HEALTH AND HUMAN SERVICES BOARD
Tuesday, June 10, 2008
Administrative Center – Room 3220
6:30 p.m.
MEMBERS PRESENT: Sharon Hampson, Jill Billings, Tammy Gamroth, Loren Kannenberg, Margaret Wood
MEMBERS EXCUSED: Dr. James Glasser
MEMBERS ABSENT: Bill Brockmiller, Robert Erickson, Al Thompson
STAFF PRESENT: Jerry Huber, Doug Mormann, Tim Garrity, Maryellen Paudler, Jane Klekamp, Sara Koopman, Ryan Banse, Sue Conard, Fran Hegenbarth, Carol Schilling, Derek Moore, Peggy Herbeck, Jennifer French, Michelle Johnson, Mary Ellen Prinsen, Larry Winter, David Steinberg, Kate Holinka, Kelly Miller, Cheryl Stephen
GUESTS PRESENT: Emily Thomas-Harned, Kim Bloyer, Randy & Rita Magno, Jim Bloedorn, Lynn Dobyns, Nick Passe, Robert Jones, Katie Rowan-Koenen, Tom Rortuedt, Ken Riley, Joan Mueller, Dan & Amy Estes, Anita Beskar, George Parke IV, Skye Manning, Craig Nestor, Patty Martin, Nick Charles Sr., Carol Gross
CALL TO ORDER
HHS Board Chair Sharon Hampson called the meeting to order at 6:33 p.m.
ANNOUNCEMENTS
Supervisor Billings Appointed as Vice Chair of HHS Board – Supervisor Billings accepted the position of Vice Chair for the HHS Board
Introduction of Tim Garrity, Managed Care Organization (MCO) Executive Director – HHS Board members welcomed Tim Garrity.
County Board Action in May – 1) Resolution re Support Increase in State Tax on alcohol for Alcohol Treatment and Prevention passed on a 17-13 vote; 2) Resolution for Authorization to Transfer Funds from Health Department’s Reserved Fund Balance to be Used for Increase in Staff Time, Contracted Services, and Equipment for Public Health Preparedness Programs passed on a 29-1 vote; and 3) Resolution for Creation of La Crosse County Long Term Care Coordinating Committee passed on a 27-3 vote.
HHS Board Representation on National Association of Counties (NACo) Steering Committee(s) – Information was sent with the HHS Board meeting packet; if interested, please contact Chair Hampson.
Jim Glasser to Continue Membership on the Coulee Region Public Health Preparedness Consortium – At this time, Chair Hampson distributed for signatures a get-well card for Dr. Glasser who is recovering from an accident.
Day in the Life Opportunities – sign up sheets were made available.
Appreciation for Mary Ellen Prinsen 40 Years with the County – Chair Hampson presented a recognition plaque to Mary Ellen for her years of service to the citizens of the County.
POLICY ISSUES
Update on Women’s Community-Based Program – Chair Hampson moved this agenda item to the beginning of the meeting due to number of guests in attendance.
Jane Klekamp distributed a handout that included exception and analysis information, including copy of letter that was sent to area neighbors near the 1023 Cameron Avenue residence that is being considered for women in the criminal justice system who do not have a safe or permanent residence and will also be on electronic monitoring. There is a neighborhood meeting scheduled for Monday, June 16 at Aquinas High School starting at 6:00 p.m. Such home could house maximum of 10 women. The County is
Page 2 – HHS Board Minutes of June 10, 2008
partnering/contracting with YWCA to provide regular staff supervision at a house; the County will also do drug and alcohol testing, including monitoring by cameras on the doors and windows of the house; and in addition, the women will be involved with community programs as provided by other agencies. Women residents in such a home will be assessed by staff based on sentencing or referral by a Judge; some may only stay a few days and up to one year; women tend be lower risk as compared to males, but with higher needs.
PUBLIC COMMENT
Due to agenda item #5G., Update on Women’s Community Based Program, in which Jane Klekamp gave a report noting a house located at 1023 Cameron is an option for consideration, citizens from that area, including other County citizens, made the following comments:
Chair Hampson thanked all for coming and for sharing their thoughts. She encouraged attendance at the Neighborhood meeting scheduled for 6:00 p.m., Monday night at Aquinas High School.
