HomeMy WebLinkAboutHelath & Human Services Board 12-10-98CHRIS BETHKE WILL REVIEW VOUCHERS AT 7:30 A.M.
REVISED
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: 12/10/98
TIME: 8:00 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: 12/22/98 (Tuesday)
ACTION ON PREVIOUS MINUTES: 11/24/98
ANNOUNCEMENTS
APPOINTMENTS:
UNFINISHED BUSINESS:
NEW BUSINESS:
1. Consideration of Claims and Vouchers
2. Financial Report
3. Transportation Fees for St. Croix Industries
4. Program Reports
a. Mental Health/AODA
b. Nursing Home
c. Home Health
d. W-2
5. Bayport Foundation Grant
6. Personnel Issues
7. Intergovernmental Transfer Program
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
DECEMBER 10, 1998
The St. Croix County Health and Human Services Board met on December 10,
1998, at the St. Croix County Human Services complex in New Richmond,
Wisconsin.
MEMBERS PRESENT: Robert Stephens, Chair
Leon Berenschot
Chris Bethke
Lois Burri
Jack Dowd
Einar Horne
Fern Johnson
Allen Limberg
Mary Louise Olson
MEMBERS ABSENT: none
STAFF PRESENT: John Borup, Health and Human Services Director
Judy Ziegler, Accounting Supervisor
Marilyn Fruit, Economic Support Supervisor
Carolyn Krieger, Nursing Home Administrator
Ron Lockwood, Long Term Support Supervisor
June Merkt, Home Health Supervisor
Ron Kiesler, AODA/Mental Health Coordinator
Steve Kirt, AODA/MH Clinical Services Supervisor
Malva Berg, Secretary
OTHERS PRESENT: none
Chair Stephens called the meeting to order at 8:00 a.m. noting the meeting
was properly and legally publicized. He introduced Lois Burri, County Board
Supervisor, who has been appointed by Chairman Dorsey to replace George
Sinclear.
NEXT MEETING: The next Health and Human Services Board meeting is scheduled
for January 12, 1999 at 8:00 a.m. at the St. Croix County Health and Human
Services/Nursing Home complex. Burri and Stephens will review vouchers at
7:30 a.m.
AGENDA: Motion: A motion was introduced by Horne, seconded by Bethke and
unanimously adopted: That the agenda be approved as circulated.
MINUTES: Motion: A motion was introduced by Berenschot, seconded by
Johnson, and unanimously adopted: That the minutes of the 11/24/98 Health
and Human Services Board meeting be approved as circulated.
CONSIDERATION OF CLAIMS: The following reports were distributed to the Board
transfer of funds report, fixed assets purchased, and cash report for
November and unemployment report for October.
Health and Human Services Board member, Bethke, reviewed the November
vouchers and questioned or reviewed the following vouchers:
HOME HEALTH:
18478: St. Croix County Human Services, $10,815.96, collections payback.
Long Term Support Home Care billing and Home Health Services are billed under
the Home Health Medicare provider number. Home Health receipts the check and
pays Health and Human Services their share.
HUMAN SERVICES:
18294: Trane, $3,009.00, maintenance expense. Cooling coil for the 1974
building.
18437: O'Connell's Valley Funeral Home, $3,140.00, funeral expense.
Funeral expense approved by Economic Support staff. This was for an
oversized casket and oversized vault. The stated required us to provide
these items. The funeral costs are reimbursable from the state.
18548: Powers, Adam and Ann, $1,800.00, shelter care. Shelter care for
two children during November. The children remained in shelter care until
such time as a foster home or return to their own home could be arranged.
NURSING HOME:
801: Stipend, $4,800.00, refund to a private pay client. The client's
insurance company has reimbursed the Nursing Home for the cost of care.
Motion: A motion was introduced by Bethke, seconded by Stephens, and
unanimously adopted: That the following vouchers be approved and be made a
part of the supplemental minute book pages 1535 through 1578:
Home Health vouchers 18464 through 18480, dated November 30, 1998 in the
amount of $16,199.99.
Human Services vouchers 18234 through 18304, dated November 12, 1998 in the
amount of $172,050.73.
Human Services vouchers 18305 through 18374, dated November 19, 1998 in the
amount of $100,564.53.
Human Services vouchers 18402 through 18463, dated November 29, 1998 in the
amount of $33,963.87.
Human Services vouchers 18375 through 18401, dated November 25, 1998 in the
amount of $90,514.57.
Human Services vouchers 18515 through 18820, dated November 30, 1998 in the
amount of $263,258.78.
