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HomeMy WebLinkAboutHealth & Human Services 08-14-01 z - 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: 08/14/01 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: 08/23/01 ACTION ON PREVIOUS MINUTES: 07/26/01 ANNOUNCEMENTS APPOINTMENTS: UNFINISHED BUSINESS% NEW BUSINESS: 1. Presentation and Action on 2002 budget for Health and Human Services/Nursing Home 2. Consideration of Claims and Vouchers 3. Financial Report 4. Program Reports a. Economic Support b. Nursing Home 5. 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 August 14, 2001 The St. Croix County Health and Human Services Board met on August 14, 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: John Borup, Health and Human Services Director Carolyn Krieger, Nursing Home Administrator Judy Ziegler, Accounting Supervisor Mary Squyer, W-2/Economic Support Supervisor Ron Lockwood, Long Term Support Coordinator Barbara Nelson, Public Health Supervisor-Health Officer Kathy Dunlap, Family and Children's Supervisor Fred Johnson, Family and Children's Supervisor Malva Berg, Secretary OTHERS PRESENT: Tom Dorsey, County Board Chair Chuck Whiting, Administrative Coordinator 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 August 23, 2001 at 6:30 PM at the St. Croix County Health and Human Services/Health Center complex. Berenschot will chair the August 23 meeting as Stephens will be absent. 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 Berenschot, seconded by Wentz, and unanimously adopted: That the minutes of the 07/26/01 Health and Human Services Board meeting be approved as circulated. At a recent meeting it was questioned why the second meeting of the month was an evening meeting rather than a day meeting. Motion: A motion was introduced by Olson, seconded by Wentz, that the second meeting of the month start at 8:30 AM. Roll call vote: Robert Stephens-no Leon Berenschot-no Chris Bethke-no Lois Burri-yes James Craig-no Einar Horne-yes Fern Johnson-no Mary Louise Olson-yes Esther Wentz-yes Four yes, five no, motion failed. Motion: A motion was introduced by Stephens, seconded by Berenschot, that the 08/23/01 Health and Human Services meeting start at 6:30 PM. Roll call vote: Robert Stephens-yes Leon Berenschot-yes Chris Bethke-yes Lois Burri-yes James Craig-yes Einar Horne-yes Fern Johnson-yes Mary Louise Olson-yes Esther Wentz-yes Nine yes, motion passed. ANNOUNCEMENTS: Borup announced that the Personnel picnic will be held today from 10:30 to 12:30 and encouraged staff and Board members to attend. PRESENTATION AND ACTION ON 2002 BUDGET FOR HEALTH AND HUMAN SERVICES/NURSING HOME: Borup said the County cost for the Department budget has raised $685,139 from $3,685,102 to $4,370,241, which equals an 18.59% increase. The Department's budget increased from $19,403,042 to $20,672,304 for a 6.54% increase. He said we have received a freeze in State funds that the County has to make up to provide mandated services. He said we had $295,000 in W-2 Community Reinvestment money in 2001 and have zero in 2002. He said this cut along with necessary program adjustments in Economic Support result in a County cost of $108,896 for Economic Support. He said W-2 has helped to eliminate the need to levy County money for Economic Support for about the last five years but that changes in 2002. Borup said $413,979 in prior year carryover funds has been applied to the 2002 budget. He said Paulson audit report shows a designated account balance of $710,033 for 2000. There is $31,300 included for ECHO software in the 2002 budget. The total cost for ECHO is $93,600, $62,300 is taken from prior year carryover for 2001. These transactions will reduce the fund balance to $233,754. The monies are taken from carryover funds rather than to increase the County allocation request. Borup reviewed salary/fringe/step increases for 2002, new position costs, along with increased maintenance and rent costs. The total cost attached to these increases is $611,236. He said salaries and fuel costs increased for maintenance costs. He said according to Ralph Robole, the maintenance costs in the 1974 and 1982 building continue to run less than maintenance costs at the Government Center. 2 Borup said the Department has not grown but is subject to inflation. He said the State has subtly shifted the cost of services to the County. This is occurring all across the State. He said we have received no State revenue increases but costs keep rising. Contracts with juvenile institutions are up 14-16W; Mental Health/AODA institutions are up as much as 16W. Institutional costs and foster care costs are not controlled by the County. Borup said Tracey and Thole has recommended Health and Human Services run with a fund balance of $250,000 to $300,000, opinion issued in 1993. Horne said the money in the fund balance is in the County account. Stephens said if the Department doesn't have a fund balance, it takes away the Department's ability to run their business. He said a fund balance allows the Department to operate without