HEALTH AND HUMAN SERVICES BOARD

 

Tuesday, March 6, 2007

Administrative Center – Room 3220

6:30 p.m.

 

MEMBERS PRESENT:  Tara Johnson, James Glasser, Anita Froegel, Margaret Wood, Loren Kannenberg, Brad Pfaff, Patrick Schippers, and Jill Billings (arr @6:35)

MEMBERS EXCUSED:  Sharon Hampson

MEMBERS ABSENT:  None

GUESTS AND STAFF PRESENT:  Doug Mormann, Jerry Huber, Dean Ruppert, Pat Killeen, Jane Klekamp, Mary Ellen Prinsen, Nicole Milliren, Deanna Kelley, John Parshall, Heather Kujak-Coon, Bob Taunt, Mary Marco, Connie Eide, Nancy Kenton, Nikki Larson, Steve  O’Malley, and Cheryl Stephen     

 

CALL TO ORDER

Tara Johnson, Board Chair, called the meeting to order at 6:33 p.m.

 

ANNOUNCEMENTS

Board Chair Johnson made the following announcements:

 

CONSENT AGENDA

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

Minutes

·        Health and Human Services Board of 2/6/07

·        Coulee Region Public Health Consortium of 2/7/07

·        Dental Care Advocacy Coalition of 1/29/07

·        Health and Human Services Labor/Management of 1/30/07

·        Criminal Justice Management Council of 2/21/07

·        Joint Governing and Management Councils of Family Policy Board of 2/15/07

·        W-2 Steering Committee of 2/22/07

·        Long Term Care Council of 2/2/07

·        Aging & Disability Resource Center Advisory Committee of 2/15/07

Fiscal

·        2007 Summary of Contract Approvals

·        Vendor Audit Policy Update – Step 3

 

Department Reports

·        Health Director’s Written Report

·        Human Services Director’s Written Report

·        Quarterly Complaint/Grievance Report from Care Management Organization

 

Miscellaneous comments and questions on the above items.  Supervisor Wood suggested future agenda item on disposal of medications.  Update on fluoridation proposal for Village of Holmen; the public hearing had approximately 50 in attendance; 150 village residents signed a petition in favor; the village will discuss at a future meeting; noted a lot of misinformation on the Internet regarding floride.  Update on City of Onalaska proposed smoking ordinance; had 75+ attend a public hearing; Supervisor Schippers noted 19 spoke in favor and 10 (3 residents) spoke against; further discussion by the City at a meeting next week.  Motion carried unanimously; Hampson excused.   

 

PUBLIC COMMENT

Supervisor Jason Gillett presented a proposal regarding Fair Housing/Housing Discrimination Prohibited.  He distributed copies of current Dane County ordinance, including an amendment that a Dane County Board Supervisor is planning to introduce that relates to “no discrimination on use of a Section 8 voucher to pay for housing”.  Some discussion and questions asked.  A copy will be given to Sharon Hampson as the Chair of the County Commission on Equal Opportunities in Housing.  Also a suggestion that he contact the County Housing Authority Director for more information.   

 

BOARD EDUCATION

Update on Paperless Board Packet - Heather Kujak-Coon of IT Dept. reviewed the proposed paperless packet as a pilot project for the HHS Board.  All packet information can be accessed from a home computer by logging onto the County network using a password.  She distributed instructions, software CD (Citrix) and a use policy form that requires signature, and offered training.  The Board would need to meet in the County Board room as there are computers already in that room; cost of purchasing laptops for 3220 conference room is estimated at $1,500 each; these in future could be used by all the standing committee members.  Supervisors suggested an analysis of savings – cost of paper, ink, postage, etc.  Member Froegel suggested only relevant information be included.  Supervisor Billings suggested capability of adding notes.  Heather noted this cannot be done at this time but there are many options that could be considered in the future.  General agreement by the members to try it for the April meeting, including a paper packet for this first meeting.        

