HomeMy WebLinkAboutHealth & Human Services 11-12-02
LEON BERENSCHOT 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: 11/12/02
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: 11/26/02 (Tuesday), following meeting 12/11/02
ACTION ON PREVIOUS MINUTES: 10/24/02
ANNOUNCEMENTS
APPOINTMENTS:
UNFINISHED BUSINESS:
1. Consideration and Action to join 9-County Western Wisconsin Regional Public
Health Partnership for Preparedness
NEW BUSINESS:
1. Consideration of Claims and Vouchers
2. Financial Report
3. Program Reports
a. Nursing Home
b. Mental Health/AODA
c. Family & Children's
d. HIPAA
4. Review of updated Juvenile Foster Care handbook
5. Request to seek bids for 20 passenger bus for St. Croix Industries
6. Personnel issues
7. Action to approve Nursing Home Medicare Consultant
8. Scheduling future Board meetings
9. Review of employee performance evaluation form
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
November 12, 2002
The St. Croix County Health and Human Services Board met on November 12, 2002
at the St. Croix County Health and Human Services/Health Center complex.
MEMBERS PRESENT: Thomas Dorsey, Chair
Leon Berenschot
Chris Bethke
James Craig
Fern Johnson-Schmidt
Mary Louise Olson
Ralph Swenson
Esther Wentz
MEMBERS ABSENT: Lois Burri, excused
STAFF PRESENT: Carolyn L. Krieger, Nursing Home Administrator
Judy Ziegler, Accounting Supervisor
Ron Kiesler, AODA/Mental Health Coordinator
Kathy Dunlap, Family and Children's Supervisor
Ron Eichstaedt, St. Croix Industries Supervisor
Fred Johnson, Family and Children's Supervisor
John Bretl, Foster Care Coordinator
Barbara Nelson, Public Health Supervisor-Health Officer
Becky Ruka, Accounts Receivable Supervisor
Malva Berg, Secretary
OTHERS PRESENT: Rich Loney, Chief Accountant/Auditor
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, December 12th at 8:30 AM. The November 26th meeting will not be
held unless important agenda items arise.
AGENDA: Motion: A motion was introduced by Berenschot, seconded by Swenson,
and unanimously adopted: That the agenda be approved as circulated.
MINUTES: Motion: A motion was introduced by Wentz, seconded by Johnson-
Schmidt, and unanimously adopted: That the minutes of the 10/24/02 Health
and Human Services Board meeting be approved as corrected below:
Page 3, paragraph 3...Krieger stated the schedule was reduced by 12.61 FTE's
and the budget amount was decreased by $361,718...
Consideration and Action to join 9-County Western Wisconsin Regional Public
Health Partnership for Preparedness: A copy of the Memorandum of Understanding
for the Western Region Partnership for Public Health Preparedness is attached
at the end of the minutes. Polk County has agreed to be the fiscal agent but
the consortium will serve all nine counties. Olson questioned the qualification
of employees. Nelson said the consortium will coordinate with Emergency
Management but will be employees of Public Health.
St. Croix County Health and Human Services Board
Page 2
November 12, 2002
Motion: A motion was introduced by Berenschot, seconded by Swenson, and
unanimously adopted: That the Board approves the memorandum of Understanding
for the Western Region Partnership for Public Health Preparedness and approves
Tom Dorsey signing the MOU.
Nelson updated the Board on the Influenza Pandemic tabletop exercise that was
held. She also reported the death of a 20-year-old UWRF student from
meningococcal disease. The cause and who is at risk are currently under
investigation. Nelson said flu shots are available in Public Health.
CONSIDERATION OF CLAIMS: The following reports were distributed to the
Board: October fixed assets, October cash report and September financial
report.
Health and Human Services Board member, Berenschot, reviewed the following
vouchers:
HUMAN SERVICES:
15923: Spring Valley Health Care Center, $3,851.75. Long Term Support Purchased Services.
We are purchasing supportive home care services for waiver clients in their homes.
This service is not in the nursing home.
15997: Myrna Prinsen, $215.00 respite. Purchase of respite services for Long Term Support
client.
15971: Everts Funeral Home, $1,096.00, funeral expense. Funeral expense paid by the State
through the W-2 program.
