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HomeMy WebLinkAboutHealth & Human Services 01-11-01 y i Mary Louise Olson to 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: 01/11/01 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: 01/25/01 ACTION ON PREVIOUS MINUTES: 12/13/00 ANNOUNCEMENTS APPOINTMENTS: UNFINISHED BUSINESS: 1. Community Support Program staffing needs request 2. Request to purchase electric low height beds for Nursing Home 3. Review of Restaurant Inspection Process-Larry Gilbertson, State of Wisconsin, 8:45 AM NEW BUSINESS: 1. Consideration of Claims and Vouchers 2. Financial Report 3. Program Reports: a. Family & Children's b. Nursing Home c. Mental Health/AODA 4. Personnel Report 5. Resolution to State of Wisconsin for Financial Support to fund Public Health Infrastructure 6. Consultation Services for Nursing Home 7. Westcap Grant to Improve Food Stamp Program Access 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 CLERIC NEWS MEDIA/NOTICE ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD January 11, 2001 The St. Croix County Health and Human Services Board met on January 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 Einar Home Fern Johnson Mary Louise Olson Esther Wentz MEMBERS ABSENT: James Craig, excused STAFF PRESENT: John Borup, Health and Human Services Director Judy Ziegler, Accountant Carolyn Krieger, Nursing Home Administrator Fred Johnson, Family & Children's Supervisor John Bred, Alternate Care/Kinship Coordinator Ron Kiesler, AODA/Mental Health Coordinator Mary Squyer, Economic Support Supervisor Barbara Nelson, Public Health Supervisor and Health Officer Judy Aronson, Secretary OTHERS PRESENT: Larry Gilbertson, State of WI Richard Stutz, Maple Manor Chair Stephens, called the meeting to order at 8:30 A.M. noting the meeting was properly and legally publicized. NEXT MEETIN G: The next Health and Human Services Board meeting is scheduled for Thursday, January 25, 2001 at 6:30 P.M. at the St. Croix County Health and Human Services/Health Center complex. 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 Bethke, seconded by Berenschot, and unanimously adopted: That the minutes of the 12/13/00 Health and Human Services Board meeting be approved as circulated. CONSIDERATION OF CLAIMS: The following reports for December were distributed to the Board: unemployment, cash report and fixed assets purchased. 1 Health and Human Services Board member, Olson, reviewed and questioned the following December vouchers: NURSING HOME: 910: Reinhart Food Services, $25,678.17 Food. Included in this voucher is $16,453.32 for the new Combi Cooker and stand. The balance of the voucher is food and dietary supplies. MOTION: A motion was introduced by Stephens, seconded by Olson, and unanimously adopted: The following vouchers be approved and be made a part of the supplemental minute book pages 1062 through 1136: Human Services vouchers 5255 through 5297, dated December 21, 2000, in the amount of $110,117.78. Human Services voucher 5298, dated December 21, 2000, in the amount of $186.00. Human Services vouchers 5299 through 5321, dated December 28, 2000, in the amount of $255,187.24. Human Services voucher 5322, dated December 29, 2000, in the amount of $300.00. Human Services vouchers 5323 through 5368, dated January 4, 2001, in the amount of $102,811.42. Human Services vouchers 5369 through 5513, dated January 11, 2001, in the amount of $93,844.19. Human Services vouchers 5514 through 5666, dated January 11, 2001, in the amount of $105,353.35. Nursing Home vouchers 857 through 862, dated December 21, 2000, in the amount of $4,562.69. Nursing Home voucher 863, dated December 28, 2000, in the amount of $5.90. Nursing Home vouchers 864 through 866, dated January 4, 2001, in the amount of $5,135.52. Nursing Home vouchers 867 through 922, dated January 11, 2001, in the amount of $82,540.33. Human Services and Nursing Home vouchers 651 through 674, dated December 19, 2000, in the amount of $152,888.96. Human Services, Workshop, Public Health vouchers 650 through 679, dated December 20, 2000, in the amount of $195,960.73. 