HEALTH AND HUMAN SERVICES BOARD

Tuesday, June 12, 2007

Administrative Center – Room 3220

6:30 p.m.

MEMBERS PRESENT:  Tara Johnson, Sharon Hampson (arr @6:36), Margaret Wood, Jill Billings, Loren Kannenberg, Brad Pfaff, Dr. James Glasser, Patrick Schippers, Al Thompson  

MEMBERS EXCUSED:  None

MEMBERS ABSENT:  None 

GUESTS AND STAFF PRESENT:  Doug Mormann, Jerry Huber, Dean Ruppert, Davit Molling, Chris Sander, Pat Killeen, Jane Klekamp, Ron berg, Karen Knox, Wayde Anger, Mary Ellen Prinsen, Bill Adams, Sandy Brekke, Patty Martin, Judy Olson, Karen Vogt, Diane Gates, Joleen Trussoni, Bridget Todd, Timothy Palubicki, Rosemary Boesen, Pat Ruda, Senator Dan Kapanke, Cheryl Stephen    

CALL TO ORDER

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

ANNOUNCEMENTS

Board Chair Johnson made the following announcements:

• Welcome Al Thompson – new HHS Board Member, replacing Anita Froegel.  Introductions were made.
• Thank you and good luck wishes to Davita Molling after 11+ years at the County.  She has taken a new job at the West Salem School District as their Financial Manager.
• Day in the Life Recap – Several HHS members suggested holding the event several times a year.  Maybe consider an evening session.  Another suggestion to do the same county-wide for all departments.
• Retreat Follow up – Supervisor Billings suggested more time be spent on budget items.
• Human Services Public Budget Hearing - July 10^th at 5:00 p.m. in the Admin. Center Auditorium.

CONSENT AGENDA

MOTION by Glasser/Billings to approve the following consent agenda items, including a correction noted by Dr. Glasser on the HHS Board minutes of May 8, 2007; he noted that he did not second the motion under the Consent Agenda as he was not present (was excused): 

Minutes

• Health and Human Services Board of 5/8/07

• Coulee Region Public Health Consortium of 5/2/07

• Health and Human Services Labor/Management of 4/24/07

• Aging & Disability Resource Center Advisory Committee of 5/17/07

• Consumer Advisory Council of 5/15/07

• Family Policy Board Governing Council of 4/19/07

• Criminal Justice Management Council of 5/16/07

Fiscal

• 2007 Summary of Contract Approvals

• Care Management Organization Summary of Revenue and Expenses

Department Reports

• Health Director’s Written Report

• Human Services Director’s Written Report

• Quarterly Complaint/Grievance Report from Care Management Organization

• 2006 Annual Reports

  • Health Department

  • Human Services Department

Motion carried unanimously.       

PUBLIC COMMENT

None requested.

BOARD EDUCATION

Policy, Practice, People of Dental Health – Karen Knox, Health Dept., and Sandy Brekke, St. Clare Health Mission, reviewed the initiatives and accomplishments of the Dental Care Access Committee as chaired by Senator Kapanke and Rep. Shilling.  This committee’s work was supported in part by a dental health community leadership team that received consultation through the Wisconsin Health Leadership Institute.  Poor dental care affects other health issues, such as diabetes, cardiovascular disease, etc.    St. Clare assists the uninsured in seeking help for them.  Currently 600 patients on a waiting list at Scenic Bluffs Community Health Center; these are patients needing non-emergency, maintenance-type dental care.

There is statewide awareness, and locally, the Dental Care Advocacy Coalition is making progress, thanks to Senator Kapanke and Rep. Shilling.  Scenic Bluffs received a $350,000 grant that will be used for building infrastructure as well as a $35,000 grant from the La Crosse Foundation to help cover patient costs.  Dental care is one of the ten initiatives of “Healthiest WI 2010”.  There seems to be more awareness at the national level as well as legislative bills are being introduced.  Effective July 1, there will be 25 dentists on rotation basis that will see emergency type patients as referred from hospital emergency care.  The State has approved a pilot project totaling $8 million over 2 years for 3 counties (La Crosse, Racine and Brown).

Doug Mormann gave an update on the fluoridation issue for the Village of Holmen.  There is a citizens group advocating it.  The Village Board had originally turned down a committee recommendation, but it’s now scheduled to go before the citizens as a referendum at the November 2008 election.

Policy, Practice, People of Justice Sanctions – Jane Klekamp, Justice Sanctions Director, introduced Timothy Palubicki, as recent participant of OWI Court.  Tim noted the benefits of the program.  He’s currently assisting others to complete the program and abstain from alcohol.  He noted the program as challenging but worthwhile.  He was very appreciative of the opportunity vs. serving jail time. 

