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
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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
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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.
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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.
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St. Croix County Health and Human Services Board
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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
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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)