HomeMy WebLinkAboutHealth & Human Services 05-11-01
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MARY LOUISE OLSON WILL REVIEW VOUCHERS AT 8:00 AM
REVISED AGENDA
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: 05/11/01
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: 05/24/01
ACTION ON PREVIOUS MINUTES: 05/02/01
ANNOUNCEMENTS
APPOINTMENTS:
ELECTION OF OFFICERS
UNFINISHED BUSINESS:
1. Resolution to obtain "Agent Status" to regulate food, lodging, recreational
facilities and tattoo/body piercing establishments.
2. Capital Outlay Planning Update
NEW BUSINESS:
1. Consideration of Claims and Vouchers
2. Financial Report
3. Request from Five Loaves Food Shelf for space at the St. Croix Health Center
4. Program Reports
a. Mental Health/AODA
b. Public Health
c. Nursing Home
5. Tour of Health Center grounds and farm land
6. Nursing Home Bed Banking/Downsizing
7. Personnel Issues
8. Request to purchase two automobiles for Department use
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
May 11, 2001
The St. Croix County Health and Human Services Board met on May 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
Einar Horne
Fern Johnson
Mary Louise Olson
Esther Wentz
MEMBERS ABSENT: None
STAFF PRESENT: Carolyn Krieger, Nursing Home Administrator
Ron Kiesler, Mental Health/AODA Coordinator
Steve Kirt, Mental Health/AODA Clinical Services Supervisor
Judy Ziegler, Accounting Supervisor
Becky Ruka Accounts Receivable Supervisor
Ron Eichstaedt, Director, St. Croix Industries
Barbara Nelson, Public Health Supervisor-Health Officer
Linda Adams, Public Health
Wendy Kramer, Public Health Nurse
Malva Berg, Secretary
OTHERS PRESENT: Tom Boron, Director of Computer Services
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 May 24, 2001 at 6:15 PM at the St. Croix County Health and Human
Services/Health Center complex. An Open Hearing regarding the 2002 budget
will be held at 7:00 PM on May 24, 2001, following the Health and Human
Services Board meeting. Stephens said he will not be at the meeting on
05/24/01 and asked Vice Chair Berenschot to chair the meeting and open
hearing.
AGENDA: Motion: A motion was introduced by Berenschot, seconded by Bethke,
and unanimously adopted: That the agenda be approved, removing item #3,
request from Five Loaves Food Shelf for space at St. Croix Health Center as
they have withdrawn their request.
MINUTES: Motion: A motion was introduced by Bethke, seconded by Berenschot,
and unanimously adopted: That the minutes of the 05/02/01 Health and Human
Services Board meeting be approved as circulated.
MINUTES: Motion: A motion was introduced by Wentz, seconded by Burri, and
unanimously adopted: That the minutes of the 05/02/01 Health and Human
Services Board Open Hearing be approved as circulated.
RESOLUTION TO OBTAIN AGENT STATUS TO REGULATE FOOD, LODGING, RECREATIONAL
FACILITIES AND TATTOO/BODY PIERCING ESTABLISHMENTS: Nelson said she changed
the fourth paragraph slightly to clarify the authority for the agent
according to statutes. She also changed the effective date of agent status to
January 1, 2002 with assuming authority effective July 1, 2002.
Olson asked what the number of facilities subject to regulation was before it
grew to 286 in 2001. Nelson will add this number as an add-on to the
resolution. Horne asked if every swimming pool and vending machine in St.
Croix County must be licensed. Nelson said part of the agent status covers
vending machines. The vendor who provides the machines must be licensed.
Horne says he wants this resolution to be a practical application and would
hate to see the inspector chasing after vending machines and not having time
to do what needs to be done. Nelson said the size of the facility determines
the length of inspection needed, but can run anywhere from 45 minutes to over
an hour and a half.
Part of the process of becoming agent status would allow more time for
education and prevention of issues in facilities. Horne said you cannot take
a college graduate and put into this job and expect to get what you would get
with someone with experience.
Nelson said the date change would work well as the licensing runs from July 1
to June 30 yearly and it will take time to do training and set up the
position for Agent Status.
Motion: A motion was introduced by Berenschot, seconded by Johnson and
unanimously adopted: That the Board approves the resolution authorizing St.
