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HomeMy WebLinkAboutHelath & Human Services Board 06-10-98EINAR HORNE 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` 06/10/98 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: 06/25/98 ACTION ON PREVIOUS MINUTES: 05/28/98 ANNOUNCEMENTS APPOINTS: UNFINISHED BUSINESS: 1. Possible Expenditures for Facility Improvements NEW BUSINESS: 1. Consideration of Claims and Vouchers 2. Financial Report 3. Personnel Issues 4. Health and Human Services Reports a. Nursing Home b. Mental Health/AODA c. Economic Support d. Public Health 5. Expansion of Shelter Home Contracts 6. Discussion of Program Waiting Lists for Juvenile Contracts ANNOUNCEMENTS & CORRESPONDENCE POSSIBLE AGENDA ITEMS FOR NEXT bMETING: ADJOURNMENT (Agenda not necessarily presented in this order) SUBMITTED BY: John M. Borup DATE: April 28, 1998 COPIES TO:COUNTY BOARD OFFICE COUNTY CLERK NEWS MEDIA/NOTICE ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD June 10, 1998 The St. Croix County Health and Human Services Board met on June 10, 1998, at St. Croix County Health and Human Services complex in New Richmond, Wisconsin. MEMBERS PRESENT: Robert Stephens, Chair Leon Berenschot Chris Bethke Einar Horne Fern Johnson Allen Limberg MEMBERS ABSENT: John Dowd Mary Louise Olson, excused George Sinclear STAFF PRESENT: John Borup, Health and Human Services Director Carolyn Krieger, Nursing Home Administrator Judy Ziegler, Accountant Ron Kiesler, Mental Health/AODA Coordinator Ron Lockwood, Long Term Support Kathy Dunlap, Family & Children's Supervisor Marilyn Fruit, Economic Support Supervisor Mary Squyer, Economic Support Barb Nelson, Public Health Kathy Carlson, Foster Care Coordinator Lisa Leahy, Director of Social Services, Nursing Home Steve Kirt, Mental Health/AODA Clinical Services Supervisor Rich Monn, Lead Maintenance Worker Malva Berg, Secretary OTHERS PRESENT: Ralph Robole, Facilities Manager Ray Mealey 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 June 25, 1998 at G:00 p.m. at the St. Croix County Health and Human Services/Nursing Home complex followed by the Open Hearing at 7:00 p.m. Stephens may not be able to attend. AGENDA: Motion: A motion was introduced by Bethke, seconded by Berenschot, and unanimously adopted: That the agenda be approved as circulated. MINUTES: Horne questioned the previous minutes. 1 Motion: A motion was introduced by Horne, seconded by Berenschot, and unanimously adopted: That page three, first paragraph of the minutes of May 28, 1998 should read: It would be better handled with finance in Hudson. Motion: A motion was introduced by Berenschot, seconded by Bethke, and unanimously adopted: That the minutes of the 06/28/98 Health and Human Services Board meeting be approved as amended. POSSIBLE EXPENDITURES FOR FACILITY IMPROVEMENTS: 1. Blacktop: Borup said the issue of blacktop was first brought up in 1991 and 1995 and tabled at that time due to lack of funds. Robole reviewed the areas for proposed chipsealing, which includes the nursing home parking lot and the west parking lot; the proposed areas for pulverizing and resurfacing which include the nursing home loading dock/ambulance entrance, workshop area, and main drive and crackfilling the main parking lot. Borup said this project could be broken down to a two or three year project. Bethke said the blacktop needs to be resealed every three years to preserve the blacktop. Robole said the main parking lot was installed in 1994. Motion: A motion was introduced by Bethke, seconded by Berenschot: That the Board approves seeking formal bids for blacktop and chip sealing. Roll call vote: Robert Stephens -yes Leon Berenschot-yes Chris Bethke -yes John Dowd -absent Einar Horne -no Fern Johnson -yes Allen Limberg-yes Mary Louise Olson -absent George Sinclear-absent Five yes, one no, three absent, motion passed. Horne asked if these monies were in the budget. Stephens said no but funding would come from the excess funds. Stephens said Finance has made this Board responsible for the grounds and buildings at Human Services. He said this has been denied in the past in order to cut the budget. Horne said he agrees that the blacktopping should be done, but not with the budgeting as this is over and above our budget and feels it needs to go to Finance. 2. Windows: Borup said last Friday a proposal was sent to Andersen Windows requesting grant monies for replacement of 2 windows in the building. The rough estimate to replace windows was $102,000. 