HomeMy WebLinkAboutHealth & Human Services 03-13-01
Leon Berenschot to review vouchers at 8:00 a.m.
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: 03/13/01
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: 03/22/01
ACTION ON PREVIOUS MINUTES: 02/28/01
ANNOUNCEMENTS
APPOINTMENTS :
UNFINISHED BUSINESS:
1. Restaurant Inspection Process - Agent Status
2. Capital Outlay Planning Update
NEW BUSINESS:
1. Consideration of Claims and Vouchers
2. Financial Report
3. Program Reports
a. Public Health
b. Mental Health/AODA
c. Nursing Home
4. Telephone 800# Service
5. Capital Outlay Plan.
6. 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
ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD
March 13, 2001
The St. Croix County Health and Human Services Board met on March 13, 2001 at
the St. Croix County Health and Human Services/Health Center complex.
MEMBERS PRESENT: Robert Stephens, Chair
Leon Berenschot
Lois Burri
James Craig
Einar Horne
Fern Johnson
Mary Louise Olson
Esther Wentz
MEMBERS ABSENT: Chris Bethke, excused
STAFF PRESENT: John Borup, Health and Human Services Director
Carolyn Krieger, Nursing Home Administrator
Judy Ziegler, Accounting Supervisor
Ron Kiesler, Mental Health/AODA Coordinator
Steve Kirt, AODA/Mental Health Clinical Services Supervisor
Wendy Kramer, Public Health
Barbara Nelson, Public Health Supervisor-Health Officer
Michele Mohn, Environmental Health Specialist
Malva Berg, Secretary
OTHERS PRESENT: Ralph Robole, Facilities Manager
Rich Loney,
Chuck Whiting, Administrative Coordinator
Tom Dorsey, County Board Chair
Michael Hoheisel, Springsted
Nick Dragisich, Springsted
Greg Pollaske, State DHFS Section Chief for Bureau of
Environmental Sanitation
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 Thursday, March 22, 2001 at 6:30 PM at the St. Croix County Health and
Human Services/Health Center complex.
AGENDA: Motion: A motion was introduced by Berenschot, seconded by Burri
and unanimously adopted: That the agenda be approved as circulated.
MINUTES: Motion: A motion was introduced by Wentz, seconded by Johnson, and
unanimously adopted: That the minutes of the 02/22/01 Health and Human
Services Board meeting be approved as circulated.
CAPITAL OUTLAY PLANNING UPDATE: Whiting introduced Michael Hoheisel and Nick
Dragisich, from Springsted Public Financing Group who will be working with
our capital outlay plan. Dragisich explained that their company will bring
together in a document what is needed as a group and how to bring that to a
reality. Their goal is to create a single financial plan for the entire
county. He said this document will include projections for revenue and
expenditures along with capital outlay improvements. The funding sources for
the capital improvements will also be identified. Individual committees will
decide on the priorities for the capital outlay requests if there are not
enough funds to meet needs. This document will cover a five year time period
and will be for the entire county. Whiting said every year the plan will be
modified so that each year a new five-year plan will be created.
Horne said the County needs to set some goals and objectives within the
County, for example what will the county do with the county land, and these
goals will need to drive the finances. Whiting said this document will be a
starting point to get an overall picture of where the county is. The funding
sources for the Nursing Home and Health and Human Services are not absolute
funding sources. Horne asked that the percent of increase for each year be
included on the worksheet.
Borup asked what Springsted can offer the county that the county cannot
provide for itself. Springsted representative said they have more exposure
to other businesses but that the county probably has the expertise in-house
to produce this document but lack the staff and time to complete the project.
Stephens said this document will serve as advice to the Board and will not be
chiseled in stone. Horne said it would be a tool for the Finance Committee
to use and Stephens said it would be a tool for the County Board to use.
Stephens said the Board will fine-tune the hardware portion of the capital
outlay plan after the County Board approves Springsted's proposed plan.
RESTAURANT INSPECTION STATUS-AGENT STATUS: Greg Pollaske, State DHFS Section
Chief for Bureau of Environmental Sanitation, addressed the Board regarding
agent status for the County. He said the State currently has 27 health
inspectors and there will not be any more inspector positions established. He
said the State of Wisconsin is neutral on the County going to agent status.
