HEALTH AND HUMAN SERVICES BOARD
Tuesday, July 10, 2007
Administrative Center – Room 3220
6:30 p.m.
MEMBERS PRESENT: Tara Johnson, Jill Billings, Loren Kannenberg, Brad Pfaff, Patrick Schippers, Al Thompson, Margaret Wood (exc/arr @7:52)
MEMBERS EXCUSED: Dr. James Glasser, Sharon Hampson
MEMBERS ABSENT: None
GUESTS AND STAFF PRESENT: Doug Mormann, Jerry Huber, Steve O’Malley, Dean Ruppert, Pat Killeen, Donna Gunnarson, Laura Gambino, Carol Kaiser, Paul Brown, Cheryl Stephen
CALL TO ORDER
Tara Johnson, Board Chair, called the meeting to order at 6:33 p.m.
ANNOUNCEMENTS
National Public Health Performance Standards Conference – Referred to future meeting due to excused absence of Sharon Hampson.
CONSENT AGENDA
MOTION by Schippers/Kannenberg to approve the following Consent Agenda items:
Minutes:
· Health and Human Services Board of 6/12/07
· Coulee Region Public Health Consortium of 6/6/07
· Dental Care Advocacy Coalition of 6/4/07 and 6/25/07
· Criminal Justice Management Council of 5/30/07 and 6/20/07
· Care Management Organization Advisory Committee of 6/12/07
· Long Term Care Council of 6/1/07
· Family Policy Board Governing Council of 6/14/07
· Family Policy Board Management Council of 6/21/07
· W-2 Community Steering Committee of 5/31/07
· Consumer Advisory Council of 6/14/07
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
Under the Health Director’s Report, Doug Mormann added that the Health Dept.-Health Education section was subcontracted by the Medical Health Science Consortium two days a week devoted to alcohol prevention efforts and community organizing of activities. Supervisor Pfaff questioned if fluoridation is offered at Sand Lake Coulee Elementary School. Doug noted the answer will be known by the August HHS Board meeting. Motion carried unanimously; Glasser, Hampson, Wood excused.
PUBLIC COMMENT
None requested.
BOARD EDUCATION
Policy, Practice, People of Public Health Nursing (Living Well with Chronic Condition Program) – Laura Gambino, Public Health Nursing Supervisor, introduced Carol Kaiser who had participated in the Living Well with Chronic Disease Program. Laura noted the Health Dept. received 4 grants (3 from the state and 1 locally). Currently 60 participants in self-management workshops designed to help people with: (1) achieve short and long terms goals of using action plans, (2) fight fatigue, (3) choose an appropriate exercise plan, (4), improve eating practices, (5) deal with depression, (6) lessen side effects from medications, and (7) get the most out of your doctor. Workshops are for 6 consecutive weeks in which each group meets 2.5 hours/week. Ms. Kaiser noted that even though her group had finished their workshop session, they continue to meet on a monthly basis. She expressed appreciation for being involved in the program.
Mid-Year Assessment of Transition of Community Support Program (CSP) - Paul Brown, of Family and Children’s Center, reviewed the transition of sixty six (66) community support program consumers that were at Riverfront last year. The transition occurred on January 2, 2007, and as of to-date, there have been no complaints; only one client wanted to retain the same schedule which occurred. Currently seventy (70) in the program; based on budget and adequate personnel and training, can now accommodate eighty (80). Mr. Brown noted conveniences of their location; have two bus stops on same block; the “payee area” is less formal and more private area; staff and consumers have ready access to the nurse and medications; and the RAVE Drop Inn Center is a short walk from the Family and Children’s Center which seems to be getting more visitors.
