Loading...
HomeMy WebLinkAboutHealth & Human Services 12-11-01 FERN JOHNSON WILL REVIEW VOUCHERS AT 8:00 AM 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: 12/11/01 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: 12/27/01 (the next meeting in 2002 is 01/11/02) ACTION ON PREVIOUS MINUTES: 11/13/01 ANNOUNCEMENTS APPOINTMENTS : UNFINISHED BUSINESS: 1. Reconsideration of Resolution to County Board recommending from one of the four options for the Nursing Home NEW BUSINESS: 1. Consideration of Claims and Vouchers 2. Financial Report 3. W-2 Program "Exit" plan 4. Program Reports a. Nursing Home b. Public Health c. Mental Health/AODA 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 t r, ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD December 11, 2001 The St. Croix County Health and Human Services Board met on December 11, 2001 at the St. Croix County Health and Human Services/Health Center complex. MEMBERS PRESENT: Robert Stephens, Chair Leon Berenschot Chris Bethke Lois Burri James Craig Fern Johnson Mary Louise Olson Esther Wentz MEMBERS ABSENT: Einar Horne, 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 Ron Kiesler, AODA/Mental Health Coordinator Steve Kirt, Mental Health/AODA Clinical Services Supervisor Barbara Nelson, Public Health Supervisor-Health Officer Malva Berg, Secretary OTHERS PRESENT: Jack Dowd Jeff Peterson, WIXK 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 is scheduled for Friday, January 11, 2002. The meeting on December 27 has been cancelled unless urgent agenda items arise. AGENDA: Motion: A motion was introduced by Bethke, seconded by Berenschot, and unanimously adopted: That the agenda be approved as circulated. MINUTES: Motion: A motion was introduced by Wentz, seconded by Bethke, and unanimously adopted: That the minutes of the 11/13/01 Health and Human Services Board meeting be approved as circulated. 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 Stephens, seconded by Wentz, That the Board reconsider the resolution for St. Croix County Health and Human Services Board to give their recommendation regarding the status of the Nursing Home. Roll call vote: Robert Stephens-yes Leon Berenschot-yes Chris Bethke-yes s' St. Croix County Health and Human Services Board Page 2 December 11, 2001 r Lois Burri-yes James Craig-yes Einar Horne-absent Fern Johnson-yes Mary Louise Olson-yes Esther Wentz-yes Eight yes, one absent, motion passed. Stephens said the resolution is on the floor for discussion. County Board Chair said no recommendation to the County Board should be made by the Health and Human Services Board. Finance Chair was upset that Keefe gave an opinion as part of the study. Stephens said he demanded an opinion from Keefe. The Health and Human Services Board has the same information from the study that the County Board members have. Stephens said it is traditional that the Committee of responsibility makes a recommendation regarding the reason for the resolution. Craig questioned if the subject of converting nursing home beds to CIP slots has been presented to the County Board. Burri and Berenschot said they would have voted in the positive for the above resolution if they had been at the last meeting. Stephens said the County Board gave specific charges for the study that Keefe performed and those charges were met. Olson expressed concern regarding the number of protectively placed residents. Borup said the number has changed slightly for the protective placed numbers due to age of residents. Borup said the Nursing Home has a unique history of admitting residents other nursing homes won't accept or aren't capable of caring for. Stephens said services should be provided by the county if private industry is unable to provide that service. Motion: A motion was introduced by Olson, That the Board withdraw the resolution for St. Croix County Health and Human Services Board to give their recommendation regarding the status of the Nursing Home. The Chair called for a second to the motion three times. The motion died for lack of a second. Motion: A motion was introduced by Wentz, seconded by Bethke, That the Board send the resolution for St. Croix County Health and Human Services Board to give their recommendation regarding the status of the Nursing Home to the County Board as is. Roll call vote: Robert Stephens-yes Leon Berenschot-yes Chris Bethke-yes Lois Burri-yes James Craig-yes Einar Horne-absent Fern Johnson-yes Mary Louise Olson-no Esther Wentz-yes Seven yes, one no, one absent, motion passed. St. Croix County Health and Human Services Board Page 3 ' December 11, 2001 It was the consensus of the Board to withhold the resolution to unbank beds due to the urgency of the Nursing Home situation. CONSIDERATION OF CLAIMS: The following reports for November were distributed to the Board: fixed assets, unemployment report for three months, financial