HomeMy WebLinkAbout08 05 2013 Health and Human Services Minutes MINUTES
HEALTH & HUMAN SERVICES BOARD
August 5, 2013 8:30 AM
Board Room, Department of Health & Human Services
1445 N 4th Street, New Richmond, Wisconsin
CALL TO ORDER
ROLL CALL
Attendee Name Title Status Arrived
Tim Hood Supervisor Absent
Fred Yoerg Supervisor Absent
Chris Kilber Supervisor Absent
Tom Hawksford Supervisor Present
Roger Larson Vice Chair Present
Fred Horne Chair Present
Leon Berenschot Board Member Present
Lisa Ramsay Board Member Absent
Deb Rasmussen Board Member Present
Others Present: Health and Human Services Director Fred Johnson, County Administrator
Patrick Thompson, Fiscal Director Tabitha Hanson, , Human Resources Director Tammy Funk,
Nursing Home Administrator Jack Williams, Director of Nursing Sandy Hackenmueller, St.
Croix Industries Administrator Clark Schroeder, Public Health Administrator Deb Lindemann,
New Richmond News Jeff Holmquist, Information and Technology Kim Dupre, Health and
Human Services Administrative Assistant Colleen Linder, County Board Chair Daryl Standafer,
County Board Supervisor Dave Ostness, Several Parents and Stakeholders representing St.
Croix Industries. CliftonLarsenAllen Representative Trenton Fast, CPA
APPROVAL OF MINUTES
1. July 1, 2013 8:30 AM
Chair, Horne asked if there were any corrections to the minutes. Chair announced if
there are no corrections to the minutes they stand as distributed.
RESULT: ACCEPTED
PUBLIC COMMENT*
No Public Comment
BUSINESS ITEMS
1. Nursing Home Report
Nursing Home Administrator Jack Williams addressed the Board and shared that we have
reached the milestone of 50% completion of the fiscal year. The 2012 audit report will be
presented later in the meeting by Trent Fast, CPA with CliftonLarsonAllen. The Year to
Date shows a loss of almost $143,000, though we are tracking better than last year. We
are approximately $300,000 better on the income side. This is attributed to the effort to
curtail labor cost and the consistent high occupancy. We still have work to do, we are
reaching near full potential on revenue side, and as we are entering into the budget
process we will be working with leadership to take a closer look at cost. We continue to
maintain a 5 star rating which is something to be proud of, but also becoming
increasingly important as this is being looked at more closely by hospitals as they
discharge clients to nursing home facilities. There is still no word on the incentive
application, and we do n't expect anything until fall.
2. Financial Reports
Tabatha Hansen shared the June YTD financial report. She has taken a deeper look at
various Health and Human Services (HHS) Departments revenues during the budget
process. They are trending below what was expected on the budget, and it appears in
particular the Children's Long Term Support Waiver revenues are coming in low. One
explanation for the shortfall could be the number of new staff in this area. It takes a lot of
time to train and get the new staff to the point they are reporting billable time. Also, they
are no longer able to back date per state changes, so the longer it takes to get a waiver
open the more time that is non-billable. Another factor is higher number of placements of
clients in higher cost care facilities in May and June which have made the expenses
higher while revenues leveled off. Collections are on target. St. Croix Industries still
looks like we will be over budget in operating expense by approximately $100,000.
Aging and ADRC continue to look good.
3. St. Croix County Nursing Home Financial Statements Years Ended December 31, 2012
and 2011
Trent Fast, CPA with CliftonLarsonAllen presented the 2012 audit reports. He shared two
documents, the actual Financial Statements and the Board Report packet which includes
some extra communication items with graphs and ratios in comparison to other years and
similar facilities. He reviewed some of the changes made to the way the report looks and
reads. CliftonLarsonAllen issued a clean op inion this year, meaning the financial
statements are materially correct. They had no difficulties in getting the audit done and
appreciated this. On the revenue side the high occupancy and the change to 50 beds has
been a positive change, many care cent ers are doing this in order to right size their
operations. The high number of Medicare residents is also helpful as Medicare typically
pays higher than Medicaid, private insurance and private pay. Accounts receivable are
doing a great job in collecting o n a timely manner. On the expense side, on cost per day,
the audited numbers again show that the cost of nursing care, wages, fringe benefits, and
taxes are the highest expenses and from a comparative standpoint remain high. There is
still a big hill to climb with some items, but there have been some positive decreases in
operating expenses which is good to see. He thanked the County for the opportunity to
work with them once again and would be happy to answer more questions.
4. Health and Human Services Facility Planning Report
Health and Human Services Director Fred Johnson shared that at last month's meeting of
the Committee of the Whole the information in the packet was shared and he wanted to
give Health and Human Services Board an update. The slides g ive an overview of what is
being proposed to the County Board including a timeline and the tentative agreement.
