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HomeMy WebLinkAboutHealth & Human Services 07-25-02 r ~ 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: 07/25/02 TIME : 6:00 PM LOCATION: St. Croix County Health and Human Services Complex, New Richmond CALL TO ORDER ROLL CALL ADOPTION OF AGENDA DATE OF NEXT MEETING: 08/13/02 ACTION ON PREVIOUS MINUTES: 07/11/02 ANNOUNCEMENTS APPOINTMENTS: UNFINISHED BUSINESS: NEW BUSINESS: 1. 2001 Department Fiscal Audit Report-Rod Paulson, CPA, Tracey and Thole 2. Program Reports a. Nursing Home b. Family and Children's 3. Medical Assistance-HMO Provider Contract for Mental Health/AODA Services 4. Budget Update 5. 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 X 1 ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD July 25, 2002 The St. Croix County Health and Human Services Board met on July 25, 2002 at the St. Croix County Health and Human Services/Health Center complex. MEMBERS PRESENT: Thomas Dorsey, Chair Chris Bethke Lois Burri Leon Berenschot Ralph Swenson Mary Louise Olson Esther Wentz MEMBERS ABSENT: James Craig, excused Fern Johnson-Schmidt, excused STAFF PRESENT: John Borup, Health and Human Services Director Judy Ziegler, Accounting Supervisor Ron Kiesler, Mental Health/AODA Coordinator Steve Kirt, Mental Health/AODA Clinical Services Supervisor Fred Johnson, Family and Children's Supervisor Kathy Leisch, Secretary OTHERS PRESENT: Clarence Malick, County Board Chair Rod Paulson, CPA, Tracey and Thole Chair Dorsey called the meeting to order at 6:00 PM noting the meeting was properly and legally publicized. NEXT MEETING: The next Health and Human Services Board meeting is scheduled for Tuesday, August 13, at 8:30 AM. 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 07/11/02 Health and Human Services Board meeting be approved as circulated. 2001 Department Fiscal Audit Report: Rod Paulson, CPA, presented the St. Croix County Department of Health and Human Services Audit Report, which gave a qualified opinion. The complete report is on file. Paulson stated that the reason for the qualification comes from the manner in which the State requires us to report. Paulson highlighted several areas of the report. Paulson went over the statement of revenues, expenditures and changes in unrestricted fund balance-budget and actual. Revenues exceeded expenditures by $85,159. Designated account set at $503,766.81. He stated that it was a very good year because we did not have to use the carryover money that was applied to the budget. Paulson reviewed the statement of assets, liabilities and fund balances. Malick asked whether the difference between the year 2000 and 2001 was the prepaid St. Croix County Health and Human Services Board Page 2 July 25, 2002 expenses were different by $21,000. Paulson stated that reason for the difference was that Aurora's prepayment was made in January. Paulson stated that the cash balance was up substantially this year from the previous year. He stated that collections were up from the previous year by $660,000. Paulson stated that we have had some large collections including settlements of $200,000 in W-2 reimbursements. Swenson questioned whether we are able to accrue each current year of PTO as a county policy. Paulson stated that PTO increased by $22,000 but looking at a $19-million operation it is not necessarily a big dollar item. Berenschot stated that he would like to see this reported to the finance committee so that they can see positive key items such as the increase in collections and the carryover from 2000. NURSING HOME: Census is 91. Census remains stable. The Nursing Home has not hired one person so far this year. This is due to our decrease by attrition, but more importantly we have a great retention rate due to our salary/benefit package. Although wages in the high labor region are high, we have saved money by not needing to train new hires. Swenson stated that he was looking for a relationship between reduction on FTE's and a reduction on operating costs. Borup stated that approximately 11.2 FTE positions have been eliminated so far via attrition with further adjustments being planned. Borup and Krieger will update on August 13. FAMILY & CHILDREN'S: Johnson reviewed alternate care expenses in the Family and Children's Department for the first 6 months of 2002. Alternate care expenses encompass a range of purchased services such as foster care, group care, childcare institutions and correctional placements. Utilization of these services can vary significantly during the course of a year's budget. Borup stated that not only have the placement numbers gone up but the length of stay has also gone up. Johnson stated that alternate care placement range from per day cost of approximately $175.00 to $215.00. Group homes range from $100.00 to $130.00 per day. Treatment foster care can vary significantly for a monthly cost of $2500.00. Shelter care fluctuates dramatically from $40.00- $50.00 up to $215.00 depending on the level of need. Respite is a $42.00 a day charge. Secure detention is a $140.00 a day charge. Corrections are at $175.00. So depending on the number of days of care and the type of care it can fluctuate significantly as far as expenses. Johnson stated that the if you take the six-month expenses of $482,742 and doubled it, the costs would be over for the year in excess of $150,000. Johnson stated that he is also taking into consideration the number of kids entering and exiting care. The concerning part is that in August there are three kids leaving the residential treatment and they will be down to