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HomeMy WebLinkAboutHealth & Human Services 08-13-02 s LEON BERENSCHOT WILL REVIEW VOUCHERS AT 8:00 AM 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: 08/13/02 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: 08/22/02 ACTION ON PREVIOUS MINUTES: 07/25/02 ANNOUNCEMENTS APPOINTMENTS : UNFINISHED BUSINESS: 1. Long Term Support Social Worker/Case Manager Job Share Request 2. Nursing Home roof repair needs NEW BUSINESS: 1. Consideration of Claims and Vouchers 2. Financial Report 3. 2003 Budget Update 4. Personnel Issues a. Deputy Director-status of position and possible action on position 5. Program Reports a. Nursing Home b. Economic Support/W-2 c. Health Insurance Portability and Accountability Act (HIPAA) 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 August 13, 2002 The St. Croix County Health and Human Services Board met on August 13, 2002 at the St. Croix County Health and Human Services/Health Center complex. MEMBERS PRESENT: Thomas Dorsey, Chair Leon Berenschot Chris Bethke James Craig Fern Johnson-Schmidt Mary Louise Olson Ralph Swenson Esther Wentz MEMBERS ABSENT: Lois Burri, excused STAFF PRESENT: John Borup, Health and Human Services Director Judy Ziegler, Accounting Supervisor Ron Lockwood, Long Term Support Coordinator Mary Squyer, Economic Support/W-2 Supervisor Becky Ruka, Accounts Receivable Supervisor Malva Berg, Secretary OTHERS PRESENT: Deb Kathan, Personnel Director 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, August 22, at 6:00 PM. AGENDA: Motion: A motion was introduced by Berenschot, seconded by Bethke, and unanimously adopted: That the agenda be approved as circulated. MINUTES: Motion: A motion was introduced by Wentz, seconded by Swenson, and unanimously adopted: That the minutes of the 07/25/02 Health and Human Services Board meeting be approved as circulated. ANNOUNCEMENT: Borup reported that the first positive West Nile Virus (WNV) bird from St. Croix County was reported to the health department on August 8, 2002. This bird was submitted on July 29 from the Hudson area. No human cases of WNV have been diagnosed in St. Croix County or in the state as of today. Borup informed Board members there was an invitation in their packets for the St. Croix Industries picnic to be held on Thursday, August 15. NURSING HOME ROOF REPAIR NEEDS: Borup, said the east wing of the Nursing Home has been repaired with a dense foam insulation but other parts of the roof are beginning to deteriorate at a more rapid rate than anticipated. As a result, Ralph Robole would like to have the balance of the roof repair moved up in the capital outlay plan to 2003. Borup circulated pictures of the areas of the roof that are deteriorating. Robole feels that the balance of the roof could be spot repaired in order to keep the building dry this winter St. Croix County Health and Human Services Board Page 2 August 13, 2002 and repair the rest in the spring of 2003. Borup said the remaining costs are estimated at $50,000. Borup stated this type of repair adds insulation value and includes a 10-year warranty. Swenson questioned why the project isn't being done now. Borup said he is trying to take a more conservative approach due to financial concerns of the nursing home. A formal bid process would have to occur if the Board decided to repair the roof. It was the consensus of the Board for Borup to get a legal opinion from Timmerman regarding proceeding with the roof repair. LONG TERM SUPPORT SOCIAL WORKER/CASE MANAGER JOB SHARE REQUEST: Lockwood explained the case manager position is held by a registered nurse and the case manager position is the position that would be job shared with the registered nurse and social worker. If this move happened, a social worker position would open up and the social work position would then be a represented position. The cost savings to the County for this job share would range from $3,000 to $7,000 per year. Lockwood said a job share was previously done in his department and worked well for over eight years. Kathan said job shares are approved in the County when the job share is in the County's best interest and most have occurred in Public Health. She said job shares are not used very often as there tend to be more efficiencies in a full time position that are not met in two part time positions. Kathan said this request is being made by two long-term employees that have worked well for the County. Kathan said it would be difficult to pilot the job share as there would be a mix of represented and non-represented