15960: Cashman Mortuary, $1,400.00, funeral expense. Funeral expense for a non W-2
client. This will be reimbursed by the State. The difference between this bill and
the previous one is due to different funeral costs and assets of the two clients.
16111: Thomas Allen, Inc. $3,886.42. Long Term Support purchased services. This is a new
provider for clients in the waiver program. They provide supervised living housing
for Long Term Support clients.
16074: Cumberland Memorial Hospital, $2,480.00. Mental Health purchased services. Cost of
care for a client with mental health inpatient needs.
NURSING HOME:
2304: Lakeview Engraving, $69.55, nursing expense. Engraving name tags for employee
badges.
2330: Cemstone Ready Mix, $554.80, maintenance expense. Expense supplies to correct
sunken slab by Nursing Home generator.
Motion: A motion was introduced by Berenschot, seconded by Bethke, and
unanimously adopted: That the following vouchers be approved and be made a
part of the supplemental minute book:
Human Services voucher 15907, dated October 16, 2002 in the amount of
$729.00.
Human Services vouchers 15908 through 15951, dated October 17, 2002 in the
amount of $118,794.22.
St. Croix County Health and Human Services Board
Page 3
November 12, 2002
Human Services voucher 15952, dated October 21, 2002 in the amount of
$450.00.
Human Services vouchers 15953 through 16014, dated October 24, 2002 in the
amount of $167,401.41.
Human Services vouchers 16015 through 16049, dated October 31, 2002 in the
amount of $176,352.83.
Human Services vouchers 16051 through 16117, dated November 07, 2002 in the
amount of $189,340.95.
Human Services vouchers 16120 through 16240, dated November 12, 2002 in the
amount of $36,792.77.
Human Services vouchers 16241 through 16351, dated November 12, 2002 in the
amount of $65,113.62.
Nursing Home vouchers 2300 through 2313, dated October 17, 2002 in the amount
of $7,401.48.
Nursing Home vouchers 2315 through 2321, dated October 21, 2002 in the amount
of $5,529.61.
Nursing Home vouchers 2322 through 2323, dated October 31, 2002 in the amount
of $82.00.
Nursing Home vouchers 2324 through 2326, dated November 07, 2002 in the
amount of $666.58.
Nursing Home vouchers 2327 through 2358, dated November 12, 2002 in the
amount of $30,231.63.
Human Services, Workshop, Public Health, Social Services vouchers 587 through
617, dated October 22, 2002 in the amount of $269,029.25.
Human Services and Nursing Home vouchers 553 through 581, dated October 22,
2002 in the amount of $158,171.06.
Human Services, Workshop, Public Health, Social Services vouchers 618 through
651, dated November 05, 2002 in the amount of $362,798.25.
Human Services and Nursing Home vouchers 582 through 611, dated November 05,
2002 in the amount of $214,566.28.
FINANCIAL REPORTS: Jane Gottwald, MA Auditor is currently working on the
Nursing Home MA rate. The rate will go back to July 1, 2002. Ziegler said
IGT funds are expected to arrive in November or December. Paulson completed
the compliance audit and it went well. This portion of the audit focuses on
State/Federal regulations. The following reports through September were
distributed:
St. Croix County Health and Human Services Board
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November 12, 2002
ST. CROIX COUNTY HUMAN SERVICES BOARD
