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HomeMy WebLinkAboutHealth & Human Services 12-16-09 J Berenschot will review vouchers. NOTICE OF MEETING AND AGENDA ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD DATE AND TIME: December 16, 2009 at 8:30 LOCATION: (Board Room, St. Croix County DHHS Building, 1445 N. Fourth Street, New Richmond WI) CALL TO ORDER ROLL CALL REVIEW OF AGENDA CONSENT AGENDA APPROVAL OF MINUTES OF PREVIOUS MEETING - 11/18/09 DATE OF NEXT MEETING – 01/20/10 at 8:30 a.m. OLD AND NEW BUSINESS 1. Consideration of Claims and Vouchers and appoint member to review vouchers at next meeting 2. Financial Report a. Monthly financial report for Nursing Home and Health and Human Services b. aged receivable report 3. Medical Assistance Maximization Study Report 4. ECHO Pilot Project—Visual Health Record 5. Nursing Home Administrator Report 6. Nursing Home diversification of revenue - construction of assisted living 7. Update regarding Spring Valley Health Care Campus project 8. Personnel Issues a. New employees /vacancies b. Staffing report from Public Health 9. Discussion of Upcoming Smokefree Air Law 10. H1N1 update 11. Prevocational services letter from Health and Human Services Board 12. Assembly Committee on Aging and Long Term Care 13. Economic Support workload update 14. 2010 Routine Meeting Dates 15. Possible agenda items for next meeting ADJOURN (Items may be taken in different order) ** Additions /Changes /Corrections Items for County Board approval must be submitted to the County Clerk's office by Wednesday morning preceding a County Board meeting. 12/1/2009 10:29 AM ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD December 16, 2009 The St. Croix County Health and Human Services Board met on December 16, 2009 at the St. Croix County Health and Human Services /Health Center complex. MEMBERS PRESENT: Esther Wentz, Chair Leon Berenschot Charles Grant Roger Larson Linda Luckey Richard Marzolf Gerald Peterson Dr. Lisa Ramsay Deb Rasmussen STAFF PRESENT: Fred Johnson, Health and Human Services Director Jennifer Pempek, Financial Manager Frank Robinson, Nursing Home Administrator Wendy Kramer, Public Health Officer /Public Health Coordinator Geralyn Karl, Health Educator Kim Dupre, Information Systems Analyst Clark Schroeder, St. Croix Industries Director Mary Squyer Malva Sirek, Secretary OTHERS PRESENT: Chuck Whiting, Administrative Coordinator Art Tobin, Facilities Manager 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, January 20, 2010 at 8:30 AM. Larson will review vouchers. AGENDA Motion A motion was introduced by Berenschot, seconded by Larson, and unanimously adopted: That the agenda be approved MINUTES Motion A motion was introduced by Peterson, seconded by Larson, and unanimously adopted: That the minutes of the 11/18/09 Health and Human Services Board meeting be approved as distributed. H1N1 UPDATE Kramer reported Public Health began holding school mass clinics this week. There was a recall of some of the H1N1 vaccine from a specific manufacturer due to the antigen being less than expected; there were no safety issues with the vaccine. Most of the children six to 35 months that received the vaccine need to receive a booster dose anyway. Public Health pulled their supply of vaccine when they were notified of the issue. There have been 2700 calls to the phone bank since its inception. A school - based clinic was held in New Richmond last week and two will be held in Hudson on 12/16 and 12/17. A clinic scheduled for Glenwood City has been rescheduled to 12/22 due to weather conditions on the original date. Public Health continues to hold walk -in clinics from 12 -4:00 PM on Mondays. Regular updates St. Croix County Health and Human Services Board Page 2 December 16, 2009 are provided to the media and made to the county website. It was announced early this week that the vaccine is now available to everyone. Rhonda Reynolds, Northwest Region WEM Director, provided Public Health with training on the incident command system on 12/15. Laurie Diaby - Gassama has been offered an all expenses paid, except for wages and food, advanced PIO training in Maryland. This training is provided through a FEMA grant and will enhance her PIO skills. Kramer reported in the last three weeks of November, Health and Human Services staff logged 454 hours of work with H1N1. Wentz expressed appreciation for receiving e -mail updates on H1N1. DISCUSSION OF UPCOMING SMOKEFREE AIR LAW It is Public Health's duty to inform elected officials about the upcoming Smoke -Free Air Law for Wisconsin. The law goes into effect July 5, 2010. Karl reported there is one pre- emption to the law for outside patio dining. Another