Human Services vouchers 18481 through 18723, dated November 30, 1998 in the
amount of $78,725.40.
Nursing Home vouchers 789 through 799, dated November 12, 1998 in the amount
of $27,008.05.
Nursing Home vouchers 800 through 804, dated December 04, 1998 in the amount
of $6,700.96.
7
Nursing Home vouchers 810 through 878, dated December 10, 1998 in the amount
of $85,007.18.
Farm voucher 15, dated December 10, 1998 in the amount of $19.58.
Human Services and Nursing Home vouchers 610 through 640, dated November 11,
1998, in the amount of $292,182.58.
Social Services and Human Services vouchers 439 through 459, dated November
11, 1998, in the amount of $103,950.45.
Human Services and Nursing Home vouchers 641 through 671, dated November 24,
1998, in the amount of $250,777.05.
Social Services and Human Services vouchers 460 through 481, dated November
24, 1998, in the amount of $85,864.39.
Human Services and Nursing Home vouchers 672 through 700, dated December 09,
1998, in the amount of $311,305.56.
Social Services and Human Services vouchers 482 through 502, dated December
09, 1998, in the amount of $102,468.21.
HOME HEALTH: Borup said there is a concern regarding Home Health Revenues.
Merkt said that Medicare reimbursement is down and census is down, resulting
in a year-end projected loss of approximately $76,000. With the surplus
amount of $132,968, we would begin 1999 with $42,963. Two private home health
agencies have started operation in St. Croix County since 1996. Merkt said we
are finding that the private agencies are not taking clients with no payment
source. St. Croix County Home Health offers a sliding fee scale to those
that cannot pay or refer to other agencies, for example, American Cancer
Society. Horne said we should be taking care of the people who cannot take
care of themselves. Stephens would like a policy that if the client doesn't
qualify for any other services that we provide the service. Stephens would .
like Merkt to follow the person that is referred and denied services to make
sure that client is not put on a waiting list and that they receive the care
they need. The Board would like to do a policy review for Home Health.
Merkt said once a person is taken for services, you cannot ethically drop
services. Stephens said we need to give care where no one else can.
Stephens asked Merkt for a tracking system to be in place and to return to
the February Board meeting to give a report to the Board.
NURSING HOME: Krieger said changes will be occurring in Medicare for the
financial pay source. It is changing from a cost report basis to a daily
rate based on nurses' assessment. Krieger said ancillary services will be
billed by the Nursing Home. She said we may have an ethical dilemma due to
the cost of some admissions. Horne asked if the computer programming was
adequate. Krieger said the first week of training has been completed and we
are in need of two more weeks of training. She said it will cost more staff
time to enter all information the State and Feds require. Stephens said we
will deny no one services here. Horne said we cannot control all areas
regarding help, ITP monies, etc. Krieger said the same State minimum for
staffing is in effect today as was in 1974 but the level of care has changed
to sub acute care so the Nursing Home is staffing at 150% of the State
minimum due to level of care needs.
3
Krieger read a letter received from Walter Cox's family to the Board.
INTERGOVERNMENT TRANSFER PROGRAM: The State Department of Health and Family
Services is proposing action that would cause a loss of ITP funds to county
homes. Krieger presented a resolution to leave ITP the way it is now
operating. She said the Wisconsin Counties Association supports this
resolution. Lockwood said Long Term Support does not support taking away ITP
monies from the Nursing Homes.
Motion: A motion was introduced by Horne, seconded by Olson, and unanimously
adopted: That the Board approves the following resolution:
WHEREAS, The Department of Health and Family Services (DHFS) has proposed to
amend the distribution of Intergovernmental Transfer Program (ITP) funds
provision so that counties, rather than county nursing homes, be paid the
funds claimed above budgeted levels. This proposal would mandate that these
funds be spent only on COP, the Medicaid Home and Community Based Waiver
Programs, or Family Care. This resolution encourages the St. Croix County
Health and Human Services Board to oppose amending the existing distribution
provision.
NOW, THEREFORE, the undersigned members of the Legislative/Audit Committee
and the Health and Human Services Committee recommend adoption of the
following resolution:
BE IT RESOLVED, that the St. Croix County Health and Human Services Board
opposes amending the distribution provision of the Intergovernmental Transfer
Program, and
BE IT FURTHER RESOLVED, that the St. Croix County Health and Human Services
Board encourages the Governor to not alter the distribution provision of the
Intergovernmental Transfer Program in his next biennial budget, and
BE IT FINALLY RESOLVED, that the St. Croix County Clerk be directed to
forward a copy of this resolution to the Governor of the State of Wisconsin,
the Secretary of the Department of Administration, the St. Croix County
Delegation of Legislators, and the Wisconsin Counties Association.
