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HomeMy WebLinkAboutHealth & Human Services 04-11-01 r Fern Johnson to review vouchers at 8:00 a.m. 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. 04/11/01 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 METING: 04/26/01 ACTION ON PREVIOUS MINUTES: 03/22/01 ANNOUNCEMENTS APPOINTMENTS: ELECTION OF OFFICERS UNFINISHED BUSINESS: NEW BUSINESS: 1. Consideration of Claims and vouchers 2. Financial Report 3. Termination of "Transition" House Lease with REM Rehab and request to sublet premises 4. Presentation of 2000 Annual Report 5. Discussion of possible action on land lease with Chiquita Processed Foods 6. Program Reports a. Public Health b. Long Term Support c. Nursing Home 7. State Child Welfare Assessment Mandate 8. 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 April 11, 2001 The St. Croix County Health and Human Services Board met on April 11, 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 Esther Wentz MEMBERS ABSENT: Mary Louise Olson, excused STAFF PRESENT: John Borup, Health and Human Services Director Carolyn Krieger, Nursing Home Administrator Judy Ziegler, Accounting Supervisor Fred Johnson, Family and Children's Supervisor Kathy Dunlap, Family and Children's Supervisor Ron Lockwood, Long Term Support Supervisor Ron Eichstaedt, Director, St. Croix Industries Barbara Nelson, Public Health Supervisor-Health Officer Deb Lindemann, Public Health Nurse Linda Adams, Public Health Geralyn Karl: Tobacco Control Specialist Wendy Kramer, Public Health Nurse Malva Berg, Secretary OTHERS PRESEN : Rod Paulson, CPA, Tracey and Thole John Schottier Gerald Christensen, Chi.quita. Processed Foods Steve Nielson, Chiquita Processed Foods David Konitzer 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 Wednesday, May 02, 2001 at 6:15 PM at the St. Croix County Health and Human Services/Health Center complex. An Open Hearing regarding restaurant inspection will be held at 7:00 PM on May 02, 2001, following the Health and Human Services Board meeting. 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 Berenschot, and unanimously adopted: That the minutes of the 03/22/01 Health and Human Services Board meeting be approved as circulated. ANNOUNCEMENTS: Stephens congratulated Burri, Wentz and Bethke on their reappointments to the Health and Human Services Board. 4 ELECTION OF OFFICERS: Stephens announced that the election of officers would take place by silent ballot. Borup distributed ballots to members. Stephens turned the meeting over to Vice Chair Berenschot. Berenschot instructed members to cast votes for the position of Chair. Stephens and Wentz were nominated for the Chair position. Wentz withdrew her nomination. Berenschot declared Stephens to be the Chair of the Health and Human Services Board. Stephens resumed position as Chair of the Board. Stephens instructed members to cast votes for the position of Vice Chair. Berenschot, Bethke, and Wentz were nominated for the Vice Chair position. Wentz and Bethke withdrew their nominations. Stephens declared Berenschot to be the vice Chair of the Health and Human Services Board. Stephens instructed members to cast votes for the position of Secretary. The Board cast a unanimous vote for Bethke. Stephens declared Bethke to be the Secretary of the Health and Human Services Board. FINANCIAL REPORT: Rod Paulson, CPA, announced that he completed the Nursing Home audit and will complete the Health and Human Services audit next week. The Board was given a draft copy of the Nursing Home audit. Paulson outlined the audit results. Borup reminded Board members that the budget instructions received from Finance were to not budget for the wage and fringe benefit increase when preparing the budget. Krieger said a copy of the draft audit has also been forwarded to Keefe and Associates for the Nursing Home study. Paulson said there was a decline in patient days in 2000 of 2,548. He said the collections on the Medicare balances are much better than it has been in past years. Paulson said there is a loss of $626,586 for the year for the Nursing Home. Borup said a copy of the draft audit was sent to Chuck Whiting and the Finance Committee members and he is scheduled to meet with the Finance Committee prior to the County Board meeting next week. Paulson said he will be back before the Health and Human Services Board when the Health and Human Services audit is complete. Stephens said the question is whether or not the County should have a Nursing Home and if so, how to stop the loss. He said a half hour presentation will be given to the County Board for the annual report. Stephens said concerns regarding the Nursing Home were brought to the County Board two years ago. He said he may ask Keefe to attend the May County Board meeting. Krieger said residency dropped much below the census for which the budget was prepared. Paulson said the reasons nursing homes are closing or are in financial difficulty is because of the low reimbursement of Medicaid, low residency and the high cost of labor. Horne said that it is important that we don't continue to understate the problem. He said he doesn't see any changes in the next year that will change the trend in loss. Paulson gave some suggestions of what other homes do so they know their financial status on a monthly basis rather than waiting for a year-end audit. 