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HomeMy WebLinkAboutHealth & Human Services 03-12-02 Chris Bethke will review vouchers. REVISED 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: 03/12/02 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 FETING: 03/28/02 ACTION ON PREVIOUS MINUTES: 02/28/02 ANNOUNCEMENTS APPOINTMENTS : UNFINISHED BUSINESS: 1. Public Health Ordinance/Resolution to obtain "Agent Status" NEW BUSINESS: 1. Consideration of Claims and Vouchers 2. Financial Report 3. Possible State budget cuts 4. Program Reports a. Puhlic Health b. Mental Health/AODA c. Nursing Home 5. Personnel Issues 6. Action on usage of -additional 24 C1P II slots 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 March 12, 2002 The St. Croix County Health and Human Services Board met on March 12, 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 I STAFF PRESENT: John Borup, Health and Human Services Director Carolyn Krieger, Nursing Home Administrator Judy Ziegler, Accounting Supervisor Ron Kiesler, AODA/Mental Health Coordinator Steve Kirt, Mental Health/AODA Clinical Services Supervisor Barbara Nelson, Public Health Supervisor-Health Officer Wendy Kramer, Lead Public Health Nurse Ellen Rominski, Public Health Aide Ron Lockwood, Long Term Support Coordinator Malva Berg, Secretary OTHERS PRESENT: none Chair Stephens 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, March 28, at 6:30 PM; the following meeting is scheduled for Thursday, April 11, 2002. AGENDA: Motion: A motion was introduced by Bethke, seconded by Johnson, and unanimously adopted: That the agenda be approved as circulated. MINUTES: Motion: A motion was introduced by Bethke, seconded by Burri, and unanimously adopted: That the minutes of the 02/28/02 Health and Human Services Board meeting be approved with the following correction on page 4: ...Borup stated that he would like to officially recognize a person internally as deputy director on a competitive recruitment basis... PUBLIC HEALTH: Kramer and Rominski gave a presentation on the success and activities of the Immunization Program. CONSIDERATION OF CLAIMS: The following reports for February were distributed to the Board: fixed assets, unemployment report for January, and cash report. Ziegler said two Ford Focus cars were purchased in January and this is reported on the fixed asset report. St. Croix County Health and Human Services Board Page 2 March 12, 2002 Health and Human Services Board member, Bethke, reviewed the vouchers. HUMAN SERVICES: 12114: Opal In-Home Services, $34.28, brain injury. This company provides supported living services in apartments in St. Croix County. They also provide supported home care and respite care as requested. This bill was for a child on the brain injury waiver. Motion: A motion was introduced by Bethke, seconded by Stephens, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book: Human Services vouchers 12068 through 12152, dated February 14, 2002 in the amount of $242,728.46. Human Services vouchers 12153 through 12154, dated February 19, 2002 in the amount of $143.01. Human Services vouchers 12155 through 12186, dated February 21, 2002 in the amount of $124,080.73. Human Services vouchers 12187 through 12216, dated February 28, 2002 in the amount of $245,161.60. Human Services vouchers 12217 through 12294, dated March 08, 2002 in the amount of $53,763.40. Human Services vouchers 12295 through 12401, dated March 12, 2002 in the amount of $99,639.61. Human Services voucher 12402 through 12515, dated March 12, 2002 in the amount of $45,664.76. Nursing Home vouchers 1808 through 1826, dated February 14, 2002 in the amount of $21,095.25. Nursing Home voucher 1827, dated February 15, 2002 in the amount of $150.00. Nursing Home vouchers 1828 through 1832, dated February 21, 2002 in the amount of $33,745.96. Nursing Home vouchers 1833 through 1837, dated February 28, 2002 in the amount of $6,900.41. Nursing Home vouchers 1838 through 1839, dated March 08, 2002 in the amount of $1,275.00. Nursing Home vouchers 1840 through 1879, dated March 12, 2002 in the amount of $57,274.71. Human Services, Workshop, Public Health vouchers 46 through 78, dated February 07, 2002 in the amount of $294,012.92. Social Services and Human Services vouchers 33 through 53, dated February 07, 2002 in the amount of $43,949.59. a St. Croix County Health and Human Services Board Page 3 March 12, 2002 Human Services and Nursing Home vouchers 47 through 76, dated February 12, 2002 in the amount of $230,850.35. Human Services, Workshop, Public Health vouchers 79 through 106, dated February 21, 2002 in the amount of $225,502.43. Social Services and Human Services vouchers 54 through 72, dated February 22, 2002 in the amount of $42,972.37. Human Services and Nursing Home vouchers 77 through 105, dated February 26, 2002 in the amount of $169,056.12. PUBLIC HEALTH ORDINANCE/RESOLUTION TO OBTAIN "AGENT STATUS": Nelson said a phone conference was held with Corp Counsel to clarify some issues in the ordinance. The ordinance does not include definitions, allowing the department to follow the administrative rule. The fee schedule has been removed from the ordinance so that the Health and Human Services Board may update as needed. The ordinance includes information that the County will retain 80% even though the rate will be 90% as the Statute still states 80%. The amount of 90% retention will be clearly stated in the contract with the State. Nelson recommended the Board approve both ordinances and bring forward to the full County Board on March 19, 2002. Motion: A motion was introduced by Berenschot, seconded by Bethke, and unanimously adopted. That the Board approves the following two ordinances: Ordinance establishing Chapter 20, St. Croix County Ordinances, Lodging and Food Protection for lodging and food protection and Ordinance establishing Chapter 21, St. Croix County Ordinances, Lodging and Food Protection for tattooing and body piercing (ordinances attached at the end of the minutes) and forward to the County Board of Supervisors for approval. Nelson said Laurie Diaby-Gassama has accepted the position of sanitarian. She is currently employed by the State doing the inspections in St. Croix County. The County should have full responsibility of inspections by July 1, 2002 but prior to that policy and procedures will need to be established and renewal notices will need to be sent out. Nelson said the Board of Health training scheduled for March 20 has been postponed. She announced there will be an environmental health seminar on April 11. Nelson said the Public Health Association annual conference will be June 11 and 12. Borup said this is an excellent conference. Nelson distributed a media release, which indicates Wisconsin and Louisiana are in the midst of an influenza epidemic. This is not true. Nelson reported there have been a number of cases of influenza but the numbers are not above normal. FINANCIAL REPORTS: Ziegler reported the new Medicaid rates were received which are retroactive to July, 2001. She said she is still waiting for the cash reconciliation to be done in Hudson. The auditor is expected to be in- house by April 1. The following reports were distributed to the Board: St. Croix County Health and Human Services Board Page 4 March 12, 2002 ST CROIX HEALTH CENTER MONTH OF NURSING HOME OPERATIONS REPORT Jan-02 TOTAL OPERATING REVENUES $ 386,750.86 OPERATING EXPENSES: DAILY PATIENT SERVICES $ 375,320.59 SPECIAL SERVICES $ 23,988.33 GENERAL SERVICES $ 91,997.15 ADMINISTRATIVE SERVICES $ 44,102.04 UNASSIGNED $ 31,917.16 TOTAL BUDGETED OPERATING EXPENSES $ 567,325.27 NET FROM OPERATIONS $ (180,574.41) NON-OPERATING REVENUES(W BASED): REVENUE FROM RATE APPEALS $ 1,500.00 INTERGOVERNMENTAL TRANSFER $ 90,250.00 COUNTY ALLOCATION $ 81,913.00 TOTAL NON OPERATING ITEMS $ 173,663.00 NET PROFIT (LOSS) FROM OPERATIONS $ (6,911.41) DEPRECIATION(NOT BUDGETED) $ 16,750.00 NET PROFIT(LOSS) $ (23,661.41) IN MARCH SEVERAL POSITIONS WERE CUT IN ORDER TO DECREASE EXPENSES BY $99,702 FOR THE LAST 10 MONTHS OF 2002 THE COST OF ANY NEW CAPITAL ASSETS WAS INCLUDED IN THE 2002 BUDGET. THE DEPRECIATION EXPENSE WAS A NON-CASH ITEM. St. Croix County