3. Telephone System Upgrade: Borup said the cost to separate the public address system between Nursing Home and Human Services would be approximately $800. He said this would give the facility more flexibility during storm warnings, fire drills, etc. He said the cost to expand our voice mail system is $15,946.50. Our voice mail system no longer has enough storage time or ports to meet the needs of staff and clients. Borup also said we need to purchase an additional station card for the telephone system. Motion: A motion was introduced by Stephens, seconded by Bethke, That the Board approves the separation of the public address system between Nursing Home and Human Services, approves expanding the voice mail system at a cost of $15,946.50, and approves purchased an additional station card at an estimated cost of $2,700.00 for the telephone system. Roll call vote: Robert Stephens -yes Leon Berenschot-yes Chris Bethke -yes John Dowd -absent Einar Horne -no Fern Johnson -yes Allen Limberg-yes Mary Louise Olson -absent George Sinclear-absent Five yes, one no, three absent, motion passed. Horne asked if this upgrade will interface with computer usage, Internet usage and connection to Hudson. Berg said the voice mail system is completely separate from the computer system. 4. In -Home Team Equipment Needs: This item was removed from the facility upgrades list. 5. Long Term Support Office Upgrade: Borup said Long Term Support needs this upgrade to obtain better sound/noise control. The Board asked if Lockwood could move into Hall's office temporarily. Lockwood said this would send the wrong signal to staff. He said Hall 's office is used on a daily basis as it is the only area in the Long Term Support area large enough to hold meetings. Horne said it seems like overall the organization is growing and we are just doing patchwork. Borup said overall the numbers of employees is down. Stephens said this item should be put on hold at this time. Motion: A motion was introduced by Horne, seconded by Berenschot, and unanimously adopted: That upgrading the Long Term Support office area be postponed until further information is obtained. Roll call vote: Robert Stephens -yes Leon Berenschot-yes Chris Bethke -yes John Dowd -absent Einar Horne -yes Fern Johnson -yes Allen Limberg-yes Mary Louise Olson -absent George Sinclear-absent Six yes, zero no, three absent, motion passed. 6. Paper Shredder: The Board questioned why the Government Center shredding is being brought to Human Services. It was felt this practice started with the incinerator being in New Richmond and with the centralization of maintenance. Motion: A motion was introduced by Berenschot, seconded by Horne: That purchasing a paper shredder be postponed until we get input from the County on how to pay for the shredder. Roll call vote: Robert Stephens -no Leon Berenschot-no Chris Bethke -no John Dowd -absent Einar Horne -yes Fern Johnson -yes Allen Limberg-no Mary Louise Olson -absent George Sinclear-absent Two yes, four no, three absent, motion failed. Monn said maintenance had been burning the confidential material, but the DNR put a stop to this earlier this year. Monn said maintenance tried several different ways to shred the confidential material and found the bale shredder worked the best. He said Schottler has agreed to take the shredding and get rid of it at no cost to the county. Borup said we could work out a cost allocation to charge the Government Center for the shredder. The Board asked who transports the confidential material to New Richmond from Hudson and who does the actual shredding. Robole said he or David Best bring the confidential material along in 4 their personal vehicles when they are coming to New Richmond for business. Maintenance personnel do the shredding. Motion: A motion was introduced by Stephens, seconded by Bethke, That the Board approves purchasing a shredder that meets our needs at the best price available. Roll call vote: Robert Stephens -yes Leon Berenschot-yes Chris Bethke -yes John Dowd -absent Einar Horne -yes Fern Johnson -yes Allen Limberg-yes Mary Louise Olson -absent George Sinclear-absent Six yes, zero no, three absent, motion passed. 