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HomeMy WebLinkAboutHealth & Human Services 05-14-02 Esther Wentz will review vouchers. 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: 05/14/02 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: 05/23/02 ACTION ON PREVIOUS MINUTES: 04/25/02 ANNOUNCEMENTS APPOINTMENTS: UNFINISHED BUSINESS: NEW BUSINESS: 1. 2001 Nursing Home Audit Report 2. Consideration of Claims and Vouchers 3. Financial Report 4. Program Reports a. Nursing Home b. ECHO and HIPPA Updates c. Public Health 5. Personnel Issues 6. Presentation of 2001 Annual Report 7. Kinship Care Program and waiting list issues and policy 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 May 14, 2002 The St. Croix County Health and Human Services Board met on May 14, 2002 at the St. Croix County Health and Human Services/Health Center complex. MEMBERS PRESENT: Thomas Dorsey, Chair Leon Berenschot Lois Burri James Craig Fern Johnson-Schmidt Mary Louise Olson Ralph Swenson Esther Wentz MEMBERS ABSENT: Chris Bethke, excused STAFF PRESENT: John Borup, Health and Human Services Director Carolyn Krieger, Nursing Home Administrator Judy Ziegler, Accounting Supervisor Fred Johnson, Family and Children's Supervisor Becky Ruka, Accounts Receivable Supervisor Malva Berg, Secretary OTHERS PRESENT: Rod Paulson, CPA, Tracey and Thole Clarence Malick, County Board Chair 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, May 23, at 6:00 PM; the annual Open Hearing will follow at 7:00 PM. AGENDA: Motion: A motion was introduced by Berenschot, seconded by Wentz, and unanimously adopted: That the agenda be approved as circulated. MINUTES: Motion: A motion was introduced by Wentz, seconded by Burri, and unanimously adopted: That the minutes of the 04/25/02 Health and Human Services Board meeting be approved with the following corrections: Page 1, paragraph 6 should read as follows... ELECTION OF OFFICERS: Berenschot announced that the election of officers would take place. Berenschot asked for nominations for the position of chair. Dorsey was nominated for the Chair position. The Board cast a unanimous vote for Dorsey for Chair. Berenschot declared Dorsey to be the Chair of the Health and Human Services Board. Page 1, paragraph 7 should read as follows... Berenschot turned the meeting over to Chair Dorsey. Dorsey asked for nominations for the position of Vice Chair. Wentz and Berenschot were nominated for the position of Vice Chair. Wentz withdrew her nomination. The Board cast a unanimous vote for Berenschot for Vice Chair. Dorsey declared Berenschot to be the Vice Chair of the Health and Human Services Board. r St. Croix County Health and Human Services Board Page 2 May 14, 2002 Margaret Wolske was listed as a County Board Rep and is a community member on the Long Term Support Planning Committee Page 4, paragraph 6, should read as follows: Wentz suggested that the Board wait until all the board members are present to vote on filling the position for July 1, 2002. APPOINTMENTS: Dorsey announced the following reappointments to the Family Support/Birth to Three Advisory Committee, Borup will notify members of their reappointments: Susan Bjerstedt, Lynn Harstad, Wendy Kramer, Nancy, Lawton- Shirley, Mike and Julie Lesher, Debbie Ramacher, Kathy Robelia, Jim Schreiber, Norma Vrieze, Esther Wentz, Shelly Weyers, Debbie Willink, and Steve Wlodyga. Malick said at the last Finance meeting it was discussed as a general principle when a vacancy occurs in a department, that before the opening is filled the opening will be reviewed to explore the possibility of job share, change in roles, etc. He said there is currently an opening at the Council on Aging and there is a possibility of realignment in that department. Malick suggested the possibility of a joint meeting with Health and Human Services Board and the Council on Aging. Borup said the Health and Human Services Board has two-thirds elected officials and the Council has two elected officials and 12-13 citizen members, which would change the dynamics of how policy is made by the Board. NURSING HOME AUDIT REPORT: Rod Paulson, CPA, presented the Nursing Home Audit Report, which gave an unqualified opinion. The complete report is on file. Paulson highlighted several areas of the report. He said there was a decline in patient days from 33,859 in 2000 to 33,068 in 2001. He said the nursing home has a good collection rate