Minutes June 28, 2011 HS

Wabasha County Human Services Board

Meeting of June 28, 2011

 

The Human Services Board of Wabasha County, Minnesota, convened in Regular Session at the County Services Building, in the City of Wabasha, Minnesota at 9:00 a.m., June 28, 2011 in accordance with MS 402.01 to 402.10. The previous meeting was recessed to this time and place.

 

The following Board members were present: Hall, Harms, Norman, Roschen, and Wobbe.

Absent: None

 

ROSCHEN – HARMS

BE IT RESOLVED, that the Wabasha County Human Services Board hereby approves the agenda, with no additions.

Adopted Unanimously.

HARMS – NORMAN

WHEREAS, the Minutes of the May 24, 2011 meeting have been presented for review and that no changes have been made to the Minutes;

BE IT RESOLVED, the Human Services Board accepts the Minutes as an accurate reflection of the content and actions taken at its previous meetings.

Adopted Unanimously

HARMS – NORMAN

WHEREAS, the Director of Social Services has advised that all Income Maintenance case actions are in conformance with State, Federal, and County laws, rule, regulations and policies;

BE IT RESOLVED, that all Income Maintenance case openings, closings, suspensions, grant changes and any other action affecting client eligibility and payments documented in the Department on listing of proposed case actions, (through MAXIS computerized client files and reports, and MMIS II), Director's Actions, abstracts of payment, and reports of refunds and cancellations for the period 5/24/11 through 6/27/11 are hereby approved.

WHEREAS, the Directors of Public Health and Social Services have advised that all Public Health and Social Services case actions are in conformance with State, Federal and County laws rules, regulations and policies;

BE IT RESOLVED, that all Public Health and Social Services case openings, closings, payments, placements and licensing actions as documented in the Department on Agency listing for Licensing actions, case records, record of Social Service plan, purchase of service abstracts, reports of refunds and cancellations, payment authorizations and computer printouts for 5/24/11 through 6/27/11are hereby approved.

WHEREAS, the Directors of Public Health and Social Services have advised that all personnel actions are in conformance with State and Federal law, Merit System rules, existing labor agreements and personnel policies;

BE IT RESOLVED, that all personnel actions for 5/24/11 through 6/27/11for employees of the Departments of Public Health and Social Services as documented in the Department on proposed personnel actions listing, personnel abstracts, payroll reports and personnel actions forms are hereby approved.

WHEREAS, the Directors of Public Health and Social Services have advised that all Public Health claims and, Social Services and Welfare claims against the County submitted for payment for 5/24/11 through 6/27/11 have been reviewed and are eligible for payment pursuant to all applicable rules, regulations, laws and policies;

BE IT RESOLVED, that all bills as listed on listing of warrants and claims against the Public Health, Social Services and Welfare funds and warrant registers shall be approved as valid claims against the County and are hereby approved for payment.

WHEREAS, the Directors of Public Health and Social Services have advised that employee requests to attend conferences and/or training have met approval of Administration, and are within the budgetary guidelines of the Agency;

BE IT RESOLVED, that all requests presented by the Directors of Public Health and Social Services are hereby approved.

Adopted Unanimously.

ROSCHEN – WOBBE

Whereas, the Wabasha County Human Services Board is the host for group residential housing (GRH) agreements to providers with facilities within Wabasha County; and

Whereas, Minnesota Statutes 256I.01 through 256I.06 set forward the "Group Residential Housing Act", which establishes a comprehensive system of rates and payments for persons who reside in the community and who meet the eligibility criteria set forward therein; and

Whereas, "Group residential housing rate" means a monthly rate set for shelter, fuel, food, utilities, household supplies, and other costs necessary to provide room and board for eligible individuals. Group residential housing rate does not include payments for foster care for children who are not blind, child welfare services, medical care, dental care, hospitalization, nursing care, drugs or medical supplies, program costs, or other social

services, and

Whereas, the State of Minnesota has approved a rate of $846.00 for GRH facilities and host counties therefore need to establish agreements with the providers to meet the needs of our residents; and