Croix County Department of Health and Human Services/Public Health Agent
Status. (Resolution attached at the end of the minutes.)
CAPITAL OUTLAY PLANNING UPDATE: The capital outlay plan needs to be updated
in order to maintain the ECHO information system. Horne stated that we
recently spent $120,000 on ECHO. Kiesler stated that it was his recollection
that we purchased the ECHO software in 1995 for approximately $84,000 and
then spent an additional $25,000 on upgrading the software by purchasing
Clinician's Desktop. And when you add in customizations to ECHO over the last
6 years the total expense on ECHO has been approximately $120,000. Boron
stated that other county systems were reviewed and the requested expenditures
for ECHO are not unusual. Boron also commented that replacing the system with
a different brand of software would probably cost from $400,000 to $500,000.
Horne said this is the first time the information that ECHO is in trouble
again has come before this Board. Horne indicated the Board needs to be kept
more aware of this expense. Kiesler said most of this is due to upgrading
and switching from UNIX to NT based system.
Motion: A motion was introduced by Horne, seconded by Stephens, That the
Board table the capital outlay planning.
Roll call vote:
Robert Stephens-yes
Leon Berenschot-no
Chris Bethke-no
Lois Burri-yes
James Craig-yes
Einar Horne-yes
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Fern Johnson-yes
Mary Louise Olson-yes
Esther Wentz-yes
Seven yes, two no, motion passed.
CONSIDERATION OF CLAIMS: The following reports for April were distributed to
the Board: unemployment, fixed assets, cash and fiscal reports.
Health and Human Services Board member, Olson, reviewed and questioned the
following April vouchers:
HUMAN SERVICES:
7183: Cumberland Hospital, $10,729.00, Mental Health purchased services.
Inpatient costs for January and February 2001 for six clients with a
total of 19 hospital days.
7250: TOP HAT, $16.25, Long Term Support client transportation. This is the
business name of River Falls taxi. The check was for taxi rides for two
Long Term Support clients in the River Falls area.
7432: Aurora Community Services, $14,078.40, Long Term Support/Mental Health
purchased services. The question asked was in regard to the new Aurora
facility that has recently opened near River Falls. The Long Term
Support Coordinator plans to move five to six clients to that facility
in the near future.
Motion: A motion was introduced by Olson, seconded by Stephens, and
unanimously adopted: That the following vouchers be approved and be made a
part of the supplemental minute book pages 1397 through 1500:
Human Services vouchers 7153 through 7158, dated April 12, 2001 in the amount
of $654.80.
Human Services voucher 7159, dated April 17, 2001 in the amount of $600.00.
Human Services vouchers 7160 through 7260, dated April 19, 2001 in the amount
of $275,102.39.
Human Services voucher 7261, dated April 23, 2001 in the amount of $300.00.
Human Services vouchers 7262 through 7295, dated April 26, 2001 in the amount
of $153,809.94.
Human Services voucher 7296, dated May 02, 2001 in the amount of $300.00.
Human Services vouchers 7297 through 7351, dated May 03, 2001 in the amount
of $32,429.33.
Human Services voucher 7352 dated May 04, 2001 in the amount of $600.00.
Human Services vouchers 7422 through 7495, dated May 11, 2001 in the amount
of $182,871.77.
Human Services vouchers 7496 through 7642, dated May 11, 2001 in the amount
of $68,963.61.
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Human Services vouchers 7353 through 7421, dated May 11, 2001 in the amount
of $32,009.08.
Nursing Home vouchers 1151 through 1157, dated April 19, 2001 in the amount
of $2,775.29.
Nursing Home vouchers 1158 through 1161, dated April 26, 2001 in the amount
of $383.74.
Nursing Home vouchers 1162 through 1166, dated May 03, 2001 in the amount of
$1,469.99.
Nursing Home vouchers 1167 through 1207, dated May 11, 2001 in the amount of
$55,403.21.
Nursing Home vouchers 1208 through 1209, dated May 11, 2001 in the amount of
$7,230.80
Human Services and Nursing Home vouchers 181 through 207, dated April 10,
2001 in the amount of $215,903.33.