employees. Kathan said with a job share only one employee receives insurance benefits per County policy. Motion: A motion was introduced by Swenson, seconded by Wentz, and adopted with Berenschot voting no, That the Board denies the job share request for Long Term Support Social Worker/Case Manager. NURSING HOME ROOF REPAIR NEEDS (continued): Timmerman gave the opinion to Borup via the telephone a $50,000 capital project should go before the full County Board for approval before the bid process could start. Robole is comfortable with the patchwork repairs to the roof and feels that the roof would be in good shape to wait until spring for the roof replacement. Borup recommended following Robole's advice. Motion: A motion was introduced by Bethke, seconded by Berenschot, and unanimously adopted: That the Board follow Robole's recommendation to put the roof replacement in the 2003 capital outlay budget. DEPUTY DIRECTOR STATUS OF POSITION AND POSSIBLE ACTION ON POSITION: Borup said the position has been on and off for the past 15 months. The 07/01/02 start date was delayed pending development of the 2003 budget due to growing concerns over the State and County budgets. The position has been vacant since April of 1997. The growth in State/Federal demands and program complexity has been continual over the past five years. Currently the State/Federal governments are demanding more accountability, numerous mandates, e.g. HIPAA, WISACWIS, and performance contracting (anticipated). Borup said that with more administrative staff, there would be more time to focus on policy, efficiencies, revenues and minimize potential for errors and omissions. Kathan said this is a high profile and expensive position in a tight budget time. She said that does not minimize the need of the position as more administrative duties are needed. The Department has survived without the position but it hasn't been easy. Work from the Deputy Director position St. Croix County Health and Human Services Board Page 3 August 13, 2002 was farmed out to other managers but they were not compensated for the additional work. Borup agreed with Kathan and asked for a decision with this budget as it is causing a division within the agency. Borup said the most senior manager has been appointed acting director without compensation when Borup is absent from the facility. Initially this was Karen Hall and now is Ron Kiesler. It was the consensus of the Board that unless Borup is gone for an extended period of time, this duty is an extension of the current job and if gone for an extended period of time an interim director would need to be appointed. Motion: A motion was introduced by Berenschot, seconded by Swenson, and unanimously adopted: That the Board will postpone a decision on the Deputy Director position until the 2003 Budget is done. PERSONNEL ISSUES: Squyer said in preparing the 2003 budget, it was decided due to reduced caseload to reduce the number of financial employment planners by one effective 01/01/03. Cheryl Roesler, Financial Employment Planner, has been on medical leave and was scheduled to return to work August 19, however when informed of staffing changes for 2003, took a voluntary lay off effective August 19, 2002. The position will remain open and will not be filled. Roesler has been employed by the county for 12 years. She will retain her seniority for one year and retains the right to post into vacant positions. Jackie Widman, Family and Children's Social Worker, resigned and we are actively recruiting to fill her position. It is necessary to fill this position due to the implementation of WISACWIS and continuing caseload demands. Audrey Nevins, CSP Social Worker, resigned effective August 12. We are now recruiting to replace her with continued caseload demands. ECONOMIC SUPPORT/W-2: The State has changed the way in which we are reimbursed for W-2, causing some negative financial implications for Income Maintenance. This change is affecting counties across the state. In the past the unit did time studies one week a month to obtain a percent to add to the CARS report. This does not give a true picture so now a continuous time study will be done that will correctly allocate towards W-2. St. Croix County will follow a format currently being used by Sauk County. The State has changed the rules and ability to access W-2 monies. Borup said he is optimistic for the W-2 program for 2003. The total case count for Economic Support/W-2 is up 55 cases over last year. The Board recessed from 10:05 to 10:10. CONSIDERATION OF CLAIMS: The following report for July was distributed to the Board: July cash report. Health and Human Services Board member, Berenschot, reviewed the following vouchers: HUMAN SERVICES: 14591: REM Ramsey, Inc. $4,839.43, Long Term Support, CIP 1A, waiver St. Croix County Health and Human Services Board Page 4 August 13, 2002 client expense. We have a severely handicapped client in this group home in Minnesota. REM operates several group homes in St. Croix County but they were not able to supply the specialized services this client requires. 