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HomeMy WebLinkAboutHealth & Human Services 11-13-01 ESTHER WENTZ WILL REVIEW VOUCHERS AT 8:00 AM 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: 11/13/01 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: 11/20/01 (TUESDAY) ACTION ON PREVIOUS MINUTES: 10/25/01 ANNOUNCEMENTS APPOINTMENTS: UNFINISHED BUSINESS: 1. Discussion/Action on possible updates to Department or Nursing Home 2002 Budget a. W-2 Program Status 2. Review of services and pharmaceutical contract with Econofoods Quality Care Pharmacy NEW BUSINESS: 1. Consideration of Claims and vouchers 2. Financial Report 3. Nursing Home Bed "Banking" withdrawal 4. Program Reports a. Nursing Home b. Long Term Support c. Family & Children's 5. Setting 2002 Child Care Rates 6. Setting 2002 Nursing Home private pay rates 7. Resolution for St. Croix County Health and Human Services Board to give their recommendation regarding the status of the Nursing Home 8. Converting Nursing Home Beds to CIP II Slots (Community Integration Program) 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 K ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD November 13, 2001 The St. Croix County Health and Human Services Board met on November 13, 2001 at the St. Croix County Health and Human Services/Health Center complex. MEMBERS PRESENT: Robert Stephens, Chair Chris Bethke James Craig Einar Horne Fern Johnson Mary Louise Olson Esther Wentz MEMBERS ABSENT: Leon Berenschot, excused Lois Burri, excused STAFF PRESENT: John Borup, Health and Human Services Director Carolyn Krieger, Nursing Home Administrator Judy Ziegler, Accounting Supervisor Mary Squyer, W-2/Economic Support Supervisor Becky Ruka, Accounts Receivable Supervisor Fred Johnson, Family and Children's Supervisor Ron Lockwood, Long Term Support Coordinator Malva Berg, Secretary OTHERS PRESENT: Audrey Roecker, Western Region Area Administrator 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 scheduled for Tuesday, November 20, 2001 has been cancelled unless urgent agenda items arise. AGENDA: Motion: A motion was introduced by Bethke, seconded by Craig, 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 10/25/01 Health and Human Services Board meeting be approved as circulated. Horne requested copies of his letters regarding the Nursing Home be sent to the remaining County Board members with the official copy of the 10/25/01 minutes. CONSIDERATION OF CLAIMS: The following reports for October were distributed to the Board: fixed assets, financial report and cash reports. Health and Human Services Board member, Wentz, reviewed the following vouchers. HUMAN SERVICES: 10049: $1,200.00, homeless. This check represents a t St. Croix County Health and Human Services Board Page 2 October 11, 2001 deposit to secure shelter for a homeless person. The checks are always issued to the landlord. 10082: Grandstand Funeral Home, $1,500.00, funeral expense. Economic Support administers the funeral/cemetery funds. This program is reimbursed 100% by the State. The amount of the check to the funeral home is determined by State guidelines after reviewing any assets of the deceased. Motion: A motion was introduced by Wentz, seconded by Stephens, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book pages 1965 through 2064: Human Services voucher 10049, dated October 17, 2001 in the amount of $1,200.00. Human Services vouchers 10050 through 10144, dated October 18, 2001 in the amount of $267,998.70. Human Services voucher 10145, dated October 19, 2001 in the amount of $600.00. Human Services vouchers 10146 through 10163, dated October 25, 2001 in the amount of $88,187.40. Human Services vouchers 10164 through 10165, dated October 26, 2001 in the amount of $389.21. Human Services voucher 10166, dated October 26, 2001 in the amount of $750.00. Human Services vouchers 10167, dated October 27, 2001 in the amount of $750.00. Human Services vouchers 10168 through 10199, dated November 11, 2001 in the amount of $212,465.51. Human Services vouchers 10200 through 10265, dated November 08, 2001 in the amount of $61,615.53. Human Services voucher 10266, dated November 08, 2001 in the amount of $385.56. Human Services vouchers 10329 through 10353, dated November 13, 2001 in the amount of $131,408.16. Human Services vouchers 10354 through 10552, dated November 13, 2001 