Tuesday, February 12, 2008

Administrative Center – Room 3220

6:30 p.m.

MEMBERS PRESENT: Tara Johnson, Margaret Wood, Sharon Hampson, Jill Billings, Brad Pfaff, Loren Kannenberg, Dr. James Glasser

MEMBERS EXCUSED: Al Thompson

MEMBERS ABSENT: Patrick Schippers

GUESTS AND STAFF PRESENT: Jerry Huber, Doug Mormann, Dean Ruppert, Maryellen Paudler, Jane Klekamp, Steve O’Malley, Sara Koopman, Mary Ellen Prinsen, Linda Lee, Lorie Mueller, Bill Adams, Melissa Gilbert, Carol Schilling, Becky Paggi, Cindy Gile, Margaret Larson, John Burgess, Tim Garrity, John Smalley, Bill Soper, Cheryl Stephen

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

Joint meeting of Health & Human Services Board and Judiciary & Law Committee was held at 6:00 p.m. today.

Staff Appreciation Letters/Countywide Recognition for Health Department in February and Human Services in March – letters were distributed for signatures.

Introduction and Welcome to Cindy Gile, Physicians Assistant in Clinical Services; Carol Schilling and Becky Paggi, Supervisors in Justice Sanctions – Jerry Huber introduced the three to the HHS Board.

None requested.

Policy, Practice, People of Pioneering Healthier Communities Project - Linda Lee (Nutrition Manager), John Smalley (Tribune Editor) and Bill Soper (YMCA) were present to review the efforts of the Pioneering Healthier Communities program. Each year, YMCA’s are selected across the country to convene a group of community leaders to serve on Pioneering Healthier Communities teams. La Crosse YMCA was selected 1 of 18 out of 75 who applied nationwide. An handout was distributed that included: (1) basic information of the program, (2) obesity trends for U.S., noting Wisconsin obesity population in range of 25-29% as of 2006, (3) strategic program partners, (4) 12-team membership, (5) local initiatives, such as “understanding the existing community initiatives/what already exists”, “understanding community realities”, and “identifying initial plans”. The 12-member local team is committed to improving healthier status in the La Crosse area through improved nutrition, exercise and other life-style changes. Miscellaneous questions and comments by HHS Board members.

Lorie Mueller, Economic Support Manager, reviewed the Food Share Employment and Training (FSET) Program. Since 2004, the food stamp program changed its name to Food Share with emphasis on nutrition; it is now handled with electronic benefit transfer cards (similar to debit/credit cards). IM workers assess Food Share participants and determine if they are mandatory for the FSET program; FSET program is mandatory for all Food Share recipients between the ages of 18-59 unless they have a qualified exemption; exemptions are: having a child under age of 6 or permanent/temporary disability. FSET participants must attend an enrollment meeting where they review previous work experience and goals; required to participate in weekly job search sessions as assisted by Job Service; and must apply for minimum of 5 jobs weekly. Transportation is offered for job searching; and those with children are eligible for up to 27 hours of paid child care on a weekly basis to assist them with job search. If an FSET participant fails to complete any of the activities, they will be sanctioned and lose their portion of the Food Share; each subsequent noncompliance carries longer sanction period. This does not affect the children of the participant who will continue to receive Food Share. Lorie noted some have no intention of following the requirements and just want the food for their children. As of January, there were 251 participants in FSET.

Starting March 1, 2008, the FSET will become a voluntary program (no longer mandatory). DHFS has determined that being it’s a nutrition program, it should not be tied to job search. Only those participating in FSET will be eligible for child care and transportation relating to job search.

Concept Paper on Crisis Resource/Assessment Center/Mental Health Capacity - John Burgess and Tim Garrity of Family & Children’s Center and Margaret Larson of the Mental Health Coalition, met with HHS Board members to review the County moratorium on behavioral health referrals. Jerry noted those needing services are either uninsured or underinsured with 60% having no insurance among County customers of mental health services. John Burgess said the Family & Children’s Center is a nonprofit agency. MA pays $55/hour for outpatient behavioral health services while costs are actually $100+/hour. The clinic has been in the red for the past 3 months. They need to put a limit on capacity in order to get back in balance. He noted some past history; back in mid 80’s, there were others that handled behavioral referrals, such as the hospitals; United Way was also a large contributor back then and over the years their funding is stretched for the many other programs that need assistance. Margaret Larson noted the Mental Health Coalition has held two meetings to discuss this issue. Some discussion on a proposal for an assessment center; noted that if provided and if assessments were done, who would see the referrals? Supervisor Billings expressed concern of “closed doors” for behavioral health referrals; maybe need to hire a second Physician’s Assistant. Jerry said the plan is to bring recommendation(s) to the HHS Board prior to the 2009 budgeting process. At the suggestion of Supervisor Pfaff and general agreement by HHS Board members, Jerry and Tara will try to meet with staff from both hospitals regarding this matter.