Human Services, Workshop, Public Health vouchers 175 through 205, dated April
11, 2001 in the amount of $264,843.19
Social Services and Human Services vouchers 104 through 122, dated April 11,
2001 in the amount of $44,598.76.
Human Services and Nursing Home vouchers 208 through 233, dated April 24,
2001 in the amount of $173,796.13.
Human Services, Workshop, Public Health vouchers 206 through 232, dated April
25, 2001 in the amount of $208,380.44.
Social Services and Human Services vouchers 123 through 140, dated April 25,
2001 in the amount of $43,933.27.
Human Services and Nursing Home vouchers 234 through 260, dated May 08, 2001
in the amount of $219,953.53.
Human Services, Workshop, Public Health vouchers 233 through 263, dated May
08, 2001 in the amount of $265,001.11.
Social Services and Human Services vouchers 141 through 160, dated May 09,
2001 in the amount of $44,786.23.
FINANCIAL REPORT: The following financial reports for March were distributed
to the Board:
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ST. CROIX COUNTY HUMAN SERVICES BOARD
FINANCIAL SUMMARIES
FOR THE PERIOD 01/01/01 THROUGH 03/31/01
NURSING HOME
Reconciled Cash Balance 03/31/01 ($210,827.38)*
Add:
Accounts Receivable, 03/31/01
Private Pay $18,839.98
Medicare $155,205.21
Medicaid $195,610.74
General $356.18
Accounts Payable-03/31/01 ($158,318.95)
Net Current Items, 03/31/01 $865.78
2001 Revenue Recorded through 03/31/01 $1,386,264.65
Includes Allocations of Anticipated Revenues
*
2001 Expenses Recorded through 03/31/01 $1,562,608.48*
Includes Allocations of Expected Expenses
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HEALTH AND HUMAN SERVICES - 2001
SUMMARY Total
OF REVENUES Jan.-Mar. Budget Balance
Administration 136,424.85 736,431.00 600,006.15 18.5%
AODA Services 96,166.36 353,366.00 257,199.64 27.2%
Intensive In-Home Treat. 35,452.04 176,471.00 141,018.96 20.1%
Long Term Support 2,326,219.41 11,519,994.00 9,193,774.59 20.2W
Mental Health 389,822.81 1,895,384.00 1,505,561.19 20.6%
Family & Children's 529,362.88 2,360,749.00 1,831,386.12 22.4%
Economic Support 145,920.02 1,256,132.00 1,110,211.98 11.6%
General Relief 365.24 5,281.00 4,915.76 6.9%
TOTAL REVENUES
ALL PROGRAMS 3,659,733.61 18,303,808.00 14,644,074.39 20.0%
SUMMARY Total
OF EXPENDITURES Jan.-Mar. Budget Balance %
Administration 168,535.88 736,431.00 567,895.12 22.9%
Alcohol-Drug Abuse 67,193.72 353,366.00 286,172.28 19.0%
Intensive In-Home Treat. 37,337.51 176,471.00 139,133.49 21.2%
Long Term Support 2,145,783.86 11,519,994.00 9,374,210.14 18.6%
Mental Health 411,433.90 1,895,384.00 1,483,950.10 21.7%
Family & Children's 432,341.07 2,360,749.00 1,928,407.93 18.3%
Economic Support 220,066.28 1,256,132.00 1,036,065.72 17.5%
General Relief 3,957.15 5,281.00 1,323.85 74.9%
TOTAL 2001 HUMAN
SERVICES BUDGET 3,486,649.37 18,303,808.00 14,817,158.63 19.0%
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PUBLIC HEALTH
Total
Jan.-Mar. Budget Balance
TOTAL REVENUES* 265,042.39 1,099,234.00 834,191.61 24.1%
TOTAL EXPENDITURES 223,598.03 1,099,234.00 875,635.97 20.3%
Becky Ruka gave quarterly information regarding accounts receivable. She
said she is working with Innovative Resource Group and more insurance
companies to be able to provide services for more companies. She said actual
collections for 2000 were $28,000 over budget and when comparing 2000 to
2001, we are currently $5,500 ahead of last year at this time. She said
accounts receivable is very current as we are now being paid for claims made
in April. She will return to the Board with another update at the end of
next quarter. Kiesler said we know what our State and County allocations are
and will be, but collections are very important.