in the amount of $194,959.23. Nursing Home vouchers 1570 through 1588, dated October 18, 2001 in the amount of $39,957.37. Nursing Home vouchers 1589 through 1591, dated October 25, 2001 in the amount of $51.50. • St. Croix County Health and Human Services Board Page 3 ` October 11, 2001 Nursing Home vouchers 1592 through 1593, dated November 01, 2001 in the amount of $2,200.00. Nursing Home vouchers 1594 through 1596, dated November 08, 2001 in the amount of $567.67. Nursing Home vouchers 1597 through 1643, dated November 13, 2001 in the amount of $47,999.15. Human Services, Workshop, Public Health vouchers 591 through 618, dated October 18, 2001 in the amount of $211,879.08. Social Services and Human Services vouchers 368 through 386, dated October 19, 2001 in the amount of $42,035.14. Human Services and Nursing Home vouchers 554 through 580, dated October 23, 2001 in the amount of $165,814.05. Human Services, Workshop, Public Health vouchers 558 through 590, dated October 04, 2001 in the amount of $269,631.80. Social Services and Human Services vouchers 347 through 567, dated October 20, 2001 in the amount of $43,033.29. Human Services and Nursing Home vouchers 524 through 553, dated October 09, 2001 in the amount of $215,286.77. Human Services, Workshop, Public Health vouchers 619 through 651, dated November 01, 2001 in the amount of $275,027.51. Social Services and Human Services vouchers 387 through 407, dated November 01, 2001 in the amount of $42,749.53. Human Services and Nursing Home vouchers 581 through 609, dated November 06, 2001 in the amount of $218,775.76. Borup announced that ECHO training began last week and will be discussed at information services tomorrow. This training is the beginning of centralizing the intake process. When a client contacts the department for services, there will be one central point of contact for services. The process will start with Mental Health and AODA and will then expand to Long Term Support. Borup said this will involve Chapter 51 programs and he feels good about the process. W-2 PROGRAM: Squyer distributed a report on W-2 caseload as defined by the State. Stephens requested Squyer to also bring this information to Finance. Stephens has been requested to report to the Finance Committee every other month. An escape/exit plan for W-2 is to be formulated by the end of the year. Finance agreed that W-2 should continue as long as it is not an undue liability to the County and then it is a decision of the Health and Human Services Board as to what to do. Borup said W-2 was authorized by resolution by the full County Board. Horne asked the definition of undue liability. Borup reminded the Board that W-2 pays a portion of administrative services in the Department. Economic Support has mandated services of food stamps, Medical Assistance, etc. even if we no longer administered W-2. Squyer will • St. Croix County Health and Human Services Board Page 4 October 11, 2001 give a presentation to the Health and Human Services Board in December. We will report to Finance upon request. Squyer said work has begun on the training room as part of the W-2 program. If we no longer have W-2, we will not need this room. Squyer said there are no dentists in St. Croix County that will provide services to medical Assistance/Badgercare recipients. SETTING 2002 CHILD CARE RATES: Motion: A motion was introduced by Wentz, seconded by Horne, and unanimously adopted: That the child care rates be approved as presented. (Rate schedule is attached at the end of the minutes.) RESOLUTION FOR ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD TO GIVE THEIR RECOMMENDATION REGARDING THE STATUS OF THE NURSING HOME: Motion: A motion was introduced by Wentz, seconded by Bethke, That the Board approve a resolution for making a recommendation for the status of the Nursing Home to be option #3-building a new building after downsizing. The Steering Committee will make a recommendation the day of the meeting but not before. Horne said more issues need to be studied regarding the Nursing Home. Stephens said the charges made to the Steering Committee were followed. The County is not mandated to operate a Nursing Home. The County is responsible for the placement of protectively placed residents. Every resident is assessed to determine the most appropriate placement. There are currently 26 