HomeMy WebLinkAboutHelath & Human Services Board 09-11-98X
JACK DOWD 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
Board
DATE: 09/11/98
TIME: 8:00 a.m.
County Health and Human Services
LOCATION: St. Croix County Health and Human Services Complex, New
Richmond
CALL TO ORDER
ROLL CALL
ADOPTION OF AGENDA
DATE OF NEXT MEETING: 09/24/98
ACTION ON PREVIOUS MINUTES: 08/27/98
ANNOUNCEMENTS
APPOINTMENTS:
UNFINISHED BUSINESS:
NEW BUSINESS:
1. Consideration of Claims and Vouchers
2. Financial deport
3. Personnel Issues
a. Review of Limited 'berm Employee for Family and Children's
Unit
4. Health and Human Services Reports
a. Nursing Home
b. Medicare changes for Nursing Home -Theresa Lange-9:00 a.m.
c. Long Term Support
d. Economic Support-W-2
e. Family & Children's
5. Child Care Rates
6. Cable TV installation for Nursing Home
ANNOUNCEMENTS fs 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
SEPTEMBER 11, 1998
The St. Croix County Health and Human Services Board met on
September 11, 1998, at the St. Croix County Human Services
complex in New Richmond, Wisconsin.
MEMBERS PRESENT: Robert Stephens, Chair
Leon Berenschot
Chris Bethke
Jack Dowd
Einar Horne
Fern Johnson
Allen Limberg
Mary Louise Olson
George Sinclear
MEMBERS ABSENT: none
STAFF PRESENT: John Borup, Health and Human Services
Director
Judy Ziegler, Accountant
Marilyn Fruit, Economic Support Supervisor
Carolyn Krieger, Nursing Home Administrator
Fred Johnson, Family & Children's Supervisor
Kathy Dunlap, Family & Children's Supervisor
Ron Kiesler, AODA/Mental Health Coordinator
Mary Coty, CSP Social Worker
Ron Lockwood, Long Term Support
"Ron Eichstaedt, St. Croix Industries
Malva Berg, Secretary
OTHERS PRESENT: Theresa Lange, Reimbursement Specialist
Don Gjesfjeld, Assistant Area Administrator
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 September 24, 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 Berenschot,
seconded by Bethke and unanimously adopted: That the agenda be
approved as circulated.
MINUTES: Motion: A motion was introduced by Bethke," -.,.seconded
by Johnson, and unanimously adopted: That the minutes of the
08/27/98 Health and Human Services Board meeting be approved as
circulated.
ANNOUNCEMENT: Mary Coty announced the Mental Health Walk for
Awareness is scheduled for October 8 at 5:30 PM. The walk will
begin at Friday Memorial Park in New Richmond. Board members
were invited to participate. October is Mental Health Awareness
month.
CONSIDERATION OF CLAIMS: Ziegler distributed the following
reports, transfer of funds report, unemployment report for July,
fixed assets purchased, and cash report for August
Health and Human Services Board member, Dowd, reviewed the
August vouchers and questioned or reviewed the following
vouchers:
HUMAN SERVICES:
15450: Derrick Construction, $5,727.00, Long Term Support
Purchased Services. Cost to construct a sidewalk and cement
block retaining wall for brain injury client. Cost will be
recouped from Brain Injury Waiver Funds.
15452: Dowd Reliance Agency, $45.00, office supplies. Cost
for three bookkeepers to renew their notary bonds.
Motion: A motion.was introduced by Dowd, seconded by Stephens,
and unanimously. adopted: That the following vouchers be
approved and be made a part of the supplemental minute book
pages 1404 through 1445:
Home Health vouchers 16986 through 17004, dated August 31, 1998
in the amount of $1,232.25.
Human Services vouchers 15322 through 15392, dated August 13,
1998 in the amount of $109,558.71.
Human Services vouchers 15393 through 15441, dated August 20,
1998 in the amount of $151,584.34.
Human Services voucher 15442, dated August 25, 1998 in the
amount of $562.09.
2
Human Services vouchers 15443 through 15473, dated August 27,
1998 in the amount of $24,196.11.
