HomeMy WebLinkAboutHealth & Human Services 10-11-02
ESTHER WENTZ WILL REVIEW VOUCHERS AT 8:00 AM
REVISED
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: 10/11/02
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: 10/24/02
ACTION ON PREVIOUS MINUTES: 09/26/02
ANNOUNCEMENTS
APPOINTMENTS:
UNFINISHED BUSINESS:
NEW BUSINESS:
1. Consideration of Claims and Vouchers
2. Financial Report
3. Personnel Issues
4. Program Reports
a. Nursing Home
b. Economic Support
c. Long Term Support
d. HIPAA Update
5. Setting 2003 Child Day Care Rates
6. Approval of Nursing Home Private Pay Rates effective 12/01/02
7. Review of Wipfli Summary Report
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
X
ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD
October 11, 2002
The St. Croix County Health and Human Services Board met on October 11, 2002
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
Ralph Swenson
Esther Wentz
MEMBERS ABSENT: James Craig, excused
Mary Louise Olson, excused
STAFF PRESENT: John Borup, Health and Human Services Director
Carolyn L. Krieger, Nursing Home Administrator
Judy Ziegler, Accounting Supervisor
Ron Lockwood, Long Term Support Supervisor
Becky Ruka, Accounts Receivable Supervisor
Malva Berg, Secretary
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, October 24, at 6:00 PM.
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 Berenschot,
and unanimously adopted: That the minutes of the 09/26/02 Health and Human
Services Board meeting be approved as circulated
CONSIDERATION OF CLAIMS: The following reports were distributed to the
Board: August unemployment, September fixed assets, September cash report
and September financial report.
Health and Human Services Board member, Wentz, reviewed the following
vouchers:
HUMAN SERVICES:
15576: Allstate Insurance Company, $1,236.31, restitution. We collect
the money from juveniles who have court-ordered restitution
payments. After the collection is complete, we send the money to
the victim. In this case, the victim's insurance company covered
the damage and the restitution payment was made to reimburse the
insurance company.
15807: Brotoloc Health Care Systems, Inc., $4,019.00, Long Term Support.
St. Croix County Health and Human Services Board
Page 2
October 11, 2002
Purchased services for September. Brotoloc's main office is in
Eau Claire. They provide services in St. Croix County (group
homes/apartments) for Long Term Support and Mental Health
clients. The majority of expenses are recouped from Federal and
State funds through the various waiver programs.
Motion: A motion was introduced by Wentz, seconded by Bethke, and
unanimously adopted: That the following vouchers be approved and be made a
part of the supplemental minute book:
Human Services vouchers 15457 through 15530, dated September 19, 2002 in the
amount of $313,643.11.
Human Services voucher 15531, dated September 23, 2002 in the amount of
$400.00.
Human Services vouchers 15532 through 15571, dated September 26, 2002 in the
amount of $234,843.52.
Human Services voucher 15572, dated September 26, 2002 in the amount of
$104.00.
Human Services voucher 15573, dated September 26, 2002 in the amount of
$450.00.
Human Services vouchers 15575 through 15656, dated October 03, 2002 in the
amount of $74,386.49.
Human Services voucher 15657, dated October 04, 2002 in the amount of
$360.00.
Human Services voucher 15658, dated October 07, 2002 in the amount of
$450.00.
Human Services vouchers 15784 through 15906, dated October 11, 2002 in the
amount of $220,105.24.
Human Services vouchers 15659 through 15778, dated October 11, 2002 in the
amount of $85,402.04.
Nursing Home vouchers 2245 through 2252, dated September 19, 2002 in the
amount of $12,589.66.
Nursing Home vouchers 2253 through 2255, dated September 26, 2002 in the
amount of $1,140.50.
Nursing Home vouchers 2256 through 2258, dated October 03, 2002 in the amount
of $3,185.96.
Nursing Home vouchers 2260 through 2298, dated October 11, 2002 in the amount
of $46,165.85.
