Loading...
HomeMy WebLinkAboutHealth & Human Services 07-11-02 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: 07/11/02 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: 07/25/02 ACTION ON PREVIOUS MINUTES: 06/27/02 ANNOUNCEMENTS APPOINTMENTS: UNFINISHED BUSINESS: NEW BUSINESS: 1. Consideration of Claims and Vouchers 2. Financial Report 3. Program Reports a. Nursing Home b. Mental Health/AODA c. Public Health 1. Tobacco Control Report 4. Review of Wipfli Nursing Home Management Audit Report 5. Turningpoint's request to reduce or eliminate lease payments for office space. 6. Birth to Three Program rate increase 7. Multi-County Child Welfare Capitation Program Participation 8. Personnel Issues 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 July 11, 2002 The St. Croix County Health and Human Services Board met on July 11, 2002 at the St. Croix County Health and Human Services/Health Center complex. MEMBERS PRESENT: Thomas Dorsey, Chair Chris Bethke Lois Burri James Craig Fern Johnson-Schmidt Mary Louise Olson Esther Wentz MEMBERS ABSENT: Leon Berenschot Ralph Swenson, excused STAFF PRESENT: John Borup, Health and Human Services Director Carolyn L. Krieger, Nursing Home Administrator Judy Ziegler, Accounting Supervisor Kathy Dunlap, Family and Children's Supervisor Barbara Nelson, Public Health Supervisor-Health Officer Norma Vrieze, Early Intervention Director Malva Berg, Secretary OTHERS PRESENT: Clarence Malick, County Board Chair Sharon Metcalf, Turningpoint Karen Klyczek, Turningpoint 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, July 25, at 6:00 PM. An invitation for the resident/family picnic on July 25 at 4:30 was given to Board members. The meeting time was changed to 6:00 PM. AGENDA: Motion: A motion was introduced by Wentz, seconded by Johnson- Schmidt, and unanimously adopted: That the agenda be approved as circulated. MINUTES: Motion: A motion was introduced by Bethke, seconded by Wentz, and unanimously adopted: That the minutes of the 06/27/02 Health and Human Services Board meeting be approved with the correction that Malick was present at the meeting. TURNINGPOINT'S REQUEST TO REDUCE OR ELIMINATE LEASE PAYMENTS FOR OFFICE SPACE: Turningpoint currently receives approximately $4000 from St. Croix County in funding for domestic abuse services. She said Turningpoint is also a First Call for Help line. Approximately 500 requests for services are received yearly and approximately 60% of the requests are from St. Croix County residents. Turningpoint is currently leasing office space in New Richmond from St. Croix County for $4,800 per year. Turningpoint is asking for a reduction or elimination of their rental charge. They currently have a rental contract that expires at the end of 2002. The County used to fund Turningpoint $6,000 in State domestic abuse money until a few years back, the State directed this St. Croix County Health and Human Services Board Page 2 July 11, 2002 money go directly to Turningpoint, thus the county reduced the funding to Turningpoint. Metcalf indicated she was not aware of the additional funding from the State. Dorsey said this will be looked at in the 2003 budget process and may request additional information from Turningpoint. Olson questioned if Turningpoint provided a duplication of services. Borup indicated the services are not duplicated, but may overlap in some areas such as Mental Health and Alcohol/Drug. CONSIDERATION OF CLAIMS: The following reports for June were distributed to the Board: June cash report and unemployment report. Health and Human Services Board member, Burri, reviewed the following vouchers: HUMAN SERVICES: 13957: $673.00, W-2 emergency payment. The W-2 contract allows for a payment to a W-2 client if their first paycheck or W-2 check is not due for three weeks or more. This emergency payment is made to prevent eviction and cover utility costs. 14088: Heartview, Inc, $5,381.08, Long Term Support Services. Heartview provides housing, respite and in-home services for Long Term Support clients. The company's main office is in Hudson 14223: The Deerfield, $5,252.64, Long Term Support purchased services- June. Cost of therapy and home care services for several waiver clients for June. Motion: A motion was introduced by Burri, seconded by Wentz, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book: Human Services voucher 13957, dated June 12, 2002 in the amount of $673.00. Human Services vouchers 13958 through 14023, dated June 13, 2002 in the amount of $233,300.71. Human Services vouchers 14024 through 14075, dated June 20, 2002 in the amount of $71,192.92. Human Services voucher 14076 through 14109, dated June 27, 2002 in the amount of $268,478.25. Human Services voucher 14110, dated July 07, 2002 in the amount of $600.00. Human Services voucher 14111 through 14174, dated July 03, 2002 in the amount of $102,192.58. Human Services voucher 14175, dated July 03, 2002 in the amount of $547.50. Human Services voucher 14176, dated July 09, 2002 in the amount of $450.00. Human Services voucher 14177 through 14324, dated July 11, 2002 in the amount of $77,751.44. St. Croix County Health and Human Services Board Page 3 July 11, 2002 Human Services voucher 14325 through 14463, dated July 11, 2002 in the amount of $80,231.75. Nursing Home vouchers 2051 through 2055, dated June 13, 2002 in the amount of $743.42. Nursing Home vouchers 2056 through 2057, dated June 20, 2002 in the amount of $22,506.01 Nursing Home vouchers 2058 through 2059, dated June 27, 2002 in the amount of $942.59. Nursing Home vouchers 2060 through 2117, dated July 11, 2002 in the amount of $59,572.24. Social Services and Human Services vouchers 213 through 232, dated June 18, 2002 in the amount of $42,039.79. Human Services, Workshop, Public Health vouchers 316 through 343, dated June 18, 2002 in the amount of $227,260.77. Human Services and Nursing Home vouchers 311 through 338, dated June 18, 2002 in the amount of $170,779.61. Human Services, Workshop, Public Health vouchers 344 through 374, dated July 01, 2002 in the amount of $302,842.93. Social Services and Human Services vouchers 233 through 254, dated July 01, 2002 in the amount of $42,850.17. Human Services and Nursing Home vouchers 339 through 368, dated July 01, 2002 in the amount of $227,919.90. FINANCIAL REPORTS: The following financial reports through May were distributed to Board members. Borup indicated we have not received the Schottler rent payment but anticipates it by the end of the week. Borup said he is pleased with the verbal audit exit interview with Rod Paulson. Paulson will be at the July 25th meeting to present the audit. He said Paulson reports revenues in excess of expenditures by $85,159.46. "Designated" account set at $503,766.81. The labor contract has been settled and back paychecks should be to staff by the end of July. Borup attended the Finance Committee meeting on July 10. The State Legislators have passed the budget on to the Governor. The County's budget instructions will be distributed to staff on Friday, July 19. Please see next page: St. Croix County Health and Human Services Board Page 4 July 11, 2002 ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD 01/01/02 THROUGH 05/31/02 NURSING HOME Cash Balance 05/31/02 $527,773.19 Add: Accounts Receivable, 05/31/02 Private Pay $4,407.79 Medicare $173,946.37 Medicaid $218,613.40* General $0.00 Accounts Payable-05/31/02 ($271,119.21) Net Current Items, 05/31/02 $653,621.54 2002 Revenue Recorded through 05/31/02 $2,867,939.51* Includes Allocations of Anticipated Revenues 2002 Expenses Recorded through 05/31/02 $2,700,279.94 Includes Allocations of Expected Expenses Excess Revenues over Expenses $167,659.57 St. Croix County Health and Human Services Board Page 5 July 11, 2002 NURSING HOME OPERATIONS REPORT 1st QTR., 2002 JAN-MAY TOTAL OPERATING REVENUES 1,151,543.38 1,933,174.51 OPERATING EXPENSES: DAILY PATIENT SERVICES 1,062,145.87 1,691,734.91 SPECIAL SERVICES 69,364.98 114,424.77 GENERAL SERVICES 274,460.52 455,216.24 ADMINISTRATIVE SERVICES 130,110.35 216,003.82 UNASSIGNED: DEPRECIATION % BASED 50,250.00 83,750.00 OTHER 88,173.98 139,150.20 TOTAL OPERATING EXPENSES 1,674,505.70 2,700,279.94 ET FROM OPERATIONS 522,962.32 767,105.43 ON-OPERATING ITEMS: REVENUE FROM RATE APPEALS 4,500.00 7,500.00 WAGE PASSTHROUGH REVENUE - INTERGOVERNMENTAL TRANSFER IGT % BASED 235,617.00 392,695.00 CO. ALLOCATION % BASED on OPS. LEVY OF $1,282,965 320,742.00 534 570.00 TOTAL NON-OPERATING ITEMS 560,589.00 934,765.00 EXCESS of REVENUES OVER EXPENSES 37,896.68 167,09.57 TERFUND TRANSFERS: - TRANSFERS FROM OTHER FUNDS - TOTAL INTERFUND TRANSFERS - TOTAL OPERATING, NON-OPERATING & TRANSFERS FUND BALANCE 2002 AUDITED NUMBER 1,506,067.69 PERIOD OPERATIONS 167,659.57 ASH REPLENISHMENT % BASED on $250,000 for YEAR 104 170.00 UND BALANCE, END of PERIOD 1,777,897.26 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. HEALTH AND HUMAN SERVICES - 2002 St. Croix County Health and Human Services Board Page 6 July 11, 2002 SUMMARY Total OF REVENUES Jan.