Policy, Practice, People of Adult Protective Services and Court Intervention -
Donna Gunnarson, of Clinical Services/Adult Protective Services, Court & Intervention Unit, gave an overview of their policies and practices. Four employees (2 Social Workers, 1 Social Service Specialist, 1 receptionist) are responsible for the court processes related to Chapter 51 (emergency mental health detentions and mental health recommitments), Chapter 54 (guardianships), and Chapter 55 (protective placements). They review and investigate all cases under their jurisdiction, including elder abuse and alcohol commitments. They also provide an intake function dealing with emergency situations that have specific timeframes per state statutes and work closely with law enforcement, medical centers, Crisis Program, Resource Center, CMO, and CCS/CSP Programs. She noted the amount of required paperwork and workload; currently about 30 guardianships on a waiting list, though in emergency situations these become priority. Concern relayed by Board Chair Johnson regarding the waiting list situation; she suggested discussions by the HHS Board at future meeting(s).
Update on Coulee Council Harm Reduction and Use Monitoring Model (CHUMM) and Female Alternatives for Detoxification and Substance Abuse Services – Donna Gunnarson gave an update on CHUMM, including background, philosophy, purpose, program description, client populations/needs/outcomes, and female alternatives. In 2003, the Coulee Council on Addictions funded a half-time position to provide case management plus additional funding to address client needs. CHUMM is an outreach and case management program which specializes in persons who repeatedly over-utilize medical detoxification services. CHUMM’s philosophy is “compassionate pragmatism” – an acceptance that some people will continue to use drugs/alcohol abusively and are either unwilling or unable to complete abstain at a given point in time. Harm reduction seeks to protect the user and the community from the worst consequences of continued substance abuse. The County, in partnership with Coulee Council on Additions, identify six (6) consumers. Each are evaluated as to needed services, such
Page 3 – HHS Board Minutes of July 10, 2007
as counseling and assistance with basic survival needs such as food, shelter and clothing; plus job-seeking or readiness skills, transportation, personal hygiene and recreational services. Clients may earn incentive funds for meeting desired program outcomes and for providing staff with outcome data. It became apparent that many detox admissions for chronic users of detox were the result of not having housing and were seeking hospitalization as temporary solution; this population is largely male. To address this need, the CHUMM program maintained an apartment where identified consumers can stay as long as they abided by the rules. Because of less demand, there is no CHUMM apartment for women, but they can receive all other CHUMM harm reduction services. Statistics for 2006 re CHUMM services: average 2.58 women per month as compared to 7.42 men per month.
Board Orientation Manual Updates (handouts) – Doug Mormann distributed a couple of handouts for HHS Board members to insert into their manuals. Supervisor Schippers noted a change to his email address.
POLICY ISSUES
The Integration of Physical Health, Mental Health, and Substance Abuse Joint Statement – Doug Mormann reviewed, noting in recent months public forums and listening sessions at regional meetings of the WI Assoc. of Local Health Departments and Boards of Health, in which mental health was identified as top priority concern for Wisconsin children and families. Based on this, the WI Maternal and Child Health Program Advisory Committee, with the support of DHFS, developed a statement serving as foundation for collaboration in integrating physical health, mental health and substance abuse. Doug asked for endorsement of the statement as well as to identify one or more activities that the HHS Board and both departments can undertake to help accomplish the integration goal. The “Joint Statement-Partner Endorsement:: We aspire to become a society that optimizes the mental, physical, social, emotional, and spiritual health of all persons. Prevention, screening, intervention, and treatment will be person and family-centered, accessible, and appropriate to the culture and language of the individuals. These principles build resiliency, facilitate recovery, and eliminate stigma.”
Discussion followed. Board Chair Johnson suggested staff bring back activity suggestions. Loren Kannenberg thought the HHS Board should initiate some suggestions. Supervisor Billings suggested the Alliance for Mentally Ill be involved; she views it as more community-wide initiative. MOTION by Kannenberg/Billings to endorse the Joint Statement as stated above. Motion carried unanimously; Glasser, Hampson, Wood excused. MOTION by Schippers/Thompson to have staff come up with activity recommendations by the November HHS Board meeting. Motion carried unanimously.
