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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