-May. Budget Balance Administration 416,775.69 786,486.00 369,710.31 53.0% AODA Services 175,433.92 434,703.00 259,269.08 40.4% Long Term Support 4,358,799.29 12,358,744.00 7,999,944.71 35.3% Mental Health 988,448.58 2,297,343.00 1,308,894.42 43.0% Family & Children's 1,264,220.42 2,519,843.00 1,255,622.58 50.2% Economic Support 401,520.22 1,095,090.00 693,569.78 36.7% General Relief 4,043.65 13,494.00 9,450.35 30.0% REVENUES HUMAN SERVICES PROGRAMS 7,609,241.77 19,505,703.00 11,896,461.23 39.0% Public Health 467,987.20 1,256,677.00 788,689.80 37.2% TOTAL REVENUES HEALTH AND HUMAN SERVICES 8,077,228.97 20,762,380.00 12,685,151.03 38.9% SUMMARY Total OF EXPENDITURES Jan.-May. Budget Balance % Administration 273,504.60 786,486.00 512,981.40 34.8% Alcohol-Drug Abuse 134,142.44 434,703.00 300,560.56 30.9% Long Term Support 4,283,452.30* 12,358,744.00 8,075,291.70 34.7% Mental Health 836,674.06 2,297,343.00 1,460,668.94 36.4% Family & Children's 993,993.32* 2,519,843.00 1,525,849.68 39.4% Economic Support 398,042.32 1,095,090.00 697,047.68 36.3% General Relief 8,995.95 13,494.00 4,498.05 66.7% Accrued Payroll 521,508.42 0.00 (521,508.42) 0.0% EXPENDITURES HUMAN SERVICES PROGRAMS 7,450,313.41 19,505,703.00 12,055,389.59 38.2% Public Health 443,144.02 1,256,677.00 813,532.98 35.3% TOTAL EXPENDITURES HEALTH AND HUMAN SERVICES 7,893,457.43 20,762,380.00 12,868,922.57 38.0% *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 41.67% MULTI-COUNTY CHILD WELFARE CAPITATION PROGRAM PARTICIPATION: Dunlap said this project is patterned after a pilot project going on in South-Central Wisconsin. This project showed that coordinated case management by public and private agencies working closely together can be a cost effective alternative to traditional approaches. She said an informational meeting will take place on July 22. Eau Claire County is heading up the RFP. She said this program may be a possible way to save money and may possibly be a mandated service in the St. Croix County Health and Human Services Board Page 7 July 11, 2002 future. She said there is no caseload limit in Family and Children's and Family and Children's is not allowed to have a waiting list. There is no cost to the county until a child actually does receive services. She said we may never need to refer a child to this program but are able to refer a child if needed but the county only pays if the contract is used. She reported that costs have gone down in the pilot program counties. There is talk that the legislature may be awarding some funding in 2004 to government agencies that consolidate some of their services. We will continue to watch this. BIRTH TO THREE PROGRAM RATE INCREASE: Vrieze requested an increase in rates for the Birth to Three Program from $85.38/hour to $93.23/hour. She reviewed some of the rates of profit and non-profit agencies in the area. Motion: A motion was introduced by Wentz, seconded by Burri, and unanimously adopted: That the Board approves increasing the Birth to Three rate to $93.23/hour effective 07/01/02. PUBLIC HEALTH: As Health Officer for St. Croix County, Nelson said she is mandated to keep the governing body informed regarding communicable disease. She reported two cases of E. coli 0157:H7 have been reported and followed up; one a 62-year-old woman and one a 6-year-old child. Both had been hospitalized but are recovering well. These may be related to hamburger consumption but do not appear to be a result of the two ground beef recalls of the past week. To date, no cases have been identified in Wisconsin related to the recalls, but outbreaks exist in Iowa and Colorado. She related safe handling and cooking practices of ground beef. She said one case of salmonellosis was reported this week, initially thought related to a Florida outbreak, but since determined to be an isolated case. Nelson reported no decisions have been made regarding the federal smallpox vaccination policy despite reports of some newspapers. CDC continues to solicit input and no final policy decision has yet been reached. There have been indications that health care workers, such as lab workers and those at risk, will be vaccinated. Vaccination of the general population is not recommended as the side effects of the vaccinations can be more serious than disease. Nelson distributed a brochure regarding the West Nile Virus that is transmitted by the bite of infected mosquitoes. Public Health has been asked to participate in surveillance for the disease. She said anyone finding a sick or dead crow, blue jay or raven can contact the local health department or DNR for assistance in submitting the bird for testing. USDA has done news releases. Local veterinarians have also been asked to participate. Thus far only one has responded