HomeMy WebLinkAboutHelath & Human Services Board 04-14-98CHRIS BETEKE 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: 04/14/98
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: 04/23/98
ACTION ON PREVIOUS MINUTES: 03/26/98
ANNOUNCEME. TS
APPOINTMENTS:
UNFINISHED BUSINESS:
1. Incinerator Status (American Resource & Recovery)
NEW BUSINESS:
1. Consideration of Claims and Vouchers
2. Financial Report
3. Personnel Issues
4. Health and Human Services Reports
a. Nursing Home
b. Public Health
c. Mental Health/Alcohol and Drug Abuse
d. Home Health
e. Wisconsin Works (W-2)
S. Presentation of 1997 Annual Report
6. Comprehensive Rehabilitation, Inc. and Transition House Lease
7. Fire Inspection Codes and 1974 Office Building
S. ECHO Management GrouD Software Training Needs
ANNOONCEMENTS a CORRESPONDENCE
POSSIBLE AGENDA ITEMS FOR NEXT MEETING:
ADaOURNMENT
(Agenda not necessarily preseated in this order)
SUBMITTED BY: John M. Borup
DATE: February 27, 1998
COPIES TO:COUNTY BOARD OFFICE
COUNTY CLERK
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ST. CROIX COUNTY HEALTH AND HUMAN SERVICES BOARD
APRIL 14, 1998
The St. Croix County Health and Human Services Board met on April
14, 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
Fern Johnson
Allen Limberg
Mary Louise Olson
George Sinclear
MEMBERS ABSENT: Einar Horne, excused
STAFF PRESENT: John Borup, Health and Human Services
Director
Carolyn Krieger, Nursing Home Administrator
Judy Ziegler, Accountant
Ron Kiesler, Mental Health/AODA Coordinator
Barb Nelson, Public Health Supervisor
Marilyn Fruit, Economic Support Supervisor
Ron Lockwood, Long Term Support
Kathy Dunlap, Family & Children's Supervisor
Fred Johnson, Family & Children's Supervisor
Marilyn Fruit, Economic Support Supervisor
Steve Kirt, Mental Health/AODA Clinical
Services Supervisor
June Merkt, Home Health Supervisor
Malva Berg, Secretary
OTHERS PRESENT: Karen Hassler, Comprehensive Rehab
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 12, 1998 at 8:00 a.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
Limberg, and unanimously adopted: That the minutes of the
03/26/98 Health and Human Services Board meeting be approved as
circulated.
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APPOINTMENTS: Stephens said Laurie Peterson resigned from the
Family Support Birth to Three Advisory Committee and he would like
to appoint Mike and Julie Lesher to replace her.
Motion: A motion was introduced by Olson, seconded by Dowd, and
unanimously adopted: That the Board approves appointment of Mike
and Julie Lesher to the Family Support Birth to Three Advisory
Committee.
INCINERATOR STATUS: The City of New Richmond has indicated an
interest in the generator at the incinerator, but wants to buy
more land with the generator. It was the consensus of the Board
to not sell any land at the County farm. Stephens said Finance
has the land the incinerator is on as it was taken on a tax deed.
CONSIDERATION OF CLAIMS: Ziegler distributed the following
reports: transfer of funds report, unemployment report for
February and March, fixed assets purchased, and cash report for
March.
Health and Human Services Board member, Bethke, reviewed the March
vouchers and questioned or reviewed the following vouchers:
HUMAN SERVICES:
12839: Eau Claire Academy, $14,810.88, CCI. Child Care
Institution. Cost for three females for a total to 76
days. These placements are court ordered for juveniles
with severe, significant emotional or behavior issues.
12917: REM-WISC III, Inc. $32,559.58, Long Term Support
purchased services. March expenses for eight clients
in an adult family home setting.
13148: Natural Gas, Inc. $10,421.04, gas. Natural gas bill
for heating and cooling for March, 1998.
NURSING HOME:
241: More-4, $4,007.62, Medicaid meds. More-4 has the
contract to supply meds for all nursing home residents.
262: Sundance Rehabilitation, $42,835.57, physical therapy.
Company provides the therapists for residents needing
PT, OT and Speech Therapy.