7. Computer Training Room: Motion: A motion was introduced by Stephens, seconded by Bethke, That the Board approves setting up a computer training room at Health and Human Services. Johnson asked what the cost would be for transportation for staff to go to Hudson. Borup said the annual expenditure for transportation would be in the $19,000 to $20,000 range for time lost. Borup said the room would be set up similar to the training room in Hudson and would be located in the basement of the Nursing Home. Horne said this training room would cost more than $23,000 due to heat and air conditioning costs. Stephens said we need the total cost. Stephens and Bethke withdrew their motion to set up a computer training room. Motion: A motion was introduced by Stephens, seconded by Bethke, That the Board postpone taking action on a computer training room at Health and Human Services until a total cost can be determined. Roll call vote: Robert Stephens -yes Leon Berenschot-yes Chris Bethke -yes John Dowd -absent Einar Horne -yes Fern Johnson -yes Allen Limberg-yes Mary Louise Olson -absent 5 George Sinclear-absent Six yes, zero no, three absent, motion passed. 8. Bus and Car Garage: This item was postponed until the 1999 budget. Borup said the Nursing Home bond issue is scheduled on the agenda for the 06/16/98 Finance Committee meeting. Borup will not be able to attend this meeting and asked if any Board members would represent Human Service at this meeting. It was the consensus of the Board that this issue will need to go to the full County Board if passed at the Finance meeting. CONSIDERATION OF CLAIMS: Ziegler distributed the following reports: transfer of funds report, unemployment report for April, fixed assets purchased, and cash report for May. Health and Human Services Board member, Horne, reviewed the May vouchers and questioned or reviewed the following vouchers: HUMAN SERVICES: 14013: Mid State Truck Service, $42,156.00. Workshop van expense. The 20-passenger workshop van has arrived. Funds were transferred from the Farm fund to the Human Services fund to pay for this vehicle per Human Services Board action. Motion: A motion was introduced by Horne, seconded by Stephens, and unanimously adopted: That the Board approves the following vouchers reviewed by Horne and be made a part of the supplemental minute book pages 1237 through 1294: Home Health vouchers 14061 through 14066, dated June 09, 1998, in the amount of $34,864.60. Human Services vouchers 13865 through 13912, dated May 14, 1998, in the amount of $173,038.15. Human Services vouchers 13913 through 13950, dated May 21, 1998, in the amount of $250,805.20. Human Services voucher 13951, dated May 22, 1998, in the amount of $1,250.00. Human Services vouchers 13952 through 13989, dated May 28, 1998, in the amount of $12,994.76. Human Services vouchers 13990 through 14047, dated June 04, 1998, in the amount of $69,557.18. 6 Human Services vouchers 14101 through 14306, dated June 09, 1998, in the amount of $214,318.82. Nursing Home vouchers 338.1 through 348, dated May 14, 1998, in the amount of $9,140.46. Nursing Home vouchers 349 through 356, dated May 21, 1998, in the amount of $6,992.48. Nursing Home vouchers 364 through 420, dated June 10, 1998, in the amount of $90,980.98. Social Services and Human Services vouchers 165 through 185, dated May 13, 1998, in the amount of $98,521.72. Human Services and Nursing Home vouchers 229 through 255, dated May 13, 1998, in the amount of $298,402.15. Social Services and Human Services vouchers 186 through 207, dated May 27, 1998, in the amount of $83,960.65. Human Services and Nursing Home vouchers 256 through 285, dated May 27, 1998, in the amount of $253,570.46. FINANCIAL REPORT: Horne asked if competitive bids are sought when purchasing equipment. Krieger said when replacing equipment, she does not always get bids as equipment does not always meet the needs of the residents. Borup said settlement of the 1997 Medicare Cost Report was completed. Payments will be as follows: Nursing Home--$207,525, Home Health--$10,479. Payments should be received in the next three months. However, these settlements for 1998 will probably require County paybacks to Medicare. Ziegler said the auditors are currently here doing a Medicare audit for the Nursing Home and Home Health. Stephens said we are working towards having a reconciled report ready on the 15`h of each month of the uncommitted cash reserves. This report will be given to the Board. Borup distributed the April financial summaries. Please see next page. 7 ST. CROIX COUNTY HUMAN SERVICES BOARD FINANCIAL SUMMARIES FOR THE PERIOD O1/01/98 THROUGH 4/30/98 NURSING HOME Reconciled Cash Balance 04/30/98 Add: Accounts Receivable, 04/30/98 Private Pay Medicare Medicaid General