at 85%. He said there were more Medicare days in 2001 as more residents are being discharged from hospitals quicker and sicker. It is difficult to predict what special services will be needed when admitted to the nursing home and most Medicare residents require specialized services. He said the average cost per patient day in 2000 was $176.90 and in 2001 it was $200.30. This increase is primarily due to salary increases. The audited expenses over revenues of $404,132, which includes a non-cash expense of $230,669 which equals a net loss of $173,463 for 2001 depreciation. CONSIDERATION OF CLAIMS: The following reports for April were distributed to the Board: April cash report. Health and Human Services Board member, Wentz, reviewed the vouchers. HUMAN SERVICES: 13105: Hudson High School, $395.90, restitution. We maintain a restitution account to collect and disburse funds for juveniles in the Family and Children's Department. If a judge orders restitution to be paid to the victims as part of the sentencing for juveniles, the money is deposited in this account. On a weekly or monthly basis, when the full amount has been collected, a check is sent to the victim. This does not include any County funds. 13444: Skoglund Oil Company, Inc., $19.00, W-2 support services, gas. St. Croix County Health and Human Services Board Page 3 May 14, 2002 W-2 clients are able to get gas for their cars to enable them to drive to job interviews, class, etc. They have to have approved paperwork from a W-2 employment specialist each time they charge at Skoglund oil. W-2 staff try to limit this to one tank of gas per month. Motion: A motion was introduced by Wentz, seconded by Berenschot, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book: Human Services voucher 13028, dated April 12, 2002 in the amount of $470.00. Human Services vouchers 13029 through 13083, dated April 18, 2002 in the amount of $111,012.10. Human Services vouchers 13084 through 13132, dated April 25, 2002 in the amount of $319,062.36. Human Services vouchers 13133 through 13187, dated May 03, 2002 in the amount of $47,128.91. Human Services voucher 13188, dated May 03, 2002 in the amount of $500.00. Human Services voucher 13189 through 13197, dated May 09, 2002 in the amount of $3,224.32. Human Services voucher 13199 through 13359, dated May 14, 2002 in the amount of $99,765.59. Human Services voucher 13360 through 13507, dated May 14, 2002 in the amount of $90,700.67. Nursing Home vouchers 1943 through 1949, dated April 18, 2002 in the amount of $17,331.83. Nursing Home vouchers 1950 through 1951, dated April 25, 2002 in the amount of $4,180.84 Nursing Home vouchers 1952 through 1955, dated May 03, 2002 in the amount of $1,289.28. Nursing Home voucher 1956, dated May 09, 2002 in the amount of $527.49. Nursing Home vouchers 1961 through 1991, dated May 14, 2002 in the amount of $52,347.33. Human Services, Workshop, Public Health vouchers 168 through 194, dated April 04, 2002 in the amount of $297,178.26. Social Services and Human Services vouchers 113 through 128, dated April 04, 2002 in the amount of $43,702.34. Human Services and Nursing Home vouchers 165 through 189, dated April 09, 2002 in the amount of $232,779.35. St. Croix County Health and Human Services Board Page 4 May 14, 2002 Human Services, Workshop, Public Health vouchers 195 through 225, dated April 17, 2002 in the amount of $226,272.89. Social Services and Human Services vouchers 128 through 149, dated April 17, 2002 in the amount of $43,112.04. Human Services and Nursing Home vouchers 190 through 221, dated April 23, 2002 in the amount of $165,225.31. Human Services, Workshop, Public Health vouchers 226 through 256, dated May 06, 2002 in the amount of $301,440.97. Social Services and Human Services vouchers 150 through 170, dated May 03, 2002 in the amount of $45,058.72. Human Services and Nursing Home vouchers 222 through 251, dated May 07, 2002 in the amount of $222,215.05. FINANCIAL REPORTS: The following reports through March, 2002 were distributed: ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD 01/01/02 THROUGH 03/31/02 NURSING HOME Cash Balance 03/31/02 $612,364.73 Add: Accounts Receivable, 03/31/02 Private Pay $4,528.08 Medicare $223,040.08 Medicaid $229,756.56* General $0.00 Accounts Payable-03/31/02 ($244,501.13) Net Current Items, 03/31/02 $825,188.32 2002 Revenue Recorded through 03/31/02 $1,712,402.38* Includes Allocations of Anticipated Revenues 2002 Expenses Recorded through 03/31/02 $1,674,505.70 Includes Allocations of Expected Expenses Profit (Loss) $37,896.68 *ICT is reported at 25% of actual 2001-2002 award. St. Croix County Health and Human Services Board Page 5 May 14, 2002 HEALTH AND HUMAN SERVICES - 2002 SUMMARY Total OF REVENUES Jan.