HomeMy WebLinkAboutHelath & Human Services Board 10-13-98FERN JOHNSON WILL REVIEW VOUCHERS AT 7:30 A.M.
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: 10/13/98
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: 10/22/98
ACTION ON PREVIOUS MINUTES: 09/24/98
ANNOUNCEMENTS
APPOINTMENTS:
UNFINISHED BUSINESS:
1. Cable TV installation for Nursing Home
NEW BUSINESS:
1. Consideration of Claims and Vouchers
2. Financial Report
3. Personnel Issues
4. Health and Human Services Reports
a. Nursing Home
b. W-2 Profit/Community Reinvestment Funds
c. Public Health
d. Home Health
5. Request approval to set 1999 Nursing Home Private Pay Rates
6. Appointments to Consulting Medical Staff and Delineation of
Privileges
7. Collections Policy approval for Mental Health/AODA Inpatient
and Outpatient Care
8. Need to upgrade State computer "connectivity" for Economic
Support,
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
OCTOBER 13, 1998
The St. Croix County Health and Human Services Board met on
October 13, 1998, at the St. Croix County Human Services complex
in New Richmond, Wisconsin.
MEMBERS PRESENT:
MEMBERS ABSENT:
Robert Stephens, Chair
Leon Berenschot
Chris Bethke
Jack Dowd
Einar Horne
Fern Johnson
Allen Limberg
Mary Louise Olson
George Sinclear, excused
STAFF PRESENT: John Borup, Health and Human Services
Director
Judy Ziegler, Accountant
Marilyn Fruit, Economic Support Supervisor
Carolyn Krieger, Nursing Home Administrator
Ron Kiesler, AODA/Mental Health Coordinator
Barbara Nelson, Public Health Supervisor
Deb Lindeman, Public Health Nurse
June Merkt, Home Health Supervisor
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.
NEXT MEETING: The next Health and Human Services Board meeting
is scheduled for October 22, 1998 at 6:30 p.m. at the St. Croix
County Health and Human Services/Nursing Home complex.
AGENDA: Motion: A motion was introduced by Bethke, seconded by
Berenschot and unanimously adopted: That the agenda be approved
as circulated.
MINUTES: Motion: A motion was introduced by Berenschot,
seconded by Bethke, and unanimously adopted: That the minutes
of the 09/24/98 Health and Human Services Board meeting be
approved as circulated.
CABLE TV INSTALLATION FOR NURSING HOME: Krieger said Audio -
Video Planners from Hudson are only consultants. Audio -Visual
Planners said the wiring in the nursing home is adequate and all
that is needed are splitters and amplifier. Krieger has written
to the local cable company for a bid on just the amplifier and
splitters. Horne asked why the local cable company is dragging
their feet. He said if there is no response from the cable
company by 10/22 we should go to Audio -Visual Planners.
CONSIDERATION OF CLAIMS: Ziegler distributed the following
reports, transfer of
August and September,
for September.
funds report, unemployment report for
fixed assets purchased, and cash report
Health and Human Services Board member, Johnson, reviewed the
September vouchers and questioned or reviewed the following
vouchers:
HUMAN SERVICES:
17380: Polfus Implement, $219.74, maintenance expense. Repair
for maintenance equipment.
17446: Dawn Bell, $1,375.84, foster care. Monthly cost for
two children in foster care for 30 days each ($22.93 per child
per day).
17493: A. H. Wilder Foundation, $4,410.30, CCI, Child Care in
Institutions. Monthly cost for one juvenile placed in an
institution by court order, $3,630.30 ($121.01 per day)
residential care and $780.00 for school portion of program
(Minnesota school district).
17562: Family Works, $5,970.00, foster care. This facility
provides treatment foster care for three children needing close
supervision or more professional treatment. Cost is $65.67 per
day per child. There was a $60 respite care charge on this bill.
17649: Northwest Passage, $5,235.00, CCI. Court -ordered
placement of one child for 30 days and one child for three days
at a cost of $158.64 per child per day. The different daily
rates between institutions reflects the different types of
services provided for the juveniles.
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Motion: A motion was introduced by Johnson, seconded by
Stephens, and unanimously adopted: That the following vouchers
be approved and be made a part of the supplemental minute book
pages 1446 through 1484:
Home Health vouchers 17750 through 17770, dated September 30,
1998 in the amount of $12,918.61.