He said the State is trying to take a cooperative educational approach to
inspection rather than just doing inspections. He said restaurant owners are
not trained to look at the same things as inspectors are. Pollaske said local
agent status allows for quicker response to questions or problems and there
is more ability to regulate public health. Pollaske said any fees collected
will stay in the County, which means that if the county decides on agent
status, there should be little financial impact on the county budget.
Pollaske said the fees charged by the State are scheduled to increase
effective 07/01/01 pending legislative approval and will amount to
approximately 40% increase. He said agencies set their own fees but agents
usually charge more than the State rates. Pollaske said he is willing to
come back to St. Croix county if an open meeting hearing is scheduled with
restaurant owners, etc. He said Larry Gilbertson would also be available to
attend such a meeting.
CONSIDERATION OF CLAIMS: The following reports for February were distributed
to the Board: unemployment report for January and February, cash and fiscal
reports.
Health and Human Services Board member, Berenschot, reviewed and questioned
the following February vouchers:
HUMAN SERVICES:
6275: Adapted Living, $1,692.19, Long Term Support purchased services. This
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company provides supported living services for Long Term Support
clients. This was for a brain injury child for one month of service.
6332: S & C Bank, $24.43, petty cash. There are many small petty cash
charges in almost all programs. These charges are for the business
reply postage for envelopes that clients send back to us. The post
office requires us to keep a $75.00 deposit with them to cover our
business reply mail. We are required to reimburse this fund once or
twice a week. The business reply charges go back to the appropriate
department.
6246: River Falls area ambulance service, $3,393.00, Long Term Support client
transportation. This charge was for six trips for a client to United
Hospitals and back to his home in River Falls.
6521: Augusta Housing Management, $600.00. This is an existing housing
company that has recently bought property in Baldwin. The check was to
enable a homeless W-2 client and two children to find appropriate
housing.
NURSING HOME:
1048: Network Services Company, $1,538.69. The new name for Schilling Paper
Company. They provide paper products as well as cleaning/disinfecting
solutions, floor wax, etc. for the Housekeeping department.
Motion: A motion was introduced by Berenschot, seconded by Stephens, and
unanimously adopted: That the following vouchers be approved and be made a
part of the supplemental minute book pages 1210 through 1300,
Human Services vouchers 6204 through 6273, dated February 15, 2001 in the
amount of $208,669.12.
Human Services vouchers 6274 through 6311, dated February 22, 2001 in the
amount of $199,016.37.
Human Services voucher 6312, dated February 27, 2001 in the amount of
$650.00.
Human Services vouchers 6313 through 6341, dated March 01, 2001 in the amount
of $146,317.10.
Human Services vouchers 6342 through 6343, dated March 02, 2001 in the amount
of $600.00.
Human Services vouchers 6498 through 6563, dated March 08, 2001 in the amount
of $97,882.85.
Human Services voucher 6564, dated March 08, 2001 in the amount of $650.00.
Human Services vouchers 6344 through 6497, dated March 13, 2001 in the amount
of $76,141.37.
Human Services vouchers 6566 through 6671, dated March 13, 2001 in the amount
of $71,388.64.
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Nursing Home vouchers 983 through 1009, dated February 15, 2001 in the amount
of $19,645.86.
Nursing Home vouchers 1011 through 1013, dated February 22, 2001 in the
amount of $488.73.
Nursing Home vouchers 1014 through 1017, dated March 01, 2001 in the amount
of $525.75.
Nursing Home voucher 1018, dated March 08, 2001 in the amount of $35.20.
Nursing Home vouchers 1020 through 1066, dated March 13, 2001 in the amount
of $47,994.05.
Human Services and Nursing Home vouchers 82 through 107, dated February 13,
2001 in the amount of $158,663.30.
Human Services, Workshop, Public Health vouchers 63 through 91, dated
February 14, 2001 in the amount of $205,399.75
Social Services and Human Services vouchers 36 through 52, dated February 14,
2001 in the amount of $43,647.98.