-Mar. Budget Balance % Administration 192,851.98 786,486.00 593,634.02 24.5% AODA Services 143,301.95 434,703.00 291,401.05 33.0% Long Term Support 2,323,962.73 12,358,744.00 10,034,781.27 18.8% Mental Health 572,999.81 2,297,343.00 1,724,343.19 24.9% Family & Children's 590,629.44 2,519,843.00 1,929,213.56 23.4% Economic Support 251,132.14 1,095,090.00 843,957.86 22.9% General Relief 3,324.00 13,494.00 10,170.00 24.6% REVENUES HUMAN SERVICES PROGRAMS 4,078,202.05 19,505,703.00 15,427,500.95 20.9% Public Health 278,598.47 1,256,677.00 978,078.53 22.2% TOTAL REVENUES HEALTH AND HUMAN SERVICES 4,356,800.52 20,762,380.00 16,405,579.48 21.0% SUMMARY Total OF EXPENDITURES Jan.-Mar. Budget Balance Administration 153,392.96 786,486.00 633,093.04 19.5% Alcohol-Drug Abuse 76,795.27 434,703.00 357,907.73 17.7% Long Term Support 2,167,117.43* 12,358,744.00 10,191,626.57 17.5% Mental Health 478,227.69 2,297,343.00 1,819,115.31 20.8% Family & Children's 509,188.41* 2,519,843.00 2,010,654.59 20.2% Economic Support 237,160.53 1,095,090.00 857,929.47 21.7% General Relief 6,854.00 13,494.00 6,640.00 50.8% Accrued Payroll 0.00 0.00 0.00 0.0% EXPENDITURES HUMAN SERVICES PROGRAMS 3,628,736.29 19,505,703.00 15,876,966.71 18.6% Public Health 254,663.51 1,256,677.00 1,002,013.49 20.3% TOTAL EXPENDITURES HEALTH AND HUMAN SERVICES 3,883,399.80 20,762,380.00 16,878,980.20 18.7% *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 25.0W. NURSING HOME OPERATIONS REPORT 1st QTR., 2002 JAN-MAR TOTAL OPERATING REVENUES 1,151,543.38 e St. Croix County Health and Human Services Board Page 6 May 14, 2002 OPERATING EXPENSES: DAILY PATIENT SERVICES 1,062,145.87 SPECIAL SERVICES 69,364.98 GENERAL SERVICES 274,460.52 ADMINISTRATIVE SERVICES 130,110.35 UNASSIGNED: DEPRECIATION % BASED 50,250.00 OTHER 88,173.98 TOTAL OPERATING EXPENSES 1,674,505.70 ET FROM OPERATIONS 522,962.32 ON-OPERATING ITEMS: REVENUE FROM RATE APPEALS 4,500.00 WAGE PASSTHROUGH REVENUE - INTERGOVERNMENTAL TRANSFER IGT % BASED 235,617.00 CO. ALLOCATION % BASED on OPS. LEVY OF $1,282,965 320 742.00 TOTAL NON-OPERATING ITEMS 560,859.00 EXCESS of REVENUES OVER EXPENSES 37,896.68 TERFUND TRANSFERS: - TRANSFERS FROM OTHER FUNDS TOTAL INTERFUND TRANSFERS - TOTAL OPERATING, NON-OPERATING & TRANSFERS 37,896.68 FUND BALANCE 2002 AUDITED NUMBER 1,506,067.69 PERIOD OPERATIONS 37,896.68 ASH REPLENISHMENT BASED on $250,000 for YEAR 62 500.00 FUND BALANCE, END of PERIOD 1,606,464.37 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. IGT REVENUE HAS BEEN ADJUSTED TO 25% OF THE ACTUAL AWARD FOR 2001-2002 OF $942,471 AMENDMENT TO MOTION ON BIDS TO LEASE/PURCHASE 14-PASSENGER BUSSETTE FOR ST. CROIX INDUSTRIES PASSED ON 02/12/02: Mid-State truck has questioned the Board's 02/12/02 motion to lease/purchase a 14-passenger bussette in terms of cost. He makes the point that the motion is for a net cost of $42,580, however, that includes a $1,000 rebate after delivery. So the purchase price is ' St. Croix County Health and Human Services Board Page 7 May 14, 2002 $43,580 and then reduced to a net of $42,580 after delivery. The motion needs to be changed to reflect the $1,000 difference with no actual net cost difference after receipt of the rebate. Motion: A motion was introduced by Berenschot, seconded by Burri, and unanimously adopted: That the Board accepts the bid as described in 1B of the spreadsheet for $45,080 less trade in of 1992 vehicle ($600) and less $1,000 discount at time of order for a total due at delivery of $43,580. A $1,000 rebate that is available after delivery will result in a final cost of $42,580. NURSING HOME: Nursing Home census is 91. The census is averaging 86 through April of this year. The transition to the new Nursing Home software has had a change in schedule, with a live demo in June and training dates of August or September. Krieger said criminal background checks need to be completed by 10/02. This is done by the Personnel Department and affects both Nursing Home and Health and Human Services. Krieger has communicated with Personnel regarding this timeline but has received no response