14615: Aurora Community Services $(20,000.00) Prepaid Expense. Our annual contract with Aurora requires a 1/12th prepayment of January 1 of each year. We recoup this money each month through the balance of the year. 14713: O'Connell Family Funeral Home, $1,058.02, funeral expense. This payment was approved by the State and we will collect the entire amount through the State CARS reimbursement system. Motion: A motion was introduced by Berenschot, seconded by Wentz, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book: Human Services vouchers 14464 through 14466, dated July 11, 2002 in the amount of $1,446.52. Human Services vouchers 14467, dated July 12, 2002 in the amount of $878.00. Human Services voucher 14468 through 14566, dated July 18, 2002 in the amount of $325,567.32. Human Services voucher 14569 through 14610, dated July 25, 2002 in the amount of $112,777.02. Human Services voucher 14611, dated July 30, 2002 in the amount of $450.00. Human Services voucher 14612 through 14657, dated August 01, 2002 in the amount of $181,948.18. Human Services voucher 14658 through 14741, dated August 08, 2002 in the amount of $156,987.11. Human Services voucher 14746 through 14891, dated August 13, 2002 in the amount of $100,903.60. Human Services voucher 14892 through 14953, dated August 13, 2002 in the amount of $37,243.64. Nursing Home vouchers 2118 through 2125, dated July 18, 2002 in the amount of $9,664.59. Nursing Home vouchers 2129 through 2132, dated August 01, 2002 in the amount of $917.86. Nursing Home vouchers 2133 through 2135, dated August 08, 2002 in the amount of $196.30. Nursing Home vouchers 2136 through 2166, dated August 13, 2002 in the amount of $49,337.66. y St. Croix County Health and Human Services Board Page 5 August 13, 2002 Social Services and Human Services vouchers 255 through 273, dated July 11, 2002 in the amount of $49,557.47. Human Services, Workshop, Public Health vouchers 375 through 403, dated July 16, 2002 in the amount of $226,993.40. Human Services and Nursing Home vouchers 361 through 388, dated July 16, 2002 in the amount of $173,845.65. Social Services and Human Services vouchers 274 through 285, dated July 18, 2002 in the amount of $204,514.83. Human Services and Nursing Home vouchers 389 through 418, dated August 01, 2002 in the amount of $225,549.93. Human Services, Workshop, Public Health vouchers 404 through 435, dated August 01, 2002 in the amount of $343,493.42. Social Services and Human Services vouchers 286 through 296, dated August 02, 2002 in the amount of $5,685.29. FINANCIAL REPORTS: The following financial reports through June were distributed to Board members. Swenson asked if in the future the Nursing Home report could include year-end or quarterly balances in addition to monthly figures so members would have figures to compare. Ziegler said the Social Worker wage contract has been settled and the July report should reflect those figures. Borup stated Family and Children's out of home expenses remain higher than budgeted and we are looking at a $45,000 deficit through June. ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD 01/01/02 THROUGH 06/30/02 NURSING HOME Cash Balance 06/30/02 $712,976.66 Add: Accounts Receivable, 06/30/02 Private Pay $40,333.37 Medicare $167,900.78 Medicaid $214,348.37 General $0.00 Accounts Payable-06/30/02 ($322,258.75) Net Current Items, 06/30/02 $813,300.43 2002 Revenue Recorded through 06/30/02 $3,479,800.22 Includes Allocations of Anticipated Revenues 2002 Expenses Recorded through 06/30/02 $3,253,289.67 Includes Allocations of Expected Expenses St. Croix County Health and Human Services Board Page 6 August 13, 2002 Excess Revenues over Expenses $226,510.55 v St. Croix County Health and Human Services Board Page 7 August 13, 2002 HEALTH AND HUMAN SERVICES - 2002 SUMMARY Total OF REVENUES Jan.