Human Services vouchers 15474 through 16963, dated August 28,
1998 in the amount of $94,285.98.
Human Services voucher 16985, dated August 29, 1998 in the
amount of $143,640.41.
Human Services vouchers 17039 through 17303, dated August 31,
1998 in the amount of $70,213.97.
Human Services vouchers 17005 through 17280, dated August 31,
1998 in the amount of $74,906.03.
Nursing Home vouchers 563 through 569, dated August 13, 1998 in
the amount of $7,892.37.
Nursing Home vouchers 570 through 576, dated August 27, 1998 in
the amount of $22,649.49.
Nursing Home vouchers 577 through 582, dated September 04, 1998
in the amount of $1,269.64.
Nursing Home vouchers 590 through 620, dated September 11, 1998
in the amount of $67,042.87.
Social Services and Human Services vouchers 315 through 335,
dated August 19, 1958, in the amount of $83,932.99.
Human Services 'and Nursing Home vouchers 430 through 463, dated
August 19, 1998, in the amount of $254,515.76.
Social Services and Human Services vouchers 336 through 356,
dated September 02, 1998, in the amount of $99,773.68.
Human Services and Nursing Home vouchers 461 through 490, dated
September 02, 1998, in the amount of $293,755.69.
HEALTH AND HUMAN SERVICES REPORTS:
FAMILY AND CHILDREN'S: Don Gjesfjeld gave a report on child
welfare matters including our efforts to purchase foster care
recruitment, retention and training. He said the Adoption and
Safe Families Act is the first major Federal legislation passed
in child welfare since 1980. He outlined the highlights of the
Act including time -limited services, concurrent planning to
91
either reunify the family or find an alternative, notices to
foster parents on court hearings, developing 'standard s- to ensure
quality foster care services, use of outcome measures, and
increase in adoptive placements. He said the funding from
Federal to state may be based on outcomes. Borup said $70,000
has been designated in the 1999 budget to purchase foster care
recruitment, retention, and training. The contract for these
services would have specific outcomes. The county would have
more flexibility with contracting for these services and the
county still has custody of the children in foster care.
Gjesfjeld said most counties use some treatment foster homes.
NURSING HOME: Theresa Lang explained the Prospective Payment
System (PPS), which resulted from the Balanced Budget Act of
1997. At the current time, this will apply only to Medicare
funds. She said PPS will affect home health, hospitals,
outpatient therapy providers, clinics and physicians, and
skilled nursing facilities. Lange said as of 01/01/99 the
Nursing Home is responsible for all components of billing as
Medicare will no longer allow outside vendors to bill Medicare,
they will have to bill the Nursing Home and the Nursing Home
will in turn bill Medicare. This will result in more work for
Nursing Home staff and also a cash flow problem. The Nursing
Home may need to add staff in admissions and this staff person
will have to be a nurse. All vendor contracts will need to be
rewritten. Currently the Nursing Home population is about 10%
Medicare residents. -
The PPS rates were'determined based on a combination of the
federal average and -the facility specific historical costs from
1995. Nurs.ing.Home therapy utilization in 1995 was very low.
The rate s:;-wi11 be transitioned in over a three-year period,
which means in 1999 the maximum St. Croix Health Center will
receive for Medicare patients will be $212/day, but homes such
as Glenhaven and Christian Community will receive $405/day. St.
Croix Health Center rates will go up each year along with
inflationary increases.
The question was raised whether ethically we are able to turn
residents down for admission.
Lang said it is possible Wisconsin Medicaid will also go to
this payment process. Lange said 1999 will be a tough year for
the Nursing Home but the years 2000, 2001 and 2002 will get
better.
The Board recessed from 9:45 to 9:50 a.m.
4
Krieger said the Nursing Home has had four software
demonstrations and have selected Long Term ,Care Solutions. The
cost is $27,Q�plus training costs of $10,200. She said this
is windows -based software and meets Nursing Home requirements.
Motion: A motion was introduced by Berenschot, seconded by
Stephens, and unanimously adopted: That the Board approves
purchasing software from Long Term Care Solutions for $27,500
plus training costs of $10,200.