Public Health Implications of Household Burn Barrels – Ron Berg showed a portion of video produced by WI DNR relating to burning barrels and open burning.  Highlights from the video:

• Outside burning causes the largest dioxin emissions

• Some burning is legal but not recommended.

• There is estimated 500,000 burning barrels in the State.

• Recycling is the law and that includes glass, plastic, cardboard

• Outdoor burning causes smoke which causes harmful particulates and gases in the air, hazardous ash waste, and sometimes causes wildfires.

Discussion followed.  Question asked why the State is not enforcing its own law?  General agreement that the key is to educate the public, including the town boards.  Some resistance is due to having to purchase trash bags or way of keeping trash from entering the landfill.  HHS Board direction to staff

includes: need copy of State law, copies of any known town or other county ordinances, and recommended ways of increasing public awareness and associated costs.    

POLICY ISSUES

Preferred Provider Solicitation Award Recommendation for Adolescents Sexual Offender Assessment and Treatment Services

MOTION by Hampson/Kannenberg to approve a contract with Family and Children’s Center as the Preferred Provider in providing sexual offender assessment and treatment services effective July 2, 2007 though December 31, 2007.  Noted $28,000 in 2207 budget for such services.  Chris Sander was available to answer questions.  Solicitation of preferred provider offers a choice of qualified providers as long as they agree to the same rate as the selected Preferred Provider.  Details of the solicitation:  RFP’s were sent to local vendors as well as those outside of the area, including publication in the Tribune and posted on the County website.  Three vendors submitted proposals which were evaluated by a team of staff.  Criteria and evaluation points given for:  (1) service methodology, (2) organization capabilities, (3) staff qualifications, (4) outcomes/documentation, (5) price, and (6) interviews with total of 825 as possible award points.  Summary of vendors and final points as follows:  Family & Children’s Center at 760.6, Center for Effective Living at 600.5, and Stein Counseling at 594.3.  Motion carried unanimously.

Preferred Provider Solicitation Award Recommendation for the Family Interaction Program

MOTION by Wood/Glasser to approve a contract with Path, Inc., as the Preferred Provider for providing all services relating to continuum of family interaction services using evidence-based research along with family/child-centered team approach, effective July 1, 2007 through December 31, 2007.  Noted $500,000 in the 2007 budget for these services.  Chris Sander and Joleen Trusonni were available to answer questions.  Noted same method of solicitation as previously mentioned and same preferred provider option of offering choice of qualified providers as long as they agree to the same rate as the selected Preferred Provider.  Criteria and evaluation points given for:  (1) program narrative and philosophy, (2) organization capabilities, (3) staff qualifications, (4) outcomes/documentation, (5) price, and (6) interviews.  Four vendors submitted price proposals per four levels of service:  (1) CHARM (child at risk monitoring program), (2) parent visitation monitoring program, (3) parent support workers, and (4) parent support worker advanced, including mileage.  Summary of vendor evaluation points as follows:  Path, Inc. at 171, Stein Counseling at 163, Coulee Youth Center at 75, and Lutheran Social Services at 75.  Motion carried unanimously.    

Request for Proposal Award Recommendation for Home Modification Specifications Professional

MOTION by Glasser/Schippers to approve the contract with Gemini Employee Leasing for securing a Home Modification Specifications Professional position, effective July 1, 2007 through December 31, 2007.  Pat Killeen was available to answer questions.  The contracted position will assist the CMO Care managers and their clients with determining specifications for home modification projects to meet the client’s needs.  RFP’s were sent to numerous vendors and posted in the La Crosse Tribune.  Only one vendor submitted a proposal, that being Gemini Employee Leasing.  Gemini is qualified per the following criteria:  (1) qualifications and references, (2) relevant experience, (3) experience and qualifications of key personnel, (4) vendor understanding and approach to providing services, (5) budget, completeness of information, (6) cost, and (7) interview.  Per hourly rate, part-time weekly hours, mileage reimbursement, and for six months of service, the cost is $4,295 for six months which will come from the CMO budget.  Motion carried unanimously.       

Daytime On-call Crisis Staff

This was noted as an informational item.  Bill Adams was available to answer questions.  Due to several internal staffing factors and increases in workload, it was determined to have a trained Crisis Responder, who normally works only during “off” hours, to work on an on-call basis two days per week (Mondays and Fridays); no change in compensation for off hour work as it’s currently $1.50/hour for being on-call; the additional expansion of service is estimated at $800/month but will be offset since regular staff will be enabled to schedule more direct service time, some of which may generate revenue.  The plan is to monitor cost, revenue and effectiveness for this on call service for the summer months and determine if the practice should continue and whether or not it should be expended as a way of providing Crisis Response 24/7.

