the amount of $280,250.98. Human Services vouchers 5817 through 5935, dated October 10, 2003 in the amount of $51,665.55. Nursing Home vouchers 4928 through 4935, dated September 18, 2003 in the amount of $6,198.29. Nursing Home vouchers 5171 through 5185, dated September 25, 2003 in the amount of $2,151.64. Nursing Home vouchers 5452 through 5456, dated October 02, 2003 in the amount of $383.80. Nursing Home vouchers 5773 through 5816, dated October 10, 2003 in the amount of $57,138.25. Human Services, Workshop, Public Health, Social Services vouchers 537 through 565, dated October 07, 2003 in the amount of $334,236.14. Human Services and Nursing Home vouchers 553 through 582, dated October 07, 2003 in the amount of $168,664.66. Human Services, Workshop, Public Health, Social Services vouchers 509 through 536, dated September 23, 2003 in the amount of $331,534.12. Human Services and Nursing Home vouchers 523 through 552, dated September 23, 2003 in the amount of $174,136.90. FINANCIAL REPORTS: The following financial reports through August were distributed. Only a portion of the position cuts is reflected in the Nursing Home financial report. St. Croix County Health and Human Services Board Page 3 October 10, 2003 ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD 01/01/03 THROUGH 08/31/03 NURSING HOME August. 2003 Cash Balance 08/31/03 $507,876.98 Add: Accounts Receivable, 08/31/03 $414,334.68 Accounts Payable-08/31/03 ($216,295.91) Net Current Items, 08/31/03 $705,915.75 2003 Revenue Recorded through 08/31/03 $4,165,282.21 Includes Allocations of Anticipated Revenues 2003 Expenses Recorded through 08/31/03 $4,195,884.96 Includes Allocations of Expected Expenses Excess Revenues over Expenses ($30,602.75) St. Croix County Health and Human Services Board Page 4 October 10, 2003 I HEALTH AND HUMAN SERVICES - 2003 SUMMARY Total OF REVENUES Jan.-August. Budget Balance % Administration 621,558.05 763,412.00 141,853.95 81.4% AODA Services 298,674.60 440,846.00 142,171.40 67.8% Long Term Support 8,382,188.09 12,731,125.00 4,348,936.91 65.8% Mental Health 1,447,206.64 2,381,245.00 934,038.36 60.8% Family & Children's 1,776,568.38 2,648,969.00 872,400.62 67.1% Economic Support 791,275.24 1,025,999.00 234,723.76 77.1% General Relief 1,642.60 18,663.00 17,020.40 8.8% REVENUES HUMAN SERVICES PROGRAMS 13 319.113.60 0 010 5 00 6.691 145 40 66.6% Public Health 94S_468.01 1.347.443.00 401 974.99 70.2% TOTAL REVENUES HEALTH AND HUMAN SERVICES 14 264.581.61 21 357.702 00 7.093.120 39 66.81 SUMMARY Total OF EXPENDITURES Jan.-August. Budget Balance % Administration 495,813.81 763,412.00 267,598.19 64.9% Alcohol-Drug Abuse 294,160.79 440,846.00 146,685.21 66.7% Long Term Support 8,982,970.38 * 12,731,125.00 3,748,154.62 70.6% Mental Health 1,761,384.46 2,381,245.00 619,860.54 74.0% Family & Children's 1,701,255.17 * 2,648,969.00 947,713.83 64.2% Economic Support 729,964.67 1,025,999.00 296,034.33 71.1% General Relief 6,887.09 18,663.00 11,775.91 36.9% EXPENDITURES HUMAN SERVICES PROGRAMS 13,972,436.37 20,010,259.00 6,037,822.63 69.88 Public Health 879.662.47 1.347.443.00 467.780.53 65.31 TOTAL EXPENDITURES HEALTH AND HUMAN SERVICES 14 952,098 84 21.357.702.00 6.90S 603 16 69.5% To be on budget, percentage should be 66.67%. • St. Croix County Health and Human Services Board Page 5 October 10, 2003 ST CROIX HEALTH CENTER OPERATIONS REPORT JANUARY THROUGH AUGUST 2003 JAN-AUG BUDGET ACTUAL DIFFERENCE % CENSUS 88 83.5 4.5 5.110% OPERATING REVENUE: MEDICARE $ 1,254,708.00 $ 579,028.17 $ 675,679.83 46.15% MEDICAID $ 2,929,061.00 $ 1,915,545.90 $ 1,013,515.10 65.40% PRIVATE PAY $ 1,025,316.00 $ 536,574.86 $ 488,741.14 52.33% ALL OTHER SOURCES $ 1,117.00 $ 20,228.19 $ (19,111.19) 1810.94% TOTAL OPERATING REVENUE $ 5,210,202.00 $ 3,051,377.12 $ 2,158,824.88 58.57% OPERATING EXPENSES: DAILY PATIENT SERVICES $ 4,252,427.00 $ 2,554,610.08 $ 1,697,816.92 60.07% SPECIAL SERVICES $ 300,748.00 $ 194,731.55 $ 106,016.45 64.75% GENERAL SERVICES $ 1,279,983.00 $ 758,087.04 $ 521,895.96 59.23% ADMINISSTRATIVE SERVICES $ 507,779.00 $ 319,491.53 $ 188,287.47 62.92% UNASSIGNED: $ - $ - 0.00% DEPRECIATION(%BASED) $ - $ 124,112.00 $ (124,112.00) 0.00% OTHERS $ 367,926.00 $ 244,852.76 $ 123,073.24 66.55% TOTAL OPERATING EXEPNSES $ 6,708,863.00 $ 4,195,884.96 $ 2,512,978.04 62.54% NET FROM OPERATIONS $ (1,144,507.84) NON-OPERATING ITEMS: REVENUE FROM RATE APPEALS $ 14,808.00 $ 9,872.00 $ 4,936.00 66.70% ITG FUNDS (%BASED) $ 798,386.00 $ 542,664.00 $ 255,722.00 67.97% CO ALLOCATION (%BASED) $ 685,467.00 $ 456,976.00 $ 228,491.00 66.67% TOTAL NON-OPERATING ITEMS $ 1,498,661.00 $ 1,009,512.00 $ 489,149.00 67.36% MA BED REDUCTION EST FUNDS $ 104,393.09 NET FROM ALL SOURCES $ - $ (30,602.75) PERCENTAGE SHOULD BE 58.33 FUND BALANCE 01/01/03 AUDITED $ 1,684,566.10 