Human Services vouchers 17306 through 17363, dated September 17,
1998 in the amount of $131,066.76.
Human Services vouchers 17364 through 17387, dated September 24,
1998 in the amount of $144,678.31.
Human Services voucher 17388, dated September 24, 1998 in the
amount of $1,030.00.
Human Services vouchers 17389 through 17438, dated September 28,
1998 in the amount of $32,595.30.
Human Services vouchers 17439 through 17490, dated September 29,
1998 in the amount of $193,471.25.
Human Services vouchers 17491 through 17749, dated September 30,
1998 in the amount of $159,626.92.
Human Services voucher 17771, dated September 30, 1998 in the
amount of $211.05.
Nursing Home vouchers 621 through 646, dated September 17, 1998
in the amount of $22,239.19.
Nursing Home vouchers 647 through 652, dated September 24, 1998
in the amount of $633.73.
Nursing Home vouchers 660 through 714, dated October 13, 1998 in
the amount of $90,071.00.
Farm vouchers 13 through 14, dated October 13, 1998 in the
amount of $330.26.
Social Services and Human Services vouchers 379 through 395,
dated September 30, 1998, in the amount of $82,707.24.
Human Services and Nursing Home vouchers 523 through 547, dated
September 30, 1998, in the amount of $248,147.87.
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Social Services and Human Services vouchers 357 through 378,
dated September 16, 1998, in the amount of $83,069.08.
Human Services and Nursing Home vouchers 491 through 522, dated
September 16, 1998, in the amount of $249,922.94.
FINANCIAL REPORT: Borup said as a result of the auditor
closeout a double payment by the State will result in $182,434
payback to State (1997). Also, a double payment by the State in
1996 will result in a payback to state of $183,003. Discussion
held on one million dollars transferred to the general fund from
Health and Human Services and how these paybacks will affect
Human Services.
The following financial report was distributed to the Board:
ST. CROIX COUNTY HUMAN SERVICES BOARD
FINANCIAL SUMMARIES
FOR THE PERIOD 01/01/98 THROUGH 08/31/98
NURSING HOME
Reconciled Cash Balance 08/31/98 $530,119.47
Add:
Accounts Receivable, 08/31/98
Private Pay
($26,607.90)
Medicare
$114,225.84
Medicaid
$256,687.79
General
$1,797.56
Accounts Payable-08/31/98 ($195,201.22)
Net Current Items, 08/31/98 $681,021.54
1998 Revenue Recorded through 08/31/98 $3,356,105.56
Includes Allocations of Anticipated Revenues
1998 Expenses Recorded through 08/31/98 $3,324,437.87
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
(93.13W of total 1998 bond principle of $275,000)
NH98sum
* Operations = $323,871.79
Capital
Acquisitions= 206,247.68
HEALTH AND HUMAN
SERVICES - 1998
SUMMARY
Total
OF REVENUES
Jan. -Aug.
Budget
Balance
96
Administration
699,784.16 *
522,095.00
(177,689.16)
134.0%
AODA Services
228,641.38
395,834.00
167,192.62
57.8t
Long Term Support
5,629,222.89
8,815,952.00
3,186,729.11
63.90
Mental Health
1,158,556.10
1,658,960.00
500,403.90
69.8%-
Family & Children's
1,429,380.54
2,046,238.00
616,857.46
69.9%
Economic Support
604,221.76
896,334.00
292,112.24
67.4!k
General Relief
6,813.03
17,204.00
10,390.97
39.6t
TOTAL REVENUES
ALL PROGRAMS
9,756,619.86
14,352,617.00
4,595,997.14
68.0%
SUMMARY
Total
OF EXPENDITURES
Jan. -Aug.
Budget
Balance
%
Administration
356,447.12
522,095.00
165,647.88
68.30
Alcohol -Drug Abuse
193,241.83
395,834.00
202,592.17
48.8g
Long Term Support
5,499,569.28
8,815,952.00
3,316,382.72
62.4%;
Mental Health
902,466.78
1,658,960.00
756,493.22
54.4t
Family & Children's
1,365,162.02
2,046,238.00
681,075.98
66.7%
Economic Support
590,604.46
896,334.00
305,729.54
65.9%-
General Relief
11,212.90
17,204.00
5,991.10
65.2g
TOTAL 1998 HUMAN
SERVICES BUDGET
8,918,704.39
14,352,617.00
5,433,912.61
62.1`•k
I
HOME HEALTH
Total
Jan. -Aug.