Human Services and Nursing Home vouchers 465 through 494, dated September 10,
2002 in the amount of $226,658.45.
St. Croix County Health and Human Services Board
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October 11, 2002
Human Services, Workshop, Public Health, social services vouchers 488 through
521, dated September 12, 2002 in the amount of $356,018.09.
Human Services, Workshop, Public Health, Social Services vouchers 522 through
552, dated September 19, 2002 in the amount of $267,093.63.
Human Services and Nursing Home vouchers 495 through 522, dated September 24,
2002 in the amount of $176,645.72.
Human Services, Workshop, Public Health, Social Services vouchers 553 through
586, dated October 04, 2002 in the amount of $359,723.49.
Human Services and Nursing Home vouchers 523 through 552, dated October 08,
2002 in the amount of $212,613.94.
FINANCIAL REPORTS: The following reports through August were distributed.
ST. CROIX COUNTY HUMAN SERVICES BOARD
FINANCIAL SUMMARIES
FOR THE PERIOD 01/01/02 THROUGH 08/31/02
NURSING HOME 08/31/02
Cash Balance 08/31/02 $288,451.93
Add:
Accounts Receivable, 08/31/02
Private Pay $48,982.71
Medicare $211,123.85
Medicaid $242,707.13
General $0.00
Accounts Payable-08/31/02 ($280,687.34)
Net Current Items, 08/31/02 $510,578.28
2002 Revenue Recorded through 08/31/02 $4,662,305.20
Includes Allocations of Anticipated Revenues
2002 Expenses Recorded through 08/31/02 $4,380,016.57
Includes Allocations of Expected Expenses
Excess Revenues over Expenses $282,288.63
• St. Croix County Health and Human Services Board
Page 4
October 11, 2002
HEALTH AND HUMAN SERVICES - 2002
SUMMARY Total
OF REVENUES Jan.-August. Budget Balance %
Administration 622,705.58 786,486.00 163,780.42 79.2%
AODA Services 277,841.26 434,703.00 156,861.74 63.9%
Long Term Support 7,063,707.15 12,358,744.00 5,295,036.85 57.2%
Mental Health 1,555,380.96 2,297,343.00 741,962.04 67.796
Family & Children's 1,887,551.08 2,519,843.00 632,291.92 74.9%
Economic Support 707,031.33 1,095,090.00 388,058.67 64.6%
General Relief 21,522.34 13,494.00 (8,028.34) 159.5%
REVENUES HUMAN
SERVICES PROGRAMS 12,135,739.70 19,505,703.00 7,369,963.30 62.2%
Public Health 858,011.14 1,256,677.00 398,665.86 68.3%
TOTAL REVENUES HEALTH
AND HUMAN SERVICES 12,993,750.84 20,762,380.00 7,768,629.16 62.6%
SUMMARY Total
OF EXPENDITURES. Jan.-August. Budget Balance %
Administration 483,139.26 786,486.00 303,346.74 61.4%
Alcohol-Drug Abuse 240,315.02 434,703.00 194,387.98 55.3%
Long Term Support 7,581,234.46* 12,358,744.00 4,777,509.54 61.3%
Mental Health 1,471,394.09 2,297,343.00 825,948.91 64.0%
Family & Children's 1,656,801.66* 2,519,843.00 863,041.34 65.8%
Economic Support 682,888.36 1,095,090.00 412,201.64 62.4%
General Relief 16,707.81 13,494.00 (3,213.81) 123.8%
Accrued Payroll 356,018.09 0.00 (356,018.09) 0.0%
EXPENDITURES HUMAN
SERVICES PROGRAMS 12,488,498.75 19,505,703.00 7,017,204.25 64.0%
Public Health 778,420.35 1,256,677.00 478,256.65 61.9%
TOTAL EXPENDITURES HEALTH
AND HUMAN SERVICES 13,266,919.10 20,762,380.00 7,495,460.90 63.9%
To be on budget; percentage should be 66.67%.