protectively placed clients in the nursing home and that number will be ongoing. There is a definite need for dementia care in nursing homes. Motion: A motion was introduced by Horne, seconded by Craig, That the Board table the existing motion regarding making a recommendation regarding the status of the Nursing Home. Roll call vote: Robert Stephens-no Leon Berenschot-absent Chris Bethke-no Lois Burri-absent James Craig-yes Einar Horne-yes Fern Johnson-no Mary Louise Olson-yes Esther Wentz-no Three yes, four no, motion defeated. A statement made by Judge Lundell for the August meeting was questioned as to why it would be a hardship to the judicial system if the Nursing Home is closed. There would be no other place accepting of some placements other than jail. The majority of the admissions to St. Croix Health Center would not be accepted in area facilities. The Chair called for a vote on the motion regarding the resolution. St. Croix County Health and Human Services Board Page 5 October 11, 2001 Roll call vote: Robert Stephens-yes Leon Berenschot-absent Chris Bethke-yes Lois Burri-absent James Craig-no Einar Horne-no Fern Johnson-yes Mary Louise Olson-no Esther Wentz-yes Four yes, three no, motion passed. (Resolution attached at the end of the minutes.) REVIEW OF SERVICES AND PHARMACEUTICAL CONTRACT WITH ECONOFOODS QUALITY CARE PHARMACY: Krieger reported there were no pharmacy errors for the last month but they are basically still doing a manual system. FINANCIAL REPORTS: The following reports through September, 2001 were distributed to the Board. The IGT funds received were better than the numbers projected by Keefe. Borup indicated MA Mental Health/AODA deficit reduction dollars received were higher than anticipated. The Department budgeted for $36,000 and $62,000 was received. ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD 01/01/01 THROUGH 09/30/01 NURSING HOME Reconciled Cash Balance 09/30/01 ($923,656.57) Add: Accounts Receivable, 09/30/01 Private Pay $49,543.73 Medicare $241,005.22 Medicaid $274,848.04 General $13,300.00 Accounts Payable-09/30/01 ($208,566.53) Net Current Items, 09/30/01 ($553,526.11) 2001 Revenue Recorded through 09/30/01 $4,545,046.19 Includes Allocations of Anticipated Revenues 2001 Expenses Recorded through 09/30/01 $4,885,491.54 Includes Allocations of Expected Expenses *Includes $72,529.79 Medicaid receivable July-September Net current items $ (553,526.11) Estimated IGT for November $ 168,000.00 Estimated IGT for December $ 250,000.00 Adjusted Net Current Items $ (135,526.11) HEALTH AND HUMAN SERVICES - 2001 • St. Croix County Health and Human Services Board Page 6 October 11, 2001 SUMMARY Total OF REVENUES Jan.-Sept. Budget Balance Administration 554,667.07 736,431.00 181,763.93 75.3$ AODA Services 329,895.32 353,366.00 23,470.68 93.4% Intensive In-Home Treat. 135,960.35 176,471.00 40,510.65 77.0% Long Term Support 8,015,163.32 11,519,994.00 3,504,830.68 69.6% Mental Health 1,485,260.82 1,895,384.00 410,123.18 78.4% Family & Children's 1,840,984.55 2,360,749.00 519,764.45 78.0% Economic Support 654,553.82 1,256,132.00 601,578.18 52.1$ General Relief 5,262.01 5,281.00 18.99 99.6 TOTAL REVENUES ALL PROGRAMS 13,021,747.26 18,303,808.00 5,282,060.74 71.1% SUMMARY Total OF EXPENDITURES Jan.-Sept. Budget Balance % Administration 517,179.87 736,431.00 219,251.13 70.2% Alcohol-Drug Abuse 244,197.79 353,366.00 109,168.21 69.1% Intensive In-Home Treat. 123,692.49 176,471.00 52,778.51 70.1% Long Term Support 7,592,283.75* 11,519,994.00 3,927,710.25 65.9% Mental Health 1,376,750.84 1,895,384.00 518,633.16 72.6% Family & Children's 1,637,913.97* 2,360,749.00 722,835.03 69.4 Economic Support 808,300.67 1,256,132.00 447,831.33 64.3% General Relief 54,842.95 5,281.00 (49,561.95) 1038.5% Accrued Payroll 0.00 0.00 0.00 0.0% TOTAL 2001 HUMAN SERVICES BUDGET 12,355,162.33 18,303,808.00 5,948,645.67 67.5% *Salaries for Human Services Professional Union Component are still being paid at 1999 rate. Estimated costs for 2001 are $50,000 to $75,000. PUBLIC HEALTH Total Jan.