Borup said the elevator has experienced several down times due
to worn out parts:- He said the electronics for the elevator are
becoming obsolete. Bids are being requested to repair it.
Motion: A motion was introduced by Sinclear, seconded by
Bethke, and unanimously adopted: That the Board approves Robert
Stephens, John Borup and Carolyn Krieger reviewing and awarding
the elevator bids when they are received.
FINANCIAL REPORT: The following financial report was
distributed and reviewed with the Board. The Nursing Home
figures include the last of the ITP funds and Medicare dollars.
Please see next page:
E
ST. CROIX COUNTY HUMAN SERVICES BOARD
FINANCIAL SUMMARIES
FOR THE PERIOD O1/01/98 THROUGH 07/31/98
NURSING HOME
Reconciled Cash Balance 07/31/98
Add:
Accounts Receivable, 07/31/98
Private Pay
Medicare
Medicaid
General
Accounts Payable-07/31/98
$610,744.63
($39,365.95)
$81,683.95
$263,659.78
$144.79
($294,195.37)
Net Current Items, 07/31/98 $622,671.83
1998 Revenue Recorded through 07/31/98 $2,973,474.18
Includes Allocations of Anticipated Revenues
1998 Expenses Recorded through 07/31/98 $2,914,403.00
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
w
* Operations', = $404,496.95
Capital
Acquisitions= 206,247.68
6
HEALTH AND HUMAN SERVICES --1998
SUMMARY Total
OF REVENUES Jan. -July Budget Balance
Administration
AODA Services
Long Term Support
Mental Health
Family & Children's
Economic Support
General Relief
TOTAL REVENUES
ALL PROGRAMS
310,895.33
522,095.00
221,074.04
395,834.00
4,562,155.72-
8,815,952.00
1,142,148.76
1,658,960.00
1,431,252.54
2,046,238.00
545,327.95
896,334.00
6,258.03
17,204.00
8,219, 112. 37 14,352,617.00
211,199.67
59.5%
174,759.96
55.9%
4,253,796.28
51.7%
516,811.24
68.8%
614,985.46
69.9%
351,006.05
60.8%
10,945.97
36.4%
6,133,504.63 57.3%
SUMMARY
Total
OF EXPENDITURES
Jan. -July
Budget
Balance
%
Administration
315,277.41
522,095.00
206,817.59
60.4%
Alcohol -Drug Abuse
169,688.00
395,834.00
226,146.00
42.9%
Long Term $fipport
4,605,028.71
8,815,952.00
4,210,923.29
52.2%
Mental Health
795,341.22
1, 658, 960. 00
863,618.78
47.9%
Family & Children's
1,170,963.75
2,046,238.00
875,274.25
57.2%
Economic Support
524,808.06
896,334.00
371,525.94
58.6%
General Relief
9,361.54
17,204.00
7,842.46
54.4%
TOTAL 1998 HUMAN
SERVICES BUDGET
7,590,468.69
14,352,617.00
6,762,148.31
52.9%
7
HOME HEALTH
Total
Jan. -July.
Budget
Balance
%*
TOTAL REVENUES**
250,343.67
531,504.00
281,160.33
47.1%
TOTAL EXPENDITURES
295,087.15
531,504.00
236,416.85
55.5%
**Report for 6 months
of revenue collected
PUBLIC HEALTH
(12 month programs)
Total
Jan. -July.
Budget
Balance
%*
TOTAL REVENUES*
467,104.71
857,670.00
390,565.29
54.5%
TOTAL EXPENDITURES
556,785.87
857,670.00
300,884.13
64.9%
*TO BE ON BUDGET, PERCENTAGE SHOULD BE 58.33%.
Stephens announced -that maintenance will receive the new Bobcat
next week.
FAMILY AND CHILDREN'S SERVICES: The Family and Children's Unit
will be short a staff person in the juvenile supervision/intake
unit for approximate three months due to family medical leave. A
temporary two-day per week position is in the 1998 and 1999
budget to cover for this extended absence.
