HEALTH AND HUMAN SERVICES BOARD
Tuesday, August 7, 2007
Administrative Center – Room 3220
6:30 p.m.
MEMBERS PRESENT: Tara Johnson, Dr. James Glasser, Loren Kannenberg, Brad Pfaff, Al Thompson, Sharon Hampson (arr @6:32), Jill Billings (arr @6:32)
MEMBERS EXCUSED: Margaret Wood
MEMBERS ABSENT: Patrick Schippers
GUESTS AND STAFF PRESENT: Doug Mormann, Jerry Huber, Dean Ruppert, Mary Ellen Paudler, John Synder, Jane Klekamp, Nancy Gardner, Jackie Newcomb, Melissa Gilbert, Doug Schoenfeld, Steve O’Malley, Nancy Wagner, Cheryl Stephen
CALL TO ORDER
Tara Johnson, Board Chair, called the meeting to order at 6:30 p.m.
ANNOUNCEMENTS
National Public Health Performance Standards Conference – Sharon Hampson noted that she attended the conference in June at Scottsdale, Arizona. Focus was on improving the performance standards for the states and local governments; purpose is to work toward accreditation for local health departments.
Input from Public Hearing on July 10, 2007 – Board Chair Johnson noted the procedure was different than previous years, that being the Chairs and Vice Chairs of advisory committees were personally invited. Noted more input was given by the agencies, but need to reach out to the consumer groups.
State Foster parent Recognition Month (September) – A Foster Parent Banquet is scheduled for September 20th at Drugan’s. If there are additional activities, Jerry will inform the board.
Joint Meeting of HHS Board and Aging & Long Term Care Committee at 5:00 p.m. on September 10th in HHS Auditorium (Meal Provided) – Board Chair Johnson noted this as the quarterly meeting scheduled from 5:00-6:00 p.m., following by 6:00 County Board meeting.
CONSENT AGENDA
MOTION by Hampson/Glasser to approve the following Consent Agenda items:
Minutes:
· Health and Human Services Board of 7/10/07
· Health and Human Services Board Public Hearing of 7/10/07
· Health and Human Services Labor/Management of 6/26/07
· Coulee Region Public Health Consortium of 7/11/07
· Criminal Justice Management Council of 7/18/07
· Criminal Justice Executive Committee of 6/27/07 and 7/11/07
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
· Health Dept. Quarterly Fiscal/Activity Report
· Human Services Quarterly Fiscal/Activity Report
· Health Dept. Quarterly Appendix D Report
· Human Services Quarterly Appendix D Report
Miscellaneous questions and comments on the above items.
· Doug Mormann noted an addition to the Health Dept. contracts, that being $99,458 from the American Legacy Foundation to provide tobacco and alcohol reduction services to an estimated 200 individuals effective July 1, 2007-June 30, 2008.
· The Restricted Reserve in CMO Summary of Revenue and Expenses is a state requirement, including the Solvency Fund. Jerry noted both well over the required funding.
· General agreement to contact the Holmen School District regarding the need for fluoride treatment program in their water systems.
· Doug also noted two handouts: (1) Copy of response letter to Board Chair Johnson from DHFS relating to the proposal of relocating the WIC Program; and (2) Health Dept. Fund Balance report of 12/31/06.
· Some discussion on $100,000 grant for the Health Dept. from EPA to be used toward lead education and screenings.
· Supervisor Billings offered to serve on the Alcohol Reduction Committee as a representative of the HHS Board.
· Supervisor Billings asked if Human Services could do similar Fiscal/Activity Report as the Health Dept. which shows current quarter, current YTD and prior year. Dean Ruppert said the Fiscal report was changed to projection format which is more accurate. Board Chair Johnson noted reporting format has changed periodically; it needs to be meaningful to the Board; she suggested further discussion at a future meeting to hear staff recommendations or perhaps discuss at a future Board Retreat.
Motion carried unanimously, including the additions as mentioned and distributed by Doug Mormann; Wood excused; Schippers absent.
PUBLIC COMMENT
None requested.
