HomeMy WebLinkAboutHelath & Human Services Board 05-12-98LEON BERENSCHOT 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: 05/12/98
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: 05/28/98
ACTION ON PREVIOUS MINUTES: 04/14/98
ANNOUNCEMENTS
APPOINTMENTS
UNFINISHED BUSINESS:
1. Presentation of 1997 Annual Report
NM BUSINESS:
1. Election of Officers
2. Consideration of Claims and 'Vouchers
3. Financial Report
4. Personnel Issues
a. Administrative staff needs
5. Health and Human Services Reports
a_ Nursing Home
b. Long Term Support
c. Economic Support
d. Family & Children's-9:15
6. Proposed usage of Federal :IV-E monies for Children and Family
Services
7. Computer Services Training Roam
ANNOUNCEMENTS & CORRESPONDENCE
POSSIBLE AGENDA ITEMS FOR NEXT MEETING:
AD JOUPJMNT
(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
May 12, 1998
The St. Croix County Health and Human Services Board met on May
12, 1998, at St. Croix County Health and Human Services complex in
New Richmond, Wisconsin.
MEMBERS PRESENT: Robert Stephens, Chair
Leon Berenschot
Chris Bethke
John Dowd
Einar Horne
Fern Johnson
Allen Limberg
Mary Louise Olson
MEMBERS ABSENT: George Sinclear, excused
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
Fred Johnson, Family & Children's Supervisor
Marilyn Fruit, Economic Support Supervisor
Jan Place, Economic Support
Jaye Hay, Public Health
Kathy Carlson, Foster Care Coordinator
Laurie Cameron, Family & Children's Services
Cindy Prokash, Activity Therapy Director
Malva Berg, Secretary
OTHERS PRESENT: Rod Paulson, CPA
Tom Dorsey, County Board Chair
John Krizek, Administrative Coordinator
Rich Loney, Chief Accountant -Auditor
Pete Kling, Foster Parent Advisory Board
Robert Boche, County Board Member
Deb Kathan, Personnel Director
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 May 28, 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 Olson, seconded by
Bethke, and unanimously adopted: That the agenda be approved as
circulated.
1
MINUTES: Motion: A motion was introduced by Dowd, seconded by
Johnson, and unanimously adopted: That the minutes of the
04/14/98 Health and Human Services Board meeting be approved as
circulated.
ELECTION OF OFFICERS: Stephens announced that nominations for
officers will be made by ballot with Johnson and Borup being the
clerks. Stephens turned the meeting over to Vice Chair Dowd.
Johnson and Borup distributed ballots. Nominations for chair were
Olson, Bethke, and Stephens. Ballots were distributed to vote for
chair. Stephens received seven votes, Olson received one vote,
Stephens is Chair. Dowd turned the meeting over to Stephens.
Ballots were distributed for vice chair nominations. Nominations
for vice chair were Dowd and Horne, Horne withdrew his nomination.
Stephens declared Dowd to be elected as vice chair.
Ballots were distributed for secretary nominations. Bethke was
the only nomination. Stephens declared Bethke to be elected as
secretary.
FINANCIAL REPORT: Rod Paulson, Auditor, distributed information
regarding the audit reports. He said the balance for the farm
account as of 12/31/97 was $51,854.17. Borup reminded the
committee that approximately $42,000 was taken from the farm
account to purchase a bussette for St. Croix Industries.
Paulson said the balance for Home Health as of 12/31/97 was
$132,996.33. He said we received deficit reduction funds from 1995
and 1996 and without these additional funds, Home Health would not
have made a profit. In 1998 there will be reductions in what
Medicare will pay for RN and Home Health Aide visits. Paulson
recommends we do not reduce rates at this time but look to other
sources for funds. Discussion followed.
Paulson said the net loss for the Nursing Home including ITP and
interfund transfers was $ (121, 061) for 1997. There was a slight
improvement in the working capital for the Nursing Home over 1996.
He said special services increased dramatically. We are dependent
on ITP funds, which at this time will continue through 1999. We
have little control over the. census for the nursing home. Paulson
said he does not recommend decertifying beds as that would devalue
the asset. Discussion followed.
Paulson said with a State of Wisconsin calculation error of
$645,000 in 1996 (COP/CIP Programs) among other items, Human
Services fund balance as of 12/31/97 is $1,774,954.70. . With the
State calculation error (1996) just identified with this audit,
our revenue exceeds our expenditures by $704,506.13. The $645,000
is credited to the 1997 books. The $1,774,954.70 balance also
includes the following items that are unspendable:
2
-------------
i
$1,774,954.70 balance 12/31/97
180,983.95 net property and plant
50,055.20 reserved for inventories
90,000.00 fixed assets
$1,453,915.55 Spendable balance 12/31/97
88,962.00 1997 carryover to 1998
$1,364,953.50 balance as of 01/01/98 (This excludes Home Health
and Farm accounts.)
