HEALTH AND HUMAN SERVICES BOARD

Tuesday, January 9, 2007

Administrative Center – Room 3220

6:30 p.m.

MEMBERS PRESENT:  Tara Johnson, Sharon Hampson, Jill Billings, Patrick Schippers, Loren Kannenberg, Margaret Wood, Brad Pfaff, and James Glasser

MEMBERS EXCUSED:  Anita Froegel

MEMBERS ABSENT:  None

GUESTS AND STAFF PRESENT:  Doug Mormann, Jerry Huber, Dean Ruppert, Davita Molling, Mary Ellen Prinsen, Pat Killeen, Jane Klekamp, David Steinberg, Keith Butler, Al Graewin, Nancy Meyers, Jodi Widuch, Lorie Mueller, Melissa Gilbert, and Cheryl Stephen     

CALL TO ORDER

Tara Johnson, Board Chair, called the meeting to order at 6:30 p.m.

ANNOUNCEMENTS

• Countywide Recognition for Nursing/Health – Doug Mormann distributed copies of a draft proclamation pertaining to January as Public Health Month.  An internal function will be held in recognition of the Health Dept. employees and the HHS Board will be invited.   The proclamation will come before the County Board at their February 5^th Policy Planning Meeting.   At this time Doug also shared copy of upcoming WIZM Radio schedule of pre-recorded sessions relating to various health topics as provided by Health staff; this is one of the initiatives of the County Public Relations Committee.

• Health & Human Services Board 2007 Work Plan/Final Version – Chairperson Johnson noted this as work in progress and it will be used as a guide for the HHS Board.

• Board Performance Evaluation Summary –  Chairperson Johnson referred this to the February HHS Board meeting per request of several members.

• HHS Board Manual - Supervisor Wood noted an upcoming meeting with staff to work on  updating the HHS Board manual; any members having suggestions, please contact her by Thursday.

CONSENT AGENDA

MOTION by Glasser/Schippers to approve the following consent agenda items: 

Minutes

• Health and Human Services Board of 12/12/06

• Joint Health & Human Services Board and Aging & Long Term Care Committee of 12/11/06

• Coulee Region Public Health Consortium of 12/6/06

• Health and Human Services Labor/Management of 12/6/06

• Aging & Disability Resource Center Advisory Committee of 11/29/06

• Care Management Organization Advisory Committee of 12/12/06

• Family Policy Board Governing Council of 12/14/06

• Family Policy Board Management Council of 12/21/06

Fiscal

• 2006 Summary of Contract Approvals

• 2007 Summary of Contract Approvals

• Vendor Audit Policy Update – Step 3

• Report on Contract Increases over 3%

• Care Management Organization Summary of Revenue and Expenses

Department Reports

• Health Director’s Written Report

• Human Services Director’s Written Report

Comments and questions as follows.  Supervisor Hampson noted on “increase in contract listing” the use of a community based residential facility that is located in another county.  Jerry Huber thought maybe due to clinical placement; he will check it out and let her know.  Supervisor Billings had question relating to Girls Circle grant; could a big sister or mentor be included in addition to parent(s).  Mary Ellen Prinsen concurred with providing the needed support.  Doug noted Dr. Glasser as a new member on the Coulee Region Public Health Consortium.  Jerry noted a recent meeting with Representative Huebsch in which he has agreed to support a hearing for upcoming mental health parity legislation.   

Motion carried unanimously; Froegel excused

PUBLIC COMMENT

None requested.

BOARD EDUCATION

Policy, Practice, People of Juvenile Detention Facility – David Steinberg, JDF Superintendent, gave PowerPoint presentation on the La Crosse County Juvenile Detention Facility.  Highlights as follows:

• Recently rewrote the mission statement with the help of staff.

• Core values include:  children, public safety and fair treatment of offenders, teamwork, professionalism, responsible use of resources, integrity, ethical behavior, promote positive work environment, positive role modeling through interaction with residents, accountability, education and exceptional customer service.

• The County facility offers 28 beds to house juvenile offenders ages 10-17 from La Crosse County and any county within the State and is governed by the Dept. of Corrections (DOC).

• 2006 statistics:  served 786 children for total of 4205 bed days (more than 50% from 24 other counties and the State DOC.  For 2005, served 547 children; noted juvenile justice is increasing statewide. 

• Very pleased with HPL routine medical services; such services include physicals, setting up meds, dental checkups, urgent medical care and TB testing.

• Reality Check Program is for pre-adjudicated, pre-detention youths and it consists of a tour of the facility as well as presentation on the effects of delinquency not only on the child but the parents, siblings and community.  Referrals come from counties, schools and hospitals; thus far have had 93 participants with only 13 actually coming through the system; this is a 86% success rate.

• Dave is currently the Chair of the Wisconsin Superintendents Committee which meets quarterly.  The group reviews issues that affect all, compare policies and try to set same fee rates.

