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HomeMy WebLinkAboutHealth & Human Services 01-24-02 C Y ST. CROIX COUNTY NOTICE OF COMMITTEE MEETING TO: Thomas Dorsey, Chairman St. Croix County Board FROM: Robert Stephens (John Borup, 246-8223) COMMITTEE TITLE: St. Croix County Health and Human Services Board DATE: 01/24/02 TIME: 6:30 p.m. LOCATION: St. Croix County Health and Human Services Complex, New Richmond CALL TO ORDER ROLL CALL ADOPTION OF AGENDA DATE OF NEXT MEETING: 02/12/02 ACTION ON PREVIOUS MINUTES: 01/11/02 ANNOUNCEMENTS APPOINTMENTS % UNFINISHED BUSINESS: 1. Review of Nursing Home bed "banking" and census issues NEW BUSINESS: 1. Program Reports a. Long Term Support b. Mental Health/AODA c. Nursing Home 2. Personnel Issues 3. Possible State Budget cuts 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 I ~ ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD January 24, 2002 The St. Croix County Health and Human Services Board met on January 24, 2002 at the St. Croix County Health and Human Services/Health Center complex. MEMBERS PRESENT: Robert Stephens, Chair Leon Berenschot Chris Bethke Lois Burri James Craig Fern Johnson Mary Louise Olson Esther Wentz MEMBERS ABSENT: Einar Horne STAFF PRESENT: John Borup, Health and Human Services Director Ron Lockwood, Long Term Support Supervisor Ron Kiesler, Mental Health/AODA Coordinator Steve Kirt, Mental Health/AODA Clinical Services Supervisor Carolyn L. Krieger, Nursing Home Administrator Kathy Leisch, Secretary OTHERS PRESENT: Chair Stephens called the meeting to order at 6:30 PM noting the meeting was properly and legally publicized. NEXT MEETING: The next Health and Human Services Board meeting is scheduled for Tuesday, February 12, 2002. AGENDA: Motion: A motion was introduced by Bethke, seconded by Wentz, 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 01/11/02 Health and Human Services Board meeting be approved as circulated. ANNOUNCEMENTS: Borup stated that we are still working with Corporate Counsel on the authority to move forward on the Public Health Ordinance Designating "Agent Status" for St. Croix County Department of Health and Human Services. Borup stated that bids would close on February 1, 2002, for a new 12- passenger bussette with lift and 2 wheelchair spaces for St. Croix Industries. REVIEW OF NURSING HOME BED "BANKING" AND CENSUS ISSUES: The County Board voted on 1/12/02 to "unbank" 24 beds. Krieger reported that on 6/30/01 we "banked" 27 beds. That was based on a formula that the state gave us on the 2000 census. We had to be at 90.5% or we would be penalized on the Medicaid rate. This is the first time in 4 years that we have decided to bank beds. Based on the last year's census we had to "bank" the beds before the July 1 rate or we would receive a penalty. We did that and now in January we lose 10%. In order to downsize our facility we need to be able to put those beds St. Croix County Health and Human Services Board Page 2 January 24, 2002 in a "bank" and get then get them back out so they can be used for CIP slots. Now we need to "unbank" beds so that in July 2003 the Department would get those beds for CIP slots. They will no longer be nursing home beds. Stephens explained that we had "banked" the beds on June 30, 2001 in order to receive the initial funds. When they told us on December 18, 2001 that we would be keeping the nursing home, but would be downsizing even more than the 24 that were there, rather than lose everything that we had on those beds, we had to "unbank" those to convert them to CIP slots. Krieger explained that on June 30, 2002 we would have to "bank" 2 more beds in order to keep our Medicaid rate effective this July. Borup explained that this is done in a consecutive fashion, not a concurrent fashion. Lockwood asked why we do not just close the 2 beds and then he will receive the beds for CIP slots immediately. Krieger explained that one of her options was to close the beds. Stephens said that a recommendation would be made to the county board in April. LONG TERM SUPPORT PROGRAM REPORT: Ron Lockwood distributed a report that indicated what the expenses were during the year and how many people were served for each program and some of the important issues that occurred the last year. Lockwood reported that in the MA Waiver lA program we are serving 12 people in the community. The State would like us to serve 4 more. Lockwood reported that we had set up plans to return some persons to the community last year but it would have required a significant amount of county money because the State wasn't willing to fully finance the care. They have estimated the cost of these 4 persons to come back into the community would be