Whereas, the Director of Social Services recommends approval of these contracts;

Now, therefore be it resolved the Wabasha County Human Services Board approves a new group residential housing agreement, effective July 1, 2011 through June 30, 2012. The monthly rate is $846.00, representing no rate increase from last year, as required by the Minnesota Department of Human Services. Providers include:

Monica Burrows, Lake City

Cheri & Ken Chaney, Lake City

Mary Fellows, Plainview

Fifth Street Elder Care, Plainview

Great River Homes, Wabasha & Lake City

Green Prairie Place, Plainview

Jacquelyn Hartzell, Wabasha

Legacies, Plainview

Lutheran Social Services, Lake City & Wabasha

Nurturing Hands Elder Care – Plainview

Nurturing Hand LLC – Kellogg

Parkside Elder Care, Plainview

Prestige Care, Lake City

River Oaks Health Care Center, Lake City

St. Elizabeth's Assisted Living, Wabasha

Janet Stock, Lake City

Adopted Unanimously.

NORMAN – HARMS

WHEREAS, Wabasha County has reviewed the responses to the 2012 PMAP and MinnesotaCare Request for Proposal for Wabasha County recipients;

WHEREAS, Wabasha County has been a member of the county-based purchasing entity, South Country Health Alliance (SCHA) since inception; and

WHEREAS, Wabasha County does not believe that enrollees will have any added value with the addition of other health plans and that the addition of other health plans will be duplicative of the network that is already available to SCHA enrollees and that the addition of other health plans will increase county administrative costs in assuring that each health plan's regulatory functions are in compliance;

WHEREAS, Wabasha County has confidence that the integration of Health and Human Services with the county-based purchasing plan is an effective model for care coordination on behalf of the enrollees as evidenced by the ongoing work and relationship that the county has with the health plan. Examples include county representation on the County Health & Human Service Directors Advisory Committee, the Quality Assurance Committee, Utilization Review Committees and ongoing workgroups made up of county representatives working on service enhancement and best practice that does not occur with the other plans that serve the MinnesotaCare population;

WHEREAS, a local Care Connector is provided by SCHA to connect enrollees to needed health and community services that the other health plans do not offer;

WHEREAS, SCHA provides a comprehensive network that meets the states requirements for access to enrollees and that adding choice of health plan without adding additional needed providers will be confusing to enrollees and will not provide any added benefit;

WHEREAS, SCHA has been successful with outcome measures and enrollee satisfaction as evidenced by indicators such as the Star ratings, HEDIS results, and the MA-CAHPS;

WHEREAS, the county-based purchasing plan is consistent with the Federal Health Care Reform movement to Accountable Care Organizations (ACO) and there would not be added value by adding additional plans to our rural community when planning for new reforms;

WHEREAS, the Directors of Public Health Services and Social Services, after reviewing the responses to the RFP, rank South Country Health Alliance as the best plan for Wabasha County and its residents,

THEREFORE, Wabasha County Human Services Board accepts the recommendation by the Directors to support SCHA as the health plan for purchasing health services on behalf of the managed care enrollees on public programs for Wabasha County, and also recommends UCare as an additional plan to meet the needs of our County residents.

Adopted Unanimously.

WOBBE – ROSCHEN

Whereas, Wabasha County has formed a Human Services Board pursuant to Minnesota Statute 402, and

Whereas the Human Services Board is required to develop a human services advisory committee to advise the Human Services Board; and

Whereas the membership of the Advisory Committee is defined by MSA 402 and additional members to the Advisory Committee is beneficial; and

Whereas, Ms Mary Arens has offered her name for consideration to join the Advisory Committee; and

Whereas, the Directors of Public Health Services and Social Services recommend the appointment of Ms. Arens to the Human Services Advisory Committee;

Now, therefore be it resolved the Wabasha County Human Services Board appoints Ms. Arens to the Wabasha County Human Services Advisory Committee for a term of 2 years, ending June 30, 2013.