Health and Human Services Board Page 5 March 12, 2002 ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD 01/01/02 THROUGH 01/31/02 NURSING HOME Cash Balance 01/31/02 $682,297.30 Add: Accounts Receivable, 01/31/02 Private Pay $8,242.37 Medicare $218,388.67 Medicaid $379,186.19* General $1,600.00 Accounts Payable-01/31/02 ($222,196.99) Net Current Items, 01/31/02 $1,067,517.54 2002 Revenue Recorded through 01/31/02 $560,413.86* Includes Allocations of Anticipated Revenues 2002 Expenses Recorded through 01/31/02 $584,075.27 Includes Allocations of Expected Expenses *July-December Medicaid Adjustment $156,493.52 January Medicaid rate adjustment (not reflected in above revenue) $26,211.05 r' St. Croix County Health and Human Services Board Page 6 March 12, 2002 HEALTH AND HUMAN SERVICES - 2002 SUMMARY Total OF REVENUES Jan.-Jan. Budget Balance Administration 65,547.95 786,486.00 720,938.05 8.3% AODA Services 25,540.17 434,703.00 409,162.83 5.9% Long Term Support 789,321.80 12,358,744.00 11,569,422.20 6.4% Mental Health 170,633.51 2,297,343.00 2,126,709.49 7.4% Family & Children's 206,622.44 2,519,843.00 2,313,220.56 8.2% Economic Support 88,722.64 1,095,090.00 1,006,367.36 8.1% General Relief 0.00 13,494.00 13,494.00 0.0% REVENUES HUMAN SERVICES PROGRAMS 1,346,388.51 19,505,703.00 18,159,314.49 6.9% Public Health 95,920.82 1,256,677.00 1,160,756.18 7.6% TOTAL REVENUES HEALTH AND HUMAN SERVICES 1,442,309.33 20,762,380.00 19,320,070.67 6.9% SUMMARY Total OF EXPENDITURES Jan.-Jan. Budget Balance % Administration 39,747.08 786,486.00 746,738.92 5.1% Alcohol-Drug Abuse 15,985.98 434,703.00 418,717.02 3.7% Long Term Support 606,680.68* 12,358,744.00 11,752,063.32 4.9% Mental Health 110,331.97 2,297,343.00 2,187,011.03 4.8% Family & Children's 104,776.94* 2,519,843.00 2,415,066.06 4.2% Economic Support 57,231.37 1,095,090.00 1,037,858.63 5.2% General Relief 319.36 13,494.00 13,174.64 2.4% Accrued Payroll 233,652.00 0.00 (233,652.00) 0.0% EXPENDITURES HUMAN SERVICES PROGRAMS 1,168,725.38 19,505,703.00 18,336,977.62 6.0% Public Health 67,372.56 1,256,677.00 1,189,304.44 5.4% TOTAL EXPENDITURES HEALTH AND HUMAN SERVICES 1,236,097.94 20,762,380.00 19,526,282.06 6.0% *Salaries for Human Services Professional Union Component are still being paid at 1999 rate. Estimated costs for 2002 are $95,000 to $110,000. To be on budget, percentage should be 8.33 • St. Croix County Health and Human Services Board Page 7 March 12, 2002 POSSIBLE STATE BUDGET CUTS: In late January, the Governor announced there may be a cut in shared revenue to the counties. This could mean a cut of approximately $935,000 for St. Croix County, of that amount approximately $200,000 cut for Health and Human Services and $80,000 for the Nursing Home plus a possible freeze in the county levy. We are still waiting for word regarding the status of the state budget. Borup said on a positive note, $103,000 was collected above what was expected for MA deficit dollars. He said there is no anticipated relief from the state as mandates remain the same. Olson asked Borup if any mandates could be removed from the County. Borup answered that if the State would take over some of the mandates, the county would have some financial relief. Borup added that State-County groups are working to generate new options to cut costs. Administration is reviewing options of reducing costs without impacting direct services. He said management positions in the nursing home have been reduced and one 30% support staff has been cut in the nursing home. Nursing Home revenues are driven by census and if census remains low or drops, there is no choice but to cut staff. Krieger said she implemented staff and supply cuts at the beginning of the year that amounted to a reduction in the budget of $263,793. She made additional cuts in staff the middle of January and again in March and to be effective in April, which amounted to another reduction of $250,246. These cuts were outlined to Board members. Krieger said the necessary software upgrade for the nursing home is being funded by the Bayport grant and staff cuts. The Nursing