2 Social Services and Human Services vouchers 479 through 495, dated December 20, 2000, in the amount of $42,426.29. Human Services and Nursing Home vouchers 1 through 27, dated January 2, 2001, in the amount of $205.617.25. Human Services, Workshop, Public Health vouchers 680 through 713, dated January 3, 2001, in the amount of $253,088.10. Social Services and Human Services vouchers 496 through 513, dated January 3, 2001, in the amount of $44,480.27. FINANCIAL REPORT: The following financial report through December was presented to the Board. Ziegler and Borup reviewed each unit briefly. PLEASE SEE NEXT PAGE. 3 ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD 01/01/00 THROUGH 11/30/00 NURSING HOME Reconciled Cash Balance 11/30/00 ($586,428.58) * Add: Accounts Receivable, 11/30/00 Private Pay $21,325.29 Medicare $137,731.10 Medicaid $203,243.78 General $452.88 Accounts Payable-11/30/00 ($66,259.64) Net Current Items, 11/30/00 ($289,935.17) 2000 Revenue Recorded through 11/30/00 $4,939,595.39 Includes Allocations of Anticipated Revenues 2000 Expenses Recorded through 11/30/00 $5,244,311.57** Includes Allocations of Expected Expenses Add or Deduct any nursing home related items not recorded on nursing home books: 2000 bond principle (93.13% of total 2000 bond principle of $148,761) NHOOsum * Operations = ($586,428.58) 4 HEALTH AND HUMAN SERVICES - 2000 SUMMARY Total OF REVENUES Jan.-Nov. Budget Balance % Administration 692,402.67 656,667.00 (35,735.67) 105.4% AODA Services 386,884.66 371,396.00 (15,488.66) 104.2% Intensive In-Home 183,436.91 217,727.00 34,290.09 84.3% Treat. Long Term Support 8,376,375.04 10,992,643.00 2,616,267.96 76.2% Mental Health 1,677,401.38 1,711,989.00 34,587.62 98.0% Family & Children's 2,111,242.85 2,265,806.00 154,563.15 93.2% Economic Support 812,906.49 986,178.00 173,271.51 82.4% General Relief 7,304.00 16,214.00 8,910.00 45.0% TOTAL REVENUES ALL PROGRAMS 14,247,954.00 17,218,620.00 2,970,666.00 82.7% SUMMARY Total OF EXPENDITURES Jan.-Nov. Budget Balance % Administration 600,387.50 656,667.00 56,279.50 91.4% Alcohol-Drug Abuse 260,858.86 371,396.00 110,537.14 70.2% Intensive In-Home 163,081.65 217,727.00 54,645.35 74.9% Treat. Long Term Support 9,078,911.61 10,992,643.00 1,913,731.39 82.6% Mental Health 1,403,201.44 1,711,989.00 308,787.56 82.0% Family & Children's 2,092,989.39 2,265,806.00 172,816.61 92.4% Economic Support 860,537.76 986,178.00 125,640.24 87.3% General Relief 6,142.82 16,214.00 10,071.18 37.9% TOTAL 2000 HUMAN SERVICES BUDGET 14,466,111.03 17,218,620.00 2,752,508.97 84.0% 5 PUBLIC HEALTH Total Jan.-Nov. Budget Balance TOTAL REVENUES* 859,622.80 993,887.00 134,264.20 86.5% TOTAL EXPENDITURES 848,665.98 993,887.00 145,221.02 85.4% *TO BE ON BUDGET, PERCENTAGE SHOULD BE 91.63%. Program Reports: Community Support Program Staffing needs request: Stephens stated at the last Board meeting Ron Kiesler presented the need to hire an LTE Social Worker in the Community Support Program. MOTION: A motion was introduced by Stephens, seconded by Wentz, and unanimously adopted: That the Health and Human Services Board approve an LTE (limited term employment) Social Worker for the Mental Health Community Support Program. Olson stated it seemed curious to her that an entry-level social worker would be hired at $40,435/year. Borup stated this is a non-union pay "Range 7" per the Hay classification system. Home commented these job positions should be posted on the Internet. Horne stated our Personnel Department is not able to do that. We have no system set up in the County where such information gets posted on the Internet. Kiesler stated he was instructed to explore the option of contracting for the required social worker time. He distributed a cost comparison between contracting versus hiring an LTE. Kiesler stated contracting would cost between $12,000 and $32,000 more than hiring an LTE. Kiesler stated the number of clients requiring CSP services has increased to 16 - 4-committed and 12-voluntary. The court commits a client when the court believes that the client is imminently dangerous to themselves or to others, when the client is believed to be mentally ill (or chemically dependent) and when the client is believed to be treatable for their mental illness. All three conditions must be met simultaneously for the court to commit an individual. When