HEALTH AND HUMAN SERVICES BOARD

Tuesday, January 8, 2008

Administrative Center – Room 3220

6:30 p.m.

MEMBERS PRESENT:  Tara Johnson, Margaret Wood, Sharon Hampson, Jill Billings, Brad Pfaff, Loren Kannenberg (arr @6:42)     

MEMBERS EXCUSED:  Al Thompson

MEMBERS ABSENT:  Dr. James Glasser, Patrick Schippers   

GUESTS AND STAFF PRESENT:  Jerry Huber, Doug Mormann, Dean Ruppert, Patrick Killeen, Jane Klekamp, Maryellen Paudler, Lori Mueller, Bill Adams, Steve O’Malley, 3 Central H.S. students, Cheryl Stephen, and

Special Guests:  Secretary Kevin Hayden and Deputy Secretary Karen Timberlake, Dept. of Health & Family Services, and Sinikka Santala, Administrator of Division of Disability and Elder Services    

CALL TO ORDER

Tara Johnson, HHS Board Chair, called the meeting to order at 6:35 p.m.   

ANNOUNCEMENTS

2008 Meeting Dates – An informational sheet that showed HHS Board regular monthly meetings for 2008 was included with the agenda packet.

HHS Board was invited to a presentation on Family Care – Presentation by Secretary Kevin Hayden, Deputy Secretary Karen Timberlake, and Administrator Sinikka Santala, at a meeting of the West Central Consortium Subcommittee and Implementation Council at 5:00 p.m., January 8^th in B190 Auditorium of the Administrative Center

PUBLIC COMMENT

None requested.

BOARD EDUCATION

Kevin Hayden, Secretary of the Dept. of Health & Family Services, Karen Timberlake, Deputy Secretary, and Sinikka Santala, Administrator of Division of Disability and Elder Services / Presentation on Family Care Expansion and Dental Care Initiatives - Secretary Hayden gave an overview of the following:

Badger Care Plus – Once in place, all children can be covered; consolidation will be more efficient; using other agencies and community partners for access; also looking at coverage for 71,000 childless adults who currently do not have access to insurance in 2009; close to having almost everyone covered.

Family Care Expansion – It’s been a challenge for La Crosse County; need to realize that the County is no longer the provider but that there is another entity taking over; there are issues of governance, risk, etc.; Wisconsin will be national leader in long term care; working on getting modifications to State statutes; counties need to have trust with all having the same goal; the State is also a partner and will assist with the infrastructure.

Dental Care Initiatives – A top priority is oral access; lack of dental care coincides with lower income families; there is need for education as well as need for cultural change.  Hope to have more innovative pilot programs.

HHS Board members and staff asked questions or raised the following concerns:

• Supervisor Pfaff expressed concern of local health care costs – being highest in the nation.  Sec. Hayden noted excellent services by the local providers; each Medicaid child should have health risk assessment done; families need to change behavior/life styles; need to move toward evidence based practices.
• Supervisor Hampson expressed concern with lack of insurance coverage for prevention-type services.  Sec. Hayden noted the consumers need to get involved and the employers can also assist.
• Supervisor Hampson questioned patchwork of MCO’s around the State.  Sec. Hayden  noted it as work in progress; currently 27 counties developing long term care MCO’s; other counties will look at local innovations; goal is to give consumers the same experience.
• Supervisor Billings & L. Kannenberg expressed concern with consolidation, which is usually done to save dollars, and that consumers may lose quality services; will La Crosse County consumers receive the same quality services?  Sec. Hayden noted pilot program results showed better service at less cost; outcome and consumer experience will be end result; managed long term care is better care.
• Supervisor Wood expressed concern with Scenic Bluffs located at Cashton, noting difficult for patients of this area to get there, etc.; why not increase the Medicaid reimbursement for the local dentists?  Sec. Hayden said the legislature has addressed this; the State is looking at other states’ models; giving the dentist more money is not the solution – it’s a delivery system issue.  Board Chair Johnson also noted since August and due to results of the Dental Coalition, PA’s and nurses are now trained to apply sealants.  Sec. Hayden noted the need to reach out to Pediatricians and early prevention.
• Doug Mormann asked if a dental care pilot could be done as was done for family care around the State.  Sec. Hayden noted during the second quarter of this year, they will be open to discuss such ideas; looking at other state models; he noted delivery strategies as a concern; plus the need for prevention and education.
• Steve O’Malley noted due to increase in health insurance for employers, this is having a major impact on County budgets.

Board Chair Johnson thanked Secretary Hayden, Deputy Secretary Karen Timberlake, and Administrator Sinikka Santala for taking time out of their busy schedule to travel to La Crosse, and she welcomed them back for a revisit.