Accounts Payable-04/30/98 Net Current Items, 04/30/98 $269,979.93 ($2,515.41) $154,291.13 $279,239.08 $2,042.75 ($177,679.16) $525,358.32 1998 Revenue Recorded through 04/30/98 $1,728,791.87 Includes Allocations of Anticipated Revenues 1998 Expenses Recorded through 04/30/98 $1,661,038.78 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 (93.13-6 of total 1998 bond principle of $275,000) NH98sum * Operations = $224,237.25 Capital Acquisitions= 45,742.68 E? HEALTH AND HUMAN SERVICES - 1998 SUMMARY Total OF REVENUES Jan. -Apr. Budget Balance Administration AODA Services Long Term Support Mental Health Family & Children's Economic Support General Relief TOTAL REVENUES ALL PROGRAMS SUMMARY OF EXPENDITURES Administration Alcohol -Drug Abuse Long Term Support Mental Health Services Family & Children's Economic Support General Relief TOTAL 1998 HUMAN SERVICES BUDGET % 209,657.74 522,095.00 312,437.26 40.2% 114,896.89 395,834.00 280,937.11 29.0% 2,240,379.18 8,815,952.00 6,575,572.82 25.4% 649,325.65 1,658,960.00 1,009,634.35 39.1% 708,086.97 2,046,238.00 1,338,151.03 34.616 361,483.39 896,334.00 534,850.61 40.3% 1,855.03 17,204.00 15,348.97 10.8% 4,285,684.85 14, 352, 617. 00 10, 066, 932. 15 29.9% Total Jan. -Apr. Budget Balance % 152,016.80 522,095.00 370,078.20 29.1% 99,252.93 395,834.00 296,581.07. 25.10-s 1,952,362.96 8,815,952.00 6,863,589.04 22.1% 473,379.75 1,658,960.00 1,185,580.25 28.5% 616,116.85 2,046,238.00 1,430,121.15 30.111 274,415.66 896,334.00 621,918.34 30.6% 1,302.02 17,204.00 15,901.98 7.6% 3, 568, 846. 97 14, 352, 617. 00 10,783,770.03 24.9% 9 HOME HEALTH Total Jan. -Apr. Budget Balance %* TOTAL REVENUES** 162,675.68 531,504.00 368,828.32 30.6% TOTAL EXPENDITURES 168,262.88 531,504.00 363,241.12 31.7% **three months of revenue PUBLIC (12 month programs) HEALTH Total Jan. -Apr. Budget Balance %* TOTAL REVENUES* 265,477.37 857,670.00 592,192.63 31.0% TOTAL EXPENDITURES 339,203.48 857,670.00 518,466.52 39.5115 *TO BE ON BUDGET, PERCENTAGE SHOULD BE 33.33%. Discussed most recent CARS report, which showed the county receiving $595,285. This represents the final payments for calendar year 1997 contract period. These relate primarily to Long Term Support activities and include $193,000 in overpayments for administration costs. The $193,000 will be returned to the State in the single audit process. The net effect is an increase of $438,000 in the fund balance as of 12/31/98. Discussed receiving four new COP slots in November, 1997 and 14 new slots in March of 1998. The slots are valued at $14,885 each. This information was not available for the 1998 budget development. Stephens said at the day meeting in July he would like to discuss breaking the Board into committees to cover the farm and maintenance, finance, Nursing Home, etc. rather than having the second Board meeting each month. He said authority should be 10 delegated to these committees. He would like this done to come up with an understandable presentation to the Board. He said it is hard to present an open and shut bookkeeping system. Stephens said simply throwing the bookkeeping department to Hudson will not solve the glitches in the system. Stephens said staff have never been found wanting and we do our business well. Borup said we are working with Loney and Krizek cooperatively regarding a central finance team. He said the complexity of the system is inherited and welcomes Loney getting more involved in the system. Stephens said a backup person with authority provision needs to be in place for Borup, Ziegler, Beutel, etc. and wants this information at the July meeting. The Board recessed from 9:30 to 9:35 a.m. PERSONNEL ISSUES: Borup said the second In -Home Team has been hired. Charlotte Skoviera posted into the W-2 Specialist/Day Care Certifier position and will be in training until the end of August. The State requires 100 hours of training. Fruit said this training is very necessary. ECONOMIC SUPPORT: Fruit reviewed the W-2 statistics for May, 1998. She said not everyone eligible for day care assistance is collecting benefits. She said summer has a higher demand for day care. Horne asked regarding the response received from letters sent to previous AFDC clients regarding Medical Assistance and asked if there was feedback to the State for marketing schemes that do not work. Fruit said W-2 is being fine tuned constantly and we are losing flexibility. Fruit also distributed information regarding open and closed status for W-2 participants. Squyer