Discussion followed.
The Board recessed from 9:07 to 9:15 a.m.
CONSIDERATION OF CLAIMS: Ziegler distributed the following
reports: transfer of funds report, fixed assets purchased, and
cash report for April.
Health and Human Services Board member, Berenschot, reviewed the
April vouchers and questioned or reviewed the following vouchers:
HOME HEALTH:
13860: River Ridge Professional Services, $4,454.40, purchased
services. River Ridge provides Occupational Therapy,
Physical Therapy and Speech Therapy to Home Health
clients. These expenses are billed to Medicare,
Medicaid, insurance and private pay sources.
13861: St. Croix County Computer Services, $2,187.50, Home
Health computer equipment. New computer for Home
Health staff.
HUMAN SERVICES:
13377: ALP Wisconsin, $44,399.17, Long Term Support
transitional living. Monthly living expense (room/
board/services) for 15 Long Term Support clients.
13381: Bear Buddies -Hudson, $738.85, day care. Four months of
day care costs for Economic Support client's child.
13410: North Central Logging, $1,716.67, Workshop lumber.
Lumber purchased for use in making pallets.
13686: Cullen Furniture and By Design Studio, $3,097.96,
carpet for Accounts Receivable and Mental Health. New
carpet for these two offices.
13735: Farm & Home, $842.65, maintenance expense. This is for
all purchases made during the month, not a single item.
K
13601: O'Connell's Valley funeral Home, $2,090.00, funeral
expenses. The amount paid for funerals on the State
grants are controlled by the grant rules.
13637: Postmaster, $5,000.00, postage for meter. We have to
purchase postage about every other month.
Motion: A motion was introduced by Berenschot, seconded by
Stephens, and unanimously adopted: The following vouchers be
approved and be made a part of the supplemental minute book pages
1196 through 1236:
Home Health vouchers 13841 through 13864, dated April 29, 1998, in
the amount of $10,719.30.
Human Services vouchers 13375 through 13427, dated April 16, 1998,
in the amount of $145,684.69.
Human Services vouchers 13428 through 13450, dated April 23, 1998,
in the amount of $121,949.29.
Human Services vouchers 13451 through 13477, dated April 30, 1998,
in the amount of $15,589.57.
Human Services vouchers 13478 through 13566, dated April 28, 1998,
in the amount of $45,551.62.
Human Services vouchers 13591 through 13840, dated April 29, 1998,
in the amount of $49,937.37.
Human Services vouchers 13567 through 13809, dated April 29, 1998,
in the amount of $67,157.62.
Nursing Home vouchers 272 through 278, dated April 16, 1998, in
the amount of $1,107.10.
Nursing Home vouchers 277 through 282, dated April 23, 1998, in
the amount of $2,345.03.
Nursing Home vouchers 289 through 338, dated May 12, 1998, in the
amount of $77,482.71.
Social Services and Human Services vouchers 126 through 147, dated
April 15, 1998, in the amount of $83,389.22.
Human Services and Nursing Home vouchers 178 through 206, dated
April 15, 1998, in the amount of $253,656.83.
Social Services and Human Services vouchers 148 through 164, dated
April 29, 1998, in the amount of $83,305.51.
Human Services and Nursing Home vouchers 207 through 228, dated
April 29, 1998, in the amount of $260,166.25.
4
m
PERSONNEL ISSUES: Stephens told Karen Hall that no matter however
long she is gone, she will have a position when she returns to
work. Kathan said budgeting and supervision still needs to be
done in Hall's absence and someone should be appointed to act as
interim coordinator in Hall's absence. Borup recommended that Ron
Lockwood be appointed.
Motion: A motion was introduced by Berenschot, seconded by Dowd,
and unanimously adopted: That the Board approves appointing Ron
Lockwood as interim Long Term Support Coordinator effective
05/01/98. Pay Range will be elevated from 9 to 10 on the non-
union grid.
Proposed usacre of Federal IV-E monies for Children and Family
Services: Dunlap said the Family and Children's unit has received
additional revenue to be spent in 1998 and 1999. The amount of
funding for each year is $88,656 (money not spent in 1998 can be
carried over to the 1999 budget). At least 50% of this money must
be spent for children who are at risk of abuse or neglect and the
remaining funds are to be expended for services and projects to
assist children and families. These monies may not be used to
supplant funding. The Department's plan is to utilize
approximately $60,000 of these funds for a second in -home team
with some distinct differences from the first team and the rest to
develop an intensive supervision program. This plan includes
filling vacant positions currently within our organizational
structure. This plan calls for no new county money. The in -home
team would reduce out -of -home placement costs. She would like
this team to be in place by 07/01/98. Some of these monies may
be carried over to 1999 if not used. The intensive supervision
program would begin in October, 1998. Horne asked how
effectiveness would be measured. Dunlap said a staff person is
currently a student at University of Minnesota and is taking an
outcome class and her project for the class will be to come up
with measurable outcomes for the in -home team. Employment for
these positions would end at the end of the funding. Discussion
followed. Borup indicated office space and equipment details
still need to be settled.