MENTAL HEALTH/AODA: Kiesler said Community Services Deficit Reduction
Benefit (CSDRB) or MA Deficit Reduction has been completed and will result in
60% additional funds from the Federal government. The 60% additional funds
are federal dollars (namely, 60% of the difference between the MA rate and
our actual service cost). He said the rates dropped from 1999 to 2000 by
$5.91 for Mental Health/AODA and by $3.29 for Community Support Program
because overhead costs decreased. He said the service units for each of
these areas went up over 1000 hours from 1999 to 2000. He said he is
currently reviewing ways to more accurately cost allocate overhead expenses
for Mental Health, Community Support Program and AODA so this doesn't happen
again. He said this will not negatively impact the budget. He said he is not
recommending a change in rates for the clinic this year.
Kirt said the hospital inpatient rates increased in 2000. When this was
reviewed in April there has been another increase in inpatient days. He said
in 2000 there were 187 admissions with 1,139 total days and so far this year
there have been 75 admissions with 420 total days. Last year there were 12
commitments and 13 settlement agreements and so far this year there have
already been 12 commitments.
Kirt said there has also been an increase in Intoxicated Driver Program
assessments. He said a waiting list was started for AODA due to this
increase. He said after clients are assessed, there is a recommendation for a
driver's safety plan, outpatient services or inpatient services. The client
is responsible for the initial assessment as part of the court process but
services recommended as a result of the assessment are figured on a sliding
fee scale. Horne asked how many of these clients follow through with
recommendations, Kirt thought the number would be between 80-90% and the rest
just lose their licenses. Horne said we have no programs to serve this
population. Kirt said treatment is provided according to State statute. In
addition, the County serves these clients on a sliding fee scale. Kirt said
we are also looking at a whole new group of clients due to changes in the law
that requires assessments for clients processed for underage drinking. Kirt
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said there are currently five on the waiting list with a three to four week
wait.
Kiesler said as part of the 2002 budget process he will request to fill one
position in AODA as a half-time AODA counselor and half-time prevention/
intervention specialist.
Kiesler said he is dissolving the In-Home Team and moving the therapist into
an office position and the social worker into Mental Health Social Worker
position in an effort to utilize the resources we currently have available in
a more effective and prudent way. He said both Mental Health Outpatient and
CSP are saturated with work. He said this would leave the unit flexible
enough to fill the voids between CSP and Mental Health and he would be able
to allocate resources where they are needed the most.
PERSONNEL ISSUES: Stephens said the Deputy Director position was vacated
about five years ago. He said he feels more and more there is a need to fill
this position and it is within the Board's authority to fill this position.
Horne said this is not in the current year budget. Stephens said there have
been some savings made that will cover the wages. Stephens said we need to
have an adequate second in command in Health and Human Services. Horne said
he feels we will not be able to get someone by 07/01/01 as this is a short
amount of time. Kiesler said Borup wanted to make this part of the 2002
budget process and to fill the position effective July of 2002.
Motion: A motion was introduced by Stephens, seconded by Wentz, and
unanimously adopted: That the Board direct John Borup to fill the Deputy
Director position effective 07/01/01.
PUBLIC HEALTH: Linda Adams updated the Board on her duties for health
benefit counseling. She receives calls from low income, uninsured and under
insured clients. Adams said last month there were 528 on Badgercare of
Medical Assistance. She said Badgercare is only for people who don't have
any health insurance, not for the underinsured. She said outreach is
ongoing. She said the largest problem clients have is access to dental care
and this is common across the county.
Adams said ABC for health is a non-profit law firm located in Madison that
helps clients who have been denied benefits. Adams is St. Croix County's
resource person for medical care and for coordinating health benefits for
clients with special health care needs.
Wisconsin Immunization Registry is a statewide program to regulate
immunizations in the state. St. Croix County has not signed onto this program
as yet. Monies have not been funded from Madison for this program. Horne
asked how much it would cost to have immunization registry on the computer.
He asked how important it is to have access to this information. St. Croix
County has the Sure Shots program. It is not a duplication of services, but
we are not able to connect with the State or other agencies or clinics with
this program but this only serves St. Croix County. Public Health also runs
reports for other health care providers. Medical providers in St. Croix
County do not have a computer link to St. Croix County's system. Nelson said
the state system would allow us to give an update on immunization records.
