HomeMy WebLinkAboutHealth & Human Services 09-12-03 X
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: 09/12/03
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: 09/25/03 or 10/10/03
ACTION ON PREVIOUS MINUTES: 08/08/03
ANNOUNCEMENTS
APPOINTMENTS:
UNFINISHED BUSINESS:
NEW BUSINESS:
1. Consideration of Claims and Vouchers
2. Financial Report
3. Presentation and action on 2004 Budget for Health and Human Services and
Nursing Home
4. Nursing Home "Bad Debt Write Offs"
5. Discussion of Resolutions the Wisconsin Counties Association will consider
regarding the following subjects:
#7 Raising mileage reimbursement for volunteers
#8 Recertification of food managers
#9 Family Planning Demonstration Project
#10 Legislative changes to temporary assistance to needy families
#11 Prohibiting sale of mercury fever thermometers
#12 Maintain funding for Tobacco Control Board
#13 Support for WIC Program
#14 Support increased MA funding
#15 Oppose closing of Northern Center for Developmentally Disabled
#16 Support proper funding of community placements from Northern Center
#17 Support legislation for Americans to purchase Canadian prescription
drugs
#18 Request audit waiver to purchase of service contracts to be raised to
$100,000 level
#19 Support increased State funding for developmentally disabled
#30 Support Federal legislation to change Medicare formulas
#31 Allows RNs to evaluate patients placed in isolation or restraints
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
September 12, 2003
The St. Croix County Health and Human Services Board met on September 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
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
Judy Ziegler, Accounting Supervisor
Lisa Leahy, Director of Social Services-Nursing Home
Malva Berg, Secretary
OTHERS PRESENT: Chuck Whiting, Administrative Coordinator
Michelle Pietrick, County Finance Director
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, September 18 at 8:00 AM. The following meeting will be held on
Friday, October 10 at 8:30 AM. Bethke will review vouchers in October.
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 Wentz, seconded by Berenschot,
and unanimously adopted: That the minutes of the 08/08/03 Health and Human
Services Board meeting be approved.
CONSIDERATION OF CLAIMS: The following reports were distributed to the
Board: August cash report, July unemployment report, and August fixed asset
report.
Health and Human Services Board member, Wentz, reviewed the following
vouchers:
HUMAN SERVICES:
3027: Rowe Funeral Home, $2,500.00, funeral expense. We are reimbursed in full by the
State on this bill.
3155: Carlson Travel, $705.50, foster care expense. The County purchased a plane ticket
to send a juvenile back home to Tennessee for care. Estimated cost to care for the
juvenile in an institution here is $7,500 per month.
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St. Croix County Health and Human Services Board
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September 12, 2003
3280: Beebe Mortuary, $2,192.50, funeral expense. We pay only one funeral home for each
burial. If there are three or four checks to funeral homes in a particular month,
then that is the number of people who have died. The cost to the county will vary
depending on the assets the deceased had that could legally be paid toward their
burial.
Motion: A motion was introduced by Wentz, seconded by Burri, and unanimously
adopted: That the following vouchers be approved and be made a part of the
supplemental minute book:
Human Services vouchers 2633 through 2710, dated August 14, 2003 in the
amount of $250,362.58.
Human Services vouchers 2967 through 3044, dated August 21, 2003 in the
amount of $242,755.00.
Human Services vouchers 3096 through 3134, dated August 28, 2003 in the
amount of $198,058.16.
Human Services vouchers 3138 through 3154, dated August 28, 2003 in the
amount of $36,417.48.
Human Services voucher 3155, dated August 28, 2003 in the amount of $705.50.
Human Services vouchers 3246 through 3358, dated September 04, 2003 in the
amount of $196,076.33.
Human Services vouchers 3772, dated September 09, 2003 in the amount of
$2,084.00.
Human Services vouchers 4419 through 4594, dated September 12, 2003 in the
amount of $294,383.38.
Human Services vouchers 4595 through 4839, dated September 12, 2003 in the
amount of $84,002.48.
Nursing Home vouchers 2602 through 2632, dated August 14, 2003 in the amount
of $28,696.61.
Nursing Home vouchers 2961 through 2966, dated August 21, 2003 in the amount
of $1,584.52.