FINANCIAL SUMMARIES
FOR THE PERIOD 01/01/02 THROUGH 09/30/02
NURSING HOME 09/30/02
Cash Balance 09/30/02 $138,345.60
Add:
Accounts Receivable, 09/30/02
Private Pay $51,781.62
Medicare $200,283.80
Medicaid $245,451.06
General $0.00
Accounts Payable-09/30/02 ($258,193.82)
Net Current Items, 09/30/02 $377,668.26
2002 Revenue Recorded through 09/30/02 $5,202,621.80
Includes Allocations of Anticipated Revenues
2002 Expenses Recorded through 09/30/02 $4,914,876.97
Includes Allocations of Expected Expenses
Excess Revenues over Expenses $287,744.83
St. Croix County Health and Human Services Board
Page 5
November 12, 2002
HEALTH AND HUMAN SERVICES - 2002
SUMMARY Total
OF REVENUES Jan.-Sept. Budget Balance
Administration 670,368.16 786,486.00 116,117.84 85.2%
AODA Services 310,131.58 434,703.00 124,571.42 71.3%
Long Term Support 8,352,552.11 12,358,744.00 4,006,191.89 67.6%
Mental Health 1,667,883.74 2,297,343.00 629,459.26 72.6%
Family & Children's 2,084,875.51 2,519,843.00 434,967.49 82.7%
Economic Support 897,325.87 1,095,090.00 197,764.13 81.9%
General Relief 24,058.43 13,494.00 (10,564.43) 178.3%
REVENUES HUMAN
SERVICES PROGRAMS 14,007,195.40 19,505,703.00 5,498,507.60 71.8%
Public Health 953,797.04 1,256,677.00 302,879.96 75.9%
TOTAL REVENUES HEALTH
AND HUMAN SERVICES 14,960,992.44 20,762,380.00 5,801,387.56 72.1%
SUMMARY Total
OF EXPENDITURES Jan.-Sept. Budget Balance %
Administration 548,972.66 786,486.00 237,513.34 69.8%
Alcohol-Drug Abuse 266,719.67 434,703.00 167,983.33 61.4%
Long Term Support 8,480,044.50* 12,358,744.00 3,878,699.50 68.6%
Mental Health 1,656,629.25 2,297,343.00 640,713.75 72.1%
Family & Children's 1,861,430.98* 2,519,843.00 658,412.02 73.9%
Economic Support 757,986.21 1,095,090.00 337,103.79 69.2%
General Relief 16,926.10 13,494.00 (3,432.10) 125.4%
Accrued Payroll 293,802.99 0.00 (293,802.99) 0.0%
EXPENDITURES HUMAN
SERVICES PROGRAMS 13,882,512.36 19,505,703.00 5,623,190.64 71.2%
Public Health 871,056.05 1,256,677.00 385,620.95 69.3%
TOTAL EXPENDITURES HEALTH
AND HUMAN SERVICES 14,753,568.41 20,762,380.00 6,008,811.59 71.1%
To be on budget, percentage should be 75.00%.
NURSING HOME OPERATIONS REPORT JAN-AUGUST SEPTEMBER
TOTAL OPERATING REVENUES 3,166,681.20 3,520,044.80
St. Croix County Health and Human Services Board
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November 12, 2002
OPERATING EXPENSES:
DAILY PATIENT SERVICES 2,723,732.55 3,059,944.51
SPECIAL SERVICES 185,382.79 208,748.43
GENERAL SERVICES 759,994.21 855,156.63
ADMINISTRATIVE SERVICES 355,595.14 390,812.32
UNASSIGNED:
DEPRECIATION % BASED 134,000.00 150,750.00
OTHER 221,311.88 249,465.08
TOTAL OPERATING EXPENSES 4,380,016.57 4,914,876.97
ET FROM OPERATIONS 1,213,335.37 1,394,832.17
ON-OPERATING ITEMS:
REVENUE FROM RATE APPEALS 12,000.00 13,500.00
WAGE PASSTHROUGH REVENUE - -
INTERGOVERNMENTAL TRANSFER IGT % BASED 628,312.00 706,851.00
CO. ALLOCATION % BASED on OPS. LEVY OF $1,282,965 855 312.00 962 226.00
TOTAL NON-OPERATING ITEMS 1,495,624.00 1,682,577.00
EXCESS of REVENUES OVER EXPENSES
TERFUND 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 282 288.63 287,744.83
CASH REPLENISHMENT % BASED on $250,000 for YEAR) 166 666.64 187 500.00
FUND BALANCE, END of PERIOD 1,955,022.96 1,981,312.52
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.