going to the County Board for funds. The 2002 budget includes an additional $55,000 for the courtyard project, $45,000 was already allocated in 2001 for this project. Stephens said the accounts receivable department does an excellent job and this project is a necessary investment. Horne questioned how much accounts receivable actually collects. He would like to see this as a separate report so the Board knows how much is collected. Other budget highlights include: • The Department Health and Human Services State Revenue for Youth Aids and Basic County Allocation are frozen. • The budget includes monies/revenues for Public Health Registered Sanitarian for Agent Status (restaurant inspection). • 53W of Public Health budget is County funded. Public Health has mandates for services that are not adequately funded by the State. • $30,000 is budgeted for secure detention services (This was transferred from the Sheriff's Department so Health and Human Services would be able to bill for secure detention services.) Horne questioned if the secure detention services could be transferred back to the Sheriff's Department. Borup indicated interest to return it as it creates Department work and generates little revenue. Horne indicated it would be a hard sell to present the budget to the County Board with an 18.59W increase. Borup reminded the Board that the total budget is up 6.5W. The 18.59% is the County cost increase, which reflects cost shifting from the State to the counties. Borup said $400,000 has already been cut from the budget and it would be extremely difficult to cut any more. Horne said the Deputy Director position would be a hard sell with the current financial figures. Horne questioned why we are in the W-2 program if the program is not supported. He questioned the level of the mandates and asked what would be the difference if it took longer to process services. He said in 2000 we hired five people in Economic Support/W-2. Borup stated these were not new positions. He said W-2 hasn't required all the staff, but that BadgerCare needs the staff. Squyer said staff are switched around as caseloads warrant. She said five new staff were hired in 2000, but that three replaced current positions and only two filled vacant positions. She said if we do not take W-2, she anticipates two positions will be dropped. 3 She said we are mandated to process within time limits set by the State. She said we will take W-2 this year but has extreme doubts about next year. She said we have fewer numbers of cases of Medicaid and Food Stamps than when we started. She said there are eight W-2 cases now but these are hard-to-employ clients. She said there is a continuous revolving door of clients who apply for W-2 and then become employed so those numbers are not shown on the monthly reports to the Board. Squyer said W-2 had community reinvestment dollars that was a way to make the program a success and those dollars are eliminated for 2002. Horne questioned purchasing a plow truck. He said we have had five years of use out of it, could it truck work for another year? Borup indicated the truck is a 1978 Dodge and was a Government Surplus vehicle. He said parts for Government vehicles are not the same as standard issue and are sometimes difficult to find. Horne questioned the Intensive In-Home Treatment Program was he was not able to locate that program in the 2002 budget. Borup said the Intensive In-Home Program closed in 2001 and services were shifted into the Community Support Program and Mental Health Outpatient Services. Horne questioned the Public Health budget. He said the income on every line is the same as it was last year. Ziegler explained there was a computer problem with the numbers for Public Health. The computer services person that was able to fix the problem was on vacation during the budget process. She said the 2002 numbers are correct. Horne asked that the Public Health budget with the correct numbers be brought back before the Board so the Board can fairly evaluate their budget. Borup will try to get this information to Board members before August 23. Horne questioned the Rest Area Maintenance Program through St. Croix Industries. Borup said this is a State contract. The program purchases equipment and the State DOT reimburses for equipment. Horne questioned why something similar is not being used for the county parks, etc. and suggested that this be explored. The Board recessed from 10:00 to 10:15 AM. Horne questioned Early Intervention/Birth to Three and Public Health Intervention. Borup said these are two totally different programs that are not related and there is no duplication of services. Borup stated that Birth to Three works with infants born with delays or disabilities. Squyer said Public Health is contracting with Economic Support/W-2 for outreach for BadgerCare as that area can provide this service cheaper than Public Health. Lockwood said the State has frozen their contributions to Long Term Support. Stephens said the State continues to have mandates for services but pulls the funds to support