Adopted Unanimously.

HARMS – ROSCHEN

Whereas, the Wabasha County Human Services Board has previously entered into a Chemical Health Care Home Pilot Services Grant Contract with the Minnesota Department of Human Services, providing chemical health services to individuals on a voluntary basis; and

Whereas, the Chemical Health Care Home Pilot Services Grant is providing chemical health services to individuals in the 10 counties of Southeast Minnesota and Washington County; and

Whereas, the participating counties and the Department of Human Services have agreed to extend the Pilot project for the State Fiscal Years 2012-2013; and

Whereas, the Director of Social Services has recommended approval of the contract amendment;

Now, therefore be it resolved by the Wabasha County Human Services Board to accept the recommendation of the Social Services Director, extending the Chemical Health Care Home Pilot Services Grant through the State Fiscal Year, ending June 30, 2013. The Board further authorizes the Director of Social Services and County Administrator to execute the contract amendment on behalf of the Wabasha County Board of Commissioners.

Adopted Unanimously.

WOBBE – HARMS

Whereas, Wabasha County and UCare have a County Participation Agreement currently in place for the provision of mental health targeted case management services; and

Whereas, the Social Services and UCare mutually desire to extend the Agreement; and

Whereas, Wabasha County is able to receive reimbursement for mental health targeted case management services at a rate determined by the Minnesota Department of Human Services; and

Whereas, the Director of Social Services recommends approval of the addendum to the existing contract;

Now therefore be it resolved by the Wabasha County Human Services Board to approve the addendum to the County Participation Agreement between UCare and Wabasha County Social Services. Further, that the Director of Social Services is authorized to execute the necessary contract addendum on behalf of Wabasha County Social Services. The addendum extends county participation through June 30, 2012.

Adopted Unanimously.

ROSCHEN – NORMAN

Whereas, For the first time MN Dept of Health had monies available to be applied for by counties that had declared disasters to assist with behavioral health issues and other areas that could be considered of Public Health concern; and

Whereas, Public Health Services applied for these funds on behalf of their own dept., the County Social Services Dept., University of MN behavioral health team, and Lutheran Social Services, and community forums that would address issues of stress, resiliency, and other topics to assist those who were victims recover mentally from their tragedy; and

Whereas, the Director of Public Health Services recommends the acceptance of the grant funds;

Now, therefore be it resolved the Wabasha County Human Services Board accepts the MN Recovers Grant Funds for the purposes and allocation as recommended below:

• Public Health Services $8,556.80

• Wabasha County Social Services $2,012.94

• University of MN $1,992.99

• Lutheran Social Services $9,000 for Camp Noah and $16,000 for community forums.

• Also included up to $30,000 for well sealing of those wells which were flooded and will be abandoned.

Adopted Unanimously.

 

DISCUSSION and INFORMATIONAL ITEMS

 

Environmental Health Services Report

Darrin Thompson requested guidance on how to administer a well-sealing grant for Wabasha County residents. These well-sealing funds are available for effected residents of the 2010 flooding along the Zumbro River. Up to $1,000 per well will be available on a first-apply basis. The County will directly pay the contractor. Eligible wells to be sealed must have had flood water within 50 feet of the well-head. Residents will be informed of the grant funding through public notice, and communication to the cities and townships. Wabasha County has a maximum of $30,000 that may be used for well-sealing under this grant.

Suzie West has assisted licensed facilities in the completion of well water testing. Since the State completes the well water test, there is a current push to get testing completed in the event of a State shutdown. Board members learned the Pioneer Campground has a new pool that has opened, that the Hammond Bar will be opening for the July 4th weekend, and that the Reads Landing Brewery & Pub will be opening in August.