BOARD EDUCATION
Policy, Practice, People of Public Health Nursing – John Snyder, Public Health Nurse, gave an overview of what the Health Dept. provides for the employees, such as health screenings, including blood pressure, blood sugar and health at risk appraisals. In addition, they provide a monthly newsletter, hold Health Fairs, and exercise challenges. Just recently, the County added immediate family members to the flu clinics. And also received discounts from various fitness centers who offer discounts to County employees. Nancy Gardner, an Economic Support employee, was present and noted her participation in all of the County employee screenings and wellness events, and expressed appreciation for such services; in particular the blood pressure clinics have helped her monitor her blood pressure and along with her doctor’s recommendations, she has improved her overall health status.
Policy, Practice, People of Adult Foster Care – Jackie Newcomb, of CMO, introduced Kevin who is in the Adult Foster Care Program. Kevin had been in other foster care homes, but when he turned 18, he moved into adult foster care. He’s been in his current home for the past 1 ½ years and totally enjoys the family who also has other teenage children; he said that he is treated like a member of the family. He currently goes to Riverfront and also volunteers at nursing homes; after having some surgery, he hopes to find a job on his own. Jackie noted the County certifies Adult Family Homes for providing care for 1-2 people; those homes providing care for 3-4 must be licensed by the State. County staff makes every effort to coordinate a living environment that meets the needs of the consumer, respects the consumer’s right to choose and is cost effective; decision are based on resources available at the time the need is identified. At the present time, the County has 156 County certified and 10 State licensed Adult Foster Care homes serving a total of 218 foster adults.
Paperless Board Packet Update – Doug Schoenfeld, of IT Dept., was present on behalf of John Parshall who had another commitment. Doug reviewed a new version of having a paperless packet for the HHS Board. It would be provided via “Share Point” and when the meetings are held in conference room 3220, board members would view the documents using the overhead screen; or another option is to meet in the County Board room where there are individual computer workstations. After some discussion, it was determined that the only way to go paperless and to have an effective meeting, is to continue to meet in room 3220 but have available workstations or laptops for the board members. John said the plan is to go wireless in room 3220. Steve O’Malley said the computers for room 3220 are in the 2008 IT budget request which is not finalized yet and also not a priority for the 2008 budget process. After some discussion, board members concurred that a single screen for viewing documents during a meeting is not practicable and meeting in the County Board room is also not practicable; until computers are provided in room 3220, the board should continue with paper packets.
POLICY ISSUES
Request for Proposal Award Recommendation for Residential Program to Support People with Challenging Behaviors – MOTION by Hampson/Thompson to approve the recommendation of the evaluation team to contract with Riverfront, Inc., effective September 1, 2007, to develop and provide a Residential Program to support people with challenging behaviors. Discussion followed. The approved vendor would provide a large enough home to house at least 3 residents and provide care 24/7, 365 days/year; the home would be licensed by the State as a 3-4 Adult Foster Care home. Two vendors submitted proposals: Riverfront, Inc. and REM Wisconsin. An evaluation team scored points on each based on the following criteria: (1) qualifications, abilities, philosophy, (2) relevant experience specific to services in this program, (3) experience, qualifications and training of key personnel, (4) vendor’s understanding and approach to providing service, including detailed plan to minimize challenging behaviors and structured, individualized program description, (5) budget, completeness of information, (6) cost, and (7) interview. Evaluation scores were: Riverfront 528 and REM 523. There are also 8 conditions that Riverfront must meet. Board Chair Johnson expressed concern relating to the detailed conditions and asked why not included in the RFP specifications. Noted that Riverfront had not seen the conditions; they will be provided to them once the RFP is approved. Motion carried unanimously; Wood excused; Schippers absent.
State of Wisconsin Health insurance Initiative – The Governor and WI Senate both have proposed changes in health insurance for WI residents. The Senate proposal would eliminate the current practice of some employers paying the cost of health insurance as a benefit and replace this system with a payroll tax for all employers. The Senate plan could result in a reduction of the local county property tax. Per letter from the County Finance Director, he estimated net County savings under the Healthy WI Plan at $4 million+. The Board should decide on whether or not to study the potential benefits to the County to support a specific proposal for change in health insurance financing mechanisms with the intent of asking
the County Board to take a position on either the Governor or Senate health insurance proposals. After some discussion, it was determined that this issue belongs with the newly created Legislative Committee; to have them review and report back to the HHS Board.