piece that will continue to be questioned is long -term room rentals in hotels /motels. Karl reported that businesses can only be fined once a day for infractions; however, individuals can also be fined. She reported the revenue from the fines will go to the state, not the county. PERSONNEL ISSUES STAFFING REPORT FROM PUBLIC HEALTH A presentation was completed by Kramer that addressed St. Croix County Public Health Nurse (PHN) staff ratios compared to other counties and their population. The results of the survey are as follows: • St. Croix 1 PHN per 15,654 • LaCrosse 1 PHN per 13,390 • Chippewa 1 PHN per 11,315 • Dunn 1 PHN per 11,024 • Wood 1 PHN per 7,684 • Polk 1 PHN per 6,456 • Pierce 1 PHN per 4,471 Kramer went on to address adjustments that have been made in the Health Department on services that are no longer provided due to limitations on staff resources. She also addressed increased duties that have been added over time as well. The continued growth in St. Croix County will put more pressure on the services the Public Health Nurses will be able to provide and this will likely be a budgetary item for 2011. PERSONNEL ISSUES NEW EMPLOYEES /VACANCIES Johnson announced Jenna Clark was hired for the YCSS program as part of the $270,000 Children's Waiver monies received. Anne Salamone has been hired as a contracted employee for ACSS. The Juvenile Treatment Court Program was approved by the County Board and Susan Morrow has accepted this position, which leaves an opening in the Family and Children's Unit. CONSIDERATION OF CLAIMS Health and Human Services (HHS) Board member Berenschot reviewed the vouchers. Motion A motion was introduced by Berenschot, seconded by Larson, and unanimously adopted: That the following vouchers be approved and be made a part of the supplemental minute book: St. Croix County Health and Human Services Board Page 3 December 16, 2009 Department on Aging vouchers 162156 through 162161, dated November 18, 2009 in the amount of $678.85. Human Services vouchers 162268 through 162269, dated November 18, 2009 in the amount of $13,361.00. Human Services vouchers 162814 through 162855, dated December 02, 2009 in the amount of $47,071.37. Human Services voucher 162856, dated December 02, 2009 in the amount of $215.00. Human Services, Nursing Home, St. Croix Industries, and Government Center vouchers 162162 through 162267, dated November 18, 2009 in the amount of $57,177.50. ADRC and Department on Aging vouchers 162411 through 162416, dated November 24, 2009 in the amount of $1,262.43. Human Services, Nursing Home, and St. Croix Industries vouchers 162417 through 162503, dated November 24, 2009 in the amount of $92,231.07. Human Services, ADRC and Department on Aging vouchers 162594 through 162618, dated December 2, 2009, in the amount of $9,813.50. Human Services, Nursing Home, Government Center, Department on Aging, and ADRC vouchers 162619 through 162731, dated December 02, 2009 in the amount of $107,194.57. Department on Aging and ADRC, vouchers 163434 through 163503, dated December 10, 2009 in the amount of $13,143.68. Human Services, Nursing Home, St. Croix Industries, and Government Center, vouchers 163504 through 163576, dated December 10, 2009 in the amount of $53,236.08. Human Services, Nursing Home, St. Croix Industries, and Government Center, vouchers 163329 through 163414, dated December 10, 2009 in the amount of $18,801.55. Nursing Home vouchers 163415 through 163433, dated December 10, 2009 in the amount of $14,980.38. FINANCIAL REPORT The following financial report for Health and Human Services through October, 2009 was distributed. To be on target, the percent should be 83.3% and Human Services is below that figure for expenses and above for revenue. A choice was given to write a check or have the State take back monies for Long Term Support payment and the choice was made to write a check for approximately $1.7 million. This was done December 7, 2009 and will be reflected on the December statement. WIMCR monies were also received and will be reflected on the November statement. St. Croix County Health and Human Services Board Page 4 December 16, 2009 HEALTH AND HUMAN SERVICES - 2009 SUMMARY Total OF REVENUES Budget October 31, 2009 Balance % Administration (282,648.48) (631,616.21) 348,967.73 223.5% AODA Services 755,822.52 624,893.25 130,929.27 82.7% Long Term Support 2,631,098.96 4,043,536.81 (1,412,437.85) 153.7% Mental Health 3,445,706.61 2,632,984.62 812,721.99 76.4% Family & Children's 2,908,835.69 2,363,386.52 545,449.17 81.2% Public Health 1,976,028.13 1,806,831.72 169,196.41 91.4% Economic Support 1,140,696.47 812,969.07 327,727.40 71.3% General Relief 0.00 0.00 0.00 0.0% Coordinated