BOARD EDUCATION
Policy, Practice, People of Epidemiology – Derek Moore gave a PowerPoint presentation relating to epidemiology/epidemiologist which studies all aspects of diseases as to who, when, where, and why and uses this information to prevent disease or negative health behaviors in the population. The position was
Page 3 – HHS Board Minutes of June 10, 2008
created in 2004 to work on public health preparedness issues for the Coulee Region Public Health Consortium, which is housed in the Health Dept. He briefly noted his efforts, in partnership with Viterbo, relating to tobacco cessation program for those 18-24 without a 4-year degree; over 2 years, recruited 77 people that completed the study. Also worked on surveys on smoking habits of Southeast Asian populations; and in addition, helps the Health Dept. write grants. Funding for his salary and related programs come from grants.
Policy, Practice, People of Care Management Organization – Jennifer French, Social Worker for CMO, and Michelle Johnson of CMO, introduced Joan Oertel who has been a member of CMO since 2001. Joan gave an overview of her services as provided by CMO and how they have improved her quality of life, including more independence and improvement of pain management. Joan noted her job at Neshonoc Center located at Lakeview where she does piece-work; she also noted her involvement with the North American Squirrel Association, a group that offers support for physically challenged individuals who want to hunt and fish. Joan gave appreciation for CMO and staff.
Board Packet on Sharepoint – Ryan Banse, IT Dept., distributed instructional sheets and diskettes in order for HHS Board members to access the monthly packets on Sharepoint. He noted DSL is needed; could try dial-up service, but it may be very slow. Jerry noted the amount of time to convert files into PDF files and place on Sharepoint. Loren questioned if it was worthwhile being the paper packet is received the following day. Supervisor Wood said she likes Sharepoint as it saves on paper. The board will try using Sharepoint for one more month and then decide if the idea is worth pursuing.
RESOLUTIONS
Resolution re Creation of Aging & Disability Resource Center Advisory Committee – Peggy Herbeck reviewed the need for the new committee due to regional partnership of MCO and the four counties that will be sharing one ADRC in Western Wisconsin; the four counties are La Crosse, Jackson, Vernon and Monroe. Membership will include 4 County Board members (1 from each county), 4 consumers or advocates (1 from each county) and 1 consumer each representing physical disabilities, developmentally disables, and mental health needs. The committee plans to meet 6 times a year rotating among the counties. MOTION by Kannenberg/Billings to approve the resolution. Motion carried unanimously; Glasser excused; Brockmiller, Erickson and Thompson absent.
POLICY ISSUES
Boys & Girls Club - Mary Ellen Prinsen noted the County has given funding to the La Crosse Boys & Girls Club over the last 5 years from the tax levy to be used for prevention services at Hamilton After-School Project. County administration and HHS Board requested performance based reports on activities in order to continue funding; these reports were not regularly sent and didn’t reflect the prevention of child abuse/neglect/delinquency. Included with the agenda was a “Logic Model of Program and Performance” as prepared by Kevin Johnston, the new Director of the Boys & Girls Program. The HHS Board and County will have to decide whether or not to continue funding in 2009. Department staff feels that this program and others like it in the community provide an integral part of the continuum of service that has shown to be most effective in meeting the needs of children and their families. Jerry Huber noted that the Carey Group, as part of their proposal, will look at all juvenile services.
2009 Budget Priorities, Completion Schedule and July Budget Hearing:
Health Dept – Doug Mormann reviewed the tentative 2009 budget priorities for the Health Dept. Services will be similar to those provided in 2008. Some of the items that may affect services or impact
Page 4 – HHS Board Minutes of June 10, 2008
the budget are: 1) transportation & reimbursement; 2) expansion of occupational health and wellness services for employees as provided by County health insurance fund; 3) reduction in Public Health Preparedness training due to less federal funding; 4) Home Health services in relation to CMO and focus more on services for pediatric population; 5) upgrade computer technology; 6) continue development of business continuity plan for records storage and access; 7) seek more grants and outside contracts; 8) continue support and expansion of community partnerships to improve County residents’ health.