RESOLUTIONS
Resolution re Aging & Disability Resource Center of Western Wisconsin Hiring of Necessary Staff – Melissa Gilbert reviewed the West Central Consortium (WCC) for long-term support and health care reform. She gave verbal presentation plus PowerPoint and related handouts. She noted the history of long-term care reform and for 2007-2009, the state budget proposal was to expand CMO services 62% within the state and extend ADRC services 75% within the state. Since receipt of a planning grant in February 2006, the WCC has been in the planning process and currently at 8 counties. There have been many large group meetings, including a retreat, and many workgroup meetings; and county boards have approved resolutions. Two ADRCs are planned for the WCC; Western Wisconsin located in La Crosse that would also serve Jackson, Monroe and Vernon and start in November; and West Central located in Trempealeau that would also serve Buffalo, Clark and Pepin with plan of opening in January 2008. The WCC/MCO will operate under authority of multi-county Long Term Care District – a new public entity that requires statutory authorization; counties will create the district, appoint representatives to the governing board, but not fiscally responsible for the district. The proposed start date is January 2008. Copy of the proposed WCC governance structure/organization chart was also distributed.
MOTION by Glasser/Kannenberg to approve the resolution as noted above. Dean Ruppert reviewed the need to hire the necessary staff for the Western Wisconsin ADRC with no impact on the County tax levy. Staff also guaranteed no disruption of current CMO services. Motion carried unanimously; Wood excused; Schippers absent.
Resolution re Authorization to Amend Care Management Organization 2007 Budget and Business Plan to Add Staff – MOTION by Kannenberg/Glasser to approve the resolution, including two corrections; in the last Whereas para., replace “a” with “is” and in the next para, it should be worded as NOW THEREFORE BE IT REVOLVED (not Be It Further Resolved). Mary Ellen Paudler was available to answer questions. Jerry noted the request for the two additional employees is for current operation and based on need - needed for the urgent care of the clients. Some discussion on current needs of CMO as well as the changeover to MCO by 2008. Motion carried unanimously; Wood excused; Schippers absent.
Resolution re Start-up Costs Associated with the Regional Expansion of Family Care – MOTION by Billings/Thompson to approve the resolution, including some revisions/additions as follows: in the 2nd Whereas para., delete “of its”; in NOW THEREFORE BE IT RESOLVED para., include wording “at an estimated cost of $240,901”; change the last para. to read as, BE IT FURTHER RESOLVED (not Further Be It Resolved); and in the Fiscal Note, delete “and is” and replace with “which is”. Lengthy discussion on who has the hiring authority and the hiring timeline. Noted the MCO Board will hire the Executive Director and the balance of the positions will be hired based on MCO Board direction. Dean noted all 13 positions are needed as part of the MCO infrastructure; all will be County employees until time of transition from CMO to MCO. Some discussion on the possibility of changes in the State budget that could affect the MCO. Staff reiterated the fact that decisions have to be made on assumptions; if wait on the final State budget, this could delay the January 2008 start date; it takes time to hire employees and need to start the process now. Motion carried unanimously; Wood excused; Schippers absent.
Resolution re Safe Routes to School Funding Acceptance and New Position Approval – MOTION by Hampson/Billings to approve the resolution, including 2 revisions; in 3rd Whereas para., remove “5” referring to the number of school districts; in the BE IT FURTHER RESOLVED para., remove the word “until”. Motion carried unanimously; Wood excused; Schippers absent.
ITEMS FOR FUTURE AGENDAS
ADDITIONAL HANDOUTS:
ADJOURNMENT
There being no further business, Board Chair Johnson declared the meeting adjourned at 9:19 p.m.
Disclaimer: The above minutes may be approved, amended or corrected at the next committee meeting.
Cheryl Stephen, Recorder