Day Care Certification and Wisconsin Shares Child Care Subsidy Program – Presentation was made by two employees of Family Resources (Jodi Widuch and Nancy Meyers) and the new Manager of Economic Support (Lorie Mueller).  Highlights as follows:

• La Crosse County child care certification has been done by Family Resources since 1997; prior to it was done in house by County employee(s).

• Family Resources follow the regulations as set by the State of Wisconsin Chapter DWD 55, Day Care Certification, and in many cases above and beyond, such as:

  • All providers receive 1 unannounced visit during their 2 year certification.

  • Makes certification available to all interested, and in some communities it is only available to those providers who accept child care subsidies as payment method.

  • Require three written references (not 2 as required by DWD 55)

  • Provides individualized SIDS training with each new certification.

  • Require all certified providers to have landline phones because cell phones are difficult for a child to use in case of emergency and cell phone batteries can go dead.

  • Part of the initial certification fee charged covers the cost of background checks and almost half of the cost for the required course work at WTC.

• Family Resources takes its certification work seriously and strictly follows the regulations.

• Currently have 193 providers of which 60 are Hmong.

• Lorie reviewed the Wisconsin Shares – Child Care Subsidy Program:

  • The program helps families pay for child care

  • Eligibility criteria:  unsubsidized work, attend high school (if under age 20), participate in W-2 employment program, participate in employment skills training and continue in unsubsidized employment, participate in food Stamp Employment and Training work search or work experience programs, or a W-2 applicant participating in up-front job search, training or orientation activities.

  • Income eligibility requirement examples:  family of 2 @$2,035, family of 4 @$3,083, family of 6 @4,132, and family of 8 @$5,180, etc.

Miscellaneous discussion and questions.  A family member who provides subsidized day care is required to be certified as well as not live in the same home as the children.  Family Resources noted the difficulty in finding child care providers for 2^nd and 3^rd shift workers, weekends, and part-time basis.

Policy, Practice, People of Public Health preparedness – Presenters Al Graewin, as Health Education Manager, and Keith Butler, as Emergency Management Coordinator, reviewed how the two departments work together on public health preparedness.

• In 2003, created Coulee Region Public Health Consortium with partnership with 4 other counties (Monroe, Buffalo, Trempealeau, Jackson) and the Ho-chunk Nation of Jackson County.

• The consortium has brought in over $500,000 from the Homeland Security Act via the WI DHFS.

• The group is working, collaborating and training with emergency management, hospitals and others in enhancing abilities to respond to public health threats and emergencies.  

• Held table-top exercises, full-scale exercises and workshops in the various counties.

• Reviewed in detail 2007 initiatives of the consortium.

• Discussion on the need for business continuity planning for the County of which training has started.

• Noted the current Emergency Operations Center (EOC) is housed in the former 9-1-1 Center in basement of the County Administrative Center.

Long Term Care Redesign Update (Q & A) and SSI Managed Care Rollout and Timelines – Jerry noted a presentation was made to the County Board on Monday evening.  Melissa Gilbert and Dean Rupert were available to any questions.  Discussion on the response of other counties in the proposed regional consortium.  Dean noted it as “fear of the unknown” as well as impact on their county nursing homes, how will the public and private work together, and what is the role of government in all of this.  Melissa reviewed the “Family Care District” statutes which allow for the creation of a regional consortium.  The district will not have its own taxing authority.  Jerry noted per Chapter 51 and 55, counties still have responsibilities.  Discussion on the transition of the employees.  Waiting on the final legislation before enabling resolutions can be presented and acted on which may take place in March or April.  Looking at late February for a County Board Retreat to do an educational session on this topic.  For the February HHS Board meeting, will have more information on employment, governance, resolutions, timeframe, County Board involvement and how HHS Board can become more of an advocate. 

Committee Flow Chart – An informational flow chart was prepared showing the various advisory committees, subcommittees and other affiliated groups with HHS Board representation.  A couple of corrections were made.  Any additional corrections, please contact Doug Mormann.

POLICY ISSUES

Economic Support Reorganization of Management Structure – Jerry Huber reviewed.  Lorie Mueller was chosen to replace Shirley Ross who retired.  Lorie worked as both a specialist and as a trainer/supervisor within the section and comes with excellent qualifications and references.  One of the first initiatives requested by the department is to work on future organizational design of her section; this will include a reclassification of one supervisor as lead supervisor and also recruit a supervisor/trainer.  This reorganization is also supported by the County Administrator and Personnel Dept.  Informational.

Accomplishments in 2006 and Work Plan for 2007:

Human Services - Jerry noted input was received from staff on the Human Services Department two-year work plan and priorities at a recently held Managers Retreat.  He briefly discussed a countywide initiative, that being “examine how we schedule our staff in light of purpose, mandate and community need.”  Hope to have changes presented as part of 2008 budget process. 