 

Policy, Practice, People of Home Health – Connie Eide, Director of County Home Health Program, Nancy Kenyon of Independent Living Resources, and Nikki Larson of Gemini were present to review current status of maintaining sufficient staff to meet the needs of the program.  The County contracts with Independent Living Resources and Gemini in order to meet the needs of the 62 in-home clients including 12 pediatric clients with an additional 5 on a waiting list.  Much of the problem of retaining staff relates to low hourly wages and no benefits.  It is a difficult job as it’s 24/7, including holidays and severe weather conditions; some employees leaving for work with other agencies, such as CMO and nursing homes where wages are higher and also receive benefits.  Connie noted the pay rate is based on MA reimbursement which is $15.84/hour and the new contracts with Gemini and Independent Living Resources is at $15.32 hour, so the remainder of about $.50 is for County administration, etc. plus the agencies also retain some for their administration costs.  After some discussion, it was determined that the solution is to pursue increase in MA reimbursement.  Staff, agencies and coalition groups need to continually contact legislators regarding this issue.

 

Policy, Practice, People of Child Protective Services – Mary Ellen Prinsen and Nicole Milliren of Child Protective Services and a consumer (Heather) shared her experience with Child Protective Services.  Heather as a young mother of 3 children came from an abusive relationship; she noted that she gave up a 4-year college scholarship for such relationship, but now has to move forward.  Heather did not have parenting skills and since being in the system (2+ years) the father was arrested for battery, etc, plus the court system held dispositional hearings on the children, Heather did separate from the children’s father and was able to retain two of the children with one remaining with her sister as kinship placement.  Heather gave praise for the assistance as provided by Child Protective Services; at first she was deviant, but now realizes that she has gained much from it all; she has learned to be a parent; enjoys being a mom; gained insight into her personal issues and increase in self esteem.  Jerry noted that Wisconsin is 1 of 10 states which child welfare is largely funded and delivered at the local level of government of which 75% of the County Human Services budget/tax levy is for this program.  In other states, child welfare is a state delivered and funded service.  Chairperson Johnson thanked Heather for sharing her story.

 

County Health Insurance and Wellness Services – Bob Taunt reviewed the County health insurance plans.  He also noted the value of receiving feedback from other departments and staff relating to employee wellness and keeping employees healthy; this in turn helps control health costs.  The County has two Preferred Provider Organization (PPO) plans as offered by the two medical facilities (these are not HMO plans).  About 80% of the employers in U.S. offer PPO plans which is a mechanism of getting discounts on services.  Premiums are based on utilization, so the key is to stay healthy.  Seventy-five percent of employers in U.S. offer wellness programs.  The County Health Dept. provides wellness programs/services for the County employees.  There are funds in the County Occupational Health budget to cover wellness related costs.  Some of the services as provided by Health Dept. include blood pressure checks, blood sugar testing, immunizations, heath fairs, smoking cessation program that covers cost of quit smoking aides such as patches, gum, etc., offers discounts at fitness centers, and etc.  (Detailed information in the Board packet.)  The County has self-funded health insurance that includes contracted administrators.  The state health plan or other plans are not as cost effective as the current PPO plan.   There is a Health Insurance Advisory Committee that continuously looks at most cost effective plans and options, including ways of keeping employees healthy. 

 

Increase in Secure Detention Placements – Jerry Huber and Mary Ellen Prinsen reviewed.  Since the non-secure portion of the JDF closed starting in 2006, numbers have increased (approx. 25%) as there is no place to put the 72-hour holds.  Some of the high risk and serious crime offenders are now placed in secure while others on home detention or at Coulee Youth group home if bed space available.  A report showing comparison of 2006 to 2005 and type of offenses was sent with the packets.  Options being considered are Coulee Youth commitment of 1 bed space on yearly basis or the possibility of a foster home specifically for delinquent youth who require a short-term non-secure placement with Lutheran Social Services.  Discussion on County fixed costs and reason for closing the non-secure; County estimated expense was approximately $285/day per youth while Coulee Youth charges $92/day.  Noted the comparison report was difficult to understand and asked for revised report for the April meeting.  Supervisor Billings also requested running population numbers month by month, average length of stay, and repeat offenders.  Further review at the April HHS Board meeting.    