well over $200.00 a day and that is the maximum that the State is willing to pay. Lockwood explained that the State feels that these people are appropriate for placement but because the cost is above $200.00 a day the state can't require the county to return these persons to the community. If the cost were less than $200.00, there is a requirement in the State law that would mandate their placement. The only person that could stop it would be the guardian. The costs are above $200.00 a day and the guardians thus far do not support placement, so it is not an immediate concern. In the CIP IB program we are receiving 4 new slots for this year in the biennial budget. There are currently 104 people on the CIP 1B program serving developmentally disabled people. We will be serving 4 people off the waiting list of 115. The top 2 people on the waiting list will have been waiting 3 years for services. The COP W program will be receiving an additional $85,000 in the budget. We will be able to serve 4-5 people off the waiting list of 23. Right now there is no local money involved in the Brain Injury Waiver program. In the MA Personal Care program there had been two agencies using our Medical Assistance number. Effective January 1, 2002, REM Corporation will provide MAPC services through the Center for Independent Living in Menomonie. St Croix County will continue to provide MAPC services through Indianhead Home Services. Lockwood also stated that the Family Support Program would be expanded in the biennial budget bill. $7,000 has been added to that program so 2-3 more families will be able to be served. There are currently 24 people on the program, with a waiting list of 104. St. Croix County Health and Human Services Board Page 3 January 24, 2002 Lockwood added that The Birth to Three Program is now serving 66 children, whereas last year at this time they were serving 56 children. No waiting list is permitted in this program. MENTAL HEALTH/AODA PROGRAM REPORT: Kiesler reported on year-end program issues-inpatient usage, 2002 contract, and the Community Support Program (CSP) waiting list grant. Kiesler reported that he has preliminary figures from Ziegler for 2001 and they will be about $130,000 in the black for 2001. Kiesler reported on the contract situation for facilities in AODA. He reported that Indianhead in Shell Lake has been forced to close because of financial issues that they were having. That left us without a transitional care facility for AODA because that was our primary residential facility. AODA recently began contracting with Fahrman Center and Arbor Place. This will bridge the gap for short-term care that was lost by Indianhead. Kirt reported on the numbers throughout 2001 for inpatient psychiatric and AODA. Kirt reported that in 2001 inpatient psychiatric admissions were up about 15 over the prior year (2000), which was a record year. He reported that we are currently pursuing a contract with Luther Hospital and should find out within a few weeks as to whether they are interested. In 2000, 95 of our residents went to United and 55 went to Cumberland as the 2 most used facilities. In 2001, 84 went to Cumberland and 59 went to United. This change was the result of increased demand in the Twin Cities. Kirt reported that in 2000, there were 15 out-of-state people that required County AODA detox services. In 2001, we have only had 2. Kirt also reported a success story about a discharge of a female from the CSP program and that she is now stable, living independently and working full time. She has commended our staff for the great job that they did. Kiesler reported on the Grant to Reduce the CSP Waiting List. He said that we have not found out whether we will receive any money yet. Kiesler stated that if we are awarded the $48,211, and choose to accept it, it would need to be used to convert the LTE CSP social work position into a permanent position. Kiesler said that no action is needed at this time. NURSING HOME: Krieger reported the census in the Nursing Home is 91 today (1/24/02). Admissions continue with few discharges, allowing census to achieve the census budgeted for this year. However, the first 2 weeks of January averaged below 93. Krieger reported that one of the nursing home administrative admission nurses will be retiring in February and they will be replacing her with an in-house staff nurse. This will save the nursing home $70,000. Krieger said that this is something that they can do in-house to stay within the budget. The following comments have been received from families regarding successful outcomes from the nursing home: a. To all the staff at the St. Croix Health Center I want to take a moment to say thank you