-Sept. Budget Balance TOTAL REVENUES* 819,114.34 1,099,234.00 280,119.66 74.5% TOTAL EXPENDITURES 735,931.65 1,099,234.00 363,302.35 66.9% • St. Croix County Health and Human Services Board Page 7 October 11, 2001 CONVERTING NURSING HOME BEDS TO CIP II SLOTS (COMMUNITY INTEGRATION PROGRAM): 27 Nursing Home beds were banked on June 27, 2001 to preserve the Medicaid rate. Administration is recommending unbanking these beds at this time to maximize the availability of CIP II funds. If the nursing home is downsized or closed, the banked beds are not eligible for CIP II slots. The value for each CIP II slot at this time is $14,885. For every year the beds are banked, the Nursing Home will lose 10% of those beds, but it takes 18 months to get the beds back once the request is made to unbank beds. Lockwood explained Long Term Support is currently serving 45 CIP II clients and there are 31 on the CIP II waiting list. He said CIP II slots are filled from the waiting lists first as the County does not receive money unless the slots are filled. A resolution authorizing the St. Croix County Nursing Home to unbank 27 beds for the purpose of creating CIP II slots was presented to the Board. Motion: A motion was introduced by Bethke, seconded by Wentz and unanimously adopted: That the Board approves the resolution authorizing the St. Croix County Nursing Home to unbank 27 beds for the purpose of creating CIP II slots. (Copy of the resolution attached at the end of the minutes.) Motion: A motion was introduced by Wentz, seconded by Bethke, That the Board approves that if anything happens that the Nursing Home is closed or downsized, that Nursing Home beds will be converted to CIP II slots. If the Nursing Home is sold, the Nursing Home beds could not be converted to CIP II slots. Motion: A motion was introduced by Horne, seconded by Olson, and unanimously adopted: That the motion regarding converting Nursing Home beds to CIP II slots be postponed. SETTING 2002 NURSING HOME PRIVATE PAY RATES: Motion: A motion was introduced by Craig, seconded by Bethke, and unanimously adopted: That the Board approves the following increase in Private Pay Rates for the Nursing Home effective January 1, 2002: ISN $145/day SNF $130/day ICF $120/day Krieger said the distributor Horne requested to be investigated at the last meeting is a bulk distributor pharmaceutical company and would not meet the Nursing Home needs. Krieger reported that the Nursing Home census is 87 with referrals being slow. She said the opinions being given by local radio stations and newspapers have resulted in a negative impact on the Nursing Home census. She said the Nursing Home is cutting expenses any way possible without dropping the quality of care. FAMILY AND CHILDREN'S: Johnson gave an update on the work through the State/County workgroup on the ongoing standards. He said the State has been working on ongoing standards for several years and recently involved County • St. Croix County Health and Human Services Board Page 8 October 11, 2001 representation. He said there is a need for standards, but is unsure how this will impact St. Croix County. He said the outcome of having ongoing standards would be more uniform services throughout the state. He said some of the standards will be piloted in 2002 but questions if some can be met and liability surrounding these standards, a concern that has been raised by several counties. Roecker said the standards are just a map to follow. Investigation standards have been in place for several years. Stephens left the meeting at 10:20 and turned the meeting over to Secretary Bethke. Horne questioned child monitoring. Johnson said this tracking service was part of our intensive supervision program, which was a six to eight month pilot program. There were a lot of restrictions to get youth into the program so the intensive supervision program was discontinued but the tracker program continues to be implemented with juvenile justice cases. Program is grant funded. Johnson said he predicts alternate care costs will be approximately $50,000 to $60,000 over for 2001. Audrey Roecker, Area Administrator for the Department of Health and Family Services, distributed a number of handouts regarding her department and the functions of the various divisions within the Department. The State is not going to give more monies to the counties but will continue to require services. Costs are being passed onto the counties. Bethke asked if there were any other issues to bring before the Board. Motion: A motion was introduced by Horne, seconded by Wentz, and unanimously adopted: that the meeting be adjourned. Time: 10:45 AM Chair: Attest: (Secretary)