Human Services – Jerry reviewed the following areas and key budget drivers of each:
1) Expansion of family care - transition issues from CMO to new MCO; expansion of ADRC with 3 other counties; changes in eligibility of family care and related funding.
2) Human Services administration – over time convert to laptops; continue development of “HS Connect”; change in contract functions due to new MCO; and transportation agreements to assure affordability and coordination of services.
3) Clinical Services – need to issue RFI to determine feasibility of alternative to ER admissions to address Chap. 51 holds; continue to inform law enforcement and hospitals to use mobile crisis prior to admittance, as well as the assistance from emergency dispatch center; also need to provide a recommendation to the budget regarding Chap. 55 relating to MCO and Corporate Guardians - hope to get some final recommendations from the State.
4) Family & Children – need to restructure and reprioritize due to funding cuts and budget deficit; there is influx of Afro American families coming to La Crosse – checking with Milwaukee to see if they can provide technical assistance and training; and the new Regional Adolescent Center.
5) Justice Sanctions – possible need for additional monitoring equipment; plus transitioning from OWI and Drug Court grants to anticipated need for County funding.
6) Economic Support – workloads continue; hope to add the liaison position that will be housed in Economic Support and funded by MCO.
2009 HHS Board budget hearing – general agreement to hold the budget hearing at 5:30 p.m. on July 8th, one hour prior to the start of the regular monthly meeting. Jerry noted all advisory committees will be invited.
Care Management Organization Transition – Tim Garrity, the new MCO Director, noted key management staff were hired, those being the Fiscal Manager, Human Resources, and IT Director. Jerry noted the transition goal from CMO to MCO is October 1, 2008. HS and CMO staff have worked on transitional issues for the past year. The departments continue to work together to develop plans that address the fiscal implications to the County and the MCO with the regionalization; program related transitions are dependent upon state decisions in terms of who will be served and who has the responsibility to serve. “Communication” is key. Sue Conard, as union representative, noted ongoing meetings with the employees and working on a new contract for this group.
Benefit Package for Non-Nursing Home Level of Care Members in the Family Care Program – Jerry noted the Centers for Medicare and Medicaid Services and the Dept. of Health & Family Services have made benefit and reimbursement changes for people at the non-nursing home care level. Included with the agenda packet was a draft letter to Secretary Karen Timberlake, as prepared by the Long Term Care Council, expressing extreme concern with these benefit changes; it’s recommended that the chair of that council and the chair of HHS Board sign the letter. General agreement to have Sharon Hampson sign the letter on behalf of the HHS Board. Discussion continued. Not sure if the letter will have any affect.
Page 5 – HHS Board Minutes of June 10, 2008
Suggestion to check with other CMO’s in the State on how they handle these non-nursing home level of care expenses. Noted in the meantime, these types of incurred expenses for the County CMO continue to draw from the fund balance.
Juvenile Justice Consultation Proposal – Jerry reviewed. In early spring, the HHS Board gave direction to request The Carey Group to provide consultation regarding the County’s juvenile justice programs as administered by Human Services. Draft copy of the proposal as submitted by The Carey Group was included with the agenda packet. General objectives:
1) Analyze data regarding juvenile arrest and disposition trends, including arrest and disposition rates comparing the County with state and national communities of similar size.
2) Assess the current juvenile offender continuum of services to determine gaps in services for the offender, parents, or both.
3) Assess how this offender continuum of services aligns with the research on effective evidence based practices.
4) Provide a one-day training to the community and regional counties on evidence based models of juvenile justice.
5) Provide feedback regarding the feasibility and advisability of a comprehensive adolescent center within the existing juvenile facility.
