HEALTH AND HUMAN SERVICES BOARD

HEALTH AND HUMAN SERVICES BOARD

Tuesday, September 11, 2007

Administrative Center – Room 3220

6:30 p.m.

MEMBERS PRESENT: Tara Johnson, Dr. James Glasser, Jill Billings (arr @6:35), Margaret Wood (arr @6:35), Brad Pfaff (arr @6:39), Loren Kannenberg (arr @6:45)

MEMBERS EXCUSED: Sharon Hampson, Patrick Schippers, Al Thompson

MEMBERS ABSENT: None

GUESTS AND STAFF PRESENT: Doug Mormann, Jerry Huber, Dean Ruppert, Patrick Killeen, Mary Ellen Prinsen, Jane Klekamp, Melissa Gilbert, Doug Schoenfeld, Robert Olson, Bryan Jostad, Emily Mlsna, Kenji Hamamoto, Fran Cordes, Cathy Buckley, Connie Muth, Va Thao, Maomoua Vue, Linda Lee, Keith Keller, Jean Dickey, Suanne Kraft, Mike Heal, Steve O’Malley, Cheryl Stephen

CALL TO ORDER

Tara Johnson, Board Chair, called the meeting to order at 6:39 p.m. (Waited until quorum present.)

CONSENT AGENDA

MOTION by Glasser/Billings to approve the following Consent Agenda items:

Minutes:

· Health and Human Services Board of 8/7/07

· Health and Human Services Labor/Management of 7/31/07

· Coulee Region Public Health Consortium of 8/1/07

· Dental Care Advocacy Committee of 7/30/07

· Aging & Disability Resource Center Advisory Committee of 8/16/07

· Long Term Care Council of 8/3/07

· Joint Meeting of Family Policy Board / Governing & Management Councils of 8/16/07

· Criminal Justice Management Council of 8/15/07

· Criminal Justice Management Council Executive Committee of 8/22/07

Fiscal:

· 2007 Summary of Contract Approvals

· 2008 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

Miscellaneous questions, comments, and some clarification on some of the above items. Committee Chair Johnson requested a correction to the HHS Board minutes of August 7, 2007, per request of Pat Schippers; he should have been excused (not absent) as he had called an office, but apparently his message did not relayed to the appropriate person(s).

At this time, Committee Chair Johnson thanked all La Crosse County staff who responded to the flooding incident that occurred on August 18-19, and who continue to provide flood related services. Affected constituents in her district have expressed their appreciation.

Motion carried unanimously; Hampson, Schippers, Thompson excused

PUBLIC COMMENT

Steve O’Malley distributed a public service announcement regarding an upcoming event at the Onalaska OmniCenter on October 10^th from 7:00-9:00 p.m. The Wisconsin Way organization is orchestrating public gatherings around the State to engage citizens in constructive, solution-oriented conversation about what they can do to make Wisconsin taxes fairer and reduce the property tax burden without sacrificing the quality of public services that makes Wisconsin a special place to live and work. These gatherings are planned for 12 sites around the State with hope of bringing in 300 citizens at each one. He encouraged attendance.

BOARD EDUCATION

Paperless Board Packet Update – Doug Schoenfeld, IT Dept., noted going paperless is not feasible at this time, but board members, including administration and staff, can utilize Share Point website to access the HHS Board packets via remote connection. Paper packets will be sent also. Instructions were available; anyone needing assistance may call the IT Help Desk at 785-9601 between normal business hours.

Policy, Practice, People of Nutrition Division-FIT WIC Families Program – Linda Lee, WIC Manager, introduced Maomoua Vue, Nutritionist, and Va Thao, FIT Families Program participant. Linda noted that children ages 1-5 who are enrolled in the WIC Programs as being overweight and obesite – almost half of them. La Crosse County pilot tested the FIT Families Program starting early 2007. The program encourages healthy eating for the entire family, but in particular for children. Thirty Hmong families were recruited during WIC certification. Each month for six months, FIT Family Program participants contacted a counselor with follow up on their goals, offering suggestions, etc. Incentives were given to families who kept their appointments; those incentives included gift cards for fruits and vegetables at Festival or gift card at Rogan’s. Va Thao, as a program participant, noted the benefit of the program for her family.