Human Services and Nursing Home vouchers 108 through 134, dated March 01,
2001 in the amount of $210,166.81.
Human Services, Workshop, Public Health vouchers 92 through 124, dated March
01, 2001 in the amount of $263,325.55
Social Services and Human Services vouchers 53 through 70, dated March 01,
2001 in the amount of $44,507.09.
FINANCIAL REPORT: Borup and Ziegler explained the new more detailed
financial report distributed to the Board and asked for Board input. It was
the consensus of the Board to stay with the previous report and to issue the
more detailed report to the Board quarterly. Borup reported new Medicare
rates effective 04/01/01 for the Nursing Home. The Department revenues do
include $446,004 for salary increases in 2000. Borup indicated Long Term
Support revenues were still pending plus M.A. Deficit Reduction monies.
Borup noted unemployment compensation expenses for Home Health of $15,984 and
modest deficit for out of home children's expenses. Public Health numbers
are close to balanced with some grant dollars still pending. Rod Paulson
will be here the end of March to continue audit work.
Please see next page.
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ST. CROIX COUNTY HUMAN SERVICES BOARD
FINANCIAL SUMMARIES
FOR THE PERIOD 01/01/00 THROUGH 12/31/00
NURSING HOME
Reconciled Cash Balance 12/31/00 ($446,867.94)*
Add:
Accounts Receivable, 12/31/00
Private Pay $12,661.38
Medicare $215,309.74
Medicaid $236,403.39
General $0.00
Accounts Payable-12/31/00 ($82,638.83)
Net Current Items, 12/31/00 ($65,132.26)
2000 Revenue Recorded through 12/31/00 $5,727,417.13
Includes Allocations of Anticipated Revenues
2000 Expenses Recorded through 12/31/00 $5,953,264.20**
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)
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HEALTH AND HUMAN SERVICES - 2000
SUMMARY Total
OF REVENUES Jan.-Dec. Budget Balance
Administration 1,169,904.67 656,667.00 (513,237.67) 178.2%
AODA Services 449,737.98 371,396.00 (78,341.98) 121.1%
Intensive In-Home Treat. 201,103.35 217,727.00 16,623.65 92.4%
Long Term Support 8,824,782.55 10,992,643.00 2,167,860.45 80.3%
Mental Health 1,777,481.15 1,711,989.00 (65,492.15) 103.8%
Family & Children's 2,177,071.30 2,265,806.00 88,734.70 96.1%
Economic Support 955,133.93 986,178.00 31,044.07 96.9%
General Relief 7,304.00 16,214.00 8,910.00 45.0%
TOTAL REVENUES
ALL PROGRAMS 15,562,518.93 17,218,620.00 1,656,101.07 90.4%
SUMMARY Total
OF EXPENDITURES Jan.-Dec. Budget Balance %
Administration 672,153.90 656,667.00 (15,486.90) 102.4%
Alcohol-Drug Abuse 296,415.42 371,396.00 74,980.58 79.8%
Intensive In-Home Treat. 176,862.16 217,727.00 40,864.84 81.2%
Long Term Support 10,152,970.92 10,992,643.00 839,672.08 92.4%
Mental Health 1,564,762.13 1,711,989.00 147,226.87 91.4%
Family & Children's 2,292,439.47 2,265,806.00 (26,633.47) 101.2%
Economic Support 943,656.01 986,178.00 42,521.99 95.7%
General Relief 10,640.50 16,214.00 5,573.50 65.6%
TOTAL 2000 HUMAN
SERVICES BUDGET 16,109,900.51 17,218,620.00 1,108,719.49 93.6%
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PUBLIC HEALTH
Total
Jan.-Dec. Budget Balance
TOTAL REVENUES* 936,977.38 993,887.00 56,909.62 94.3%
TOTAL EXPENDITURES 972,879.10 993,887.00 21,007.90 97.9%
The Board recessed from 10:05 to 10:10 AM.
PUBLIC HEALTH: Nelson announced that there was information in the Board
packets regarding bio-terrorism. She also announced that Geralyn Karl would
give a presentation at the April Board meeting regarding tobacco control.