2 Berenschot said it doesn't do anything if we get the figures and don't do anything about the loss. Paulson said Wisconsin is the lowest in the nation in Medicaid reimbursement. He said Minnesota homes are closing and they receive more reimbursement than Wisconsin homes. CONSIDERATION OF CLAIMS: The following reports for March were distributed to the Board: fixed assets, cash and fiscal reports. Health and Human Services Board member, Johnson, reviewed and questioned the following March vouchers: HUMAN SERVICES: 1458: Walmart, $1,500.00, Economic Support-WAA Post Employment Services. W-2 clients area able to receive retention bonuses after they have maintained continuous employment. The client is eligible for a $50 bonus after completing 30-days of employment and $100 after 180 days (six months). St. Croix County uses the option of presenting the bonuses in the form of gift certificates as approved by the State of Wisconsin. 1494: Hoistad, Jonathan C., $2,610.00, Psychologist Consultant. Dr. Hoistad is here once a week. We are able to bill for all of his direct client time. 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 1301 through 1396, Human Services vouchers 6672 through 6721, dated March 15, 2001 in the amount of $147,007.87. Human Services vouchers 6722 through 6768, dated March 22, 2001 in the amount of $106,992.66. Human Services voucher 6769, dated March 23, 2001 in the amount of $430.00. Human Services vouchers 6770 through 6794, dated March 29, 2001 in the amount of $145,128.59. Human Services voucher 6795, dated March 29, 2001 in the amount of $1,500.00. Human Services vouchers 6799 through 6857, dated April 05, 2001 in the amount of $29,878.90. Human Services vouchers 6858 through 7001, dated April 11, 2001 in the amount of $83,691.94. Human Services vouchers 7002 through 7152, dated April 11, 2001 in the amount of $305,819.57. Nursing Home vouchers 1067 through 1079, dated March 15, 2001 in the amount of $7,339.40. 3 i Nursing Home vouchers 1080 through 1094, dated March 22, 2001 in the amount of $9,030.67. Nursing Home vouchers 1095 through 1099, dated March 29, 2001 in the amount of $905.81. Nursing Home vouchers 1100 through 1101, dated April 05, 2001 in the amount of $599.00. Nursing Home vouchers 1102 through 1150, dated April 11, 2001 in the amount of $68,637.90 Human Services and Nursing Home vouchers 135 through 160, dated March 13, 2001 in the amount of $160,546.65. Human Services, Workshop, Public Health vouchers 125 through 153, dated March 14, 2001 in the amount of $208,787.29 Social Services and Human Services vouchers 71 through 88, dated March 14, 2001 in the amount of $43,867.02. Human Services and Nursing Home vouchers 161 through 180, dated March 27, 2001 in the amount of $158,318.95. Human Services, Workshop, Public Health vouchers 154 through 174, dated March 28, 2001 in the amount of $204,245.79 Social Services and Human Services vouchers 89 through 103, dated March 29, 2001 in the amount of $38,621.28. DISCUSSION OF POSSIBLE ACTION ON LAND LEASE WITH CHIQUITA PROCESSED FOODS Chiquita Processed Foods is requesting approximately 80 acres to dispense wash water through a center pivot irrigation system. John Schottler currently has five years left on the land lease. It was the consensus of the Board.that an agreement should be worked out between Schottler and Chiquita and that the Board should not interfere with an agreement between Schottler and Chiquita. Schottler said Chiquita's irrigation would be beneficial to both he and Chiquita. Christensen said there are two agreements that need to be reached, between Chiquita and Schottler, and between Chiquita and the Health and Human Services Board. Christensen said after discussing with Schottler the amount of discharge created by Chiquita would be better discharged over approximately 200 acres versus 40-80 acres. He said they have not surveyed the land to determine the best area for installing the center pivots. Chiquita proposes that the Schottler land lease renew for 10 years to end in the year 2011 with an option to renew another 10 years at the end of 2011. Stephens asked that Chiquita put their proposal in writing so that the Board can review further as the plan is complicated. Horne said the County owns the property and wanted to know why an offer to purchase was not presented. Chiquita said when they approached the County they understood purchasing the property was not an option. Stephens said he looks at the County farm land as the County's savings account. Horne said 4 the land should be sold and added to the County tax rolls. He said the issue is getting too complicated the way it stands now. Chiquita said at the first meeting they were directed to work with Schottler. Christensen said if they are going to work with Schottler, then Chiquita will need more than 80 acres to distribute their wastewater. Schottler said there would be some good benefits from this agreement. Christensen said they are asking for a commitment for 20 years