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Home My WebLink About04-04-2012 Health & Human ServicesNOTICE OF MEETING AND AGENDA ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD April 4, 2012 - 8:00 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: 03/21/2012 IV. BUSINESS ITEMS 1. Discussion on size of the Nursing Home V. ANNOUNCEMENTS & CORRESPONDENCE VI. ADJOURN DATE OF NEXT MEETING: REVIEWED AND APPROVED BY: Committee Chair and County Administrator DATE APPROVED: 03/30/2012 Please note meeting start time of 8:00 AM. 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. 3/30/2012 ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD April 04, 2012 The St. Croix County Health and Human Services Board met on April 04, 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 Deb Rasmussen Alfred Schrank STAFF PRESENT: Fred Johnson, Health and Human Services Director Deb Suchla, Fiscal Administrator Cindy Anderson, Nursing Home Administrator Connie Sarauer, Director of Nursing Malva Sirek, Administrative Support Supervisor OTHERS PRESENT: Pat Thompson, County Administrator Heather Wolske, Corporation Counsel Kim Dupre, Information Systems Analyst Dave Ostness Steve Hermsen, County Board Member Ron Raymond Norm Matzek Shirley Matzek Karen Lindloff Rick Prokash Jeff Holmquist, New Richmond News Jeff Middleton, AFSCME staff representative 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, April 18, 2012 at 8:30 AM. MINUTES Marzolf questioned the difference in the minutes and what was reported in the March 29, 2012 edition of the Hudson Star Observer. Discussion took place that the Health and Human Services (HHS) Board did not need to take formal action on an operational adjustment to go to 50 -beds in the Nursing Home. It is management's responsibility to stay within the budget. St. Croix County Health and Human Services Board Page 2 April 04, 2012 Horne questioned if the number beds could be reduced to zero by the manager. The auditors have confirmed that the Nursing Home was $400,000 over budget for 2011 in addition to the County levy already contributed to the Nursing Home budget for 2011. Adjustments in other departments have occurred to stay within budget parameters, which include not filling a vacant Public Health Nurse position, not filling a vacant Behavioral Health management position, and making changes in the St. Croix Industries' transportation services. The Board recessed from 8:15 — 8:20 AM. Notes from the meeting were reviewed. Corporation Counsel read statutes regarding County Administrator form of government. The County Administrator and Health and Human Services Director have the authority to manage operations, which would include a decision to de- license beds. It is the Board's charge to have a policy to have a nursing home and authority over the budget of the nursing home. The Statutes that cover St. Croix County have changed due to the move to the County Administrator form of government from Administrative Coordinator form of government. A decision to close the Nursing Home would be a policy decision and Wolske indicated she believes this would be a Board decision. Motion A motion was made by Marzolf to amend the 03/21/12 minutes. Luckey reviewed her notes from the March 21 meeting and said it was reported there would be an operational change to go to 50 -beds before going to the State to de- license beds. It was recommended to go to 50 -beds, not to de- license beds. Marzolf withdrew his motion. Motion A motion was introduced by Berenschot, seconded by Luckey, and unanimously adopted: That the minutes of the 03/21/12 Health and Human Services Board meeting be approved as distributed. DISCUSSION ON SIZE OF THE NURSING HOME Johnson indicated the operational decision to move to 50 -beds was made to stay within budget. Review of the 2012 budget projections have been completed by the auditors. Anderson estimated it will take one to two months to get census down to 50 beds. There is no agenda to close the Nursing Home or reduce the Nursing Home to zero beds. Operational changes are needed to make the budget viable. The Nursing Home is a passionate issue as we are talking about people's lives and if the HHS Board does not want to reduce the Nursing Home operation to 50 beds, then the HHS Board could go back to the County Board to change the Nursing Home budget to allow the Nursing Home to continue to operate as is. The financials and current census are driving the decision to reduce the Nursing Home to 50 -beds. St. Croix County Health and Human Services Board Page 3 April 04, 2012 The census in the Nursing Home today is 53. The average monthly census for the last three months has been as follows: January — 60, February — 58, March — 53. Horne said there will be 12 new County Board supervisors and recommended not reducing the number of Nursing Home beds until the new County Board is sworn in. The levy estimated for 50 -beds is approximately $298,000. The 2012 Nursing Home budget includes $330,000 in County levy and a current estimated need for levy, without additional operational changes, is roughly $460,000. There has been a strong Medicare census the last few months, which helps the budget, but this is not consistent with what has been the census trend. Matzek questioned if the Nursing Home is being treated as a business and questioned the difference between a department and a business. Matzek questioned the budget scenarios. He questioned what reassurance can be given that the quality of the Nursing Home will be maintained. Raymond spoke that a 50 -bed facility has been on the agenda for quite a while. The statutes are clear that Thompson has the responsibility and authority to make operational changes. If the HHS Board does not want that change, then the HHS Board can go to the County Board with a revised budget. Luckey voiced concern regarding the impact on the census of the St. Croix Health Center when the Deerfield opens its new nursing home in June. Matzek indicated the voters have voted twice to support funding of the St. Croix Health Center. Dr. Ramsay indicated de- licensure could take months, recruitment of a half -time Nursing Home Administrator could take months, possibly through the rest of 2012 to accomplish this work and no costs will change until the Nursing Home is de- licensed to 50 beds. Motion A motion was introduced by Schrank, seconded by Rasmussen: That the Nursing Home go to 50 -beds and stay within the budget. If the Nursing Home goes over budget at 50 -beds, then will need to go to the County Board to exceed the budget. Larson questioned why a motion is being made when staff already has the right to do the operational change. Rasmussen and Schrank withdrew the motion. Motion A motion was introduced by Schrank, seconded by Rasmussen: That the Health and Human Services Board support the recommendation to de- license the Nursing Home to 50 -beds. Roll call vote: Esther Wentz -no Leon Berenschot -yes Frederick Horne -no St. Croix County Health and Human Services Board Page 4 April 04, 2012 Roger Larson -no Linda Luckey -yes Richard Marzolf -no Dr. Lisa Ramsay -yes Deb Rasmussen -yes Alfred Schrank -yes Five yes, four no, motion passed. Human Resources will work with management, the union, and Corporation Counsel to follow the contract with the reduction to 50 -beds. Wentz asked if there were any other issues to bring before the Board. Horne thanked Wentz, Luckey, Schrank and Marzolf for serving on the Health and Human Services Board. Applause. Wentz adjourned the meeting. Time: 9:23 AM Chair: Attest: (Secretary)