Budget
Balance
�*
TOTAL
REVENUES**
287,824.89
531,504.00
243,679.11
54.20
TOTAL
EXPENDITURES
330,888.36
531,504.00
200,615.64
62.39.
**Report for 7 months
of revenue collected
PUBLIC HEALTH
(12 month programs)
Total
Jan. -Aug.
Budget
Balance
o*
TOTAL
REVENUES*
534,341.92
857,670.00
323,328.08
62.3%
TOTAL
EXPENDITURES
622,290.68
857,670.00
235,379.32
72.696
*TO BE ON BUDGET, PERCENTAGE SHOULD BE 66.67%
PERSONNEL: Borup announced that Char Croes returned to
Government Center employment after one day on the job in
Accounts Receivable. Recruitment is taking place to fill this
position.
Erik Hellie, Family and Children's Social Worker, has resigned
for employment in the private sector.
Krieger said there is a crunch in staffing in the Nursing Home,
especially for CNA coverage. She said other facilities in the
area are also facing a shortage of CNAs and are offering bonuses
to help recruitment.
Krieger said census in the Nursing Home is 104 as of today, with
referrals being slow. Krieger said criminal background checks
are required on all new employees after 10/01/98 and for all
current employees by 10/01/99. Criminal background checks are
an unfunded mandate by the State for all caregivers.
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Motion: A motion was introduced by Horne, seconded by Olson,
and unanimously adopted: That the Board approves the Personnel
Department to do all criminal background checks.
Krieger said the definition of reportable abuse and
misappropriations has been more defined by the State. She said
the State has hired a private investigator to investigate any of
these claims. Krieger said if a CNA leaves in the middle of a
shift, this is reportable as neglect. She said reportable
offenses will be judgement calls.
W-2 PROFIT/COMMUNITY REINVESTMENT FUNDS: Fruit said at the end
of September there were 10 open W-2 cases with one pending. She
said a total of 33 W-2 cases were served so far in 1998.
Fruit said the Community Reinvestment dollars must be used for
services covered under the State TANF plan. The State will only
reimburse us for those allowable expenditures and we will not
get a check for the entire amount. Fruit said the State plans to
release the guidelines for the Preliminary Profit/Community
Reinvestment Funds by October 15, 1998 and our plan will need to
be submitted to the State by November 15, 1998.
Fruit outlined the estimated W-2 Preliminary and Final Profit/
Reinvestment Funds and how those figures are obtained. She
cautioned that these are temporary figures and that the monies
must go into the community according to the guidelines set by
the State. It is possible that some of the services billed to
TANF will reduce the County levy. Discussion followed.
The Board recessed from 9:25 to 9:30 a.m.
HOME HEALTH: Merkt said there are currently 63 clients on the
Home Health caseload with the majority of the clients being on
Medical Assistance. She said in October applications for
Community Services Deficit Reduction Benefit will be started.
These dollars will help offset the losses generated by Medical
Assistance clients.
Merkt said the United Government Services Rate Review was done
last week. Medicare will pay Home Health in one of three ways
and we won't know which way that will be until the cost report
is done.
One RN resigned in Home Health because she needed full-time
hours and the caseload isn't large enough to give full-time
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hours. This position will not be filled unless the Home Health
caseload increases.
PUBLIC HEALTH: Lindeman was present to give an update on SIDS
(Sudden Infant Death Syndrome). She said October is SIDS
awareness month. She said in 1994 the "Back to Sleep Campaign"
was started to encourage parents to lay babies on their backs
rather than their stomachs to help prevent SIDS.
Nelson gave an update on the flu vaccine. She said the fee is
$8.00 and is covered under Medicare Part B. Nelson reported the
loss of vaccine in transit; other vaccines have been obtained.
Nelson said in September, 1998 Public Health became a Division
rather than a Bureau under the State. She said John Chapin,
Administrator of the Division of Health, will be here on 11/10
and invited Board members to a potluck in Public Health on that
date.
Nelson distributed the Public Health Newsletter to the Board.