on approximately 200 acres as there will be a lot of expense to Chiquita to set up the center pivots. He said they are looking to hopefully complete the project in the spring of 2002. Stephens said he will try to meet with Chiquita representatives tomorrow. NURSING HOME: Krieger said the census is 89 today. She said there has been a decrease in referrals and feels the study of the nursing home may be affecting admissicns. She said the United Way grant was awarded to the nursing home but was put on hold due to rumors that the Nursing Home is going to be sold. She said she continues to advertise in the local papers "Pathways to Home" for residents who are discharged home. Krieger said with the anticipation of more Federal money for nursing homes, the State financial department has made recommendations to change the Medicaid formula, which would result in a wide variation of the Medicaid rate across the state for each facility. She said Brian Schoeneck's estimate for St. Croix Health Center's rate could be -6a to r18% change. Krieger said the Nursing Home just received $21,814 refund from the Wisconsin Health Care Liability Insurance for a premium adjustment. Krieger notified the Board that the deadline for bed banking is 06/30/01. FINANCIAL REPORT: The following-financial reports for January were distributed to the Board: Please see next page. 5 a 4 ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD 01/01/01 THROUGH 01/31/01 NURSING HOME Reconciled Cash Balance 01/31/01 ($375,626.09) Add: Accounts Receivable, 01/31/01 Private Pay $8,868.29 Medicare $143,785.03 Medicaid $235,477.22 General $0.00 Accounts Payable-01/31/01 ($234,685.29) Net Current Items, 01/31/01 ($222,180.84) 2001 Revenue Recorded through 01/31/01 $495,447.68 Includes Allocations of Anticipated Revenues 2001 Expenses Recorded through 01/31/01 $398,727.47** Includes Allocations of Expected Expenses 6 HEALTH AND HUMAN SERVICES - 2001 SUMMARY Total OF REVENUES Jan.-Jan. Budget Balance a Administration 55,019.62 736,431.00 681,411.38 7.5% AODA Services 33,681.44 353,366.00 319,684.56 9.5% Intensive In-Home Treat. 11,021.46 176,471.00 165,449.54 6.2% Long Term Support 685,534.97 11,519,994.00 10,834,459.03 6.0% Mental Health 158,625.66 1,895,384.00 1, 736, 758. 34 8.4% Family & Children's 186,871.73 2,360,749.00 2,173,877.27 7.9% Economic Support 46,595.15 1, 256, 132.00 1,209,536.85 3.7% General Relief 0.00 5,281.00 5,281.00 0.0% TOTAL REVENUES ALL PROGRAMS 1,177,350.03 18,303,808.00 17, 126, 457. 97 6.4°s SUMMARY Total OF EXPENDITURES Jan.-Jan. Budget Balance % Administration 70,541.65 736,431.00 665,889.35 9.6% Alcohol-Drug Abuse 11,412.53 353,366.00 341,953.47 3.2% Intensive In-Home Treat. 14,934.31 176,471.00 161,536.69 8.5% Long Term Support 421,550.60 11, 519, 994.00 11,098,443.40 3.7% Mental Health 109,548.17 1,895,384.00 1, 785, 835-83 5.8% Family & Children's 152,132.49 2,360,749.00 2, 208, 616.51 6.4% Economic Support 74,763.97 1,256,132.00 1,181,368.03 6.0% General Relief 1,216.34 5,281.00 4,064.66 23.0% TOTAL 2001 HUMAN SERVICES BUDGET 856,100.06 18,303,808.00 17,447,707.94 4.7% 7 PUBLIC HEALTH Total Jan.-Jan. Budget Balance TOTAL REVENUES* 78,265.78 1, 099, 234. 00 1, 020, 968. 22 7.1% TOTAL EXPENDITURES 63,916.39 1,099,234.00 1,035,317.61 5.8% TERMINATION OF "TRANSITION" HOUSE LEASE WITH REM REHAB AND REQUEST TO SUBLET PREMISES: Borup said REM Rehab has been sold and has requested to terminate the lease agreement which expires 06/30/01. Ron Eichstaedt and St. Croix Industries Day Services Program is interested in locating in this building as it would enhance their programming. They would be able to provide revenues for the cost of the building. Borup said Turningpoint currently leases one office in this building for $350/month and we would intend to continue this lease. Eichstaedt said there are a lot of stipulations with renting at the Methodist church and has looked at other options in the community but has not found anything suitable. Eichstaedt said there would probably be no retrofit costs but there may be some minor repairs that need to be made. Eichstaedt said the program needs to give a 30-day notice to the Methodist Church to terminate the rental agreement. Eichstaedt said St. Croix Industries-would assume all rental costs. St. Croix Industries is paid 60% by Federal and State revenues to reimburse these costs. Borup indicated that the cost to maintain the building would be covered by St. Croix Industries, revenues. Motion: A motion was introduced by Berenschot, seconded by Wentz and unanimously adopted: That the Board approves leasing the Transition House to St. Croix Industries effective 07/01/01. ANNUAL REPORT: Year 2000 Annual Report was distributed to the Board members. Stephens asked that the members take it home and review it. He said the report will be given to the full County Board on April 17, 2001. Borup said a head count was done to compare the number of employees from 1990 to 2000 and the department is employing less people in 2000 than it did in 1990. LONG TERM SUPPORT: Lockwood reviewed the contracts Long Term Support has with vendors. He said efforts are continuing to be made to reduce costs for services