St. Croix County Health and Human Services Board
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November 12, 2002
OPERATING EXPENSES:
DAILY PATIENT SERVICES 2,723,732.55 3,059,944.51
SPECIAL SERVICES 185,382.79 208,748.43
GENERAL SERVICES 759,994.21 855,156.63
ADMINISTRATIVE SERVICES 355,595.14 390,812.32
UNASSIGNED:
DEPRECIATION % BASED 134,000.00 150,750.00
OTHER 221,311.88 249,465.08
TOTAL OPERATING EXPENSES 4,380,016.57 4,914,876.97
ET FROM OPERATIONS 1,213,335.37 1,394,832.17
ON-OPERATING ITEMS:
REVENUE FROM RATE APPEALS 12,000.00 13,500.00
WAGE PASSTHROUGH REVENUE - -
INTERGOVERNMENTAL TRANSFER IGT % BASED 628,312.00 706,851.00
CO. ALLOCATION % BASED on OPS. LEVY OF $1,282,965 855 312.00 962 226.00
TOTAL NON-OPERATING ITEMS 1,495,624.00 1,682,577.00
EXCESS of REVENUES OVER EXPENSES 282,288.63 287,744M
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 282 288.63 287,744.83
CASH REPLENISHMENT BASED on $250,000 for YEAR 166 666.64 187 500.00
FUND BALANCE, END of PERIOD 1,955,022.96 1,981,312.52
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.
St. Croix County Health and Human Services Board
Page 7
November 12, 2002
NURSING HOME: Krieger said the Nursing Home census today is 92 with one
admission pending. Krieger distributed a staff newsletter, which was
implemented to try to improve communications with staff. She said the
December newsletter will be included with the paychecks so all Nursing Home
employees will receive it.
Krieger said after meeting with nurses, it was the consensus to put the case
manager concept on hold for now until the State changes MDS, etc.
requirements and have a unit or head nurse position.
Krieger said maintenance installed a wheelchair washer without her knowledge.
The washer is located across from the tub room, which would mean staff would
have to leave a resident alone in order to bring the wheelchair across the
hall to be washed while the resident is bathing. Krieger said this is not
acceptable and the washer will be removed. Board members were concerned how
this was installed without Krieger's knowledge and that policy be in place
that something like that doesn't happen again. Krieger said she and Borup
meet with Maintenance staff every Monday.
Krieger updated the Board on the software transition in the Nursing Home.
She said the support for the current system will end the end of December. The
Nursing Home started transitioning to the new software the beginning of
September. She said there are some issues with the current software, with the
biggest issue being that the new software cannot bill Wisconsin MA or Federal
Medicare. She said she sent a letter to the company the end of October
outlining the concerns with the new software and is holding payment on the
invoice for training and $20,000 transition fee until the issue is resolved.
She said we are the only facility in the area that is transitioning to this
system. Krieger will report this issue further at the Information Systems
meeting. The Nursing Home billing is now being done on the DOS LTC Systems as
the new system doesn't work. This results in double entry with support for
the LTC Systems software ending in December and the new software not being
available for billing until spring. She said Tom Boron and Jim Williams of
Computer Services are aware of the problems the Nursing Home is experiencing.
The Federal Quality Measure Release was distributed to Board members. She
said this report does not indicate quality of care in the Nursing Home as the
quality has not been defined.
NURSING HOME MEDICARE CONSULTANT: The Nursing Home has used a Medicare
Consultant for the last four years due to the complication of the Medicare
rules and the ever-changing interpretation of those rules. The Nursing Home
currently has a contract through 03/03 for Medicare consultation with
Specialized Medical Services, Inc. (SMS). Three bids for Medicare
consultation services by phone were received.
Motion: A motion was introduced by Berenschot, seconded by Wentz, and
unanimously adopted: That the Board approves staying with SMS for Medicare
consultation.
Board members questioned if the template for the Nursing Home and the
appendices for the report was received from Wipfli. Krieger said the
template has been received but the appendices have not arrived. She said the
numbers on the template are off due to the number of holidays in the first
half of the year so she is working to make the comparisons.
St. Croix County Health and Human Services Board
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November 12, 2002
The Board recessed from 9:45 to 9:50.
REQUEST TO SEEK BIDS FOR 20-PASSENGER BUS FOR ST. CROIX INDUSTRIES:
Eichstaedt requested permission to seek bids for a new 20-passenger bus for
St. Croix Industries. The 2003 budget includes monies to obtain two vehicles
with payments spread out over four years. Eichstaedt said the bids will
probably be reviewed at the January meeting and it takes about six months to
actually receive a vehicle. He said there is increasing paperwork with a
lease/purchase of a vehicle compared to purchasing a vehicle outright. Loney
said it may be possible to get a State trust fund loan at about 4% interest,
which the County has done before, but needs to be approved by the full County
Board. Another option to consider would be funding through a bond issue. He
said a consultant is usually needed to float the issue and interest may be
less than 4%. Loney suggested the ideal way to do this would be to fund
yourself when there is a recurring expense. Dorsey requested that Loney,
Ziegler and Eichstaedt meet to explore the best option to finance the bus.