Olson said she contacted all the schools in St. Croix County to inquire as to
what education was being done on tobacco prevention. She said the schools
are actively educating students. Surveys done showed in 1990 22% of students
were smoking, in 1995 12% were smoking, and in 2000 6% were smoking.
Kramer gave an update on the immunization program. She said a new vaccine
called Prevnar-Pneumococcal was started in February for infants two, four,
six months of age with a booster given at 15 months. She said there is a
shortage of Tetanus vaccine for adults only in the state due to a buy out of
companies. She said two school-based clinics have been cancelled. Kramer
said the Varicella (chicken pox) vaccine is not currently required for entry
into school but will be in the future.
Kramer said the number of flu vaccines given was down from 1914 in 1999 to
675 in 2000. She said this was primarily due to the lack of supply of
vaccine. She said there have been two confirmed cases of Pertussis in St.
Croix County in 2001 and eight cases in Pierce County.
Kramer said Public Health is in the process of purchasing vanish point
needles as a safe needle device due to OSHA requirements. She said 2000
marked the 20th anniversary of the eradication of small pox and Public Health
is looking at the possible eradication of polio soon.
MENTAL HEALTH/AODA: Kiesler said Mental Health continues to be a growth area
as the county grows and the need for services grows. He said the good news
is that more clients have insurance coverage which means increased revenues,
the bad news is with the increase in clients, it taxes staff resources to
meet clients, needs. He said they will continue to analyze trends for
staffing impact in preparation for the 2002 budget.
Kirt said St. Croix County has grown over 25% since 1990 and is the second
fastest growing county in the state. He said we have seen an increase in
referrals to both Mental Health and Alcohol/Drug Abuse and commitments. He
said there are not enough inpatient beds available. We are currently trying
to re-contract with St. Joe's for inpatient services.
Kirt said we have one of the only psychiatrists left working in an outpatient
setting in St. Croix County so the pressure on the County to provide
psychiatry is greater than ever. He said with the increase in referrals and
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commitments as well as insurance providers, there has been increasing demands
on staff resources including accounts receivable, therapists and clerical. We
are required to provide more documentation for authorizations, which vary
from insurance company to insurance company. We are also realizing an
increasing demand on computer software to monitor this information to allow
for accurate and timely billing.
Kirt and Kiesler asked the Board if there is specific information they would
like provided from Mental Health and Alcohol Drug Abuse in order for the
county to meet staffing needs so client needs may be met.
Kiesler said we have reallocated resources to maximize use of staff and
resources but reorganization alone is not the answer to our problem. He will
continue to update the Board on the increasing client load. Borup indicated
we will continue to update the Board as we approach the 2002 Budget and staff
needs.
NURSING HOME: Krieger said the census for the nursing home is 88. She said
this was good for the survey as if the census is under 90 the numbers for
samples to survey is lower. She said the survey went well. We have not
received the results of the survey in writing but have been told verbally
what the results are. She said we will need to do some additional inservices
on pressure sores residents develop. Individual care plans will be needed
for residents on skin treatment. Krieger said all employee criminal
background checks need to be resubmitted because the general box was marked
rather than the caregiver box. She said we were not cited on this at this
time but the survey team can be back in nine months and the checks will have
to be done and in the employee chart by then. Krieger said it is estimated
it will take between 20 to 40 hours to resubmit these forms. She said we are
also at risk if we hire someone with a criminal background and the check is
not done in a timely manner.
Horne asked Borup what it would take to get the personnel records for Health
and Human Services and the Nursing Home to be located in New Richmond rather
than Hudson. Borup said the location of the files is not as important as the
availability of service so necessary paperwork and recruitment can be done in
a timely fashion. If the criminal background checks are not done by May,
this item will be brought back to the Board. Stephens said the Personnel
Committee should be pushing to settle the contract with the remaining social
workers.
TELEPHONE 800 SERVICE: Borup recommended staff seek alternatives for clients
on an individual basis rather than installing an 800 number for Health and
Human Services due to cost factors.
Motion: A motion was introduced by Johnson, seconded by Berenschot, and
unanimously adopted: that the meeting be adjourned.
Time: 11:15 AM
Chair:
Attest:
(Secretary)
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