report and cash reports. Health and Human Services Board member, Johnson, reviewed the following vouchers. HUMAN SERVICES: 10642: Baby Jogger, $860.00, Long Term Support client supplies. This is a stroller (heavy duty recreational wheelchair) for an eight- year-old girl with autism and seizure disorder. She has outgrown her previous stroller and this one is almost adult size. The family lives in the country and this stroller allows the caregiver to take the girl out for walks, go shopping, etc. This is a CIP client and the State will provide waiver funds to cover this cost. Motion: A motion was introduced by Johnson, seconded by Stephens, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book pages 2065 through 2149: Human Services vouchers 10553 through 10608, dated November 15, 2001 in the amount of $142,323.47. Human Services vouchers 10609 through 10630, dated November 21, 2001 in the amount of $98,803.70. Human Services voucher 10631, dated November 21, 2001 in the amount of $1,019.28. Human Services vouchers 10632, dated November 27, 2001 in the amount of $750.00. Human Services vouchers 10633 through 10674, dated November 29, 2001 in the amount of $294,125.69. Human Services voucher 10675, dated November 30, 2001 in the amount of $300.00. Human Services vouchers 10676 through 10755, dated December 06, 2001 in the amount of $136,700.32. Human Services vouchers 10756 through 10837, dated December 11, 2001 in the amount of $42,580.35. Human Services vouchers 10838 through 10889, dated December 11, 2001 in the amount of $42,870.25. Human Services vouchers 10890 through 10939, dated December 11, 2001 in the amount of $13,386.22. . T St. Croix County Health and Human Services Board Page 4 December 11, 2001 Human Services vouchers 10940 through 11009, dated December 11, 2001 in the amount of $38,009.23. Nursing Home vouchers 1644 through 1652, dated November 15, 2001 in the amount of $26,057.83. Nursing Home voucher 1653, dated November 21, 2001 in the amount of $616.58. Nursing Home vouchers 1654, dated November 29, 2001 in the amount of $6.50. Nursing Home vouchers 1655 through 1658, dated December 06, 2001 in the amount of $1,104.89. Nursing Home vouchers 1659 through 1690, dated December 11, 2001 in the amount of $24,553.99. Human Services, Workshop, Public Health vouchers 652 through 679, dated November 15, 2001 in the amount of $212,197.94. Social Services and Human Services vouchers 408 through 426, dated November 15, 2001 in the amount of $41,690.09. Human Services and Nursing Home vouchers 610 through 636, dated November 20, 2001 in the amount of $163,908.64. Human Services, Workshop, Public Health vouchers 680 through 712, dated December 03, 2001 in the amount of $288,426.50. Social Services and Human Services vouchers 427 through 447, dated December 03, 2001 in the amount of $43,994.85. Human Services and Nursing Home vouchers 637 through 665, dated December 04, 2001 in the amount of $244,011.18. FINANCIAL REPORTS: The following financial reports for October were distributed to Board members. Krieger said we received IGT funds in November of $168,000 and expect $374,000 in IGT funds in December. Krieger said we will receive over $1,000,000 IGT funds, which is more than anticipated. Krieger pointed out that PPS, reduced census and salary increases are the major causes for the negative cash balance in the Nursing Home. Ziegler pointed out the General Relief balance, which is high due to two major medical claims. St. Croix County Health and Human Services Board Page 5 December 11, 2001 ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD 01/01/01 THROUGH 10/31/01 NURSING HOME Cash Balance 10/31/01 ($976,401.38) Add: Accounts Receivable, 10/31/01 Private Pay $44,596.88 Medicare $210,097.62 Medicaid $288,148.77* General $13,300.00 Accounts Payable-10/31/01 ($258,565.02) Net Current Items, 10/31/01 ($678,823.13) 2001 Revenue Recorded through 10/31/01 $5,057,206.85* Includes Allocations of Anticipated Revenues 2001 Expenses Recorded through 10/31/01 $5,439,210.35 Includes Allocations of Expected Expenses Includes estimated rate increase July 1-October 31 of $96,706.39 St. Croix County Health and Human Services Board Page 6 i December 11, 2001 HEALTH AND HUMAN SERVICES - 2001 SUMMARY Total OF REVENUES Jan.-Oct. Budget Balance % Administration 597,409.98 736,431.00 139,021.02 81.19. AODA Services 365,817.26 353,366.00 (12,451.26) 103.5% Intensive In-Home Treat. 128,500.82 176,471.00 47,970.18 72.8% Long Term Support 8,729,822.09 11,519,994.00 2,790,171.91 75.8% Mental Health 1,629,182.76 1,895,384.00 266,201.24 86.0% Family & Children's 1,971,823.17 2,360,749.00 388,925.83 83.5°% Economic Support 776,139.63 1,256,132.00 479,992.37 61.8% General Relief 7,398.01 5,281.00 (2,117.01) 140.1% TOTAL REVENUES ALL PROGRAMS 14,206,093.72 18,303,808.00 4,097,714.28 77.616 SUMMARY Total OF EXPENDITURES Jan.