Health Dept. – Doug Mormann said he was appreciative of guidance given by the HHS Board.

Wisconsin Department of Health & Family Services Oral Health Access Grant Update – Doug reviewed noting the La Crosse Area Dental Care Advocacy Coalition has encouraged that applications be made for a couple of grants from the Wisconsin Dept. of Health & Family Services; due date is February 5, 2007.  One grant would be to help the Village of Holmen get started in their fluoridation program, if the Village Board so approves. The other as suggested by Supervisor Hampson would include dental sealants.

Support for Holmen Fluoridation – A copy of draft letter from the Chair of HHS Board to the Holmen Village Board President was in the packet.  The letter encourages support for the fluoridation program for the community water supply.  It was pointed out that the Village is holding a public hearing on this topic on February 28^th.  MOTION by Schippers/Billings to authorize the mailing of the letter.  Motion carried unanimously; Froegel excused.  Suggestion to send copies of same letter to the County Board Members who are district representatives of the village. 

RESOLUTIONS AND ORDINANCES

Ordinance to Amend s. 11.45 entitled “Clean Air Act” of the General Code of La Crosse County, Wisconsin – Doug noted that La Crosse County has already become a smoke free work place, but this new ordinance will extend the smoking prohibition to all county buildings and surrounding non-recreational grounds, joint use buildings, recreational areas, and other County properties that are owned or leased by the County including both indoor and outdoor areas.  It adds to the list:  leased joint use buildings, recreational areas including parks, trails, forested areas, campgrounds, picnic areas, lakes and islands, farm properties, landfills, parking lots and vehicles.  It was noted that this as an initiative of the La Crosse Area Smoke Free Campus Alliance; other businesses who have done the same or in the midst of doing are the two hospitals/clinics, WTC, Logistics Health, and many other businesses.  MOTION by Glasser/Hampson to approve the ordinance as presented.  Lengthy discussion followed.  Each member of the Board spoke in favor or against while others questioned the enforcement of it.   

MOTION by Pfaff/Schippers to delete paragraphs 11.45(2) (c) and (d) as follows:

(c)   "Recreational areas” means parks, trails, forested areas, campgrounds, picnic areas, lakes, and island that are owned or leased by the County of La Crosse

(d)   “Other county properties” means farm properties, landfills, parking lots, and vehicles that are owned or leased by the County of La Crosse.

Supervisor Billings offered a friendly amendment to separate the two.  Supervisors Pfaff and Schippers concurred.  Discussion continued.  Supervisors Pfaff and Schippers spoke against the outdoor prohibition.  Supervisor Billings had concern of Lakeview residents who are placed there and that this is their only home; she would like input from Pam Semb as Lakeview’s Administrator.  Loren Kannenberg concurred with the ordinance but questioned how it would be enforced.  Dr. Glasser concurred with the enforcement issues but stated that it’s time to approve it in its entirety.  Supervisor Hampson said the County needs to take the lead role in this effort.

Motion on the amendment to delete 11.45(2) (c) “Recreational areas” means parks, trails, forested areas, campgrounds, picnic areas, lakes, and island that are owned or leased by the County of La Crosse - FAILED on 3 to 5 vote:  Pfaff-yes, Schippers-yes, Kannenberg-yes, Wood-no, Billings-no, Glasser-no, Hampson-no, and Johnson-no; Froegel excused.. 

Motion on the amendment to delete 11.45(2) (d) “Other county properties” means farm properties, landfills, parking lots, and vehicles that are owned or leased by the County of La Crosse – FAILED on 2 to 6 vote:  Pfaff-yes, Schippers-yes, Johnson-no, Hampson-no, Kannenberg-no, Glasser-no, Billings-no, and Wood-no; Froegel excused.

MOTION by Billings/Schippers to reinstate 11.45(4) and most of the language of (4)(a), to read  as:  (4) In addition to the exceptions pursuant to s. 101.123(3) Wis. Stats., the following exception shall also apply:  (a) Designated smoking areas for residents of Lakeview Health Center.  After further discussion most members wanted more information from Lakeview’s Administrator.

MOTION by Billings/Schippers to hold over the ordinance until the February HHS Board meeting in order to get feedback from Lakeview Administrator.  Motion carried on 6 to 2 vote:  Glasser-no, Hampson-no; Froegel excused.

ITEMS FOR FUTURE AGENDAS

• Board Performance Evaluation Summary

• Clean Air Act Ordinance

ADDITIONAL HANDOUTS

• Coulee Region Smoke-Free Dining Guide

• Notification of Coulee Region LTC Workforce Coalition meeting on January 19 from 10:00-11:30 a.m. with guest Speaker State Representative Huebsch

ADJOURNMENT

There being no further business, Committee Chair Johnson declared the meeting adjourned at 9:27 p.m.

Disclaimer:  The above minutes may be approved, amended or corrected at the next committee meeting.

Cheryl Stephen, Recorder