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Home My WebLink About01-18-2012 Health & Human Services NOTICE OF MEETING AND AGENDA ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD January 18, 2012 - 8:30 A.M. Board Room, St. Croix County DHHS Building 1445 N. 4ch Street, New Richmond Wisconsin L CALL TO ORDER II. ROLL CALL III. APPROVAL OF MINUTES OF PREVIOUS MEETING: 12/14/2011 IV. BUSINESS ITEMS 1. Financial Report for Nursing Home and Health and Human Services 2. 2011 Departmental Operational Goals-Behavioral Health 3. St. Croix County Crisis Network Meeting Report 4. Nursing Home Administrator's Report 5. Nursing Home Operational changes report 6. 2020 Wisconsin Health Plan Endorsement by the Health and Human Services Board 7. Health Department Quality Improvement $5,000 Grant Request 8. Family Care Cap Report V. ANNOUNCEMENTS & CORRESPONDENCE VI. ADJOURN DATE OF NEXT MEETING: 02/15/12 at 8:30 A.M. REVIEWED AND APPROVED BY: Committee Chair and County Administrator DATE APPROVED: A quorum of the St. Croix County Board of Supervisors (County Board) may he present at this meeting. Therefore, this notice also serves as notice of'a meeting of'the County Boardfor the purpose of'ohtaining information relaxing to subjects listed above for use at future County Board Meetings. 1/9/2012 ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD January 18, 2012 The St. Croix County Health and Human Services Board met on January 18, 2012 at the St. Croix County Health and Human Services/Health Center complex. MEMBERS PRESENT: Esther Wentz, Chair Leon Berenschot Frederick Horne Roger Larson Linda Luckey Richard Marzolf Dr. Lisa Ramsay Alfred Schrank MEMBERS ABSENT: Deb Rasmussen STAFF PRESENT: Fred Johnson, Health and Human Services Director Cindy Anderson, Nursing Home Administrator Wendy Kramer, Health Officer/Public Health Coordinator Steve Kirt, Behavioral Health Administrator Malva Sirek, Administrative Support Supervisor OTHERS PRESENT: Pat Thompson, County Administrator Kim Dupre, Information Systems Analyst Dave Ostness Norm Matzek Chair Wentz 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, February 15, 2012 at 8:30 AM. MINUTES: Motion: A motion was introduced by Berenschot, seconded by Schrank, and unanimously adopted: That the minutes of the 12/14/11 and 12/21/11 Health and Human Services Board meetings be approved as distributed. FINANCIAL REPORT FOR NURSING HOME AND HEALTH AND HUMAN SERVICES: The following financial report for Health and Human Services, Nursing Home, St. Croix Industries, Aging and ADRC through November, 2011 was distributed. This is the same report that was distributed to the Board at the December meeting. Johnson reported that after speaking to Michelle Pietrick, finance is going back to a two month lag for financial reports to allow for uniform reporting for the standing committees. Johnson reported the December financial reports would be distributed at the February meeting. Thompson indicated this issue is on the Administration St. Croix County Health and Human Services Board Page 2 January 18, 2012 Committee agenda to work on this matter. Thompson would like to see more current financial information reported than information that is two months old so does not consider the matter as totally settled at this time. Novendw2D77 AnntgA N vem6er Ackols Budget % of Revenues Budget Axe TO Date 6AMM &jaw Heats & Human Services S 15,971,121 S 1,153,103 S 11,599,291 S 4,371,830 726% St Croix Mushier 418182 243,505 335104 83,078 96.6% AgIFIg 943,3B2 69,047 854,849 88,513 90.6% ADRC Z274,50 56,296 364195 (89,595) 103.9% Nursi Fig Home 6,499,631 361,972 4 928 925 1570 706 75.8% Total Progarn Reve- S 28,106"5 = 1.M,922 $ 22,082,364 S 6,024,531 78.6% Eames Heakh & Human Services S 15,975,121 S 1,073,789 S 12,268,878 S 3,706,243 76.8% St Croix tdlstries 2,418,182 176,568 2,047,597 370,585 84.7% Aging 943,362 72,283 82,815 122,547 87.0% ADRC 2,274,599 75,560 2,154,890 119,709 94.7% Nursing Home 6,499,631 431,039 5,478,972 1,020,659 84.3% Total PMWa Eames S 28,110 5 S 1,M,2A1 S 22,771,152 S 5,338,743 81A% Re nums Onw(thadag E*amNwvs S 60.681 S 688.788 Peraer►taef 91.7% Supervisor Wentz asked if work continues towards hiring a full-time, permanent employee in the HHS Financial Manager position. Johnson reported that Deb Suchla has been working under an employment agreement and this arrangement will continue through year end close out in March. Discussions on filling the position with a permanent employee will take place. Currently, Suchla has been working with the audit firm on updating Health and Human Services (Fund 225) chart of accounts. 