one placement. Johnson stated that it is hard to predict what will happen with the rest of the year but he does not see it slowing down in the next two or three months. Swenson asked whether these programs are State mandated. Johnson stated that the only program that may not be mandated would be respite. Borup stated that what the State doesn't pay or what isn't collected from the family falls back onto the levy. This is a statewide concern. St. Croix County Health and Human Services Board Page 3 July 25, 2002 MEDICAL ASSISTANCE-HMO PROVIDER CONTRACT FOR MENTAL HEALTH/AODA SERVICES: Kiesler updated the Board on his meeting with Group Health Cooperative of Eau Claire on 7/16/02. They offered to match the State Medical Assistance reimbursement rate for services. A master's level psychotherapy would increase from $34.00 to $55.00, an AODA counseling hour would increase from $29.00 to $31.96, and a MD 15 minute med. check would increase from $22.00 to $31.68. Kiesler stated that while the rates they are offering are an improvement, they fall short of the "breakeven point" for each of the disciplines. They stated that this is their "best offer". They also stated that if we terminated the contract with them they would have a difficult time finding providers for the 130 clients we currently have open to our MH/AODA clinic that are covered by Group Health Cooperative of Eau Claire and that these clients may need to travel out-of-county to find a provider. Kiesler stated that potential options include: 1. Terminate the contract. 2. Continue the contract. 3. The H&HS Board set a maximum number of HMO MA clients that we would see in our clinic at a time. a. This could be dependent on the service rate of the contract. 4. Other options identified by the H&HS Board. Kiesler stated statistical information on potential number of clients affected (report run date 7/16/02): Mental Health Outpatient: 112 HMO MA (5 more clients since last report) AODA Outpatient: 18 MHO MA (1 more client since last report) Dorsey asked how full we are right now. Kirt stated we are busy right now but we have some flexibility with scheduling clients. Kirt stated that they have just hired a new counselor and they have the ability to slide one of the staff in mental health up to full time because it was already budgeted. Kirt stated that the clients need to be served. Kirt stated that the average length of treatment is 12 sessions. Kiesler stated that Borup has the contracts and he will be forwarding them for legal approval. Kiesler stated that contract is considered an "Evergreen" contract and as the State rate goes up our rate goes up with it. Borup said that these are some of our neediest clients and our responsibility to serve. Motion: A motion was introduced by Wentz, seconded by Berenschot, and unanimously adopted: That the Board approves to continue the contract with Group Health Cooperative of Eau Claire at the new rates. BIOTERRORISM UPDATE: Borup commented on bioterrorism that was discussed at the last meeting. Borup stated that the state is pushing us to become involved in regional consortiums. Borup stated that we are working with the State on program development. BUDGET UPDATE: No increased revenues are anticipated from the State. The Department will continue to focus on collections and other revenues to minimize the County levy increase. While the County budget instructions have not yet been released, we do anticipate health insurance to increase about 17w, salaries to be increased at a modest retirement costs are going up about and a -0- increase on operational expenses (exclude salaries/fringes and approved capital outlay items). Property insurance increases are estimated at St. Croix County Health and Human Services Board Page 4 July 25, 2002 24%, which equals the following increased in 2003: Nursing Home +$477, Health and Human Services Department +$604, County Farm +$129, for a total of $1,210. Borup stated that budget report should be completed and brought to the Board for action in late August. Borup stated it is a tight schedule to be ready by August 22 and the Department may need an additional week to finish. PERSONNEL ISSUES: Borup stated that Ed Thurman has been hired to fill the Environmental Health Specialist position in Public Health. Ed has worked in a similar position for Rock County for the past seven years. Ed will begin work here on August 5. Beth Adams, LPN, is resigning effective 7/26/02. Her position is filled with another LPN who is the "doctor's" nurse. Duties are shifted to the administrative nurses resulting in a position reduction. The Nursing Home continues to downsize with 11.21 position reduction. These reductions have met the recommendation of the Wipfli report. Borup requested that the Board bring closure on the deputy director position. Borup stated that he has an acting director in his absence but this work is not compensated. Borup stated that he is not comfortable with having someone function as the acting director and not be compensated for it. The options are to hire a deputy director from the outside or open recruitment from the inside or to continue as we are now. Borup reminded the Board that this is actually a vacant position, not a new request, and was approved last year by the County Board. The issue now of filling this position is complicated by tight fiscal times. Dorsey asked if there were any other issues to bring before the Board. Motion: A motion was introduced by Wentz, seconded by Swenson, and unanimously adopted: that the meeting be adjourned. Time: 7:50 PM Chair: Attest: (Secretary)