for the wonderful care that you gave to my Aunt, and also to thank all of you that were on duty on her last day. r ~ St. Croix County Health and Human Services Board Page 4 January 24, 2002 You all were so kind to us and caring to her. Your words and actions were a great comfort. I miss my auntie and think of her daily, but I'm also happy for her now that she is at peace. You perform great service to our town and community! Thank You!! b. Thank you so much for the beautiful rose you sent and the special care you gave while she was a resident of the St. Croix Health Center. This was very much appreciated. C. My sister received excellent care. All personnel were very caring. d. We were extremely pleased with the care mother received. It was A-1-- couldn't be better!!! Your staff is kind, pleasant, responsive, attuned to needs, loving, caring, happy, and hardworking. We were so lucky to experience your care. e. To the staff of St. Croix Health Center--Thank you very much for the wonderful resident and family party on December 22, 2001. It was wonderful! It was great that the party was on Saturday also so that working family members could come. f. The family is most grateful for all of the help and care the staff at the Health Center gave to our mother. You were great and her care and facilities were outstanding. g. I have been a frequent visitor to the Health Center for ten years-- visiting a combination of friends and family I applaud the work, the care, the T.L.C. and the respect given to my loved ones. h. My mother has recently passed away, but I am very, very satisfied with how she was cared for. I hope the Health Center will be available for others for many years to come. I hope the talk of closing is just talk and never happens. i. Totally happy with every aspect. Great job!!! Krieger discussed the evaluation forms that are currently being used for union staff. They are using 6 pages of narrative. They are looking at a being able to use a 1-page evaluation form for each type of job. This will be more efficient and will take less time for the staff nurses to fill out. Krieger stated that she had asked for this to be put on the agenda at the January 19, 2002 personnel meeting. Krieger stated that she was not allowed to go to the meeting. The personnel director stated that this was preliminary and they would be deciding what kind of evaluation form that they would be using for the county. Krieger will continue to pursue this. Olson stated that she would call the chairman and ask that this be put on the agenda for the personnel meeting on February 20, 2002. Krieger gave an update on the software that the nursing home currently uses to bill Medicare and Medicaid and to transmit information to the state that they are required to do. This software was purchased in 1998. We are currently upgrading to a windows based product. The total bill for this upgrade will be $45,000. The training for this software is currently being r, St. Croix County Health and Human Services Board Page 5 January 24, 2002 done in St. Louis. Krieger stated that she could not send all of her staff to training in St. Louis so therefore they will be charged more for the training to be held here. Stephens requested that this be added to the agenda for February 12, 2002 for possible action on the billing for nursing home software. PERSONNEL ISSUES: Stephens stated that he will be talking to Chuck Whiting regarding the personnel evaluations and that he needs the appropriate forms for the meeting on February 12, 2002. Borup stated that Whiting had some questions as to who would be conducting Krieger's evaluation. Borup stated that it is his job to do the Nursing Home Administrator's and Department of Health & Human Service Manager evaluations. Stephens stated that the Health & Human Services Board would be conducting Borup's evaluation at the next meeting and invited Mr. Whiting to participate. Borup stated that the "Springsted" personnel study is underway. He invited the board to the meeting with "Springsted" on Wednesday, February 13, 2002 at 10:00 a.m. in the Boardroom. Borup distributed a personnel package on the purpose of the organizational study. Borup announced that the first meeting of the Nursing Home Management Audit Committee would be held on January 28, 2002 at 8:30 a.m. at the Health Center. Olson and Berenschot requested to be excused from the next meeting. Wentz also stated that she would be gone for both meetings in February. Stephens asked if there were any other issues to bring before the Board. Motion: A motion was introduced by Berenschot, seconded by Bethke, and unanimously adopted: that the meeting be adjourned. Time: 7:45 PM Chair: Attest: (Secretary)