Motion: A motion was introduced by Bethke, seconded by Stephens,
and unanimously adopted: The following vouchers be approved
nd
be made a part of the supplemental minute book pages 1149 through
1195:
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Home Health voucher 12876, dated March 12, 1998, in the amount of
$420.00.
Home Health vouchers 13075 through 13097, dated March 31, 1998, in
the amount of $11,557.07.
Human Services vouchers 12827 through 12875, dated March 12, 1998,
in the amount of $59,612.49.
Human Services vouchers 12877 through 12924, dated March 19, 1998,
in the amount of $187,766.49.
Human Services vouchers 12925 through 12994, dated March 26, 1998,
in the amount of $38,479.06.
Human Services vouchers 12995 through 13018, dated March 29, 1998,
in the amount of $145,679.09.
Human Services vouchers 13019 through 13074, dated March 30, 1998,
in the amount of $68,023.45.
Human Services vouchers 13098 through 13374, dated March 31, 1998,
in the amount of $65,503.59.
Human Services vouchers 13109 through 13368, dated March 31, 1998,
in the amount of $99,133.41.
Nursing Home vouchers 162 through 169, dated March 12, 1998, in
the amount of $2,052.66.
Nursing Home vouchers 170 through 179, dated March 19, 1998, in
the amount of $4,585.01.
Nursing Home vouchers 179 through 183, dated March 26, 1998, in
the amount of $1,070.99.
Nursing Home vouchers 184 through 193, dated March 02, 1998, in
the amount of $14,938.28.
Nursing Home vouchers 200 through 271, dated April 14, 1998, in
the amount of $102,892.88.
Human Services and Nursing Home vouchers 121 through 150, dated
March 18, 1998, in the amount of $251,395.94.
Social Services and Human Services vouchers 83 through 104, dated
March 18, 1998, in the amount of $82,864.96.
Human Services and Nursing Home vouchers 151 through 177, dated
April 1, 1998, in the amount of $292,951.94.
Social Services and Human Services vouchers 105 through 125, dated
April 1, 1998, in the amount of $98,898.43.
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FINANCIAL REPORT: Stephens said the farm fuel tanks need to be
removed this summer and the monies to do this will come from the
farm account. Maintenance is investigating filling in the
building where the boilers were to possibly house the buses.
Maintenance is also investigating patching and doing some
blacktopping this summer and will report to the Board on this
project in the next few months.
The Board received the following financial reports for January and
February, 1998. Krieger said the census is 106 with two admissions
expected at the end of the week. Krieger said the State sets the
Medicaid rate and ITP funds bridge the gap of those rates. She
said the nursing home does not discriminate on pay source and this
is also carried through to Health and Human Services programs.
Borup said there is a strong belief in privatizing, but we have a
unique product to offer the public.
Berenschot recommended advertising the nursing home on WIXK.
Krieger said beginning 07/01/98, nursing homes will be required to
bill Medicare Part B for all residents who have received Medicare -
covered services such as parenteral/enteral nutrition,
urologicals, therapies, wound care, labs, x rays, and
transportation. We are waiting for HCFA to finalize the details.
Issues that will affect the Nursing Home are: a) tracking
supplies and services for billing, b) developing agreements with
vendors and risk sharing, c) cash flow problems. These changes
will impact the staff in the amount of time and systems used to
accurately track and bill supplies. HCFA has not set fees yet for
all the services, so the question will arise as to whether the
vendors will accept payment or if the Nursing Home will be billed
more for the services than Medicare pays. Lastly, cash flow
issues will develop because these changes were not known when the
budget was developed last year. The Nursing Home will need to
arrange delayed payments to vendors if possible and if vendors
will accept it. Medicare payments are sometimes received six to
nine months after the service has been provided.
Krieger said the following costs have been incurred by the Nursing
Home: a) The nurses call light system has been malfunctioning
since last fall. Replacement of the parts is $22,850. Work began
04/08/98, b) Two bath tubs are being replaced because residents
are not able to get into them. The cost of replacement of these
is $24,000 and will be installed around May 1. The Nursing Home
did get $3, 000 from United Way to be used for the bath tubs, c)
The Norstan Cabling bid is $10,855.05. This bid does include
cabling for a training room, which has been discussed as a future
need.
Please see next page.