Policy, Practice, People of Child Foster Care – Noted that September is Wisconsin Foster Care Recognition Month. Keith Keller, Family & Children Section, introduced 3 foster parents: Jean Dickey, Suanne Kraft & Mike Heal. Keith noted that foster children are more challenging (emotionally and behaviorally) as compared to 5-10 years ago. He did point out that 90-95% foster parents are adopting special needs children; statewide this is about 85%. Jean Dickey gave an overview of her challenges as a foster parent; thus far she has had 58 in her home and has adopted 2. She said the experience is very rewarding; La Crosse County has the best foster care system. Suanne Kraft and Mile Heal (husband/wife) also gave an overview of their foster parenting challenges; thus far they have had 15 in their home with 1 being returned to bio-parent. Discussion on why children have more challenging behavior. Noted reasons could be drug usage by parents before birth, plus abuse and neglect. Committee Chair Johnson commended and thanked them on behalf of La Crosse County for their willingness and dedication in being a foster parent.

Board Representation on Wisconsin County Human Services Association (WCHSA) – Jerry, who is past President of WCHSA, said the organization is looking for membership from county boards. Per their by-laws, the membership should be 50% directors and 50% county board members. Meetings are monthly at Stevens Point. If interested, contact Jerry.

POLICY ISSUES

Clinical Services Pharmacy Provider Request for Proposal (RFP) Recommendation – MOTION by Glasser/Wood to approve Pinnacle/Omnicare as the pharmacy provider for Clinical Services, based on evaluation scores and the evaluation team recommendation, for the period of October 17, 2007 to May 20, 2012. Discussion followed. Bryan Jostad noted three vendors submitted proposals. An evaluation team of 5 staff evaluated each proposal based on qualifications (35%) approach to service/scope of work (55%), and cost (10%). Vendors and individual scores as follows: Pinnacle/Omnicare 662, Phillips Pharmacy 637, and Health-One 569. Motion carried unanimously; Hampson, Schippers, Thompson excused.

Family Care Update – Jerry Huber, Dean Ruppert, and Melissa Gilbert gave an update on the 8-county Long Term Health Care Reform / Family Care District. Four additional handouts were distributed:

Letter from Judith Frye, Director of Office of Family Care Expansion, dated September 6, 2007, re MCO notified of intent to award contracts.
Letter from Judith Frye, dated September 7, 2007, noting insufficient information in the RFP as submitted by the West Central Consortium; some missing information relating to financials, including a plan for managing risk related to enrollment and capitation fluctuation, plus a business plan for staffing assumptions, strengths and gaps of the existing CMO and ongoing areas of expertise to be assumed by MCO.
Letter from Kevin Hayden, Secretary of DHFS, re proposed plan for reducing Medicaid expenditures to preserve the integrity of the state’s budget.
West Central Consortium Informational Paper dated August 29, 2007.

Jerry noted a delay in implementation due to hold up with the State budget as well as State requesting additional information as noted above in #2. Still need to move forward with the planning until the State budget passes.

Family District Implementation Council – In order to move forward, the West Central Consortium (WCC) would like to develop a Family Care District Implementation Council; their function would serve as the “bridge” for the development of the Family Care District Governing Board which cannot be established until after the State budget is approved. The council would provide direction to the consortium, the CMO and the development of the MCO; also assist with the planning and staffing for start-up functions as well as develop new collective bargaining contracts for staff converting over to MCO.

The WCC has also discussed the potential of bringing on an Interim Director of the new MCO. Jerry relayed some concerns regarding this – who would pay for the position and the resolution that was approved last month approved the hiring of the new CEO of the MCO and not an interim director. In lieu of an Interim Director, Jerry proposed a “Transition Committee” made up of Dean Ruppert, Pat Killeen, Mary Ellen Paudler, himself, Melissa Gilbert and 2 reps from other counties. Purpose of this group is to meet weekly, have assigned tasks to carry out for transition and report back to the Steering Committee. The WCC agrees with the concerns and have agreed to move forward with an interim governing council. County staff asked for approval of the development of the Family Care District Implementation Council and also requested one (1) County Board Member to serve on the Council.