these programs. Lockwood said three clients on the waiting list were protectively placed by the courts that Health and Human Services were required to serve in the last year. Dunlap and Johnson reported salaries are not increased in the Family and Children's budget for the unsettled contract amount. There are additional funds in the budget to cover arbitration. The health insurance for Family and Children's staff is budgeted the same as all other departments. Dunlap said truancy is not in the budget as they are waiting for more information 4 from the judges. This issue may impact the budget in the future. Berenschot suggested contacting Eau Claire North Memorial as that school just put a truancy policy in place. Horne said Child Protection Ongoing had the largest increase in allocation. Dunlap said Youth Aids dollars may only be applied towards delinquent children. She said there was no choice for cuts in the budget but to cut out- of-home dollars. Johnson said alternate care costs are unpredictable. Out- of-home costs will increase 10 to 15% with contract placements. State Juvenile Correctional Institutions are proposing almost 14% increase in per diems and purchased services. The unit will also receive $35,000 less in community reinvestment dollars in 2002. Motion: A motion was introduced by Horne, seconded by Olson, That the Board approves removing the Deputy Director position from the 2002 budget. Stephens said it is necessary to bring on a Deputy Director and would like this position to begin in July, 2002. Horne said he would like to see Health and Human Services split from the Nursing Home and have two separate committees as there are too many decisions for the Board to make. Olson withdrew her second, Horne withdrew his motion regarding Deputy Director. Motion: A motion was introduced by Stephens, seconded by Berenschot, and unanimously adopted: That the Board approve hiring a Deputy Director effective 07/01/01 rather than 01/01/02. Motion: A motion was introduced by Horne, seconded by Olson: That the $20,000 for the plow truck be removed from the budget for one year. Stephens said he disagrees with this. He said the truck has been heavily used and if we go for another year, it will be worth less on trade. Borup said specs for military vehicles are different and parts are hard to locate. Olson withdrew her second, Horne withdrew his motion to remove the plow truck. Finance Committee is discussing fund balances so there is a standard policy to apply throughout the county. Motion: A motion was introduced by Horne, seconded by Olson, That the budget be adjusted so all carry over into 2002 is put in administration area for allocation. Stephens said this is a separate issue and may be brought back at the next meeting. Motion: A motion was introduced by Stephens, seconded by Wentz, and unanimously adopted: That the Board approves delaying action on the above motion for 60 days so the issue may be better defined. Motion: A motion was introduced by Stephens, seconded by Bethke, That the Board accepts the Health and Human Services Budget as presented less the Deputy Director position for six months and less Public Health which will be presented at the 08/23/01 meeting. Roll call vote: Robert Stephens-yes 5 Leon Berenschot-yes Chris Bethke-yes Lois Burri-yes James Craig-yes Einar Horne-no Fern Johnson-yes Mary Louise Olson-no Esther Wentz-yes Seven yes, two no, motion passed. Horne questioned the amount of money estimated as income from the department set up to do collections. He said there is a discrepancy from actual collections last year and what was budgeted for 2002. Ziegler said there was an influx of collections from past due claims in the last year and the amount to be collected has leveled off. The Nursing Home budget for 2002 is formed based on a census of 93. This is a five-bed reduction, which reduces revenues by about $200,000. The overdraft for 2000 was questioned. The fund balances will probably be addressed in the 2003 budget year. Horne questioned the forecast for the loss for the Nursing Home in 2001. Krieger said she isn't able to make a forecast. The Medicaid rates will be adjusted by the State and IGT monies remain uncertain. The budget contains an expense of $205,311 for depreciation, which was not budgeted in 2001. Motion: A motion was introduced by Stephens, seconded by Berenschot: That the Board approves the Nursing Home budget with a county cost of $991,469. Roll call vote: Robert Stephens-yes Leon Berenschot-yes Chris Bethke-yes Lois Burri-yes James Craig-yes Einar Horne-no Fern Johnson-yes Mary Louise Olson-no Esther Wentz-yes Seven yes, two no, motion passed. CONSIDERATION OF CLAIMS: The following reports for July were distributed to the Board: fixed assets, unemployment for June and July, financial report and cash reports. Health and Human Services Board member, Olson, reviewed and questioned the following July vouchers: HUMAN SERVICES: 8620: Brotoloc Health Care Systems, Inc., $1,021.00, Long Term Support Transitional Living. Brotoloc is a corporation providing both hourly and residential services to developmentally disabled and mental health clients in St. Croix County. They provide three or four bedroom living accommodations in Hudson, River Falls, and New Richmond. 