 

Towards Zero Deaths Grant

Judy Barton presented a request to apply for a Towards Zero Death grant from the Dept. of Public Safety. This grant will target education and policy development around seat belt and child car seat usage. In addition it will require a Fatality Review Committee with specified public safety personnel, engineering, EMS and the grant coordination to meet following any accident which has a fatality, review the accident, causing factors, etc. and develop a plan that could help to reduce crashes due to that reason in the future. Board gave consensus to apply for the grant.

 

Social Services Monthly Reports

DAANES Report: Chris Dallmann, Social Worker, provided an update on the 2010 Drug and Alcohol Normative Evaluation System data for Wabasha County. The DAANES report gives data that is reported by the chemical dependency providers. We are able to look at age, race, marital status, and treatment data from all clients that have received a treatment episode. It was pointed out that the number of residents being treated for "farm plants" is on the increase. These products are sold (often) in tobacco shops. While marked as not for human consumption, when used internally, they cause an intense high and then may cause significant medical problems to the user. Board members suggested a strong effort be coordinated to inform the public about the hazards of these products.

 

2012 Budget

Barton shared information on the PHS proposed 2010 budget. She shared information showing the amount of tax levy decreasing each year over the past 3 years. She also shared that she will be doing a report on the Home Care Program, what is mandated within that budget and what is not at the next Board meeting. Other considerations she shared were: Do we want to cut programs to residents which are not requiring the use of county levy dollars? If so we lose that programs money to help support the overall Administrative budget, many of these programs address some mandates for Public Health, WIC is a non-mandated program that is projected to need county levy dollars to support it. If we are the only providers who can offer it, do we want to look at not providing the program, thus not having it available for Wabasha County residents? If we were to cut back on staffing we would lose revenue as we are paid per member per month that is seen. Disease Prevention and Control is very dependent on the type of communicable disease and amount of activity we have in the county. This number could be significantly higher or somewhat lower dependent on what happens with communicable diseases in 20102

Smith shared background information on the development of the annual budget. For discussion, the financial data from calendar year 2009 was shared with the Board. This included levy amounts by major program area, and actual expenditures by target population and/or service area. The lack of a State budget makes the development of our local budget very difficult. We have no certainty on the allocations that will flow to the County for services provided. Then, add the uncertainty of which clients will need services in the coming year, it continues to be difficult to budget.

Should the Board want to make significant reductions in the Social Services 2012 levy that can be accomplished. If there is not enough funding is allocated for expenses beyond the budget, the County would then need to find the funding elsewhere, including borrowing funds, if needed. The development of the budget will need to consider the risks and long-range impacts.

The only certain way to reduce the levy is to cut fixed expenses. Reductions in equipment or staff will have implications in the Department's ability to maintain a level of service. The Social Services Department provides very few optional services to the public. Eventually the Board will make a final decision on eliminating optional services and to what level of service is provided the residents. The preliminary budget will soon be provided to the budget committee, along with narrative.

 

State Shutdown

Smith provided a working document on what services might be impacted in the event of a State shutdown on July 1st. Until there is more information from a judicial ruling, much of the details will remain unknown. Staff is reviewing what services are funded primarily by State sources, and how that would impact Wabasha County. The potential exists that some staff may not be needed, depending on the level of support maintained by the State.

 

PHS/SS Miscellaneous

Barton shared wonderful comments on how well staff (Jodi Johnson) responded to a medical issue at the hospital. Her ability to diagnose a serious medical condition and get treatment saved the inmates life (according to the responding doctor). Board members expressed gratitude for the good work.

Public Health Services recently underwent an audit by South Country Health Alliance in which the auditor found 100% accuracy. This rating is significant, as SCHA is very demanding on the documentation necessary for local staff.

In closing, Barton commented on a client letter received by the County in which staff was complimented for the level of services provided. The cooperation between Public Health Services and Social Services was evident, and appreciated.

 

ROSCHEN – WOBBE

Being no further business to come before the Board, motion was made and duly carried at 10:55 a.m. to recess this meeting until 9:00 a.m. on July 26, 2011

Adopted Unanimously.

 

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