Nursing Home vouchers 3095, dated August 28, 2003 in the amount of $971.91.
Nursing Home vouchers 4840 through 4908, dated September 12, 2003 in the
amount of $37,048.46.
Human Services and Nursing Home vouchers 433 through 462, dated August 12,
2003 in the amount of $187,993.64.
Human Services, Workshop, Public Health, Social Services vouchers 423 through
451, dated August 12, 2003 in the amount of $331,127.65.
Human Services and Nursing Home vouchers 463 through 492, dated August 26,
2003 in the amount of $179,596.93.
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St. Croix County Health and Human Services Board
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September 12, 2003
Human Services, Workshop, Public Health, Social Services vouchers 452 through
479, dated August 28, 2003 in the amount of $326,889.01.
Human Services and Nursing Home vouchers 493 through 522, dated September 09,
2003 in the amount of $181,167.99.
Human Services, Workshop, Public Health, Social Services vouchers 480 through
508, dated September 09, 2003 in the amount of $328,445.25.
FINANCIAL REPORTS: The following financial reports through July were
distributed. The Nursing Home report includes the adjustment in the MA rate
but does not reflect staff reduction. Krieger said Medicare days are down
from what was budgeted due to downsizing in the Nursing Home. Krieger said
the Medicaid population did not decrease during the downsizing process so the
patient ratio for Medicaid to Medicare was affected.
ST. CROIX COUNTY HUMAN SERVICES BOARD
FINANCIAL SUMMARIES
FOR THE PERIOD 01101/03 THROUGH 07/31/03
NURSING HOME Fir OuaXte Second Oua1^tnr July 20nI
Cash Balance 07/31/03 $481,269.48 $802,693.44 $591,907.75
Add:
Accounts Receivable, 07/31/03 $483,281.50 $414,006.71 $346,425.88
Accounts Payable-07/31/03 ($204,004.29) ($382,430.92) ($253,519.84)
Net Current Items, 07/31/03 $760,546.69 $834,269.23 S684.813.79
2003 Revenue Recorded through 07/31/03 $1,539,011.74 $3,121.737.53 S3,692.590.06
Includes Allocations of Anticipated Revenues
2003 Expenses Recorded through 07/31/03 $1,567,98B.39 $3,185,855.02 S3,706.926.90
Includes Allocations of Expected Expenses
Excess Revenues over Expenses ($28,976.65) ($64,117.49) ($14,336.84)
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St. Croix County Health and Human Services Board
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September 12, 2003
HEALTH AND HUMAN SERVICES - 2003
SUMMARY Total
OF REVENUES Jan.-July. Budget Balance %
Administration 575 625.70 763,412.00 187,786.30 75.4%
AODA Services 271,B55.35 440,846.00 168,990.65 61.7%
Long Term Support 7,244,972.29 12,731,125.00 5,486,152.71 56.9%
Mental Health 1,278,991.59 2,381,245.00 1,102,253.41 53.7%
Family & Children's 1,650,135.00 2,646,969.00 998,834.00 62.3%
Economic Support 722,867.77 1,025,999.00 303,131.23 70.5%
General Relief 1,642.60 18,663.00 17,020.40 8.8%
REVENUES HUMAN
SERVICES PROGRAMS 1 746 0 0 30 D 010 59 00 8,264-16R 70 58_7%
Public Health 830.394 7575 1.347.443 DO 517517 u49 sS 616
TOTAL REVENUES HEALTH
AND HUMAN SERVICES 12.576.485.0 21,357 70 DO 8.781 16 5 5858.9%
SUMMARY Total
OF EXPENDITURES Jan.-July. Budget Balance %
Administration 439,917.41 763,412.00 323,494.59 57.6%
Alcohol-Drug Abuse 261,452.60 440,846.00 179,393.40 59.3%
Long Term Support 7,627,681.73 * 12,731,125.00 5,103,443.27 59.9%
Mental Health 1,485,329.95 2,381,245.00 895,915.05 62.4%
Family & Children's 1,490,103.28 * 2,648,969.00 1,158,865.72 56.3%
Economic Support 651,843.82 1,025,999.00 374,155.1E 63.5:
General Relief 4,329.23 18.663.00 14,333.77 23.2%
Accrued Payroll 0.00 0.00 0.00 0.0%
EXPENDITURES HUMAN
SERVICES PROGRAMS 11,960,65B.02 20,010,259.00 8,049,600.96 59.8%
Public Health 768 187 75 1 347.443.00 579.255_2S 57_0%
TOTAL EXPENDITURES HEALTH
AND HUMAN SERVICES 12.728 84 77 21 7 7D 00 8.62E_856 3 59_6%
To be on budget, percentage should be 58.33%
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St. Croix County Health and Human Services Board
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September 12, 2003
ST CROIX HEALTH CENTER
OPERATIONS REPORT
JANUARY THROUGH JULY 2003 JAN-JULY
BUDGET ACTUAL DIFFERENCE
CENSUS 88 85 31 3.41%:
OPERATING REVENUE:
'MEDICARE $ 1,254,708.00: $ 517,823.93 $ 736,884.07 ` 41.27%
MEDICAID 2,929,061.00 $ 1,676,721.90 $ 1,260,914.23 57.24%.