LONG TERM SUPPORT: Lockwood updated the Board on Long Term Care
redesign. He said the Long Term Care redesign is based on
managed care principles. He said PPS will have a massive impact
on Long Term Support, Nursing Home, Home Health, and St. Croix
Industries. He said the redesign is going slower than
originally anticipated. Day Services is anticipating 18 to 20
additional clients who have severe physical disabilities. St.
Croix Industries has physical plant problems to meet the needs
of these clients and would also need more staff to meet the
needs of these anticipated clients. Discussion followed.
8
ECONOMIC SUPPORT/W-2: Fruit said the W-2 caseload remains about
the same; however, intake for Medical Assistance, Food Stamps,
and Child Care has increased in the last month. Horne asked if
a method of tracking has been set up with Rich Loney and the
County Treasurer when the $300,000 comes in from W-2. Staff
were asked to wait until October until the budget process is
done before setting up a method of tracking for these funds.
Fruit said most of these funds are earmarked.
Fruit said many applications are pending at this time. The Food
Stamp Employment and Training (FSET) cases are significantly
reduced. She said -many are employed but still eligible for Food
Stamps, Medical Assistance and Child Care.
Fruit said the workload in her area is very high with the
increased intake, vacations, additional training to move Diane
Peterson into Financial Employment Planner position and being
down one person.
CHILD DAY CARE RATES: Federal regulations and state
administrative rules require an annual rate survey. This survey
is used to establish a level of maximum reimbursable rates for
each county. Two separate surveys are conducted; one for
licensed group child care providers and licensed family child
care providers. For regularly certified child care providers,
rates will be set at 75% of the licensed family day care rates.
Provisionally Certified child care provider rates will be set at
50% of the licensed family day care rate. A copy of these
surveys was distributed to Board members.
Motion: A motion was introduced by Horne,, seconded by
Berenschot, and unanimously adopted: That the Board approves
the child...day care rates from the survey, which are attached at
the end &f , the minutes.
Stephens asked if there were any other issues to bring before
the Board.
Motion: A motion was introduced by Sinclear, seconded by Horne,
and unanimously adopted: That the meeting be adjourned.
Time: 10:40 a.m.
Chairman:
Attest:
(Secretary)
9
oEPnR rMENT OF WORKFORCE OEVELOPMENT
Division of Economic Support
DES-2465 (REV. 6198)
REQUEST FOR APPROVAL OF
CHILD DAY CARE RATES '-
Completion of this form meets the requirements of Wisconsin Statutes, S. 49.165 (6), and'OWO 56.06 of the Wisconsin Administrative code.
P,.
E OF COUNTY/TRIBE: Effective Date of New Rate: January 1, 1999
St. Croix County
Licensed Grouo Child Care I Divisor: Hour/v Rate Weekly Ceiling
S
S
a.)
Under Age 2
3.86
135.00
35
$
$
b.)
2 -12 Years Old
3.20
112.00
2. Licensed Family Child Care
Divisor:
Hourly Rate
Weekly Ceiling
$
S
a.)
Under Age 2
3.29
115.00
b.)
2 -12 Years Old
35
$ 3.00
$
105.00
3. Regularly Certified Child Care
Divisor:
Hourly Rate
S
a.)
Under Age 2
2.88
30
$
b.)
2 -12 Years Old
2.63
4. Provisionally Certified Child Care
Divisor:
Hourly Rate
$ 1.92
a.)
Under Age 2
30
$
b.)
2 -12 Years Old
1.75
Counties and Tribes have authority to authorize child care reimbursement in excess of the weekly ceiling on a
case by case basis if payment is for 50 or more hours of child care, or if other extenuating circumstances are
involved within the case.
Counties and Tribes have authority to authorize child care reimbursement in excess of the hourly rates or weekly
ceilings on a case by case basis. if payment is for a child with a special need.
Note: Be sure to indicate your county/tribe and the divisor used for each provider category.
"Attach survey results and methods used to establish rates.
Charlotte G. Skoviera County Certifier 715/246-8344 09/11/98
Submitted by: (print) Signature Title Phone Date
Office of Child Care Review
Child Day Care Rates Are:
Approved, effective: 1-1-99 Disapproved
Comments:
ISignature Office of Child Care _Date
99regapp.doc