Motion: A motion was introduced by Berenschot, seconded by Wentz, and
unanimously adopted: That the Board approves advertising for bids for a new
20-passenger bus for St. Croix Industries.
FAMILY AND CHILDREN'S: Dunlap said Family and Children's went live with all
staff with WISACWIS on 10/28. She said a new T1 line was installed which
dramatically speeds up the system. She said the system is slow at times with
only 20 counties currently on WISACWIS and doesn't know how the system will
run when all 72 are live. The trainers are amazed how positive St. Croix
County staff have been with this process and have commented that they are
quick learners. Dunlap said she is concerned with the number of people who
have access to WISACWIS system. She said other counties have given mental
health access and some private vendors have access to the system. She said
anyone can make a report which may be found to be false later but there are
no safeguards in place and that report cannot be erased, so confidentiality
is an issue. St. Croix County does not release records without a court order.
MENTAL HEALTH/AODA: Kiesler said the number of Mental Health commitments and
emergency detentions continue to increase this year. Due to this a new
tracking system has been developed. He said CSP case managers will track
anyone under a Mental Health commitment until or unless they are involved in
Mental Health Services through the County. Tracking includes monitoring their
compliance with the provisions of the commitment, providing assistance and
referrals when needed, completing the necessary documentation for the court,
etc. The goal is to provide timely intervention when needed in an effort to
prevent re-hospitalization and the costs associated with that. Kiesler said
the request for services outpaces the growth in the County.
HIPAA: Ruka reported the GAP Analysis tool has been delivered to the County
and the process has begun to answer the questions related to transactions,
privacy and security. Ruka will be conducting a department "walk through"
with department managers to determine if there are areas within the
department that may not be physically compliant with HIPAA privacy/security.
Ruka is still investigating a clearinghouse for electronic claims. It is
possible that paper claims for primary insurance may be eliminated by the end
of the year and all claims will be submitted electronically.
REVIEW OF UPDATED JUVENILE FOSTER CARE HANDBOOK: A draft of the updated St.
Croix County Foster Parent Handbook was distributed to Board members. Johnson
St. Croix County Health and Human Services Board
Page 9
November 12, 2002
highlighted various areas of the handbook. Foster care licensing criteria is
outlined in the handbook. Johnson mentioned that foster parents are not
allowed to sponsor foster children for driver's licenses as the county would
be in the loop of liability. This is somewhat of a conflict for older foster
children in that they are also being prepared for independent living. Johnson
said there are currently no children in foster care who are driving.
Berenschot questioned if use of a trampoline is addressed in the handbook.
He also questioned the limits of liability required for insurance. Neither
of these are in the handbook and Johnson will address this and get more legal
guidance from Corp Counsel. Risk management and Corp Counsel will review the
handbook before it is finalized.
PERSONNEL ISSUES: Kiesler said Jennifer Rodriquez has resigned as CSP Social
Worker and Jessica Blaiser has been hired to replace her.
Bethke left the meeting at 11:00.
SCHEDULING OF FUTURE BOARD MEETINGS: Finance Committee set 2003 meetings to
be held the Thursday nearest the 10th of the month. Swenson suggested the
Health and Human Services Board meeting be held the Friday after Finance
meets. Swenson questioned if it was possible to have one meeting per month or
to have both meetings during the day on a trial basis.
Motion: A motion was introduced by Swenson, seconded by Wentz, and adopted
with Berenschot voting no, That the first meeting of the month for the Health
and Human Services Board be held on the second Friday of the month for 2003.
REVIEW OF EMPLOYEE PERFORMANCE EVALUATION FORM: Members questioned Board
input into performance evaluations. The Board and Chuck Whiting complete the
Director's evaluation in closed session. Questioned if the evaluation form
could be retooled to be job specific but members felt the evaluation was tied
to the Hay System and should not be changed. Evaluations are currently being
done on the employee's anniversary and members felt they should be done at
the end of the year. Suggestion was made to have a closed session to discuss
this issue further.
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: 11:35 AM
Chair:
Attest:
(Secretary)
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consortium contract
agreement.doc