PRIVATE PAY $ 1102016.00 $ 460,067.34 $ 56_5_,2'48-_6_ 6__';' 44.87%
ALL OTHER SOURCES $ 1,117.00 $ 20,024.24 $ (18,907.24) 1792.68%
TOTAL OPERATING REVENUE $ 5,210,202.00 $ 2,674,637.41 $ 2,544,139.72 ' 51.33%
OPERATING EXPENSES:
DAILY PATIENT SERVICES $ 4_ ,252,427.00 ' $ 2,262,406.97 $ 1,990,020.03 ' 53.20%
SPECIAL SERVICES $ 300,748.00 $ 171,230.23 $ 129,517.77 56.93%
GENERAL SERVICES $ 1,279,983.00 $ 670,806.13 $ 609,176.87 ; 52.411.%.1
,ADMINISTRATIVE SERVICES $ 507,779.00 $ 281,766.30 $ _226,012.70 55.49%
UNASSIGNED.-
.DEPRECIATION(%BASED) $ $ 108,598.00 $ (108,598.00) 57.65%1
OTHERS $ 367,926.00 $ 212,119.27 $ 155,806.73 55.25%
-TOTAL OPERATING EXEPNSES $ 6,708,863.00 $ 3,706,926.90 $ 31001,936.10
NET FROM OPERATIONS $ (1,032,289.49)
NON-OPERATING ITEMS:
REVENUE FRAM RATE_AP_ PEALS $ 14,808.00 $ 8,638.00 $ 6,170.00 ' 58.33%
ITG FUNDS (%BASED) $ 798.386..00: $ 474,831.00 ; $ 323,555.00 59.47°l0
CO ALLOCATION (%BASED) $ 685,467.00 $ 399,854.00 $ 285,613.00 = 58.33%`
TOTAL NON-OPERATING ITEMS
$ 1,498,661.00 883,323.00 $ 615,338.00 - 58.94%
MA BED REDUCTION EST FUNDS $ 134,629.65
NET FROM ALL SOURCES $ - $ (14,336.84)
PERCENTAGE SHOULD BE 58.33
FUND BALANCE 01/01/03 AUDITED $ 1,684,566.10
PRIOR OPERATIONS
$ (14.336.84) CASH REPLENISHMENT(%$250,000) $ 145,833.00
FUND BALANCE END OF PERIOD $ 1,816,062.26
2004 NURSING HOME BUDGET PROPOSAL: Krieger distributed a summary document
for the Nursing Home 2004 budget based on the best estimate for operations'
with remodeling costs to be added later. The budget is based on all 72 beds
being filled in 2004. Krieger will request an increase in private pay rates
effective January 1, 2004. The Nursing Home has not received bedhold for
years but it is included in the 2004 budget. When a resident is in the
hospital, LOA, etc. and the Nursing Home is at 950 occupancy, the State will
pay at 85% of the rate for bedhold. Private pay residents have a 100% charge
for bedhold. Krieger pointed out that the operations levy is up due to 2004
being a leap year.
St. Croix County Health and Human Services Board
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September 12, 2003
Remodeling costs for the Nursing Home have been received in bits and pieces.