4
ST. CROIX COUNTY HUMAN SERVICES BOARD
FINANCIAL SUMMARIES
FOR THE PERIOD O1/01/98 THROUGH O1/31/98
NURSING HOME
Reconciled Cash Balance 01/31/98 $396,339.93 x
Add:
Accounts Receivable, 01/31/98
Private Pay $680.27
Medicare $278,436.39
Medicaid $225,242.40
General $1,694.22
Accounts Payable-01/31/98 ($306,195.17)
Net Current Items, 01/31/98 $596,198.04
1998 Revenue Recorded through 01/31/98 $392,133.42
Includes Allocations of Anticipated Revenues
1998 Expenses Recorded through 01/31/98 $446,395.37
Includes Allocations of Expected Expenses
Add or Deduct any nursing home related items not
recorded on nursing home books: 1998
bond principle $246,794.50
(93.13% of total 1998 bond principle of $265,000)
NH98sum
* Operations = $271,394.68
Capital
Acquisitions = 124,945.25
HEALTH AND H-JMAN
SERVICES - 1998
SCARY
Total
OF REVENUES
Jan. -Jan.
Budget
Balance
a
Administration
41,855.33
522,095.00
480,239.07
8.Oo
AODA Services
36,509.75
395,834.00
359,324.25
9.20
Long Term Support
569,364.14
8,815,952.00
8,246,587.86
6.5%
Mental Health
150,945.13
1,658,960.00
1,508,014.87
9.10
Family & Children's
193,530.52
2,046,238.00
1,852,707.48
9.5%
Economic Support
21,479.28
896,334.00
874,854.72
2.40
General Relief
0.00
17,204.00
17,204.00
0.01-.
TOTAL REVENUES
ALL PROGRAMS
1,013,684.75
14,352,617.00
13,338,932.25
7.10
SUMMARY
Total
OF EXPENDITURES
Jan. -Jan.
Budget
Balance
o
Administration
43,181.81
522,095.00
478,913.19
8.3%
Alcohol -Drug Abuse
32,862.02
395,834.00
362,971.98
8.39,;
Long Term Support
252,061.85
8,815,952.00
8,563,890.15
2.90
Mental Health Services
96,272.95
1,658,960.00
1,562,687.05
5.8%
Family & Children's
162,130.69
2,046,238.00
1,884,107.31
7.90
Economic Support
65,206.58
896,334.00
831,127.42
7.30
General Relief
49.94
17,204.00
17,154.06
0.3%
TOTAL 1998 HUMAN
SERVICES BUDGET
651,765.84
14,352,617.00
13,700,851.16
4.50
hs97-sum
HOME HEALTH
Total
Jan. -Jan. Budget Balance %*
TOTAL REVENUES** 18,081.67 531,504.00 513,422.33 3.40
TOTAL EXPENDITURES 44,727.38 531,504.00 486,776.62 8.40
PUBLIC HEALTH (12 month programs)
Total
Jan. -Jan. Budget Balance o*
TOTAL REVENUES 76,258.19 857,670.00 781,411.81 8.90
TOTAL EXPENDITURES 130,513.01 857,670.00 727,156.99 15.20
*TO BE ON BUDGET, PERCENTAGE SHOULD BE 8.33°r.
ph98-sum
ST. CROIX COUNTY HUMAN SERVICES BOARD
FINANCIAL SUMMARIES
FOR THE PERIOD O1/01/98 THROUGH 02/28/98
NURSING HOME
Reconciled Cash Balance 02/28/98
Add:
Accounts Receivable, 02/28/98
Private Pay
Medicare
Medicaid
General
Accounts Payable-02/28/98
$344,247.11
($3,557.77)
$311,246.74
$214,679.33
$1,631.22
($297,188.45)
Net Current Items, 02/28/98 $571,058.18
1998 Revenue Recorded through 02/28/98 $883,362.02
Includes Allocations of Anticipated Revenues
1998 Expenses Recorded through 02/28/98 $849,250.37
Includes Allocations of Expected Expenses
Add or Deduct any nursing home related items not
recorded on nursing home books: 1998
bond principle $246,794.50
(93.130 of total 1998 bond principle of $265,000)
NH98sum
* Operations = $219,301.86
Capital
Acquisitions = 124,945.25
HEALTH AND HUMAN
SERVICES - 1998
SUN24ARY
Total
OF REVENUES
Jan. -Feb.