-Oct. Budget Balance Administration 580,414.99 736,431.00 156,016.01 78.81 Alcohol-Drug Abuse 267,430.87 353,366.00 85,935.13 75.7% Intensive In-Home Treat. 123,152.77 176,471.00 53,318.23 69.89. Long Term Support 8,556,068.91* 11,519,994.00 2,963,925.09 74.39. Mental Health 1,546,355.32 1,895,384.00 349,028.68 81.6% Family & Children's 1,876,147.71* 2,360,749.00 484,601.29 79.5% Economic Support 887,993.38 1,256,132.00 368,138.62 70.7% General Relief 55,750.35 5,281.00 (50,469.35) 1055.7% Accrued Payroll 308,010.94 0.00 (308, 010. 94) 0.0% TOTAL 2001 HUMAN SERVICES BUDGET 14,201,325.24 18,303,808.00 4,102,482.76 77.6% *Salaries for Human Services Professional Union Component are still being paid at 1999 rate. Estimated costs for 2001 are $50,000 to $75,000. St. Croix County Health and Human Services Board Page 7 December 11, 2001 PUBLIC HEALTH Total Jan.-Oct. Budget Balance TOTAL REVENUES* 908,423.56 1,099,234.00 190,810.44 82.6% TOTAL EXPENDITURES 817,624.61 1,099,234.00 281,609.39 74.496 *TO BE ON BUDGET, PERCENTAGE SHOULD BE 83.33% W-2 PROGRAM "EXIT" PLAN: Squyer reported the State of Wisconsin issues a "report card" each month to monitor W-2 expenses. She said this report card shows our available dollar amount, what we have spent for the month and balance of our money and she closely monitors this report. The first six months experience will be a strong indicator of W-2 financial condition. Should State funding become a liability to St. Croix County (should the State reduce the contract amount), administration will recommend executing the 120- day "exit letter" to terminate the W-2 program in St. Croix County. This termination would have to be done by resolution of the full County Board as it was authorized by the full County Board. Squyer said two to three positions would be impacted if W-2 was terminated. This information was presented to the Finance Committee on December 10 and Administration will report back to the Finance Committee in two months. Olson, Berenschot, Squyer and Borup attended a meeting held by Senator Harsdorf on 12/10. Squyer said all counties who attended the workshop are looking at the exit clause. No counties were pleased with how the State has handled the W-2 finances. GENERAL RELIEF POLICY: Squyer distributed copies of the General Relief policy. There have been no changes in the policy from last year and the income limits have not changed in the last seven years. She said the program is for adults only as children are usually eligible for some other program. Borup reminded Board members that since 1995 General Relief is no longer a mandated program. Motion: A motion was introduced by Wentz, seconded by Burri and unanimously adopted: That the Board approves the General Relief policy as distributed. (Copy attached at the end of the minutes.) MENTAL HEALTH/AODA PROGRAM REPORT: Kirt gave a summary of detox services for 2000 and 2001. He said the days of service are not dramatically different from last year. In 2000 detox services were provided for 57 clients, through November, 2001, detox services have been provided to 34 clients. Kirt reported that methamphetamine usage has been more prevalent in St. Croix County than the rest of the State. He said there are more complications for detox with meth use and a longer recovery time. St. Croix County Health and Human Services Board t Page 8 December 11, 2001 Kirt reported that Mental Health hospitalizations in 2000 were 187 and are at 191 so far in 2001. Kirt said in 2000 a LTE social worker position was added due to increased commitments. He said in 2001 there have been 13 commitments and 17 settlement agreements so the need for services has continued. Borup said the numbers for services are being well controlled in Mental Health and credits Kirt and Kiesler for that effort. Kiesler reported that 3 mental health clients died in 2001. He stated that one was due to medical reasons and 2 were as a result of suicide. Kiesler said any time there is a death due to a suicide it must be reported to the State, which then triggers a State investigation by the Bureau of Quality Assurance (BQA). Kiesler stated that BQA investigated the first suicide earlier this year and mental health service was cleared of any wrongdoing. He also stated that the BQA investigator was just here yesterday to conduct the investigation regarding the second suicide. He stated the results of that investigation should be sent to him within the next 30 days. Kiesler and Kirt gave a couple of case examples of how mental health and AODA services have been effective improving people lives and reducing costly institutional placements. The Board recessed from 9:55 to 10:00 AM. NURSING HOME: Krieger reported the census in the Nursing Home is 87 today. She said we have had several admissions but discharges have also been brisk. She said direct care costs have increased and it is possible