and a crow was submitted through Dr. Bray's office in Hudson yesterday. Nelson reported rabies control follow-up being done as a result of a raccoon bite. At the last meeting it was reported that Wisconsin is eligible for $19+ million in federal funding for public health expenditure to combat bioterrorism as a result of an application by the Division of Public Health. Nelson referred the Board to the article sent with the fact sheet, March and April/May letters to the Board from John Chapin, Administrator, DPH, and the handouts from last • St. Croix County Health and Human Services Board Page 8 July 11, 2002 meeting. She discussed the existing regions and draft bioterrorism consortium and asked for input regarding fiscal management and/or housing potential staff. The contract for the health department's funds has been signed and is dated January-December, 2002, therefore local activities around pandemic planning can be billed back to this. Nelson referenced the letters sent to Board members about WI Wins and indicated St. Croix County is at risk for losing considerable funds for substance abuse prevention and treatment if Synar Regulations are not met. She indicated the local Pierce-St. Croix Tobacco Free Coalition has agreed to take on the WI Wins initiative and the application has been submitted. Secretary Dube' and John Chapin have highly encouraged participation. Nelson said the next Legislative Event will be held July 16 at noon in Baldwin. She said the agenda is strictly a tobacco topic and Dr. Fiore will be the special guest. Board members were also referred to a flyer invitation to Dr. Fiore's presentation at UW-RF that same afternoon. Dr. Craig shared that Dr. Fiore would be presenting at the local medical society meeting that evening. The Board recessed from 9:50 to 10:05. MENTAL HEALTH/AODA: A chart comparing Polk and St. Croix County Mental Health/AODA program costs was presented. Polk County was part of a five- county coalition for the provision of Mental Health/AODA services until 2000 when it dissolved. Since then they have provided those services on their own through a combination of contracted providers and hired staff. The chart shows St. Croix County in-house management of these services allows St. Croix County better control of our costs. Borup offered to have Mental Health/AODA staff available at the July 25th meeting if the Board would like to discuss further. Review of Wipfli Nursing Home Management Audit Report: The final report received from Wipfli is similar to the original. The report does not report any staff cuts made or address the facility layout or census discrepancy reported in the original report. Also not addressed were the issues of St. Croix Health Center being in a high labor region and high CMI population as verified by Keefe's report. The charges made by the committee were not fully addressed in the Wipfli report. Keefe did exactly what was asked of him and gave an in-depth report on the charges made by the committee. One more meeting will be held with the Nursing Home Management Audit Committee and Wipfli staff as it was the consensus of the Board that the report from Wipfli is still a work in progress. The Nursing Home Management Audit Committee meeting will be August 13 at 2:30 PM. The Board suggested to wait until the September County Board meeting to present the Wipfli report to the County Board. Krieger reported the State would negotiate a lump sum payment to the Nursing Home to downsize and the State changed its mind regarding CIP slots. She stated St. Croix County lost out in the downsizing rate due to bed banking and also lost the ability to maximize CIP slots. Krieger said she is dependent upon the Board as to what to implement and for Board direction. The budget will be prepared according to direction given by the Board. St. Croix County Health and Human Services Board Page 9 July 11, 2002 Krieger said the facility requires the same staffing level with a census of 84-88, however, approximately $40,000 revenue is lost per year per decertified nursing home beds. According to Keefe's report, the nursing home census will continue to decrease for the next 10-15 years. The Board suggested preparing a budget based on a census of 88 or 90. Krieger surveyed other facilities in this area and found we are running our facility just like everyone else in the area. Dorsey asked if there were any other issues to bring before the Board. Motion: A motion was introduced by Wentz, seconded by Bethke, and unanimously adopted: that the meeting be adjourned. Time: 10:55 AM Chair: Attest: (Secretary)