Jerry reviewed in detail the scope of duties and task outline, and the proposed workplan and budget per the proposal by The Carey Group. Suggestions to seek funding elsewhere to help cover the cost, such as from other internal or outside agencies, such as La Crosse Community Foundation, District Attorney, or the Judges. Discussion on the need to develop a community philosophy to address juvenile issues. Jerry noted staff could provide more assistance in-house as well as eliminate Phase 3 relating to correctional program checklist assessments on the major providers (was optional) – this would save $23,000. MOTION by Wood/Kannenberg to request The Carey Group to refine the scope based on Jerry’s recommendations of doing more in-house and the elimination of Phase 3 for an estimated cost of $60,000. Motion carried unanimously; Glasser excused; Brockmiller, Erickson and Thompson absent.
Development of the Regional Adolescent Center – David Steinberg reviewed as well as gave PowerPoint presentation on the development of a Regional Adolescent Center. Larry White also reviewed in detail and answered questions. Information included history of the non-secure detention and its closing, and the Day Report Program that started in 2006 and closed in February 2008. The new proposed Regional Adolescent Center:
1) For children with developmental disabilities between ages 10-17; children in need of protection, delinquent children and children with emotional/behavioral and mental health issues.
2) It will be licensed by DHFS as small group 8-bed shelter; 4 beds reserved for the County and 3 other beds contracted out to other counties, and 1 left for first-come, first-serve basis.
3) The residents will be allowed more freedom and privileges and there will be more therapeutic atmosphere within the center – creating a culture of safety and healing.
4) Cost to run the center is estimated at $333,000; revenue will come from other counties, MA reimbursement, various grants, OJA, parental fees, and fees from waiver for children with special needs.
Have met with six area counties that have shown interest; plan to hold another meeting with them on June 18. MOTION by Wood/Billings to direct staff to continue pursuit of the Regional Adolescent Center and bring back details for consideration at a future meeting. Motion carried unanimously; Glasser excused; Brockmiller, Erickson and Thompson absent.
Page 6 – HHS Board Minutes of June 10, 2008
Update on Women’s Community-Based Program – County Board Chair Steve Doyle asked for reaction from the HHS Board as to the comments from the neighbors relating to the proposed women’s community-based home. Steve suggested more planning; may want to consider another neighborhood in which the City may assist or partner using CDBG funds as previously mentioned by the City Planner; need to sell the idea as an improvement to a neighborhood; maybe do a snapshot of the types of women that may be living in the home. Lengthy discussion ensued. General agreement to go ahead with the Monday night neighborhood meeting on June 16th, slow down the process, and keep all options open.
DIRECTORS’ REPORTS (sent with the agenda)
Health Dept. Director’s Written Report
Human Services Director’s Written Report
Health Dept. 2007 Annual Report Summary
Human Services 2007 Executive Summary & Public Flyer
CONSENT AGENDA
MOTION by Kannenberg/Billings to approve the following Consent Agenda items:
Minutes:
· Health & Human Services Board of 5/6/08
· Long Term Care Council of 5/2/08
· Consumer Advisory Council of 4/18/08
· Coulee Region Public Health Consortium of 5/7/08
· Labor/Management of 5/6/08 and 5/27/08
· West Central Consortium Steering Subcommittee of 4/22/08
· W-2 Community Steering Committee of 5/20/08
· Criminal Justice Management Council of 5/21/08
· Family Policy Board Joint Meeting – Governing & Management Councils of 4/17/08
· Dental Care Advocacy Coalition of 5/19/08
Fiscal:
· June 2008 Vendor Contract Approvals
· Vendor Audit Policy Update
· Summary of Revenue and Expenses for Care Management Organization
· Human Services Quarterly Fiscal Report
Department/Board Reports:
· Quarterly Complaint/Grievance Report from Care Management Organization
Motion carried unanimously; Glasser excused; Brockmiller, Erickson and Thompson absent.
ITEMS FOR FUTURE AGENDAS
Chair Hampson noted CMO and any other resolved issues from tonight’s meeting.
NEXT MEETING
Tuesday, July 8th at 6:30 p.m., with 2009 budget hearing at 5:30 p.m.
ADJOURNMENT
There being no further business, Chair Hampson declared the meeting adjourned at 10:42 p.m.
Disclaimer: the above minutes may be approved, amended or corrected at the next board meeting.
Cheryl Stephen, Recorder