Budget
Balance
o
Administration
83,725.61
522,095.00
438,369.39
16.Oo
AODA Services
57,189.10
395,834.00
338,644.90
14.40
Long Term Support
1,170,221.99
8,815,952.00
7,645,730.01
13.30
Mental Health
306,280.40
1,658,960.00
1,352,679.60
18.50
Family & Children's
356,815.46
2,046,238.00
1,689,422.54
17.40
Economic Support
201,777.95
896,334.00
694,556.05
22.59.,
General Relief
0.00
17,204.00
17,204.00
0.0°s
TOTAL REVENUES
ALL PROGRAMS
2,176,010.51
14,352,617.00
12,176,606.49
15.2t
SUMMARY
Total
OF EXPENDITURES
Jan. -Feb.
Budget
Balance
Administration
79,300.03
522,095.00
442,794.97
15.2t
Alcohol -Drug Abuse
49,210.51
395,834.00
346,623.49
12.4t
Long Term Support
808,894.33
8,815,952.00
8,007,057.67
9.2%
Mental Health Services
207,570.68
1,658,960.00
1,451,389.32
12.5t
Family & Children's
279,494.84
2,046,238.00
1,766,743.16
13.716
Economic Support
123,284.55
896,334.00
773,049.45
13.8t
General Relief
254.63
17,204.00
16,949.37
1.50
TOTAL 1998 HUMAN
SERVICES BUDGET
1,548,009.57
14,352,617.00
12,804,607.43
10.8t
hs97-sum
HOME HEALTH
Total
Jan. -Feb. Budget Balance a*
TOTAL
REVENUES**
88,368.87
531,504.00
443,135.13
16.60
TOTAL
EXPENDITURES
84,432.22
531,504.00
447,071.78
15.91-.
**on month = 8.330
PUBLIC HEALTH (12 month programs)
Total
Jan. -Feb. Budget Balance �*
TOTAL
REVENUES*
133,841.09
857,670.00
723,828.91
15.6%
TOTAL
EXPENDITURES
197,991.76
857,670.00
659,678.24
23.10
*TO BE ON BUDGET, PERCENTAGE SHOULD BE 16.67%.
ph98-sum
COMPREHENSIVE REHABILITATION, INC. LEASE: Karen Hassler was
present to represent Don Lindstedt for Comprehensive
Rehabilitation, Inc. Comprehensive Rehabilitation, Inc. has
continued interest in leasing the "transition house" and the
Health and Human Services Board is interesting in updating the
contract. Comprehensive Rehabilitation, Inc. took over River
Ridge Rehabilitation as of April 1, 1998. Discussion followed.
Motion: A motion was introduced by Berenschct, seconded by
Sinclear and unanimously adopted: That the Board offer
Comprehensive Rehabilitation, Inc. a contract to lease the
"transition house".
PERSONNEL ISSUES: Karen Hall will be out on medical leave for an
undetermined time. Barb Nelson announced that Dianne Richardson,
RD, is leaving Public Health. Advertisements have been run to
replace this position.
Krieger distributed an article from the Glenwood City Tribune
Press Reporter from 03/25/98 regarding the wage contract Dunn
County negotiated with its union employees for the next three
years. The percentages received in Dunn County were lower than
St. Croix County's increases. It was the consensus of the Board
that the wages need to be competitive to retain staff.
HEALTH AND HUMAN SERVICES REPORTS:
Mental Health: Kiesler reported that ECHO has continued to be
updated and implemented. He said more training is needed on
billing.
Kiesler also reported to the Board the suicide of a CSP client.
This has been reported to the state.
Kiesler highlighted areas of the annual report. He said there is
a six to nine month waiting list for the In -Home Program. This
program is geared toward keeping children out of foster care,
hospitals, or other out -of -home placements. Kiesler said
inpatient services have been purchased from St. Joseph's since
01/01/96 and the unit experienced an increase in length of client
stay for acute inpatient psychiatric services since then. Staff
have been working with St. Joseph's staff to reduce the length of
client's stay. In 1996 the length of stay went from 3.46 days to
8.5 days. In 1997 the length of stay went from 8.5 to 4.29.
Kiesler said in Transition Services the length of client stay
decreased by ten days. He said in AODA, clients used to have a
30-day inpatient stay, now they are provided with more outpatient
services with a shorter inpatient stay.