the court commits a client, it orders the County of residence to treat and monitor the client and to provide the court with regular updates on the client's progress (or lack thereof). The obvious concern is that of the County's liability exposure to having an imminently dangerous client on a waiting list for services, particularly when the court orders the County to treat and monitor the client's mental illness. Services provided to these clients generates revenue that offset the cost of care. 6 Kiesler gave an overview of the limited term employment Social Worker for the Mental Health Community Support Program. This persons job description of Community Support Program Social Worker position requires 60%-70% billing quota so that it is considered a full case load. Basically they would manage the client's life. Kiesler stated this is a self-paying position where every hour we see the client we bill MA or their insurance. Kiesler notified the Board we are providing services to the jail for which we will receive $20,000 in 2001. He stated we made a commitment late in 2000 so it was not in the 2001 budget. This is a good working relationship supplying the jail with AODA and Mental Health services. Olson again stated it is incomprehensible that and entry-level social worker start at $40,435. That seems very high for St. Croix County. Kiesler stated the person would need 2 to 5 years experience in order to bill MA. For that salary we should be able to hire someone with experience. Horne readdressed the $466,000 Mental Health/AODA carryover discussed at the last Board meeting during the Mental Health/AODA program report. Home stated that at no time last year was the Board told about an excess of $466,000. Kiesler stated we had unspent funds and increased revenues. The carryover was the result of many factors experienced in 2000. Kiesler stated one factor was projecting $80,000 in MA deficit reduction dollars and we actually captured $260,000. Borup stated MA deficit reduction revenues like Nursing Home ITP monies are difficult to predict. This resulted in $180,000 of the 2000 carryover dollars for Mental Health/AODA. Kiesler also stated that while we had a record number of hospitalizations in 2000, we also experienced a record number of clients who have insurance to cover their health care costs. The net result was cost savings in hospital and out-of-home placement. Finally, Kiesser stated that the Board helped to create the increased revenue when they agreed to raise the salary level of the A/R supervisor (Becky Ruka). The Board also agreed to increase the number of A/R staff by one. Stephens expressed concern about these dollars. Borup stated that these surplus dollars only represent one area of the budget and that these funds can be applied elsewhere. Borup stated the year-end 2000 budget is anticipated to be stable. Review of Restaurant Inspection Process: Nelson introduced Gilbertson to the Health & Human Services Board. Gilbertson was here to present the State's perspective and future plans on "agent" status. Gilbertson distributed copies of the Environmental Health Licenses for St. Croix County and the advantages of agent status. Gilbertson stated the focus is on outbreaks in the county and is the public being protected. Stephens asked if we assume this position, could we set the fee? Gilbertson state yes but 10% reimbursement would be sent to the State as they are still responsible. Home stated the way the inspection is being done now is working. Stephens stated the inspector has to be a talented person to do all of these duties. The applicant would need to be a registered sanitarian in Wisconsin. This position would be in the ballpark of $18.00/hr. with benefits. Olson questioned who would supervise this position. Borup said Public Health would assume responsibility. Gilbertson stated Dunn and Pierce Counties are doing this and it is working for them. 7 Stephens thanked Gilbertson and stated we have gained a great deal from this presentation. We will take a look at this again at the next meeting in February. At 9:45 a.m. Stephens declared a break to honor and thank Judy Aronson for her 25 years of service with St. Croix County. Wes" Grant to imp-rove Food Stamp Program