NURSING HOME OPERATIONS REPORT JAN-JULY 2002 AUGUST
TOTAL OPERATING REVENUES 2,758,130.90 3,166,681.20
St. Croix County Health and Human Services Board
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October 11, 2002
OPERATING EXPENSES:
DAILY PATIENT SERVICES 2,376,061.87 2,723,732.55
SPECIAL SERVICES 162,543.16 185,382.79
GENERAL SERVICES 658,209.64 759,994.21
ADMINISTRATIVE SERVICES 311,892.08 355,595.14
UNASSIGNED:
DEPRECIATION % BASED) 117,250.00 134,000.00
OTHER 195,199.66 221,311.88
TOTAL OPERATING EXPENSES 3,821,156.41 4,380,016.57
ET FROM OPERATIONS 1,063,025.51 1,213,335.37)
ON-OPERATING ITEMS:
REVENUE FROM RATE APPEALS 10,500.00 12,000.00
WAGE PASSTHROUGH REVENUE - -
INTERGOVERNMENTAL TRANSFER (IGT) % BASED) 549,773.00 628,312.00
CO. ALLOCATION % BASED on OPS. LEVY OF $1,282,965 748 398.00 855 312.00
TOTAL NON-OPERATING ITEMS 1,308,671.00 1,495,624.00
EXCESS of REVENUES OVER EXPENSES 245,645.49 282,298.63
INTERFUND 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 245 645.49 282,288.63
CASH REPLENISHMENT BASED on $250,000 for YEAR) 145 833.39 166 666.64
FUND BALANCE, END of PERIOD 1,897,546.57 1,955,022.96
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.
PERSONNEL ISSUES: Borup announced that Marion Curtis has been hired for a
part time RN position in the Nursing Home effective 11/01/02. He also
announced that Matt Zabel has been hired as a Social Worker in the Family and
Children's Unit.
• St. Croix County Health and Human Services Board
Page 6
October 11, 2002
NURSING HOME: The Nursing Home census has remained stable. Krieger said she
attended a meeting in Eau Claire regarding OSHA. It is anticipated that OSHA
will be conducting surprise visits to Nursing Homes and the Nursing Home may
need to review some policies and procedures. She said measures are in place
to keep employees safe but paperwork may need some improvement. Berenschot
said improvements may affect worker's comp costs.
ECONOMIC SUPPORT: Borup said there will be a report on W-2 next month. He
said 2004 may be a year of potential change for W-2. The general relief
policy will be updated for one of the next two meetings.
LONG TERM SUPPORT: The policy on bed banking has changed so that CIP 2 slots
are no longer guaranteed for banked beds that are later closed. Originally
Long Term Support got CIP 2 slots for any closed nursing home beds but that
policy has now changed. The award of slots will depend on what the nursing
home negotiates as part of a phase-down scenario. This is a complex issue
but if there are no additional CIP 2 slots, then the waiting list for Long
Term Support services cannot be reduced.
Lockwood said Community Health Partnership (CHP) is a community-based managed
care organization providing long-term care services to residents of Eau
Claire, Chippewa and Dunn Counties. CHP is considering expanding services to
include residents of Pierce and St. Croix Counties. This is a federal and
state sponsored program that provides a comprehensive range of medical and
support services to persons with long term care needs. Medicare and Medicaid
capitations are the primary funding sources for the program. Services are
targeted to elderly and persons with physical disabilities. Resources
channeled through this program would represent the equivalent of 60 CIP 2
Waiver slots or'$900,000 annually during the first two years. To accomplish
the expansion would require legislative action and support from the
respective county boards of supervisors. Lockwood said expanding into this
program would be the only way to get more monies to service Long Term Support
clients. He said monies for this program are not in the governor's budget now
but could be introduced by legislators. The program would have no County
monies and would be 59% Federally funded and 41% State funded. Board members
expressed concern if the program was expanded and the State and Federal
monies stopped if the County would be obligated to provide the services.
