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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 Page 3 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 Page 5 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 Page 8 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 ons.doc