2008 Budget Planning/Drivers

• Initial Reflections on the 2008 Budget related to Human Services – Jerry Huber reviewed noting trends, initiatives, and lack of funding that will impact the Human Services budget.  Some of those being:  (1) expansion of family care, (2) development of new IT software for the dept. , (3) effects of Carey Group report on Justice Sanctions and Clinical Services, (4) mental health and family & children mandates, and (5) JDF concerns.  
• Health Dept. – Doug Mormann noted about 38% of the Health Dept. funding comes from the tax levy.  He noted possible decreases in federal and state funding (grants), plus increases in postage and gasoline that affects the department’s operations.  Expect some increases in tobacco education funding.  Dental health and alcohol misuse prevention are community topics and may require funding.
• Budget Hearing for Human Services in June (suggested format) – Date of the budget hearing is July 10 at 5:00 p.m. – prior to start of the regular monthly meeting of the HHS Board.  General agreement by HHS members to invite the chairs and vice chairs of the various advisory committees to the budget hearing.  Also agreed to include Health Dept. in the budget hearing.

Juvenile Justice Update

• Explore Alternatives for Detention – Referred to a future meeting, if needed.
• Acute Protective Supervision Program - Wayde Anger, HS/JDF, and Bridget Todd, ATTIC Correctional Services, were present to answer questions regarding the 10-page report that was sent with the agenda.  Bridget noted this particular program is for youth who are adjudicated delinquent and are considered moderate/high risk for out-of-home care, correctional placements or unable to remain in placement within the County.  Wayde noted that when most were sentenced to corrections, they came back worse, so this program takes that place on a one-year basis and if that doesn’t work, then there is no other alternative except for corrections.  Some may stay a little longer than a year in order to get them through high school.  Nineteen were enrolled in the program in 2006 of which 16 exited the program.  Seven successfully completed the entire program with 7 ending up in alternate care placements; 3 were sent to corrections which included 1 that completed the program but had to serve for prior offense.
• Vision of the Future – Wayde noted gaps in services and some of the drivers for services.  Girls Circle is working but can only handle 8 at a time.  Truancy is an issue and need to figure out how to better serve the schools.  Gaps in services include:  (1) mental health (Cutters); currently seeing 15-20 youth; (2) prescription drugs is a major issue; they don’t seem to care what they take; more in demand that alcohol or marijuana; and (3) also cultural issues such as:  urban flight, “boys to men”, 4-5 Hmong gangs in La Crosse, trafficking of females.  Budget drivers are gangs, girls, and 17 year olds being moved into the juvenile justice system.

Carey Group Recommendation-Impact on Justice Sanctions and Clinical Services – Jerry said the Executive Summary is good but recommended review of the entire report.  The County Administrator has

indicated the Carey Report and recommendations will be separate discussions and not included in the Human Services budget.  To see the full Carey Report, please visit the County website:  http://www.co.la-crosse.wi.us/; then under Minutes / Agendas, then under the LEC Addition Committee. 

A Public Health Approach to Drinking and Related Consequences-Implications to Develop a Social Detox Assessment Center Model of Intervention

Pat Ruda and Rosemary Boesen were present, representing the Mayor’s Alcohol Task Force.  Jerry noted Human Services over the past few months has been planning strategies to implement a comprehensive model of continuum of AODA services and approaches to detoxification/assessment services.  The Health Dept. has also worked with community groups on planning for services that prevent alcohol misuse.  Per a study done by Harvard University, Dept. of Society, Human Development and Health, the researchers noted WI and City of La Crosse for its high incidence rates of high-risk alcohol consumption.  Human Services and Health would like to do more preventative measures and be less reactive.  The plan or recommendation is to issue an RFI to community agencies to develop a comprehensive continuum of intervention model for AODA related services including prevention, assessment, early intervention and brief counseling.  MOTION by Hampson/Glasser to approve the issuing of RFI to community agencies to develop a comprehensive continuum of intervention model for AODA related services including prevention, assessment, early intervention and brief counseling.  Motion carried unanimously.

RESOLUTIONS/ORDINANCES

Resolution re Retention of WIC Program within the Wisconsin Division of Health – MOTION by Schippers/Hampson to approve the resolution.  The resolution is asking the State to retain the administration of WIC Program within the Division of Health.  There’s been talk of moving it under Family & Children, but the feds have indicated no more funding if this occurs.  Motion carried unanimously.

ITEMS FOR FUTURE AGENDAS

• Update on Chumm (Coulee Council Harm Reduction and Use Monitoring Model)

At this time Senator Kapanke commended the work of the HHS Board and to keep up the good work! 

ADJOURNMENT

There being no further business, Committee Chair Johnson declared the meeting adjourned at 9:18 p.m.

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

Cheryl Stephen, Recorder