Dorsey questioned if the director of the Community Health Partnership would
be willing to attend a Board meeting. Borup felt it would be a reasonable
risk to expand this program. Lockwood said counties who have piloted this
program have had an impact on decreasing their waiting lists but waiting
lists do continue. An attempt will be made to schedule the Director of the
Community Health Partnership to attend the 10/24/02 Health and Human Services
Board meeting.
2003 CHILD DAY CARE RATES: Borup indicated it was time to set the 2003
rates. Proposed rates are calculated from State survey document. Borup will
have Mary Squyer answer any further questions at next meeting if needed.
Motion: A motion was introduced by Berenschot, seconded by Burri and adopted
with Swenson and Dorsey voting no, That the Board approves the proposed 2003
child day care rates. (Rates are attached at the end of the minutes.)
HIPAA UPDATE: Ruka said the waiver that was filed this spring covers the
entire county so there is no need for each department to file individual
waivers. A meeting regarding HIPAA regulations was held with the Sheriff's
St. Croix County Health and Human Services Board
Page 7
October 11, 2002
department, Tom Boron, Dawn Budrow and Human Services staff. It is
recommended that each county purchase a "GAP" analysis tool to determine
where the county is at with HIPAA compliance. Counties have expressed concern
regarding the time factor to implement HIPAA and the costs associated with
HIPAA and also have expressed concern over the review process as it should be
the state's responsibility to interpret the State statutes. St. Croix County
has identified security groups within the ECHO software, determined which
security group each position belongs to, contact has been made with another
clearinghouse to determine what services could be provided in regards to
being a provider as well as a health plan, reviewed the physical security
within this building, and has begun the documentation process that is
required to measure our compliance.
A "HIPAA Team" needs to be developed to look at various issues that affect
each unit. This will be an ongoing committee. It was the consensus of the
Board that HIPAA should be an ongoing agenda item to further educate members
on HIPAA.
NURSING HOME PRIVATE PAY RATES: Krieger said other facilities were surveyed
to determine the rate of increase to request. Berenschot questioned if these
rates are competitive with other facilities in the area and Krieger said they
were set according to the figures received because of the survey.
Motion: A motion was introduced by Bethke, seconded by Wentz, and unanimously
adopted: That the Board approves the following Nursing Home Private Pay
Rates effective 12/01/02:
ISN $150
SNF $145
ICF $140
WIPFLI SUMMARY REPORT: There were no substantial changes in the document
received from Wipfli and the appendices have not been received. Krieger said
the cost report was sent to Wipfli over two weeks ago but haven't received a
response back from them.
Krieger reminded Board members that the report reflects figures and events to
the end of last year. Berenschot felt the committee should take items that
could be helpful from the report, noting that many improvements/changes had
already been done, and consider implementing any remaining recommendations
that could be helpful to the nursing home. Wentz felt one of the charges to
the Committee was to report back to the full County Board when the report was
completed.
Dorsey asked if there were any other issues to bring before the Board.
Borup noted that Maintenance has fixed the foundation of the Nursing Home and
the foundation looks much better. He said a small amount was placed in the
budget to repair/replace windows in the 1974 building and maintenance has
replaced several windows.
Borup indicated that recently questions have come up about IDP assessments
and who can perform them. He said out of state facilities are not acceptable
to perform assessments to the State of Wisconsin DOT. The IDP assessment
must be performed by Board-approved programs/staff for the assessment to be
valid and accepted by the Wisconsin DOT. The Board-approved facility for St.
St. Croix County Health and Human Services Board
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October 11, 2002
Croix County resident is the St. Croix County Mental Health/AODA unit. The
only exception to the initial assessment being done through the St. Croix
County Mental Health/AODA unit for a St. Croix County resident is if there is
a direct conflict of interest between the Mental Health/AODA unit/staff and
the resident.
Swenson requested to be excused from the 10/24/02 Health and Human Services
meeting.
Motion: A motion was introduced by Berenschot, seconded by Wentz, and
unanimously adopted: that the meeting be adjourned.
Time: 9:50 AM
Chair:
Attest:
(Secretary)
daycare03comparis
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