Lengthy discussion followed, in particular relating to the Family Care District Implementation Council membership. MOTION by Wood/Glasser to approve the development of the Family Care District Implementation Council as presented. More discussion on the membership make up of the Council. Total membership is 14. One being a County Board Member from each of the eight (8) counties – no issues with this. The next four (4) members would be consumers, their families or advocates. Several HHS Board members raised concerns with this makeup. Most felt that being La Crosse County has over half of the total client population of the 8 counties that at least 2 of these should be from La Crosse County, including one (1) with business background and expertise. The remaining two (2) members will have knowledge and expertise in managed care business operations – no issues with this. Noted that TMG, as the hired consultant firm, had prepared the membership makeup. Some HHS members expressed dissatisfaction regarding TMG’s recommended makeup of the Council, in particular when they know La Crosse County has more than half of the clients and has more at risk. Suggestion that membership be proportionate to population served plus large provider network. Supervisor Billings said La Crosse County should have at leave 4 of the 14 members. Melissa said the WCC was “sold” on even partners; it needs to be more publicly driven model. Discussion on staff time involved and if this can be charged back to CMO. MOTION WITHDRAWN by Wood/Glasser.

MOTION by Pfaff/Billings to refer for 30 days the development of a Family Care District Implementation Council based on the following: categories 2 and 3 of the council representation should reflect consumers, providers and experts who have experience and knowledge about long term care, plus a response to Judith Frye’s letter of September 6, 2007, and also want to know from the steering committee what the specific plans are to successfully fulfill the requirements as outlined in the letter and what that timeline is. Motion carried unanimously; Hampson, Schippers, Thompson excused.

Internal Budget Preparations for 2008:

Health – Doug Mormann and Steve O’Malley noted the following key factors:

Federal and State budgets not passed so this may impact public health services; the budget was prepared with assumption no change in funding, except for emergency preparedness planning which reduced funding was known.
Two dental hygienists were eliminated from the budget but seeking grants or other funding sources which may overturn this decision.
Home Health services have increased due to CMO clients; staff is reviewing reimbursement for these services.

Human Services – Jerry and Steve O’Malley noted the following key factors:

Additional Justice Sanction’s staff per recommendation of the Carey Report; looking at funding options.
No change in Juvenile Detention but considering an NIC or Carey Group study/analysis that may be funded by an OJA grant or other sources.
Increase demand for services relating to behavioral and clinical; some are waiting 6-9 months for assistance. Looking at additional psychiatry services.

Steve distributed copies of 2008 budget information to HHS Board citizen members – same information as was distributed to County Board Members on Monday night. He is recommending the use of Human Services fund balance to cover a portion of the 2008 budget expenditures. Next month, the HHS Board will be review the 2008 Health Dept. and Human Services budgets in more detail, as needed.

RESOLUTIONS

Resolution re Support State Funding of Communicable Disease Mandates for Local Health Departments – MOTION by Billings/Kannenberg to approve the resolution which requests the State of Wisconsin to provide ongoing funding to counties to carry out the duties and responsibilities of local health departments for communicable disease prevention and control that are mandated under Chapter 252 of the Wisconsin Statutes. Motion carried unanimously; Hampson, Schippers, Thompson excused.

OCTOBER HHS BOARD MEETING

By general agreement, determined to start the meeting at 6:00 p.m. and not include any Board Education items on the agenda. More time will be spent on 2008 budget overview.

ITEMS FOR FUTURE AGENDAS

Update on female inmate programs.

Update on use of meth in the County/community.

ADJOURNMENT

There being no further business, Board Chair Johnson declared the meeting adjourned at 9:13 p.m.

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

Cheryl Stephen, Recorder