explained the Medical Assistance and Medicaid programs.and the Board received a handout detailing each area. NURSING HOME: Krieger introduced Lisa Leahy, Nursing Home Director of Social Services. The census today is 94 with two pending admissions. Leahy distributed a chart of where admissions have come from and where discharges have gone in 1998. She said we have had 15 deaths since the first of the year. Leahy said our best advertisement is the community and families that have family members here. She said the 82-bed assisted living complex that will be built at Holy Family Hospital will hurt the nursing home. MENTAL HEALTH: Kirt said the second In -Home team has been hired. He said both candidates have a child protection background, which is good. Kirt said AODA referrals have slowed and the volume in AODA is 11 down from spring. He said Mental Health referrals are lower also, which means clients have only a one to two week wait rather than three weeks. He said the Psychologist's time will be cut from ten hours to eight hours per week. Kirt said we applied for emergency funds that are available from the state from Intoxicated Driver Program (IDP) surcharges. He said we have not received confirmation of this in writing, but will be receiving $25,000 from the state to augment funds spent for IDP. Horne left the meeting at 10:30 a.m. PUBLIC HEALTH: Nelson said Public Health had a 50% cut in the Immunization Grant. She said this may be restored, but it has not happened. Public Health will look at other funding sources if the monies are not restored. Nelson said Maternal Child Health monies were cut 3.8% for 1999. Nelson reported there will be an outreach program for Medicaid this summer and this will be aimed at the same population that would be affected by the immunization dollars. The Immunization Coalition meets on 06/16/98 at 7:30 a.m. in Public Health. She said Pierce County has joined the Coalition this year. Nelson said Public Health is currently running a Bike Helmet Program and has extended this program to the community. A short bike safety course and helmet are available for $5.00. June is Dairy Month and Nelson said milk is available in Public Health. She said the calcium requirement for adults was raised to three glasses of milk per day. There will be a Board of Health training update in Eau Claire on 07/23/98 and Nelson would like some Board representation at this meeting. EXPANSION OF SHELTER HOME CONTRACTS FOR JUVENILE CONTRACTS: Carlson gave a brief review of presentation regarding shelter contracts given at a previous meeting. Carlson said out -of -county shelter is more expensive than in county homes due to less transportation costs. An in -county home would also allow for easier access to court, Mental Health and Alcohol/Drug services, and family. The unit has been unable to recruit any in -county shelter homes. It is hoped by increasing the fee paid for shelter homes that more people would be willing to open their homes as shelter homes. Dunlap said shelter homes would be used exclusively for St. Croix County residents, they would not be used for long term care or respite. Stephens asked if additional funds were granted if the unit could guarantee less out of county 12 placement by 1999. Dunlap said this would not be possible as homes still need to be recruited and is not sure the additional monies will be incentive enough for people to open their homes as a shelter home. Motion: A motion was introduced by Limberg, seconded by Bethke, that the Board approves adding $11,000 to shelter care to recruit for shelter care homes in St. Croix County. Roll call vote: Robert Stephens -yes Leon Berenschot-yes Chris Bethke -yes John Dowd -absent Einar Horne -absent Fern Johnson -yes Allen Limberg-yes Mary Louise Olson -absent George Sinclear-absent Five yes, four absent, motion passed. Stephens asked if there were any other issues to bring before the Board.• Borup arranged a conference call with Greg Timmerman, Corporation Counsel regarding following a formal bid process if a county department is going to do work for another county department. Timmerman said a resolution needs to be passed by three -fourths County Board vote for work to be internally. Otherwise the Public Works Law needs to be followed and formal bids need to be obtained. Motion: A motion was introduced by Stephens, seconded by Berenschot, and unanimously adopted: that the meeting be adjourned. Time: 11:20 a.m. Chairman• Attest: ( secretary) 13