County Administrator Pat Thompson shared that the seller of County Market has met all
contingencies and so this resolution will be put to a vot e tomorrow at the County Board
meeting. A question was raised regarding Baldwin Ag center employees and the potential
they be moved to Hudson in the future. As the Federal Government lease is terminated
and they vacate, the Baldwin office would only be ho using approximately 20 employees
so this would seem an inefficient use of space. The potential of the Federal Government
approaching the county in the future seems unlikely as they have changed their location
model, but the door is always open. The building is an asset, but is only large enough to
accommodate parts of Health and Human Services, so would potentially best benefit the
county to sell that building.
5. St. Croix Industries Parent/Stakeholder Meetings Report
HHS Director Johnson is providing an update on this matter. The Board packet includes
notes from the meetings that were held throughout June and into July with parents and
stakeholders. Additionally, a power point provided by Southwest Family Care Alliance
(SFCA) was also included.
Since July 1st there has also been a meeting with SCI staff including SCI Administrator
Clark Schroeder, Johnson, and Human Resources. Some staff questions were addressed at
that time, but many are on hold until the County Board makes a decision regarding
transition. There has been one staff retirement so we will be reviewing the Day Services
program based on that retirement. Another staff person is leaving for a job outside the
county, and there is potential for others to leave. The transition discussion has sta ff
looking at other options and as noted, some have already made changes.
After the July 9th parent meeting, the parents made the decision they did not need any
further information from HHS staff, so all further scheduled meetings with HHS were
cancelled. This was clarified and confirmed with Kris Ainsworth, parent representative.
The door was left open to them if they felt the need to meet at any time. Since these
meetings were cancelled, the opportunity did not present itself for a transition report to be
put together. Some of the main concerns shared by parents if transition happens were
quality of services, the voice of SCC being heard, and lastly transportation. The quality
issue was addressed by SFCA during parent meetings. SFCA also shared they wo uld
want SCC staff and SCI parents to be part of writing the Request For Proposal (RFP) so
their voice would be heard. Johnson shared that Administration is committed to working
with another entity to continue transportation if this is necessary. The use of the SCI
building is also in question and this is another area that Administration is willing to work
with another provider on, if need be, during transition. SFCA is committed to working
with the County if transition is approved. If the need arises SFCA is willing to attend
future meetings and report to the Board if there are issues regarding their commitments.
Johnson did not want to speak for the parents but did give his impression that after
meeting with parents they did feel more comfortable with t he county staying involved.
Parent Representative Ainsworth spoke and shared that they did gain a lot of knowledge
while meeting with HHS staff, and they have continued to meet on their own to gather
more information for themselves. Concern was shared what if no providers accept our
RFP. The county has received several inquiries regarding SCI and SFCA will put
together a strong proposal that is expected to generate a lot of response. Another concern
is that if transition happens tomorrow the county will cu t off services. The County has all
intentions of working closely with SFCA during transition and will provide services until
another responsible provider is found. Services will continue and SFCA has agreed to
keep the rates the same through the first quarter of 2014. County Supervisor Ostness
shared that he and another Supervisor went to Eau Claire and met with SFCA staff, it was
an excellent meeting and that he felt much better about a potential transition after this
meeting.
6. Resolution Supporting Wisconsin Counties Collaborative Statutory Language for Health
and Human Services Programs (Umbrella Human Service Statute)
This was an informational item at last meeting and the board requested a resolution be
drafted and brought to this meeting in support of the proposed umbrella statute. Johnson
is looking for Board support in this statutory change. There is one change in wording
that will need to be made to the Resolution as the Human Services Board for Wisconsin
counties has voted to endorse and support this statue proposal. Johnson will bring the
Statute to the Board when it is written in its final form. Motion was made by Rasmussen
to accept with the changes recommended, Hawksford 2nd. No one was opposed.
Johnson will get the wording in the resolution changed to indicate that the WCA Board
voted to support the umbrella statute and bring it to the County Board.
RESULT: APPROVED AS AMENDED [UNANIMOUS]
AYES: Tom Hawksford, Roger Larson, Fred Horne, Leon Berenschot,
Deb Rasmussen
ABSENT: Tim Hood, Fred Yoerg, Chris Kilber, Lisa Ramsay
ANNOUNCEMENTS & CORRESPONDENCE
Next meeting is scheduled on a Holiday so will need to be rescheduled. It has been rescheduled
for September 9, 2013 at 1:00pm at HHS Board Room. We will need to reach out to the other
Board members to be certain there is a quorum.
ADJOURN
Respectfully Submitted: Colleen Linder
This meting was adjourned at 9:50 A.M.
DATE OF NEXT MEETING: SEPTEMBER 9, 2013 1:00 P.M.
September 9, 2013 at 1:00 P.M.