If the architect could get proposals out in October, costs could run less as
it would be off-season. However, the remodeling is not budgeted for 2003 but
there may be monies in the building fund to cover the remodeling costs.
There will be no or little savings in staff costs with remodeling but there
will be greater efficiency. The original estimate for remodeling costs was
$110,000 and now it is $235,000. A final report has not been received from
the architect. Robole and the architect will be at the meeting when the
budget numbers are close to final.
Swenson recommended increasing the budget 10% for the remodeling fund.
Swenson also recommended increasing the software budget as there is a need to
invest in better tools for software in the future. It was the consensus of
the Board that the census figure for the 2004 budget should be reduced by 1.5
residents to reflect a most probable case scenario.
It was questioned how many hospice rooms would be in the Nursing Home. There
will be two hospice beds, one on each floor. These are non-licensed beds.
The Board recessed from 9:50 to 10:05.
NURSING HOME BAD DEBTS WRITE OFFS:
Motion: A motion was introduced by Burri, seconded by Bethke, and
unanimously adopted: That the Board approves writing off the following bad
debts for the Nursing Home:
Resident #1 = $ 17.09
Resident #2 = 1,086.09
Resident #3 = 220.79
Resident #4 = 844.25
Resident #5 = 1,198.07
Resident #6 = 2,440.56
Resident #7 = 2,945.00
DISCUSSION OF RESOLUTIONS THE WISCONSIN COUNTIES ASSOCIATION WILL CONSIDER
REGARDING THE FOLLOWING SUBJECTS: Berenschot requested support for the
following resolutions to be submitted to the WCA Convention on September 16,
2003. Resolutions require full County Board approval to be official and there
is not enough time to bring these to the full County Board before the
convention. The Board reviewed the resolutions individually.
#7 Raising mileage reimbursement for volunteers. The Board
supports this resolution.
#8 Recertification of food managers. The Board supports this
resolution.
#9 Family Planning Demonstration Project. The Board supports this
resolution.
#10 Legislative changes to temporary assistance to needy families.
The Board supports this resolution with an amendment to see
results measuring success.
#11 Prohibiting sale of mercury fever thermometers. The Board
supports this resolution.
#12 Maintain funding for Tobacco Control Board. The Board supports
this resolution with an amendment to have a tool to measure
success. The Tobacco Control Board no longer exists but would
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St. Croix County Health and Human Services Board
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September 12, 2003
propose a changed to fund to the minimum CDC guidelines.
#13 Support for WIC Program. The Board supports this resolution.
#14 Support increased MA funding. The Board supports this resolution
with an amendment on the second "Whereas" to include personal
care, nursing homes, private duty nursing.
#15 Oppose closing of Northern Center for Developmentally Disabled.
The Board supports this resolution with the title changed to
conform with the message in the resolution.
#16 Support proper funding of community placements from Northern
Center. The Board supports this resolution.
#17 Support legislation for Americans to purchase Canadian
prescription drugs. The Board opposes this resolution.
#18 Request audit waiver to purchase of service contracts to be
raised to $100,000 level. The Board supports this resolution.
#19 Support increased State funding for developmentally disabled.
The Board supports this resolution.
#30 Support Federal legislation to change Medicare formulas. The
Board supports this resolution.
#31 Allows RNs to evaluate patients placed in isolation or
restraints. The Board supports this resolution.
Motion: A motion was introduced by Berenschot, seconded by Wentz, and
unanimously adopted: That the Board supports all of the above resolutions
except for Resolution #17.
NURSING HOME ADMISSION/DISCHARGE POLICY: Kretz said out of county Nursing
Home residents should go back to their own county if it is financially
beneficial for St. Croix County. There are currently three out of county
residents in the Nursing Home. Leahy said priority is given to St. Croix
County residents for admission to the Nursing Home. The Board requested
staff to draft a written admission/discharge policy for the Nursing Home and
to bring back to the Board in October.
Dorsey asked if there were any other issues to bring before the Board.
Motion: A motion was introduced by Berenschot, seconded by Wentz, and
unanimously adopted: that the meeting be adjourned.
Time: 11:40 AM
Chair:
Attest:
(Secretary)