from Personnel. Krieger will work with Berenschot, who is on the Personnel Committee, regarding the completion of the criminal background checks. The Wage and Hour Division of the U.S. Department of Labor has requested nursing homes do a self-audit on the calculation of overtime. This information has also been communicated to Personnel with no response. ECHO AND HIPAA UPDATE: Ruka reported ECHO is a billing and management information system for client information. The ECHO conversion is scheduled to begin June 6th and be completed on June loth. This conversion will make us HIPAA compliant. Ruka reported HIPAA is an unfunded, federal mandate that deals with three specific areas of healthcare with the advent of the electronic era. These three standards are transactions, privacy and security. The transaction standards apply to any type of transmission that is completed electronically. These standards apply to health care providers, insurance companies, third-party administrators, clearinghouses, and employers. The privacy standards are confidentiality issues and how information is released to outside individuals (in our setting this would also include how information is released from unit to unit). The security standard deals with how secure is our computer network. All three areas have rigorous standards that will have to be met and in all cases any infractions will be subject to fines and sanctions. She said this is a start of health care reform by making reporting standardized and protecting the security of client information. She said we will have to go through a clearinghouse, which will cost money. She said the Long Term Support waiver programs are now considered a health plan and will be affected by this. Also the Mental Health and AODA block grants may be affected by HIPAA. She said General Relief is also considered a health plan but may get exempted as not enough money is spent for the program. She anticipates it will cost close to $10,000 to become HIPAA compliant. A privacy officer may also be required to oversee records and perform audits of where records have been sent. Berenschot left the meeting at 10:45. The Board recessed from 10:45 to 10:55. r St. Croix County Health and Human Services Board Page 8 May 14, 2002 PERSONNEL: Borup reported the 40% LTE Social worker (to handle expanded CIP II slots with Nursing Home downsizing) will be referred to Personnel Committee for late May or June meeting to make permanent in 2003 budget. 2001 ANNUAL REPORT: Borup distributed the 2001 Annual report to Board members. Swenson suggested mailing the report to County Board members in advance of the meeting. Discussion was held on the presentation of the audited Nursing Home figures and Swenson suggested changes to the report. Borup will make changes to further clarify the report before distributing to County Board members. Swenson questioned information for the annual report that it also include what has worked well for the Department, what are new challenges, what are issues and what are we doing about the issues. KINSHIP CARE PROGRAM AND WAITING LIST ISSUES AND POLICY: Johnson said Kinship Care was transferred from Economic Support to Family and Children's responsibility in 1997 and changed from a sum sufficient amount to a sum certain amount. In 1997 the policy was established by the Board included no waiting list for $215 monthly reimbursement of eligible relatives. When and if the sum certain State kinship allocation was expended, the Health and Human Services Board policy decision was to utilize county funds to cover reimbursement to relative caretakers. Johnson said there are between 25-30 children that fall under the Kinship Care program. He supports continuing with the same policy of no waiting list and utilizing county funds to cover when State kinship allocation is expended as the alternative to kinship care is quite expensive and could become a foster care situation. Motion: A motion was introduced by Wentz, seconded by Johnson-Schmidt, and unanimously adopted: That the Board continue with the policy with no waiting list for Kinship Care and to continue to utilize County funds if the State Kinship Care allocation is expended. Dorsey asked if there were any other issues to bring before the Board. Motion: A motion was introduced by Wentz, seconded by Dorsey, and unanimously adopted: that the meeting be adjourned. Time: 11:30 AM Chair: Attest: (Secretary)