POLICY ISSUES

Preferred Provider Recommendation for Supportive Home Care – MOTION by Pfaff/Kannenberg to approve the recommendation of the evaluation team to contract with Gemini Employee Leasing as the Supportive Home Care Preferred Provider for CMO at a rate of $14.50/hour, effective January 1, 2008 through December 31, 2008.  Discussion followed.  Per the information sent with the agenda packet, the objective of preferred provider solicitation is to choose a vendor who will set the rate for Supportive Home Care Services and be the CMO preferred provider for supportive home care services.  In the preferred provider purchasing option, service recipients are given a choice of all qualified providers of services including similar or lower rate; CMO cannot limit the pool of qualified providers by offering an exclusive agency contract.   Two proposals were received and a review team evaluated each based on 1) agency qualifications, 2) organization capabilities, 3) staff qualifications, 4) evaluation and documentation methods, and 5) budget and cost information.  Evaluation points of each:  512 for Gemini Employee Leasing and 377 for Comfort Keepers that had hourly rate of $14.40.  Noted Comfort Keepers is a new vendor to the area and maybe that affected their lower score; general agreement by HHS Board members to have Jerry include the scoring detail/difference in his February report.  Motion carried unanimously; Thompson excused; Glasser, Schippers absent.   

Menu of Options for the HHS Board to Implement the Joint Statement on Integration of Physical Health, Mental Health and Substance Abuse – Doug Mormann reviewed.  In September 2007, the HHS approved a joint statement on the integration of physical health, mental health and substance abuse.  The statement is part of an initiative of the WI Assoc. of Local Health Depts. and Boards and the WI DHFS to improve the quality of health and life for WI residents.  HHS Board gave staff direction to prepare policy options for consideration; 11 options were sent with the agenda.  After discussion and review, HHS Board had general agreement on the following:

• HHS Board Priority

ü       #2 – Set aside La Crosse County tax levy as part of the 2009 budget to be used to improve existing La Crosse County services for mental health, substance abuse and substance abuse services.

• Forward to the Legislative Committee

ü       #1 – Support a resolution that would encourage the State of Wisconsin to increase the tax on   alcohol with funds to be used to improve substance abuse prevention and treatment services in the state.

ü       #11 – Advocate for proactive state and federal legislation that reduces the stigma associated with mental health and substance treatment needs and promotes accessibility and affordability of services.

·         Direct staff to bring back detailed policy direction

ü       #4 – HHS Board hold educational sessions for the public on current mental health and            substance abuse prevention and treatment services available in the community.

ü       #8 – Encouraging a policy that public and private health care providers routinely screen for mental health and substance abuse needs in individual clients as part of their normal intake process.

ü       #10 – Communicate with institutions of higher learning regarding the specific amount of unmet professional need there is in La Crosse County for mental health, substance abuse prevention and treatment services.

• Delay or incorporate into other options

ü       #5 – Delay action on a policy initiative in substance abuse until the recommendations of the “Changing the Culture of Risky Drinking Behavior” study are available in September 2008.

ü       #6 – Delay action on making a policy recommendation on mental health or substance abuse policies until the COMPASS 3.0 community needs assessment and community priority setting process are completed in March 2008.

• No action needed on #3, #7 or #9.

CONSENT AGENDA

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

Minutes:

·         Health & Human Services Board of 12/11/07 and 12/20/07

·         La Crosse County Labor/Management of 11/28/07 and 12/18/07

·         CMO Advisory Committee of 12/11/07

·         W-2 Steering Committee of 11/27/07

Page 4 – HHS Board Minutes of January 8, 2008

·         West Central Consortium Steering Subcommittee of 11/28/07

·         West Central Consortium Implementation Council of 11/28/07

Fiscal:

·         2007 Summary of Contract Approvals

·         2008 Summary of Contract Approvals

·         2008 Contracts not yet Settled

·         Vendor Audit Policy Update

·         2008 Vendor Contracts Exceeding 2% Increase in Rate

·         Care Management Organization Summary of Revenue and Expenses

Department/Board Reports:

·         Health Director’s Written Report

·         Human Services Director’s Written Report

·         Board Performance Evaluation Summary

·         Update of 2008 Work Plan for HHS Board

Miscellaneous questions, comments, and some clarification on some of the above items.

• Supervisor Hampson questioned the contract with O’Brien Investigation; Lori Mueller said it’s for fraud investigation or anything questionable in Economic Support.
• Supervisor Billings questioned the number of unsettled contracts for CMO; Pat Killeen noted over 200 contracts for CMO, he did not see this as unusual; he noted 2 have since settled with a 3^rd being very close; Maryellen Paudler also noted late notification as well as reduced rate from the State that delayed contract preparation.  HHS Board will receive an updated report in February.
• Doug noted in his written monthly report, there is a section on onsite waste enforcement activities by the Health Dept. that relates to the new state law.  He noted in October, 152 citation notices were sent; they indicated additional 6 weeks given in order to pump their septic tanks; after the deadline, 45 citations were recorded by the courts.  Supervisor Hampson noted it as an impressive report.    
• Also in Doug’s monthly written report, he provided information on soup kitchen regulations, including a copy of pamphlet “La Crosse Area Food and Nutrition Resources”.  Is this adequate information or would the HHS Board like additional? 

Motion carried unanimously; Thompson excused; Glasser, Schippers absent.

ADDITIONAL HANDOUTS AT THE MEETING

• Notes – Human Services Management Retreat of December 3, 2007

ITEMS FOR FUTURE AGENDAS

• More information on well testing, etc.
• Report card on restaurants
• Effectiveness of Girls Circle 

ADJOURNMENT

There being no further business, Board Chair Johnson declared the meeting adjourned at 8:07 p.m.

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

Cheryl Stephen, Recorder