Public Health: Barb Nelson reported on the LaCrosse Encephalitis
Program. This program would cover surveillance of an area to see
5
if the tree -hole mosquito is thriving, trapping mosquitoes, maybe
doing some spraying, etc. The cost is $3,500. Nelson said there
was one confirmed case of Encephalitis in St. Croix County in
1997. The Chair declared this item eligible to be voted on under
program reports. Discussion followed.
Motion: A motion was introduced by Sinclear, seconded by
Berenschot, and unanimously adopted: That the Board approves
participating in the LaCrosse Encephalitis Program at a cost of
$3,500.
Nelson said the Public Health Newsletter was included in the Board
packets. She also announced that the next Legislative breakfast
will be April 20, 1998 at 9:00 at St. Croix Health Center. An
agenda was provided to the Board members. Nelson said the week of
April 6 was Public Health Week. Displays were set up in Public
Health. Nelson reported that SB313 did pass the legislature in
March but was less than initially reported and she outlined some
of the differences.
Nelson said the budget is expected to be cut for the WIC program.
Currently 706 participants are enrolled in the program and we are
funded for 747. She said there are no funds for outreach for the
WIC program.
Home Health: June Merkt highlighted areas of the annual report
for the Home Health unit. She said there is a lot of competition
in home health services. She said the number of visits provided
by Home Health have declined 7.5% from 1996 to 1997. Merkt said
the nurses in the Home Health unit have been with the unit for a
long time and are very dedicated.
Merkt distributed information regarding Understanding the Medicare
Home Health Benefit and Implications of the 1997 Balance Budget
Act for the Board to read. Merkt said Home Health has received 45
new referrals since 01/01/98. The Medicare rate is set by the
cost report. Merkt said we do not have control over reimbursement
or referrals, but we do control the quality of care.
W-2: Fruit distributed information regarding W-2. She included
information regarding intakes. She said there is a 60% no-show
rate for intakes. Discussion followed.
Stephens said with Board approval, he would ask the County Board
Chair for three-quarters of an hour to present the annual report
to the County Board.
The Board recessed from 9:50 to 10:00 a.m.
Presentation of the annual report will be at the May 12, 1998
County Board meeting. The annual reports will be distributed in
County Board members' mailboxes before the meeting and extra
copies will be brought to the May meeting.
6
Fruit said the Legislature is looking ac changing child care
dollars for W-2. Fruit said the implementation contract
specifically spells out what will be done with any excess W-2
monies and the legislators are also looking at those monies.
Discussion followed.
Stephens asked if there were any other issues to bring before the
Board.
Borup said this week he received he received a request from the
State to bid on providing three full time or six part time
counselors to provide AODA services to the Department of
Corrections. It was the consensus of the Board to not bid on
this contract.
Borup reported that four slots for the CIP 2 program have been
authorized in writing by the state and 14 have been authorized
verbally, which is very good news for St. Croix County.
Borup said St. Croix County will receive $88,656 for 1998 and 1999
to be used to prevent services for children who are at risk of
abuse and neglect and for services and projects to assist families
and children. Staff are recommending these funds be used to begin
another in -home team and to start a joint venture into a mentor
program with Pierce County.
FIRE INSPECTION CODES AND 1974 OFFICE BUILDING: The Board was
given a copy of a letter from James Vander Wyst, New Richmond Fire
Chief, regarding fire codes. Brian Larson from Ayres has been
consulted to address these concerns. Borup indicated a proposal
should be received this week. Stephens stated action will need to
be taken.
ECHO MANAGEMENT GROUP SOFTWARE TRAINING NEEDS:
Motion: A motion was introduced by Dowd, seconded by Berenschot,
and unanimously adopted: That the Board approves $5,500 for
additional ECHO software training needs.
Berenschot stated Glenwood City started a Citizens for Healthy
Youth Group and invited Board members and staff to attend the next
meeting on 04/19/98 at 5:30 p.m. in the Glenwood City High School
Commons. This evolved out of Family Preservation dollars.
Motion: A motion was introduced by Berenschot, seconded by
Sinclear, and unanimously adopted: that the meeting be adjourned.
Time: 10:30 a.m.
Chairman:
Attest:
7
secretary