Home census is 84 with two residents on LOA. Krieger was at a recent meeting with other nursing home administrators and the whole state is having an issue with low census. She said Wausau is not accepting any Medicaid residents at this time. Two articles regarding IGT were included in the Board packets. IGT is scheduled to go through 2010 but the program will be broke by 2005. Krieger said negotiations for labor contracts will begin soon for next year. MENTAL HEALTH/AODA PROGRAM REPORT: Kirt reported that in-patient hospital days continue to increase due to more admissions. Hospital admissions increased 10% last year, which was a record number. Kiesler said recruitment has begun for the AODA counselor position due to increased demand for services. AODA currently has a waiting list. The numbers for IDP assessments also continue to increase. Kiesler is exploring the possibility of changing the emergency services system to realize a cost benefit to the county. He said LaCrosse County although slightly larger has a similar set up to St. Croix County services and has served as a model for services for us. If emergency services were updated from a Chapter II to a Chapter III, the County would be able to bill for Medicaid services for group home, etc. and may also generate some revenues from Family and Children's that was not billable before. This would cost shift from County funding to a Federal funding source. Services would be reimbursed at 60% whereas now we are not receiving any funding for these services. The Board recessed from 9:50 to 9:55 AM. F St. Croix County Health and Human Services Board Page 8 March 12, 2002 ACTION ON USAGE OF ADDITIONAL 24 CIP II SLOTS: Lockwood reported that when the Nursing Home banked beds, the Division of Health told us we had to wait 18 months for the CIP II slots. The Division of Supportive Living tried to get the Division of Health to change its mind, but couldn't. The Division of Supportive Living had extra slots from other counties that had under utilized their CIP II slots last year and said it would give them to St. Croix County but wanted documentation that the Nursing Home intention is to close the beds and the slots have to be used for clients on the waiting list. There are currently 20 people on the waiting list. Lockwood said clients on the COP waiver program could be switched to CIP II slots. These two programs have similar requirements for qualification except there is a different method to allocate money to each. If a CIP slot is not filled, the County is not paid for that slot. With the COP waiver, a block of money is given to the County to serve clients through the year. Lockwood said there is a question regarding serving clients on the waiting list but if clients were transferred from COP to CIP slots, there would be a savings in local match monies. Lockwood said the savings in local match monies could be offered as a service cut if we lose shared revenue, however that State allocated dollars are intended to be used for the waiting list. Borup said St. Croix County provides more match dollars than is required and is bringing this issue to the Board as a matter of policy. Motion: A motion was introduced by Berenschot, seconded by Bethke, That the Board approves Option A for use of the new CIP II slots, utilizing local match savings to serve 24 persons from the COP-W waiting list. Roll call vote: Robert Stephens-no Leon Berenschot-yes Chris Bethke-yes Lois Burri-no James Craig-yes Einar Horne--absent Fern Johnson-yes Mary Louise Olson-no Esther Wentz-no Four yes, four no, one absent, motion failed. Motion: A motion was introduced by Stephens, seconded by Wentz, and unanimously adopted: That the Board approves Option B for use of the new CIP II slots, using local match savings to serve 19 persons from the COP-W waiting list and use $30,678 for the budget shortfall. Stephens asked if there were any other issues to bring before the Board. Motion: A motion was introduced by Wentz, seconded by Stephens, and unanimously adopted: that the meeting be adjourned. Time: 10:15 AM Chair: Attest: (Secretary)