6 8732: Geralyn Karl, $570.65. Purchased services. Ms. Karl is in charge of providing services under the Tobacco Control Grant. She is considered a contracted service, not a County employee. 9097: Geralyn Karl, $657.08. This is for purchased services and mileage for the Tobacco Control Grant person. We share all costs 50/50 with Pierce County. $515.10 was for services and $141.98 for mileage. 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 1689 through 1781: Human Services voucher 8610 dated July 11, 2001 in the amount of $1,500.00. Human Services vouchers 8611 through 8716, dated July 19, 2001 in the amount of $241,411.32. Human Services vouchers 8719 through 8720, dated July 24, 2001 in the amount of $1,500.00. Human Services vouchers 8721 through 8754, dated July 26, 2001 in the amount of $235,446.32. Human Services vouchers 8756 through 8780, dated August 03, 2001 in the amount of $25,167.01. Human Services voucher 8781 dated August 03, 2001 in the amount of $300.00. Human Services voucher 8782 dated August 03, 2001 in the amount of $631.42. Human Services voucher 8783 dated August 03, 2001 in the amount of $300.00. Human Services vouchers 8784 through 8851, dated August 09, 2001 in the amount of $205,932.58. Human Services vouchers 8978 through 9110, dated August 14, 2001 in the amount of $61,438.75. Human Services vouchers 8853 through 8977, dated August 14, 2001 in the amount of $91,395.22. Nursing Home vouchers 1330 through 1367, dated July 19, 2001 in the amount of $38,009.21. Nursing Home vouchers 1373 through 1376, dated August 03, 2001 in the amount of $762.37. Nursing Home vouchers 1377 through 1378, dated August 09, 2001 in the amount of $4,160.20. Nursing Home vouchers 1379 through 1422, dated August 14, 2001 in the amount of $38,388.97. Human Services and Nursing Home vouchers 399 through 426, dated August 01, 2001 in the amount of $223,673.63. 7 Human Services, Workshop, Public Health vouchers 414 through 447, dated July 26, 2001 in the amount of $264,084.14. Social Services and Human Services vouchers 255 through 274, dated July 26, 2001 in the amount of $42,097.56. Human Services and Nursing Home vouchers 373 through 398, dated July 17, 2001 in the amount of $181,621.56. Human Services, Workshop, Public Health vouchers 386 through 413, dated July 11, 2001 in the amount of $208,037.65. Social Services and Human Services vouchers 236 through 254, dated July 12, 2001 in the amount of $44,406.90. FINANCIAL REPORTS: The following reports through June, 2001 were distributed to the Board. ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD 01/01/01 THROUGH 06/30/01 NURSING HOME Reconciled Cash Balance 06/30/01 ($506,827.49) Add: Accounts Receivable, 06/30/01 Private Pay $34,786.68 Medicare $265,780.08 Medicaid $200,206.79 General $0.00 Accounts Payable-06/30/01 ($168,243.44) Net Current Items, 06/30/01 ($174,297.38) 2001 Revenue Recorded through 06/30/01 $2,964,181.56 Includes Allocations of Anticipated Revenues 2001 Expenses Recorded through 06/30/01 $3,122,408.16 Includes Allocations of Expected Expenses 8 HEALTH AND HUMAN SERVICES - 2001 SUMMARY Total OF REVENUES Jan.-June. Budget Balance Administration 427,543.01 736,431.00 308,887.99 58.1% AODA Services 208,666.54 353,366.00 144,699.46 59.1% Intensive In-Home Treat. 83,980.34 176,471.00 92,490.66 47.6% Long Term Support 4,720,745.22 11,519,994.00 6,799,248.78 41.0% Mental Health 1,107,143.20 1,895,384.00 788,240.80 58.4% Family & Children's 1,444,225.12 2,360,749.00 916,523.88 61.2% Economic Support 378,847.41 1,256,132.00 877,284.59 30.21 General Relief 362.24 5,281.00 4,918.76 6.9% TOTAL REVENUES ALL PROGRAMS 8,371,513.08 18,303,808.00 9,932,294.92 45.7% SUMMARY Total OF EXPENDITURES Jan.-June. Budget Balance % Administration 339,048.89 736,431.00 397,382.11 46.0% Alcohol-Drug Abuse 168,970.99 353,366.00 184,395.01 47.8% Intensive In-Home Treat. 81,793.83 176,471.00 94,677.17 46.3% Long Term Support 4,900,423.17* 11,519,994.00 6,619,570.83 42.5% Mental Health 933,399.90 1,895,384.00 961,984.10 49.2% Family & Children's 1,102,074.13* 2,360,749.00 1,258,674.87 46.7 Economic Support 518,142.48 1,256,132.00 737,989.52 41.2% General Relief 9,829.71 5,281.00 (4,548.71) 186.1% Accrued Payroll 243,888.20 0.00 (243,888.20) 0.0% TOTAL 2001 HUMAN SERVICES BUDGET 8,297,571.30 18,303,808.00 10,006,236.70 45.3% *Salaries for Human Services Professional Union Component are still being paid at 1999 rate. Estimated costs for 2001 are $50,000 to $75,000. PUBLIC HEALTH Total Jan.-June. Budget Balance TOTAL REVENUES* 541,554.61 1,099,234.00 557,679.39 49.396 TOTAL EXPENDITURES 484,582.72 1,099,234.00 614,651.28 44.1% Stephens asked if there were any other issues to bring before the Board. Motion: A motion was introduced by Wentz, seconded by Stephens, and unanimously adopted: that the meeting be adjourned. Time: 11:17 AM Chair: Attest: (Secretary)