Access: Borup stated Westcap is asking for our support for a Federal "RFP" outreach program. As food stamps are underutilized in Wisconsin, Administration support this effort. Squyer stated increased utilization would impact our workload so we need your review and action. MOTI N: A motion was introduced by Horne, seconded by Wentz: That the Health and Human Services Board move to table the Westcap Grant to improve the Food Stamp Program. Roll call vote: Robert Stephens - yes Leon Berenschot - no Chris Bethke - yes Lois Burri - yes Einar Horne - yes Fern Johnson - yes Mary Louise Olson - yes Esther Wentz - yes Seven yes, one no, motion passed. Resolution to State of Wisconsin for Financial Support to fund Public Health Infrastructure : Nelson distributed copies of the Public Health Report. Nelson stated the flu vaccine is still available and it is not too late to get the vaccine. Changes in immunization clinics were shared and the Board was advised of confirmed cases of pertussis. M I N: A motion was introduced by Horne, seconded by Wentz, and unanimously adopted: That the Health and Human Services Board move to approve the Resolution For State Funding of Public Health Core Functions. Nelson distributed a copy of the Wisconsin Tobacco Control Board web page and discussed it vision, mission and strategic plan. Nelson stated we would receive funds of $18,072 for coalition purposes. The Department intends to utilize these dollars for prevention activities via private contract. Nursing Home: Krieger stated the Nursing Home census is 92. Krieger stated the information has been received for pricing on the low height electric beds. The price per bed is $856.00. The volume discount is about $100 per bed. Krieger stated the low beds would be able to serve both of the populations we serve. Krieger would like to replace all the beds with low height electric beds but stated that at this time it is not feasible. Krieger is asking for 24 beds to be replaced. 8 f ~ The State says we are to be restraint free. MOTI N: A motion was introduced by Berenschot, seconded by Bethke, and unanimously adopted: That the Health and Human Services Board approve 24 beds at $856.00/each, to be taken out of the Farm account. Consultation Services for Nursing Home: Stephens stated we met with Finance and Human Services Committee and John Keefe on 01/10/01. The purpose of the meeting was to have Keefe's input from studies he has done for other counties and what he can offer St. Croix County. Both committees support contracting with Keefe and will present a resolution to the County Board on January 23, 2001. Financial Report: Ziegler stated Rod Paulson, Auditor will be here at the end of March or first week in April to review client files to see that all paperwork is current. Borup stated he is pleased revenues exceeded the 2000 budget. Family and Children's Services: Johnson stated we are currently paying $31.00/day for shelter and $40.00/day for respite care. He stated those rates are now on the low side. He would like to change them to $43.00/day and $50.00/day respectively. Brett stated we have homes that are willing to do respite but more homes are needed. Family and Children's Services also works with the Long Term Support Unit to provide respite homes. Johnson stated in 2000 - an average month consisted of 38 days of respite and 65 days of shelter provided. Stephens asked if there were any other issues to bring before the Board. Bethke gave an update on the apple tree orchard and community gardening project. He has received an estimate from Powers in the amount of $1,500.00 to widen the road, parking area for the community garden and to dispose of the wood stumps taken out by the sportsman Alliance. Bethke drew a diagram on the black board as to where the road would be. Stephens stated this would need to be put on the agenda for the next meeting in two weeks as that spot may be used for independent care housing. Bethke stated we had already passed a motion for the apple tree orchard and gardening project. M ON: A motion was introduced by Stephens, seconded by Burri, and unanimously adopted: That the Health and Human Services Board meeting be adjourned. Time: 10:46 a.m. Chapman: Attest: Secretary 9