The Legislative breakfast will be held at Health and Human
Services on 10/19/98. Legislative candidates have been invited
and so far two have replied that they will attend the breakfast.
Nelson said this week is Adult Immunization Week and reminded
Board members to check their vaccination records. Tetanus
booster shots are recommended every ten years.
Nelson said there has been another cut in Maternal Child Health
Care funding for a total cut of 7.5% in 1999.
Nelson distributed a profile from 1996 for public health
services for St. Croix, Chippewa, Eau Claire, and Pierce County.
She said St. Croix County Public Health is consistent with other
Public Health departments in the State. She said Pierce and St.
Croix Counties have been classified as urban areas.
Nelson said October is Pink Ribbon Month and distributed
bookmarks to the Board regarding the Pink Ribbon campaign.
1999 NURSING HOME PRIVATE PAY RATES:
Motion: A motion was introduced by Berenschot, seconded by
Johnson, and unanimously adopted: That the Board approves the
1999 Private Pay Rates as follows:
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ISN:
$125
SNF:
$110
ICF:
$105
APPOINTMENTS TO CONSULTING MEDICAL STAFF AND DELINEATION OF
PRIVILEGES:
Motion: A motion was introduced by Horne, seconded by Limberg,
and unanimously adopted: That the Board approves the following
appointments to the consulting medical staff and delineation of
privileges:
1. APPOINTMENTS TO MEDICAL STAFF: Sandra Z. Beulke, MD
Anthony C. Hecht, MD
The Credentials Committee of the Medical Staff recommends to
the St. Croix County Department of Health and Human Services
Board the appointments to the Medical Staff for Sandra Z.
Beulke, MD and Anthony C. Hecht, MD.
2. DELINEATION OF PRIVILEGES:
The Credentials Committee of the Medical Staff recommends to
the St. Croix County Department of Health and Human Services
Board the approval of the Delineation of Privileges as
applied for by Sandra Z. Beulke, MD and Anthony C. Hecht, MD
to include:
Group 1 Privileges:
1. Care of non -critical medical and geriatric patients, and
patients who are admitted for diagnostic purposes.
2. Care of terminally ill patients.
3. Care of first and second degree burns.
4. Minor surgery, including simply lacerations, incision
and drainage of superficial abscesses, removal of
lightly imbedded corneal foreign bodies, and emergency
tracheotomy.
And recommends Group 11 Specialty Privileges as applied for
by Sandra Z. Beulke, MD and Anthony C. Hecht, MD.
COLLECTIONS POLICY APPROVAL FOR MENTAL HEALTH/AODA INPATIENT AND
OUTPATIENT CARE: Over the past year a "Collections Committee"
has been working to update the collections policy. Kiesler said
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we are billing on a calendar month basis and explained the
billing cycle. The Board recommended looking at weekly billing.
Kiesler requested raising the minimum monthly charge. Horne
questioned this and no action taken to raise the minimum charge.
Motion: A motion was introduced by Horne, seconded by Dowd, and
unanimously adopted: That the Board approve the Mental Health/
AODA Inpatient and Outpatient Collections Policy.
UPGRADE STATE COMPUTER CONNECTIVITY FOR ECONOMIC SUPPORT: Fruit
said in the last couple of months, the connection to the State
Computer for Economic Support went down, the first time for two
days and the second time for one day. This creates a great loss
in productivity. The problem is with the controller and the
present phone line connection. We now have a terminal controller
with a leased phone line.
Computer services has been collaborating with the State on this
problem. Both are recommending we upgrade to a T1 line with a
router. This would need an NT server with a SNA Gateway router
(which is in the 1999 budget).
Motion: A motion was introduced by Olson, seconded by Horne,
and unanimously adopted: That the Board approves upgrading to a
T1 line with a router for a one-time cost of approximately
$4,479 with the cost to be funded from the W-2 Profit/
Reinvestment Funds. The monthly cost of $100 per month would be
absorbed through program administration.
Stephens asked if there were any other issues to bring before
the Board.
Horne said Governor Thompson will be at the J-R Range at noon on
10/13/98.
Motion: A motion was introduced by Bethke, seconded by Johnson,
and unanimously adopted: That the meeting be adjourned.
Time: 10:30 a.m.
Chairman:
Attest:
(Secretary)
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