County Burial Fund Balance – Jerry Huber reviewed, noting greater demand for these funds. For 2007, $14,565 was budgeted; in previous years, this had been around $10,000. As of June 14, 2007, the department has already expended $14,042. Noted that the HHS Board has supported the funding for General Relief burials in which the department has established policies and procedures, those being: (1) individuals not covered by Medicaid whose available resources are insufficient to cover their funeral and cemetery expense can be determined eligible to receive county assistance; (2) if the funeral expense does not exceed $1,000, the County will reimburse up to that amount; and (3) if the cemetery expense does not exceed $1,000, the County will reimburse up to that amount. It is anticipated that the Human Services Dept. will seek funds in other accounts in order to do an account transfer at year end. Informational.
District Court Decision re Wisconsin Works (W2) Program – Jerry reviewed, noting a recent WI Appeals Court ruling that participants in the W2 Program who are ready to enter the workforce, but can-
Page 4 – HHS Board Minutes of July 10, 2007
not find jobs, must receive state assistance. A judge noted in his dissent that the ruling could result in WI becoming a “welfare magnet” for those in other states with employment skills but no jobs. DWD noted that W2 is a jobs program and not welfare or unemployment insurance. It is anticipated that the State will appeal the court decision. In addition to this, Jerry noted that DWD recently contacted Human Services noting a $7 million shortfall in W2 and emergency assistance budget, and requested a de-obligation to its W2 contract in amount of $255,761. DWD has contacted four other counties with same request. Jerry noted this de-obligation should not impact the County budget, but is frustrated with DWD in not honoring their contract.
Letters of Support for Four-County Aging & Disability Resource Center
Board Chair Johnson noted Loren Kannenberg as being instrumental in assisting the four counties in developing the model for the ADRC. In the HHS Board packet of information, there was a draft copy of a letter to Janice Smith of DHFS, Division of Long Term Care, whereby the HHS Board is requesting DHFS to approve the ADRC-WW application for funds to serve Jackson, La Crosse, Monroe and Vernon counties. MOTION by Kannenberg/Pfaff to approve sending the letter of support. Motion carried unanimously; Glasser, Hampson excused.
RESOLUTIONS
Resolution re Authorization to Amend Care Management Organization 2007 Budget and Business Plan to Add Staff
Jerry reviewed the need for additional staff for CMO based on growth. He also noted all costs for the additional staff will be paid out of the State per member per month capitation rate and no tax levy required. Pat Killeen reviewed in more detail the need for the additional staff, noting for every 40 clients, need one (1) Social Worker and for every eighty (80) clients need one (1) Nurse. MOTION by Kannenberg/Schippers to approve the resolution. Lengthy discussion followed. Jerry noted within the next few months, resolutions will come forth pertaining to the transition of CMO to the new regional Management Care Organization; currently a consortium of 8 counties and it could go up to 11 counties due to other interest. Dean Ruppert reviewed the staffing for the MCO. Supervisor Pfaff suggested continual education to the full County Board on this transition. Regarding the extra Nurse position in this resolution, Pat noted per State requirement, a Nurse is required to do recertification and sometimes midyear year screening based on changes; the ADRC is required to do the initial screening. For the MCO, this Nurse will be the Lead Screen Nurse as well as train other staff in doing the same. For over a year, this position has been a requirement of the State; the County had not fulfilled this obligation until now; so once hired, the County will be in compliance effective November. Board Chair Johnson expressed concern that the 2nd Nurse position should have been a part of the upcoming MCO organization. Pat reiterated again that the position should have been onboard earlier and does not consider it as part of the new MCO. Motion carried unanimously; Glasser, Hampson excused.
ITEMS FOR FUTURE AGENDAS
ADJOURNMENT
There being no further business, Board Chair Johnson declared the meeting adjourned at 8:33 p.m.
Disclaimer: The above minutes may be approved, amended or corrected at the next committee meeting.
Cheryl Stephen, Recorder