2011 DEPARTMENTAL OPERATIONAL GOALS-BEHAVIORAL HEALTH: Johnson reminded Board members that a different Department will be highlighted each month to help guide the Board with policy decisions. Kirt reviewed each of the 2011 Operational Performance Targets for Behavioral Health. The first target was high quality effective community service provider. The Multi-Systemic Therapy (MST) program received licensure in 2010. There was staff and supervisor training in January and clients were accepted into the program in February of 2011. Kirt indicated that youth in the program are at high risk for out-of-home placement if they had not had the MST program available. Many positives have resulted from the MST program. Kirt explained under the broad category of adjust/retool to meet changing needs, efforts are ongoing to research electronic health records (EHR). He indicated the County may be eligible to receive $60,000 over a six year period for each psychiatrist in Behavioral Health and St. Croix County has two eligible psychiatrists, which would result in $120,000. The ECHO program for EHR was assessed through contracted consultants and ECHO fell short of meeting the county's needs. After that assessment, alternative EHR systems were explored and the search has been narrowed to two vendors. Reference checks are currently being performed on providers to determine which system should be recommended. Kirt indicated contracted consultants St. Croix County Health and Human Services Board Page 3 January 18, 2012 experienced a change of staff which has delayed this process. Work continues on recommending an EHR vendor. Under the category of financial accountability, billing for Northwest for mobile crisis services is now being done through Accounts Receivable to capture more revenue. Some billing for ACSS clients is being done through emergency services as well. Staff have attended a Medicaid training in an additional attempt to capture more funding. Kirt reported that objectives for stable and motivated staff have been met. The County has provided 15 of the 30 training hours staff need for licensure over the past year. It is cost effective to bring the training in house versus sending staff to training outside the county. Luckey questioned how St. Croix County compares with other counties regarding crisis response. Kirt reported there are only three other counties that provide 24/7 crisis response and he does not have stats for the other counties but can get those figures. ST. CROIX COUNTY CRISIS NETWORK MEETING REPORT: Kirt reported on a mobile crisis meeting that was held in November of 2011 and distributed the power point presentation from that meeting. He reported a crisis network meeting needs to be held twice a year to maintain certification. The next meeting will be held in April or May. Out of 402 possible client emergency detentions, 236 or 59% were diverted. This results in savings to the county and the client. Two Behavioral Health staff are assigned to follow up on diversion clients to make sure the clients follow their crisis plan. The percent of diversions has increased and Kirt reviewed. NURSING HOME ADMINISTRATOR'S REPORT: The average monthly census for December was 59, with 7 Medicare, 36 Medicaid, and 16 private pay residents. There were four admissions and four discharges during the month. Census today is 61. Anderson reported there were 11 referrals from 12/14 to 12/23/11. Of the 11 referrals, two were admitted, seven referrals were declined due to not being able to meet resident needs and two went elsewhere. Admissions were stopped 12/23/11 due to a flu bug in the Nursing Home. Admissions were accepted again 01/07/2012. It was questioned how the flu was defined and the decision made to stop admissions. Stool samples are sent to the Health Department who in turn determines whether to stop admissions. Residents received the flu vaccine, which is for respiratory illness; however, the flu that struck the facility was gastrointestinal and was very communicable. The flu virus was determined to be Norovirus, which has no vaccine. The decision to stop accepting admissions was based on guidance received from the State due to the number of cases in the building and the type of flu. There were also outbreaks of the flu in another nursing home in the county at the same time St. Croix Health Center had the outbreak. Anderson reported over 300 people attended the 12/17/11 Nursing Home Christmas party for the residents. Anderson reported seven contractors did a walk-through of the Nursing Home this week so they can