Services /SED 2,835,374.19 1,887,734.57 947,639.62 66.6% ARDC 632,000.00 422,075.00 209,925.00 66.8% Department on Aging 846,623.00 743,422.16 103,200.84 87.8% Carryover Funds 1,312,360.00 984,270.00 328,090.00 75.0% REVENUES HUMAN SERVICES PROGRAMS 18,201,897.09 15,690,487.51 2,511,409.58 86.2% SUMMARY Total OF EXPENDITURES Budget October 31, 2009 Balance % Administration 1,029,711.52 835,538.99 194,172.53 81.1% Alcohol -Drug Abuse 755,822.52 602,123.74 153,698.78 79.7% Long Term Support 2,631,098.96 2,135,749.88 495,349.08 81.2% Mental Health 3,445,706.61 2,817,284.31 628,422.30 81.8% Family & Children's 2,908,835.69 2,332,460.65 576,375.04 80.2% Public Health 1,976,028.13 1,543,612.91 432,415.22 78.1% Economic Support 1,140,696.47 963,957.83 176,738.64 84.5% General Relief 0.00 29.59 (29.59) 0.0% Coordinated Service /SED 2,835,374.19 1,897,260.49 938,113.70 66.9% ARDC 632,000.00 439,956.87 192,043.13 69.6% Department on Aging 846,623.00 600,246.73 246,376.27 70.9% EXPENDITURES HUMAN SERVICES PROGRAMS 18,201,897.09 14,168,221.99 4,033,675.10 77.8% Total 3 1,522,265.52 The following financial report for St. Croix Industries through October was distributed. Both revenues and expenditures are under the targeted 83.3% mark for St. Croix Industries. St. Croix Industries will be prepaying worker's comp claims for future years due to currently running a surplus. Kristen Ziliak, Risk Manager; Michele Pietrick, Finance Director; Jennifer Pempek, Financial Manager; and Clark Schroeder, St. Croix Industries Director will work together to adjust the St. Croix Industries worker's comp account. St. Croix County Health and Human Services Board Page 5 December 16, 2009 St. Croix Industries - 2009 SUMMARY Total OF REVENUES Budget October 31, 2009 Balance % WS Operations 1,342,664.56 1,167,090.19 175,574.37 86.9% WS Production 422,286.84 252,911.98 169,374.86 59.9% WS Helping Hands 71,726.26 88,841.25 (17,114.99) 123.9% WS Pop/Vending 7,250.00 8,384.90 (1,134.90) 115.7% WS Ram 77,443.00 27,031.75 50,411.25 34.9% WS Vocational Placement 371,831.60 284,538.45 87,293.15 76.5% WS Comm Based Day Prog 183,214.95 131,823.65 51,391.30 72.0% REVENUES 2,476,417.21 1,960,622.17 515,795.04 79.2% SUMMARY Total OF EXPENDITURES Budget October 31, 2009 Balance % WS Operations 1,342,664.56 1,046,670.95 295,993.61 78.0% WS Production 422,286.84 262,622.04 159,664.80 62.2% WS Helping Hands 71,726.26 59,796.25 11,930.01 83.4% WS Pop/Vending 7,250.00 5,022.60 2,227.40 69.3% WS Ram 77,443.00 20,065.47 57,377.53 25.9% WS Vocational Placement 371,831.60 263,365.51 108,466.09 70.8% WS Comm Based Day Prog 183,214.95 147,361.78 35,853.17 80.4% EXPENDITURES 2,476,417.21 1,804,904.60 671,512.61 72.9% Total S 155.717.57 The following financial report for the Nursing Home through October, 2009 was distributed. The Nursing Home revenue is at 88.21 %, which above the 83.3% and expenditures are below that figure at 80.55 %. St. Croix County Health and Human Services Board Page 6 December 16, 2009 St. Croix Health Center October 2009 Budget Actual Difference Percentag4 Census 0 Operating Revenue: Medicare $903,252.00 $969,661.60 - $66,409.60 107.35% Medicaid $2,481,432.00 $1,922,717.03 $558,714.97 77.48% Private Pay $760,413.00 $733,172.98 $27,240.02 96.42% Outstanding Rate Appeal rev $12,000.00 $0.00 $12,000.00 0.00% Revenue - IGT /Supplemental Funds $350,000.00 $348,738.00 $1,262.00 99.64 % All Other Sources $216,041.00 $192,221.84 $23,819.16 86.97% Total Operating Revenue $4. 723,138.00 $4.166,511.45 $556,626.55 88.21% Operating Expenses Daily Patient Services $3,397,31736 $2,786,125.24 $611,192.12 82.01% Special Services $284,262.00 $215,732.99 $68,529.01 75.89% General Services $1,148,672.04 $899,316.44 $249,355.60 78.29 % Administrative Services $628,277.68 $603,451.56 $24,826.12 96.05% Unassigned: Depreciation (% Based) $0.00 Others: $402,923.00 $216,657.75 $186,265.25 53.77% Utilities $202,080.00 $92,712.33 Workers Comp, Computer Tech $133,400.00 $33,288.42 Insurance $67,443.00 $90,657.00 Total Operating Expenses $5.861,452.08 $4,721,283.98 $1,140,168.10 80.55% Net From Operations ($554,772.53) (Cost of doing business prior to applying levy & outstanding rev) County Revenues Co Allocations (% Based) $947,314.08 $789,428.40 $157,885.68 83.33% Nursing Home Carry Over $191,000.00 $159,166.67 $31,833.33 83.33% Total Outstanding $1,138,314.08 $938,595.07 $189,719.01 Net from all Sources $393,822.54 AGED HEALTH AND HUMAN SERVICES RECEIVABLES REPORT: The aging Accounts Receivable report for Health and Human Services through October was reviewed. The 2007 and 2008 columns are reducing and accounts will be moving to a doubtful account at year end to move to collection status. Money