provided to current clients in order to serve persons on the waiting list. He said all agencies providing personal care will soon be required to become certified as MA Personal Provider in order to maximize the limited amount of county and MA Waiver dollars available. He said contracts will be terminated with vendors whose costs are unjustifiably high and/or whose services are of poor quality. He said the Adapted Living contract was recently terminated due to dissatisfaction with costs. He said Long Term Support has had communication with Heartview, REM and Brotoloc who are willing to provide the additional services needed after the Adapted Living contract termination. He said vendors are encouraged to consolidate services so there are fewer vacant beds. 8 Lockwood said application was made for $175,000 in supplement State aid to match Federal CIP 2/COP-W MA Waiver resources. He said we have received informal notification that the funding will be awarded. The Board recessed from 10:15 to 10:20 AM. PUBLIC HEALTH: Nelson said the first week of April is Public Health is Everywhere week. Kramer and Adams gave a brief presentation on some of the activities that happened during April to celebrate Public Health is Everywhere which included visits by a Public Health nurse and nutritionist to county grocery stores every Monday in April to describe healthy eating, releases to local newspapers, and an award to this year's Friend of Public Health who is Dr. Skip Rasmussen and his wife Barb, who is Glenwood City's school nurse, who was instrumental in the Seal a Smile Project. This project allowed all the second graders in the Glenwood School to have dental sealant applied to their teeth. Karl said the Pierce/St. Croix Tobacco Free Coalition just submitted it annual action plan to the Wisconsin Control Board. She said the focus is to attack the smoke, not the smoker. She said for the first time funding is available for a truly comprehensive tobacco control plan; a plan that has the ability to reach all aspects of our communities. Karl said the areas of focus will be protection from secondhand smoke, increased availability of cessation services, and prevention of youth initiation, coupled with media campaigns. She said the current media campaigns from the State are counter- marketing campaigns and showed the Board a preview of some of the commercials that will be aired in the coming months. Nelson said notices of the Open Hearing on May 2, 2001 regarding restaurant inspection were sent to 290 licensed facilities in St. Croix County. She said she asked for a RSVP for people planning to attend. Nelson said as Health Officer of St. Croix County she is required to notify the Board that she received the following reports of communicable disease in St. Croix County, one case of cholera and one case of streptococcal meningitis. She said she also received notice of a dog bite on 04/10/01. Nelson said information is in the Board packets regarding the Legislative Event to be held on April 16 at St. Croix County Health and Human Services. Nelson said WIC received expanded funds for a farmer's market nutrition program. Nelson said a student from UW Stout will be doing a survey regarding the extent of herbal use in children and will share those results with Public Health. STATE CHILD WELFARE ASSESSMENT MANDATE : Borup said he, Dunlap and Johnson met with the State regarding Child Welfare Assessment. He said this is an unfunded mandate that will significantly change how we do business. Dunlap said this is outcome based and will be implemented to prepare the State for the 2003 Federal audit. She said it won't change our practices but will change how reports are written. A leadership team needs to be created including the Sheriff, school superintendent, Judges, District Attorney, Court Commissioner, and possibly a County Board member. Johnson said this is a lengthy process that must be completed within three months. Borup questioned whether Dorsey should be contacted to authorize per diem, etc. Stephens appointed Wentz and Berenschot to the leadership team. The meeting will be held on April 12 at noon in the Family Court Commissioner's Chambers in the Government Center. 9 Johnson reported the Statewide Automated Child Welfare Information System was originally going to be implemented at no cost but now the State is saying the cost to the counties will be $150,000 for start up costs with approximately $10,000 per year for ongoing costs. The State has been working on this system for a long time and they are just making the Board aware that there may be a possibility that the system will cost the county money. The system may be in place by 2002-2003 as it is part of a Federal mandate. This system, however, only covers a portion of the population and does not include mental health, alcohol drug, economic support or delinquency. Stephens reminded Board members that the next meeting will be May 2, 2001 at 6:15 PM. Stephens asked if there were any other issues to bring before the Board. Motion: A motion was introduced by Bethke, seconded by Berenschot, and unanimously adopted: that the meeting be adjourned. Time: 11:05 AM Chair: Attest: (Secretary) 10