submit a bid on work needed to be done in the Nursing Home as part of the plan of correction. St. Croix County Health and Human Services Board Page 4 January 18, 2012 NURSING HOME OPERATIONAL CHANGES REPORT: Anderson reported work continues on projections for a 50 to 57 bed nursing home and hopes to report to the Board in February or March. The year-end financial figures are not completed at this time, which are needed to make the projections. Johnson said this will be a standing agenda item. He reported no permanent changes have been made but a shift has been made to have 62 beds as the census at this time. Referrals and trends for the Nursing Home are being monitored. The nursing home bed availability report for the County was distributed. He said there are currently approximately 80 vacant beds in the county, which is a decrease from the previous month report. Pathway recommended a 50 or 57 bed facility in their operational review of the Nursing Home. Johnson indicated he will work with fiscal staff to complete a financial analysis regarding the Nursing Home and this will be done by February. Johnson indicated if the facility went to a 57- bed facility, all rooms would be private rooms. If the facility went to a 50-bed facility, there are financial incentives for Medicaid reimbursement. 2020 WISCONSIN HEALTH PLAN ENDORSEMENT BY THE HEALTH AND HUMAN SERVICES BOARD: Kramer reported the Health Plan has two big-picture goals: 1. Eliminating persistent disparities in health outcomes based on race, ethnicity, socioeconomic factors, sexual or gender orientation and disability. 2. Focusing on quality of life for individuals throughout life both by increasing prevention efforts and providing good care for people with chronic disease and disabilities. The local community health improvement process, Healthier Together, aligns with the State Health Plan. Kramer reported this year began the implementation phase for Healthier Together and the evaluation phase will begin at the end of 2012. When the Healthiest Wisconsin 2020 Health Plan was released, they asked for endorsement from the local health departments. Endorsement is encouraged to be done by the Public Health's policy board. Motion: A motion was introduced by Berenschot, seconded by Horne, and unanimously adopted: That the Health and Human Services Board endorses the 2020 Wisconsin Health Plan Initiative. Johnson indicated a cover letter will be sent to the State indicating Health and Human Services Board endorsement. HEALTH DEPARTMENT QUALITY IMPROVEMENT $5,000 GRANT REQUEST: Public Health received notice of award of a $10,000 CDC Infrastructure Mini Grant to be used towards quality improvement work, which moves Public Health forward in the accreditation process. The grant runs from January 1 through September 30, 2012. The Board congratulated Kramer on receipt of the $10,000 grant. St. Croix County Health and Human Services Board Page 5 January 18, 2012 Kramer asked for the Board's support to apply for a $5,000 grant from the National Network of Public Health Institutes, which is part of the Strengthening the Community of Practice for Public Health Improvement initiative. In addition to the funding, the department will receive 15 hours of individualized quality improvement (QI) assistance from an experienced QI coach. Kramer indicated this is a national grant with only 60 agencies across the nation being awarded the grant. There is no county match required for the grant. Motion: A motion was introduced by Berenschot, seconded by Horne, and unanimously adopted: That the Board approves applying for the Health Department Quality Improvement Grant in the amount of $5,000. FAMILY CARE CAP REPORT: Johnson distributed a report on Long Term Care Enrollment Cap for Resource Center across the state. He indicated St. Croix County has a local cap of 488 for number of clients served. When the cap on the number of clients was put into place, counties could still serve consumers through statewide emergency slots; however, as we anticipated in the budget process for 2012, utilization has been low. Counties could also serve consumers when a local slot became available that put our number of consumers served fewer than 488. St. Croix County has been able to enroll consumers from the wait list when these local slots are available and there has not been a significant delay for access to Family Care due to disenrollment. Legislators may remove caps as soon as March, 2012. Wentz asked if there were any other issues to bring before the Board. Wentz adjourned the meeting. Time: 9:38 AM Chair: Attest: (Secretary)