Adams said the electronic system is more mobile for access to records at
satellite clinics.
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Kramer said a shortage in Tetanus vaccine is expected to run through the fall
of this year and a contingency plan is in place because of this. Kramer said
effective 06/01/01 the chicken pox vaccine will be required for admission to
schools.
The Board recessed from 9:50 to 10:00 AM.
Boron said UNIX will not support our computer system any long and ECHO will
end support at the end of this year. He said ECHO has been adequate at best.
He said new HIPA regulations will be in effect in 2003. Boron said updates
are needed in the amount of approximately $80,000, some of which may come
this year and at the beginning of next year. He said ECHO is the least
expensive of all updates and will provide the information we need. Boron
said the upgrade and continuing maintenance will serve us for the next five
years. He said most software has a five to ten year life expectancy.
Horne said the Board needs feedback in advance when things are not working,
i.e. ECHO. Boron said this is an evolving technology.
Olson read a portion of a newspaper clipping regarding the Pierce/St. Croix
Tobacco Free Coalition. This is a contracted employee with Tobacco Control
funds and is not a county employee. Olson requested a copy of the exact
minutes when this position was brought to the Board. Olson asked if this
issue is already being adequately addressed in the public school system, why
are more monies being given to something that is already working adequately.
She said she doesn't like to see a duplication of services or efforts.
Nelson said different schools have different curriculums and we will not
change what is already working. Nelson said the monies under this fund are
not monies that can be shifted as it is designated specifically for tobacco
control. The State Tobacco Control Board has specific items that need to be
addressed in their plan. Olson requested that the Tobacco Control Specialist
be scheduled for the June 12t" meeting.
NURSING HOME: Krieger said the Nursing Home census is 97 today. She said
we have had eight admissions in the last nine days. She said the hospital is
not utilizing their swing bed unit while the hospital is under construction
thus resulting in more admissions to the Nursing Home. However, the
admissions have been more heavy care residents. Krieger said the Nursing
Home is looking at two more years of financial stability with Federal funding
that has become available to the state for IGT dollars.
Krieger said the Nursing Home is looking at bed banking and/or downsizing.
Bed banking was started because there were too many nursing home beds in the
State. Krieger said the facility is able to bank beds to get a higher
Medicaid rate. Beds can be requested back each year, but are not given back
until 18 months after the request is made. In January of every year, 10% of
the banked beds are taken away so at the end of 10 years all banked beds
would be eliminated. She said Keefe will give further information on this at
the meeting for the Nursing Home Steering Committee on May 23.
The capital value of the business drops if beds are banked or the number
downsized. Olson asked if the bed banking goes with the sale of the facility
and Krieger said it does.
Krieger said another option would be downsizing as the state offers an
incentive to permanently downsize by 25% or 32 beds for St. Croix Health
Center but this is not an option at this time as the state has no monies
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available for downsizing. She said this issue will also be discussed on May
23. Krieger said June 30 is the deadline with the state to bank beds. Bed
banking or downsizing would have to be voted on by the full County Board.
REQUEST TO PURCHASE TWO AUTOMOBILES FOR DEPARTMENT USE: Kiesler said these
two automobiles are not budgeted items but the department would be able to
recoup the cost within two-year's time due to gas prices. He said he
contacted Greg Timmerman who said these do not have to be bid as the price
received from Cox Motors was less than the State contract price. He is
proposing buying two cars and selling one.
Horne left the meeting at 10:40 AM.
Motion: A motion was introduced by Wentz, seconded by Bethke, and
unanimously adopted: That the Board approves purchasing two cars and selling
one to Cox Motors for a price delivered of $14,495 each.
Stephens reminded Board members that the next meeting will be May 24, 2001 at
6:15 PM.
The tour of the Health Center grounds/farm land was postponed until the June
meeting.
Stephens asked if there were any other issues to bring before the Board.
Motion: A motion was introduced by Wentz, seconded by Olson, and unanimously
adopted: that the meeting be adjourned.
Time: 10:43 AM
Chair:
Attest:
(Secretary)
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