 

March 9 – Local Long Term Care Reform Planning Retreat – 9:30 a.m. to 3:30 p.m. at Midway Hotel on Rose Street; HHS Board members are encouraged to attend and should encourage other County Board Members to attend as well.  There will be a lot of questions on governance.  Supervisor Hampson will be making a presentation on Family Care in La Crosse County.  HHS Board members should act as advocates.

 

Committee Flow Charts for Health and Human Services Departments – A final draft, though on-going project, was sent with the Board packet; this can be added to the HHS Board binder/manual.  It shows the involvement of the HHS Board with other committees.  Chairperson Johnson noted that if any HHS Board member would like to join another committee(s), to please let her know.

 

POLICY ISSUES

Child Protective Services – Staff Retention Workgroup – Mary Ellen Prinsen, Nicole Milliren, Deanna Kelley, and Mary Marco addressed the board regarding their work as a Staff Retention Workgroup.  For the past 6-7 years, there has been constant staff turnover in Child Protection Services with reason being a high stress, burn-out job.  This is a nationwide problem.  Have seen County staff transfer to other departments (CMO and Justice Sanctions) with no one transferring in.  Because of this, a workgroup was formed and Mary Marco served as a facilitator.  After several meetings, the group compiled a needs assessment that included categories of safety, equipment, financial, supervision, worker responsibilities, upper management and retention needs.  Some of these have been implemented with balance being part of a long-range plan.  Noted state mandate requires a lot of documentation and paperwork including court processes which adds to the workload.  Some questions asked.  Steve O’Malley noted this as on-going in the entire County organization and how important for labor and management to interact.  Chairperson Johnson thanked staff for their work and requested the management team to bring back how and when these might be implemented.          

 

Public Relations/Input re Human Services Planning and Budget – Jerry noted per State Stats., the HHS Board is to obtain public input on its yearly budget and planning process.  Previously, this has been done by holding a public hearing after the department/sections had prepared a budget.  Jerry is recommending an alternative to getting more public input.  In doing so, he has requested each section identify their “key” budget/planning goals and issues by May 2007 and then these will be presented to the appropriate advisory committees for interaction or reaction.  Advisory committee members will be encouraged to become proactive in paying attention to federal, state and local policy issues that could impact service provision.  Their input will then be shared with the HHS Board.  Noted this could also be done for the Health Department though it does not have the requirement of obtaining public input.  

 

Next Steps in Detox Planning – Jerry reviewed noting 4-5 years ago, Gundersen/Lutheran did provide detox services at a cost of about $300,000/year cap; they requested an increase due to costs, and at that time the County formed the Coulee Council Harm Reduction and Use Monitoring (CHUMM) and also researched a model to residential services called “Social Detox” at which time Lakeview was going to host a provider of services.  Since, that plan has fizzled out due to timing, market analysis and location of Lakeview.  Over the past year, CJMC has discussed the concept of a comprehensive assessment center for law enforcement to use to determine mental health and substance abuse issues; the County is also looking at unnecessary detention holds which can cause jail overcrowding.  Combining functions and funding of numerous crisis responses could result in a more efficient and effective way of addressing these needs.  Jerry noted detox services as a state mandate (Ch. 51); currently the County has the highest cost in detox per capita; he noted for just January & February there were 12 suicides in the City of La Crosse; such a comprehensive assessment center is needed in downtown La Crosse.  Supervisor Pfaff suggested Human Services also work with the non-profit organizations and not take this on alone.  This is only informational; more detailed information will be presented at the April HHS Board meeting.

 

RESOLUTIONS/ORDINANCES

Update on Public Hearing for the Clean Air Act Ordinance (Smoke Free Campus) – Chairperson noted because a conflict in public hearing dates, this will be referred to April.

 

ADDITIONAL HANDOUTS

 

ITEMS FOR FUTURE AGENDAS

 

ADJOURNMENT

There being no further business, Committee Chair Johnson declared the meeting adjourned at 9:11 p.m.

 

 

 

 

 

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

 

Cheryl Stephen, Recorder