This resolution is approved on the loth day of December, 1998, by the St.
Croix County Health and Human Services Board of the St. Croix County Board of
Supervisors.
FINANCIAL REPORT: The following financial report through October was
presented to the Board. Borup reviewed each unit briefly.
PLEASE SEE NEXT PAGE.
4
ST. CROIX COUNTY HUMAN SERVICES BOARD
FINANCIAL SUMMARIES
FOR THE PERIOD 01/01/98 THROUGH 10/31/98
NURSING HOME
Reconciled Cash Balance 10/31/98
Add:
Accounts Receivable, 10/31/98
Private Pay
Medicare
Medicaid
General
Accounts Payable-10/31/98
$331,522.81
($12,832.50)
$123,522.92
$296,353.82
$441.52
($217,389.78)
Net Current Items, 10/31/98 $521,618.79
1998 Revenue Recorded through 10/31/98 $4,112,206.23
Includes Allocations of Anticipated Revenues
1998 Expenses Recorded through 10/31/98 $4,143,562.21
Includes Allocations of Expected Expenses
Add or Deduct any nursing home related items not
recorded on nursing home books: 1998
bond principle $256,107.50
(93.13% of total 1998 bond principle of $275,000)
NH98sum
* Operations = $125,275.13
Capital
Acquisitions= 206,247.68
5
HEALTH AND HUMAN
SERVICES - 1998
SUMMARY
Total
OF REVENUES
Jan. -Oct.
Budget
Administration
661,667.81 *
522,095.00
AODA Services
312,803.45
395,834.00
Long Term Support
7,253,861.04
8,815,952.00
Mental Health
1,476,351.56
1,658,960.00
Family & Children's
1,703,395.40
2,046,238.00
Economic Support
778,357.75
896,334.00
General Relief
6,813.03
17,204.00
TOTAL REVENUES
ALL PROGRAMS
12,193,250.04
14,352,617.00
SUMMARY
Total
OF EXPENDITURES
Jan. -Oct.
Budget
Administration
546,711.42
522,095.00
Alcohol -Drug Abuse
248,177.41
395,834.00
Long Term Support
6,877,821.70
8,815,952.00
Mental Health
1,152,306.91
1,658,960.00
Family & Children's
1,698,737.58
2,046,238.00
Economic Support
735,187.71
896,334.00
General Relief
12,846.01
17,204.00
TOTAL 1998 HUMAN
SERVICES BUDGET
11,271,788.74
14,352,617.00
*Prior year close out net $317,250.00
Balance %
(139, 572. 81) 126.7%
83,030.55 79.0%
1,562,090.96 82.3%
182,608.44 89.0%
342,842.60 83.2%
117,976.25 86.816
10,390.97 39.6%
2,159,366.96 85.0%
Balance %
(24,616.42) 104.7%
147,656.59 62.79.
1,938,130.30 78.0%
506,653.09 69.5%
347,500.42 83.0%
161,146.29 82.0%
4,357.99 74.7%
3,080,828.26 78.5%
6
HOME HEALTH
Total
Jan. -Oct. Budget Balance �*
TOTAL
REVENUES**
333,462.19
531,504.00
198,041.81
62.7%-
TOTAL
EXPENDITURES
409,782.58
531,504.00
121,721.42
77.1%
PUBLIC HEALTH
(12 month programs)
Total
Jan. -Oct.
Budget
Balance
o*
TOTAL
REVENUES*
664,429.32
857,670.00
193,.240.68
77.5t
TOTAL
EXPENDITURES
776,684.42
857,670.00
80,985.58
90.6t
*TO BE ON BUDGET, PERCENTAGE SHOULD BE 83.33t.
TRANSPORTATION FEES FOR ST. CROIX INDUSTRIES: Since 1991 we have charged a
nominal fee of $.75 per day for transportation fees for clients of St. Croix
Industries. Administration is recommending increasing this fee to $1.50 per
day (actual cost is close to $9.50 per day). Lockwood said Social Security
is based on net earnings and transportation costs are deducted from earnings.
He said the $1.50 per day should not be a hardship and this would affect
about 25 people.
Motion: A motion was introduced by Olson, seconded by Berenschot, and
unanimously adopted: That the Board approves increasing transportation costs
from $.75 per day to $1.50 per day for workers at St. Croix Industries.
Long Term Support is looking at a policy in the future to mandate clients to
participate in Federal programs if their name comes up on a waiting list so
the County does not have to pay the full cost.