in the doubtful account is not lost; however, history there is about 3% recovery of balances due after a referral to collections is made. MEDICAL ASSISTANCE MAXIMIZATION STUDY REPORT Open Minds was here in November for a site visit and held a conference in -house yesterday to review the results of their study. The study was done with hopes to find opportunities to increase some operational efficiency and address any opportunities to enhance Medical Assistance revenue. A thorough review took place and found there is St. Croix County Health and Human Services Board Page 7 December 16, 2009 minimal opportunity where we may have lost revenue. Overall, Health and Human Services is doing a good job and has a good understanding of what to bill Medical Assistance. We will be looking to improve some operational efficiency which was highlighted in the report. This will be an agenda item next month. ECHO PILOT PROJECT — VISUAL HEALTH RECORD St. Croix has been selected to be a pilot project for ECHO for visual health records that includes progress notes, care plans, etc. It is anticipated ECHO staff will be on site in January and the system will go live by March. Walworth County is in process to transfer HSRS and ESACWIS into the ECHO system. Johnson thanked Tom Boron for allowing Kim Dupre's time to work on this program. Wentz expressed appreciation to the extra work staff has done to work smarter, not harder. NURSING HOME ADMINISTRATOR'S REPORT Robinson said the average monthly census for October was 65, with 9 Medicare, 39 Medicaid, 16 private pay and 1 Family Care resident. He reported the November average Medicare census was 12, and the budget is for 6. Robinson said admissions for rehab are a little slower due to the upcoming holidays but admissions are still ahead for the year. Robinson reported several purchasing needs for the Nursing Home in the amount of approximately $29,340. Beds are needed for the Nursing Home in addition to room furniture, which is critical as the Nursing Home could get cited as the wood is chipping on the furniture. Also needed are adjustable tables for residents to use for dining and activities, plus parallel bars for the therapy room. He said there is approximately $39,618 extra monies for October due to additional Medicare residents. Some flexibility is needed to stay in the business to purchase these identified needs. In the past, the nursing home has not funded depreciated items, so there has been more difficulty with routine replacement. These items are also looked at on a yearly basis in the capital outlay budget, but a plan is needed to schedule for purchases. Whiting indicated he supports aggressively pursuing such efforts. It was recommended to put together an appropriate depreciation schedule and follow it. With a depreciation schedule in place, anything brought forward to the board would then be an emergency. Whiting questioned the amount left in the Nursing Home budget for capital items for 2009. Robinson announced that Connie Sarauer has been hired as a permanent position to fill the Director of Nursing position. She will give 60 -day notice to Pathways and will begin as a permanent St. Croix County employee at the end of January. Robinson is working with Tobin to create a plan to update a few rooms on first floor as they are in pretty bad shape. Costs and timeframe have not been determined yet. Robinson reported the new van should arrive on 12/17. It was determined the lettering on the side of the van will read: St. Croix County Health and Rehab Center and our phone number. The State will install a sign on Highway 64 to direct the general population to our location. Motion A motion was introduced by Marzolf, seconded by Berenschot, and unanimously adopted: That the Board approves the Highway 64 road sign to read: St. Croix County Health and Rehab Center. St. Croix County Health and Human Services Board Page 8 December 16, 2009 Johnson will place the order for the sign. The Board recessed from 9:55 - 10 :10 AM. NURSING HOME ADMINISTRATOR'S REPORT Pempek reported the balance of the Nursing Home capital outlay account is $44,361. Motion A motion was introduced by Peterson, seconded by Larson, and unanimously adopted: That the Board approves the purchases as recommended by Robinson in the amount of $29,340 and the balance of the monies in the capital outlay account to be used for updating the rooms in the Nursing Home. NURSING HOME DIVERSIFICATION OF REVENUE - CONSTRUCTION OF ASSISTED LIVING Phase II of the Long Range Planning Study has been approved. We will provide information as needed with the Phase II planning and wait for the results of what that study reveals about the life expectancy of the