Adolescent Center Proposal – Mary Ellen Prinsen brought a proposal to the HHS Board, that being the closing of the Juvenile Day Reporting Center planned for Monday, February 18th, and continue negotiations with the Boys & Girls Club to possibly provide this service. Mary Ellen noted the Day Reporting Program for juveniles started in early 2006, which replaced the non-secure detention facility. The program has become an alternative school and it’s not cost effective to continue the program; currently only one child being served with 3 workers. The Family & Children section is proposing an Adolescent Center in same location that would open sometime in 2008. It would be an 8-bed short-term facility to provide services to children to prevent disruptions and expensive residential placements; children are at risk of disrupting their placement at home, in foster homes and adoptive homes; other residential placements can cost $7,000-12,000 per month. Mary Ellen said the goal is to stabilize the children and get them back home as soon as possible. Miscellaneous questions and discussion followed.

Supervisor Hampson expressed concern of short notice of the Day Reporting closing. Jerry noted Mark Carey was contacted regarding consulting services for juvenile justice. Jerry has also contacted National Institute of Corrections (NIC) to fund such service, but no reply as of to-date. Noted that the schools can handle these issues through their Leadership so no need for the current Day Reporting Center to be a school tutor. General agreement to further discuss at the March HHS Board meeting.

Contract and Audit Issues for 2007-2008 with Vendors – Dean Ruppert and Sara Koopman addressed the board on vendor issues. The 2006 audit noted the need to ensure vendor contracts and addendums be signed and returned. At the end of 2007, the department also realized that 58 contracts were not signed and returned. Since, there is a new practice in place. Providers will be given 60 days to sign and return their 2008 provider contracts; during the 60 days, bills for provider services will be paid at rates stated in the draft contract; if not signed and returned within the 60-day requirement, payments for services will be withheld until signed and returned. MOTION by Glasser/Billings to approve the new contract policy, as presented, and to include same clause within all contracts. Motion carried unanimously; Thompson excused; Schippers absent.

Human Services Quarterly Fiscal Report/Section Exception Analysis Reports of Fiscal Analysis/Section Benchmarks / Budget Drivers – Jerry reviewed. In the agenda packet was a detailed “Human Services Projection Report/Summary” relating to each section within Human Services; some included background, exception, analysis, and action needed. Then this information was used to help develop budget benchmarks for each section. If the HHS Board likes this type of reporting, these can be shared quarterly with the HHS Board. Several HHS Board members commented that they liked the reports and would like to receive on quarterly basis.

At this time, Doug Mormann noted the Health Department does similar type of reporting. Each month he reviews with department managers their budgets and status of expenditures and revenues.

Update on Family Care Expansion - Melissa Gilbert and Maryellen Paudler gave an update. They recently submitted an enrollment strategy to the State; the plan includes transition of clients by county and CMO, waiver and wait list designation. Because MCO will not receive any revenue prior to the transfer of assets, La Crosse County will be the first to enroll CMO members who wish to remain in Family Care, starting October 1; the County has over 50% of the clients as well as being able to use CMO reserve funds. After that, the home and community-based waiver clients from the other partner counties would enroll on county-by-county basis; last would be the enrollment of those on waiting lists. Melissa reviewed in more detail the process of startup and the state requirements. Maryellen ensured that no one from La Crosse County would ever be on a waiting list. Also discussion on new legislation relating to new second window for long term care districts to register in order for their employees to receive WRS/state retirement benefits; area legislators and WCA are working on this effort; legislative public hearings are set for February 19th and 20th. Suggestion to have Renee email the details of these hearings to the HHS Board members.

RESOLUTIONS

Resolution re Juvenile Detention Supervisors – MOTION by Glasser/Wood to approve the resolution which would give Juvenile Detention Supervisors compensation as hourly employees and not salaried employees, including provision for overtime pay if over 40 hours/week. Jerry briefly reviewed and noted estimated yearly savings of $5,800 due to this change. Motion carried unanimously; Thompson excused; Schippers absent.

Resolution re Authorization to Fully Implement Family Care Expansion and Hire Necessary Staff – MOTION by Hampson/Kannenberg to approve the resolution. Miscellaneous questions. Board Chair Johnson noted the West Central Consortium Implementation Council approved the resolution in concept. Start up costs are estimated at $2 to 2.5 million of non-tax levy dollars. Start up includes development of fiscal and personnel department infrastructure, staffing, office space, equipment, furniture, information technology needs, and consulting fees. The State DHFS expects the start up costs be financed by existing reserves of CMO’s and that these will be replenished once regional expansion begins. The County CMO has $5.4 million in reserve as of November 2007, including over $2.8 million as considered in excess of WI solvency requirements. No County funding is required. Motion carried unanimously; Thompson excused; Schippers excused.

CONSENT AGENDA

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

Minutes:

Fiscal:

Department/Board Reports:

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

Motion carried unanimously.

ADDITIONAL HANDOUTS AT THE MEETING

ADDITIONAL ANNOUNCEMENTS

Doug noted the La Crosse Area Dental Health Advocacy Coalition received a recognition plaque from the Wisconsin Dental Association; Senator Kapanke received the award on behalf of the group.

Doug also invited the HHS Board to participate in the Health Dept. Employee Recognition luncheon planned for March 6th.

ITEMS FOR FUTURE AGENDAS

ADJOURNMENT

There being no further business, Board Chair Johnson declared the meeting adjourned at 9:00 p.m.

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

Cheryl Stephen, Recorder