Motion: A motion was introduced by Bethke, seconded by Johnson
and unanimously approved: That the Board approves developing a
second in -home team and an intensive supervision program with the
additional .monies received by Family and Children's Services as
outlined above.
FAMILY AND CHILDREN'S SERVICES: Kathy Carlson reported for the
Foster Care Advisory Committee on work the committee has focused
on over the past several months related to foster care and shelter
care issues. She said people are working out of the home rather
than doing foster care/shelter home care. St. Croix County
currently has no contracted shelter homes. The ideal would be to
have three shelter homes in St. Croix County. It is the hope of
5
the committee that some incentives would encourage people to offer
their homes as shelter homes or foster care homes. She said many
of the past county foster homes have gone to contracted private
homes due to getting more money. The county has no control over
who is placed in the private foster care homes. Stephens asked
for comparatives between what costs are if county homes are not
available and a child has to be placed elsewhere. He also asked
how many children this would involve. Discussion followed.
Stephens said this will be a budgeting item and invited the
committee to come back to the June meeting with more information
for the Board.
ECONOMIC SUPPORT-W-2: Fruit explained the proposed elimination of
the Day Care Coordinator position. She would like to fill this
position with a W-2 Specialist/Day Care Certifier effective June
1, 1998. She said this position would determine eligibility for
W-2 related Medical Assistance and Food Stamps, certify day care
providers and determine eligibility and process Crisis Respite Day
Care. Fruit said the state is doing a massive outreach effort for
Medical Assistance. Discussion followed.
Motion: A motion was introduced by Horne, seconded by Olson and
adopted with Horne voting no: That the Board approve eliminating
the Day Care Coordinator position and replacing the position with
a W-2 Specialist/Day Care Certifier position.
Fruit said Badger Care is not yet in place. Fruit reviewed W-2
statistics, including the W-2 participants, open and closed
status. Discussion followed.
NURSING HOME: Cindy Prokash said May loth through 16th is National
Nursing Home Week. She outlined events planned for the residents
during the week.
Krieger said the census is 98. She said an upper respiratory
infection has gone through the facility causing many residents to
decline in health. Krieger said the census is down in all
surrounding nursing homes also.
Krieger said ITP funding was originally designed to cover all the
losses of county nursing homes. Costs continue to increase at
5.101 each year. She said the State uses the total losses of the
county homes to obtain federal matching dollars, but only returns
a portion of it and uses the rest to fund the State MA budget.
Facilities are now receiving less ITP dollars. Six large
southeastern Wisconsin county homes are generating about $5
million more in losses and are using legislators and lobbyists to
get more money.
Krieger said the Wisconsin County Homes Association has recognized
the dilemma of county home losses. The large southeast Wisconsin
facilities have used their legislators to lobby for those homes to
6
obtain more ITP dollars. She said this lobbying effort puts the
rest of the county homes in jeopardy.
The annual county homes meeting addressed a different distribution
of the ITP dollars to fund more of the southeastern Wisconsin
county homes' losses by taking dollars away from the other 43
homes. The action was not voted upon since it was not published
on the agenda. The group agreed that our boards need to be aware
of this issue and take action on the matter.
Krieger asked the Board to support a resolution from the County
Home Association to the State for the State to not change the ITP
formula. Stephens instructed Krieger to bring the resolution to
the May 28 meeting for the Board's consideration.
Krieger said the Nursing Home has had many regulatory changes the
past three years. The software being used has not kept up with
the changes adequately. Consequently, it has cost the facility
time and money to manually keep records that are required. Forms
needed by surveyors within one hour of their arrival have never
been able to be furnished. Also data given to surveyors has been
inaccurate. The latest regulatory changes have increased amount
of data to be tracked and electronically transmitted.
She said the present software is not windows based and is not
ready for the year 2000 change (Y2K compliant)and past experience
with this company has not been positive. Krieger asked for Board
support to shop for software for the nursing home. Discussion
followed.
Motion: A motion was introduced by Dowd, seconded by Horne, and
unanimously adopted: That the Board supports looking into a new
software package for the Nursing Home.
Borup said the computer services training room will be tabled
until June. Administration would like the Board to consider staff
training needs and will return with this agenda item at the June
meeting.
Stephens asked if there were any other issues to bring before the
Board.
Krieger indicated a hand-out the Board received regarding Kenosha
County's skilled nursing facility. Social Worker, Lisa Leahy,
will give a presentation at the June Board meeting regarding
nursing home census and recruitment.
Lockwood gave a brief update on Long Term Care Redesign.
Motion: A motion was introduced by Stephens, seconded by Dowd,
and unanimously adopted: that the meeting be adjourned.
Time: 11:15 a.m.
7
Chairman:
Attest:
(secretary