MENTAL HEALTH/AODA: Kiesler gave a brief update on MA Deficit Reduction. He
said if the actual cost for providing services in 1997 is higher than the
State rate, you get 60% of the difference. He said actual costs have
fluctuated and have decreased from 1996 to 1997 due to increased productivity
and lower overhead. It was the consensus of the Board to wait until April to
establish rates for 1999 based on 1998 information.
7
Kirt gave a brief update on ECHO. He said Accounts Receivable is on the DRI
system for billing. He said the County Board authorized four months of 1999
to maintain the DRI system. He said we are in a position to do a parallel
run, which will be done for two months, and hopefully everyone will be off
DRI and on ECHO by March.
FOSTER CARE ADVERTISTING: A memo from Fred Johnson was distributed to the
Board outlining the amount spent on advertising for foster care homes since
10/28/98. Out of this advertising, there were only two possible respite
homes and no foster homes recruited. Horne and Stephens said to go ahead and
spend what we have budgeted for advertising.
W-2 UPDATE: Fruit reported that W-2 remains stable with the caseload being
up three cases. She said we have received tentative approval for the
Community Reinvestment Plan and need to send in reassurances to the State.
Horne requested a final copy of the Community Reinvestment Plan be included
in the minutes (attached at end of minutes). Fruit said she will need to
rewrite the Supportive Services Section of the W-2 plan.
BAYPORT FOUNDATION GRANT: A grant of $10,000 was received from the Bayport
Foundation. Administration is recommending using this for enhancement of the
facility. Administration is recommending a canopy for the front of the
Nursing Home and we are seeking bids for this.
PERSONNEL: Krieger said a 26-year employee in the Nursing Home is no longer
medically able to continue her employment and is off work on medical
disability.
Stephens asked if there were any other issues to bring before the Board.
The Board received invitations from St. Croix Industries to attend their
Christmas party to be held at the Hudson House on 12/18.
Stephens said both underground tanks have been removed.
The Finance Committee approved removal of the rest of the incinerator at the
12/09/98 meeting.
Motion: A motion was introduced by Berenschot, seconded by Bethke, and
unanimously adopted: That the meeting be adjourned.
Time: 9:45 a.m.
Chairman:
Attest:
(Secretary)
8
RESOLUTION #
WHEREAS, The Department of Health and Family Services (DHFS) has proposed to
amend the distribution of Intergovernmental Transfer Program (ITP) funds
provision so that counties, rather than county nursing homes, be paid the
funds claimed above budgeted levels. This proposal would mandate that these
funds be spent only on COP, the Medicaid Home and Community Based Waiver
Programs, or Family Care. This resolution encourages the St. Croix County
Health and Human Services Board to oppose amending the existing distribution
provision.
NOW, THEREFORE, the undersigned members of the Legislative/Audit Committee
and the Health and Human Services Committee recommend adoption of the
following resolution:
BE IT RESOLVED, that the St. Croix County Health and Human Services Board
opposes amending the distribution provision of the Intergovernmental Transfer
Program, and
BE IT FURTHER RESOLVED, that the St. Croix County Health and Human Services
Board encourages the Governor to not alter the distribution provision of the
Intergovernmental Transfer Program in his next biennial budget, and
BE IT FINALLY RESOLVED, that .he St. Croix County Clerk be directed to
forward a copy of this resolution to the Governor of the State of Wisconsin,
the Secretary of the Department of Administration, the St. Croix County
Delegation of Legislators, and the Wisconsin Counties Association.
This resolution is approved on the loth day of December, 1998, by the St.
Croix County Health and Human Services Board of the St. Croix County Board of
Supervisors.
RESPECTFULLY SUBMITTED:
Health and Human Services Board
'IVE:
� •t/t�ti
COMMUNITY REINVESTMENT IDEAS
$217,093
Approved by Human Services Board-11-10-98
Crisis Respite Child Care
Additional Job Access Loan Funding
Supportive Services(115-200% of Poverty)
Per W-2 policy and plan
(Examples:
Trans. Expenses i.e. car repairs etc.
Employment Expenses, i.e. uniforms, tools etc.
One time housing costs)
AODA Services
Detoxification
Evaluation
Counseling
Transitional Housing
Mental Health Services
Community Support Program
Domestic Abuse Shelter Services
Planned Respite Care
Short —term respite care for severely disabled children of
working parents
Positive Parenting/Life Skills Home Visitation Services
Mentoring Program
TOTAL
$12,000
$ 50,093
$10,000
$26,000
$15,000
$ 4,000
$15,000
$40,000
$27,000
$18,000
$217,093