buildings on the New Richmond campus. Phase II will give direction on the next steps regarding building or remodeling for the Nursing Home and this will assist with planning that is needed for revenue diversification for 2010. A decision regarding the New Richmond campus will impact additional services that may be added to this campus. Robinson would like to get the results of the Phase II study before revenue diversification work is pursued further. He will continue to investigate revenue sources for identified services, but would like to take this item off the agenda until there is a better idea of where the New Richmond campus is going. According to the findings of the Phase I study, the New Richmond campus is the lead domino to figure out what to do with the buildings in the future. UPDATE REGARDING SPRING VALLEY HEALTH CARE CAMPUS PROJECT Robinson has not been successful in making connection with Kevin Larson at the Spring Valley campus. He will continue attempts to contact and report at the next meeting. PREVOCATIONAL SERVICES LETTER FROM HEALTH AND HUMAN SERVICES BOARD This issue has been resolved due to pressure from parents, guardians, etc. Department of Health Services, Disability Rights Wisconsin, Rehabilitation for Wisconsin and Wisconsin Board for People with Developmental Disabilities have agreed to a compromised position giving clients an informed choice for sheltered workshop, day services, supported employment, or integrated employment. Marzolf complimented staff on the letter sent to Timberlake. Schroeder announced the St. Croix Industries client Christmas party is Friday afternoon at Ready Randy's and invited Board members to stop by between 1:00 PM to 3:00 as the band Trigger Happy will be playing. Clients from St. Croix Industries signed and distributed a card to each Board member. ASSEMBLY COMMITTEE ON AGING AND LONG TERM CARE With the expansion of Long Term Care, Community Health Partners (CHP) is experiencing a loss of approximately $9.4 million for 2009 and estimates a loss of $10 million for 2010. CHP will likely be asking for lower fees for programming for 2010. CHP will be meeting with St. Croix Industries in January to discuss rates and future planning. CHP is still a good entity to work with and they report that their administration is as streamlined as possible. Staff certainly have an interest in seeing CHP succeed and make the program work long term. St. Croix County Health and Human Services Board Page 9 December 16, 2009 ECONOMIC SUPPORT WORKLOAD UPDATE Squyer reported caseloads for Economic Support increased 599 cases since January, 2009. St. Croix County Food Share cases increased 117% from 2007 to 2009. Many existing Medical Assistance cases are now coming back and requesting Food Share assistance due to the economy. WHEAP has processed 956 cases since October 2009 for 2010 payments. The entire year of 2009 had 1391 cases. Squyer reported Westcap is repairing/ replacing furnaces and has taken care of two furnaces so far this year. She also has an agreement with three separate Super 8 Motels for placement of any crisis energy assistance clients. Squyer reported applications for BadgerCare Plus Core are being processed from 09/13/09. She said Food Share applications must be screened within 48 hours. She said there are no fraud monies for Economic Support and self - declaration is in place and income for these cases is not verified. Squyer reported Pierce County caseloads are being decreased as they are being pulled by the State due to Badger Care Plus Core. The highest caseload in Pierce County is 300 and the lowest in St. Croix County is 435. If the state begins to pull caseloads from St. Croix County, St. Croix County's caseloads would be much more manageable, but we have no indication of when caseloads will be pulled. 2010 ROUTINE MEETING DATES A schedule of proposed meeting dates was distributed with the intention to have all committee meetings regularly scheduled before a County Board meeting. Adjusting the Health and Human Services meeting to earlier in the month as indicated on the draft schedule would impact financial statements. Whiting said meeting timing has more effect on financial reports, not as much impact on vouchers, but financial reports are not necessarily the primary reason committees meet. Health and Human Services will continue with the planned schedule through April 2010, but will keep this item on the agenda to keep the board updated on scheduling adjustments. POSSIBLE AGENDA ITEMS FOR NEXT MEETING No items were brought to the Board. Wentz asked if there were any other issues to bring before the Board. Wentz adjourned the meeting. Time: 11:10 AM Chair: Attest: (Secretary)