-June. Budget Balance Administration 528,214.23 786,486.00 258,271.77 67.2% AODA Services 214,125.63 434,703.00 220,577.37 49.3% Long Term Support 5,194,839.73 12,358,744.00 7,163,904.27 42.0% Mental Health 1,242,128.29 2,297,343.00 1,055,214.71 54.1% Family & Children's 1,530,284.33 2,519,843.00 989,558.67 60.7% Economic Support 534,240.18 1,095,090.00 560,849.82 48.8% General Relief 4,238.56 13,494.00 9,255.44 31.4% REVENUES HUMAN SERVICES PROGRAMS 9,248,070.95 19,505,703.00 10,257,632.05 47.4-W Public Health 607,950.63 1,256,677.00 648,726.37 48.4% TOTAL REVENUES HEALTH AND HUMAN SERVICES 9,856,021.58 20,762,380.00 10,906,358.42 47.5% SUMMARY Total OF EXPENDITURES Jan.-June. Budget Balance % Administration 358,491.96 786,486.00 427,994.04 45.6% Alcohol-Drug Abuse 177,368.48 434,703.00 257,334.52 40.8% Long Term Support 5,506,799.14* 12,358,744.00 6,851,944.86 44.6% Mental Health 1,094,644.66 2,297,343.00 1,202,698.34 47.6% Family & Children's 1,221,440.34* 2,519,843.00 1,298,402.66 48.5% Economic Support 525,029.61 1,095,090.00 570,060.39 47.9% General Relief 15,363.04 13,494.00 (1,869.04) 113.9% Accrued Payroll 0.00 0.00 0.00 0.0% EXPENDITURES HUMAN SERVICES PROGRAMS 8,899,137.23 19,505,703.00 10,606,565.77 45.6% Public Health 596,051.47 1,256,677.00 660,625.53 47.4% TOTAL EXPENDITURES HEALTH AND HUMAN SERVICES 9,495,188.70 20,762,380.00 11,267,191.30 45.7% *Salaries for Human Services Professional Union Component are still being paid at 1999 rate. Estimated costs for 2002 are $95,000 to $110,000. To be on budget, percentage should be 50$. NURSING HOME OPERATIONS REPORT 1st QTR., 2002 JAN-JUNE TOTAL OPERATING REVENUES 1,151,543.38 2,358,082.22 St. Croix County Health and Human Services Board Page 8 August 13, 2002 OPERATING EXPENSES: DAILY PATIENT SERVICES 1,062,145.87 2,031,203.38 SPECIAL SERVICES 69,364.98 136,434.93 GENERAL SERVICES 274,460.52 556,764.43 ADMINISTRATIVE SERVICES 130,110.35 263,963.51 UNASSIGNED: DEPRECIATION % BASED 50,250.00 100,500.00 OTHER 88,173.98 164,423.42 TOTAL OPERATING EXPENSES 1,674,505.70 3,253,289.67 ET FROM OPERATIONS 522,962.32 895,207.45 ON-OPERATING ITEMS: REVENUE FROM RATE APPEALS 4,500.00 9,000.00 WAGE PASSTHROUGH REVENUE - INTERGOVERNMENTAL TRANSFER IGT % BASED 235,617.00 471,234.00 CO. ALLOCATION % BASED on OPS. LEVY OF $1,282,965 320,742.00 641 484.00 TOTAL NON-OPERATING ITEMS 560,589.00 1,121,718.00 EXCESS of REVENUES OVER EXPENSES 37,896.68 22-6,510.55 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 226,510.55 CASH REPLENISHMENT % BASED on $250,000 for YEAR 125 000.00 FUND BALANCE, END of PERIOD 1,857,578.24 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 INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA): Ruka said HIPAA is an unfunded federal mandate. A final decision regarding amendments to the Privacy Rule was made on August 12th so the compliance date for the Privacy Rule of April 14, 2003 will be maintained. Ruka said the extension has been filed but we need to be ready to test electronic claims in April of 2003. Ruka distributed a project overview report on HIPAA to the Board. She reviewed the report with members and highlighted various areas. HIPAA is the t ' St. Croix County Health and Human Services Board Page 9 August 13, 2002 first law to mandate national standards to protect the privacy and security of Americans, personal health records. She said phase one of HIPAA allows you to change employment without loss of health insurance benefits due to pre- existing conditions. She said the estimated cost for implementation of HIPAA is over $15,000 in the 2003 budget. Ruka said she has seen a trend that more clients requesting services are uninsured or have Medical Assistance. She said she is receiving reports that employee work hours are being cut and health insurance premiums are skyrocketing. She said we had a recent out of home placement at a CCI. The county cost for this placement will be over $5,000 per month, but the parent liability for that cost will be $19.22/month. Parental responsibility is based on the child support standards or the state impoverishment schedule - whichever is the least of the two. Dorsey asked if there were any other issues to bring before the Board. Swenson presented a letter he received from St. Croix Family Resource Center. Borup said this is a non-profit group that was set up through the Extension office. There are no eligibility guidelines. Borup said they have lost significant grant monies so are financially strapped and are looking for funds. Olson said she is opposed to using county money for this type of program as she sees it as a duplication of efforts. Motion: A motion was introduced by Berenschot, seconded by Wentz, and unanimously adopted: that the meeting be adjourned. Time: 11:05 AM Chair: Attest: (Secretary)