the Nursing Home may receive more than the $1,000,083 in IGT funds. The Medicaid rates increased 07/01/01 but we have not received that rate due to the legislature. PUBLIC HEALTH: Nelson thanked Dr. Craig for the donation of a book to Public Health. Nelson alerted Board members to a campylobacter outbreak in northwestern Wisconsin related to unpasteurized milk. Facts about the disease and prevention, especially good handwashing, was discussed. Nelson said flu vaccine supplies are plentiful and there have been low levels of influenza reported thus far this year. Public Health plays an important role in surveillance and reports from both state and federal level were shared. Nelson reported there was an influenza pandemic planning meeting sponsored by Public Health on 12/04/01 and an additional planning meeting will be held in January, 2002. The goal of these meetings is to increase the local public health system's preparedness for next influenza pandemic (a worldwide epidemic. Fern Johnson represented the DHHS Board and shared comments about the meeting. Nelson updated the Board regarding Anthrax cases; she said as of December 5, 22 cases have been identified. There are no cases identified in Wisconsin. She also updated the Board on the status of bioterriorism funding. Board members were encouraged to access the HAN (Health Alert Network) on the internet. Nelson said the varicella vaccine will be available at satellite clinics starting January 2002 after a special cooler and ice packs were purchased through a grant. Periodic surveys of residents utilizing the clinics have w St. Croix County Health and Human Services Board Page 9 December 11, 2001 indicated this as a need. Due to vaccine storage issues (must be kept frozen), we have not been able to provide the vaccine at satellites. Nelson said an official ordinance is needed to transfer authority for agent status from the State to the County. She said she is meeting with State and Regional Department of Public Health Staff on this on Friday, December 14. It is hopeful the Registered Sanitarian position will be filled in February. Nelson distributed a copy of the STOP! Magazine, which is a quit smoking magazine. This magazine will be available at local libraries. Recently FACT members from areas schools surveyed restaurants. To date, St. Croix County has eight restaurants interested in voluntary smoke-free policies and more information on secondhand smoke. A copy of "Second-Hand Smoke Kills Fact sheet" from the Tobacco Control Board was distributed to the Board. The coalition is working with all school districts to encourage increased signage regarding laws prohibiting any tobacco use on public school property. The community needs assessment was last done in 1996. It is a requirement to do the community needs assessment to receive grants and meet statutes. Nelson thanked Berenschot for his attendance at the state training on November 12 and 13. Nelson gave a brief update on WIC. The status of the Farmer's Market Nutrition program is unsure for next year due to budget deficits. She displayed a certificate of appreciation received from WestCAP for collaboration with Senior Farmer's Market pilot program. Stephens asked if there were any other issues to bring before the Board. Motion: A motion was introduced by Berenschot, seconded by Wentz, and unanimously adopted: that the meeting be adjourned. Time: 10:40 AM Chair: Attest: (Secretary) J GENERAL RELIEF General Relief is a program of last resorts. Our program includes medical and shelter. Shelter is paid directly to a landlord, in the amount of $160.00 for 1 person and $220.00 for a couple. No children receive General Relief. Shelter is paid to SSI pending application customers for a maximun of 4 months a year. For non-SSI applicants payment is made for a maximun of 2 months during the moratorium months (Nov.-March). Financial eligibility is determined by prospectively testing available income and assets. The income limit is $591.67. Exempt resources are, one life insurance policy with cash or loan value not greater than $501.00. One vehicle with equity value less than $4500.00. Homestead credit, and Energy Assistance. Medical payments for prescriptions/treatment services are limited to: Treatment required due to a condition which is or will soon become life threatening. Treatment is required to prevent deterioration resulting in permanent disability. Lack of treatment would severely hamper employability or threaten likelihood of independent living. Any other treatment required essential by a physician will be evaluated and Decision based on severity. Medical bills are paid at the Medical Assistance rates with out of state hospitals being paid at 60% of the bill. All General Relief recipients that have not applied for SSI must seek employment at 8 places during the calendar month. All recipients must reapply monthly.