PRIOR OPERATIONS $ (30,602.75) CASH REPLENISHMENT(%$250,000) $ 166,675.00 FUND BALANCE END OF PERIOD $ 1,820,638.35 2004 BUDGET UPDATE: Borup expressed frustration over the 2004 budget process. He said it would have gone much smoother if the Sage and Access programs had run parallel and the way the process went, it created much more work for staff. Borup sees the benefits from Sage and feels next year will go much better. Borup summarized cuts of $62,000, down from $200,000 originally directed by the Finance Committee. Swenson said the budget was approved by Finance as presented. There has been a reduction of the health insurance costs. ARCHITECT'S REPORT ON NURSING HOME REMODELING: Cost estimates for the remodeling were distributed. Copies of the remodeling plans were reviewed. Four rooms on first floor will be combined to make one room for a dining room and three rooms on second floor will be combined to make one room for a dining room. The majority of the work is able to be done during the winter St. Croix County Health and Human Services Board Page 6 October 10, 2003 months except for the replacement of the windows. It will take four to six weeks for the architectural work, two to three weeks for the contractor's bid, approximate one week to award the bid and from two to three months for the construction. Cost of the project is estimated at $261,000 plus draperies, etc. This item is on the County Board agenda for the end of October. It is anticipated the contract will be awarded in mid-January and construction will be done approximately mid-April. Motion: A motion was introduced by Berenschot, seconded by Bethke and approved with Swenson voting no, That the Board approves continuing with the project when the full County Board approves the budget. Dorsey instructed that the project should move forward at the fastest possible pace. The Board recessed from 9:35 to 9:40 AM. NURSING HOME PRIVATE PAY RATES: Administration is requesting an increase in private pay rates effective 12/01/03. Swenson questioned if the Nursing Home breaks even at the proposed rates. Krieger said no, to breakeven the rate would have to be over $200/day and then we would not be competitive to other area homes. She conducted a survey of rates at other area homes and the rates are very similar to our rates. Motion: A motion was introduced by Wentz, seconded by Berenschot, and unanimously adopted: That the Board accepts the three levels of private pay rates for the Nursing Home effective 12/01/03 with the following increases: ISN $155 SNF $150 ICF $145 2004 CHILD DAY CARE RATES: Motion: A motion was introduced by Swenson, seconded by Wentz, and unanimously adopted: That the Board approves the proposed child day care rates as presented. (Outline of rates attached at end of minutes.) NURSING HOME ADMISSION/DISCHARGE POLICY: Copies of the waiting list policy, open admissions policy, and admission policy were distributed to Board members for review. A request has been made for a legal opinion on the policies. Krieger said there is a concern for discrimination when no beds are available and we have a waiting list. Krieger said the list is an open referral list and the waiting list is not numbered. She said it is necessary to determine if the Nursing Home is clinically able to take care of the possible admissions before admitting them. Krieger said the policies have been given to Corp Council but that it may be some time before an opinion can be given on them. She also consulted and received an opinion from the legal hotline. She said there would be a cost if we went to an outside source to receive an opinion. Swenson requested Krieger to investigate the cost of an outside opinion and return the issue at the next meeting. It was felt the current policies meet our needs and administration will return to the Board if different recommendations are needed. FAMILY AND CHILDREN'S: Johnson reported on a grant of $20,000 received to process termination of parental rights for children in foster care. He said St. Croix County Health and Human Services Board Page 7 October 10, 2003 four cases have been completed with four children being freed up for adoption. He said there are two more cases pending. The financial savings to the County for freeing these children up for adoption is $2800/month in placement costs. To receive these grant dollars, the County is required to pay the money up front for costs and they provide documentation and submit for reimbursement. Approximately $15,000 has been spent this year on this program. Dorsey asked if there were any other issues to bring before the Board. Motion: A motion was introduced by Wentz, seconded by Berenschot, and unanimously adopted: that the meeting be adjourned. Time: 10:25 AM Chair: Attest: (Secretary)