Human Services Committee

Human Services March 8, 2010 Minutes (24 KB)

Members Present: Alexander, Bowers, Fabisiak, Vertein, Dippel, Fordham, Endres, Stoeckmann, Sinklair

Members Excused:  None

Members Absent:  None

Others Present:  Orth, Brattset, Box

Chair Alexander called the meeting to order and certified compliance with the Open Meeting Law.

Motion by Dippel, seconded by Fordham to adopt the agenda.  Motion Carried.

Motion by Fordham, seconded by Stoeckmann to approve minutes of the previous meeting.  Motion Carried.

Public Comment: 

None

Communications: 

None

Business Items:

1. Review and Approval of Monthly Vouchers:  Box distributed the monthly voucher report (See attached).  Stoeckmann reported that Salary and Benefits were down approximately $125,000 due to a pay period timing calendar issue.  Administration was up $5,000 due to the timing of mileage payments.  Community Living and Support was up $15,000 due to back payments.  Community Residential was up due to increased expenses to LaCrosse Health Care and Tellurian.  Community Treatment was down due to LSS payments awaiting the signing of contract.  Institution was down due to delayed payments.  Income Maintenance was down due to a decrease in funderals.  MA transportation had late billing this month.  Motion by Stoeckmann, seconded by Fabisiak to approve vouchers at $975,644.38.  Motion Carried.
2. Consideration of Programs and Priorities:  Orth referred to the Program Grading Sheet (See attached).  He discussed the various services outlined as mandated.  Orth also described staffing patterns compared to revenues and pointed out potential increase risks.  Undated services such as Families Come First, Children's Waiver result in decreasing higher costs.  If these programs were ended the alternate care budget would have increased costs potentially.  Orth further outlined SCAN (Sauk County Adolescent Needs) is subsidized with a social work position and $50,000.  This could be reduced if absolutely necessary, however, we would like to continue to support these services.  Endres asked where is the money for the LaCrosse Juneau County Agreements?  Orth indicated that they are in the institution budget.  Fordham outlined that Family Care is mandated because the county board approved it and therefore it is locally mandated and if not, Sauk County Department of Human Services would have to pay for those individuals not covered.  Orth will footnote that while it is not mandated by statute, it is required due to these reasons.  In addition, adult protective services is a mandated service.  Endres asked about the institution agreements that even if it is private pay there would be a fee.  Orth indicated that yes, but the guardian will agree to reimburse the county.  If the guardian refuses to pay, Sauk County Department of Human Services will not pay for this placement.  Orth further indicated that it is his opinion that this issue should be reviewed at the next board meeting for these institutions as an agenda item to discuss.  It could be proposed that the institutions work directly with private pay families.  Sinklair asked what the FPI, Families Come First budget impact is?  Orth responded, approximately $363,000 for FPI and $190,000 for FCF.  Orth described some additional offset revenues for CCS and Children's Waiver as yet to be determined in the next budget.  Endres indicated an opinion that if the state reduces funding for mandated services by a certain percent, Sauk County Department of Human Services should also reduce these services by the same percent.  Orth indicated that this could be a challenging concept to implement in that certain mandated services cannot just be percent reduced due to a high risk in mandated populations.  Fordham indicated that there could be a wait list and serving less people.  Once again, Orth reiterated mandated services are a increased risk if we should go to that model it would have to be discussed at length.

Department Updates:

1. Family Care Update CMO/CMU:  Orth reported that the Southwest Family Care CMO has received increased state revenues, therefore, leading to being in the black in 2009.  Also, as of January 2010, Southwest Family Care Alliance essentially broke even.  County Directors will continue to meet with Terri Burrows, CEO of Southwest Family Care Alliance individually to talk about each particular county's contribution.  Orth noted that Sauk County Department of Human Services is less than 1% over fiscally as opposed to some counties that may be as much as 25% over.  Continued meetings will continue to discuss cost efficiencies and service delivery quality.  2010 will be a crucial year.  Fordham indicated that adult family home providers are struggling and the rates are inconsistent for various services provided.  Southwest Family Care Alliance is making efforts to standardize rates.  This has been dififcult for many of the providers.  Orth indicated that this is an advantage of family care so that rates can be standardized throughout the state or across regions and other providers may compete for services.  Overall, this is a positive as this will ultimately decrease costs.  Fordham indicated that the bottom line is that this is a cost efficient way to keep people in their homes to receive quality services.  Sinklair indicated he supports this as best for individuals as well as cost efficiencies.
2. School Day Treatment:  Brattset reported on the Day Treatment Project that includes partners of CESA 5, Sauk-Prairie Schools, LSS, and Sauk County Department of Human Services. The project focuses on a local option for alternatives to hospitalization with seamless teams both within and external to the school.  LSS willhave the state license for day treatmaent and will conceivably bill MA for reimbursable services.  Sauk-Prairie Schools has agreed to possibly invest startup dollars from stimulus money to get the services started.  There is some potential for the school district to bill MA for part of the school day for children in t he school component (see attached handout).
3. Crisis Response-Adolescents:  Orth spoke about the county's collaborations with diverting hospitalizations from Winnebago/Mendota to other institutions via Wisconsin Association for Children and Family Agencies.  Such private/non-profit, residential treatment group homes, treatment foster care settings could provide crisis management in a voluntary fashion at this time.  The settings would cost less than Mendota/Winnebago.  Now, there can only be voluntary admissions, but there has been an RFP that received two responses.  Of these responses, Northwest Passage was awarded the agreement to assess if diversions can occur.  Northwest Passage can be called and they will find a match to a placement for a child rather than Mendota/Winnebago.  This could save significant money for counties.  Orth noted a future statute change could occur regarding involuntary clients being allowed to go to a certified crisis setting.  Orth will update the committee in the future on these issues.
4. Legislative Day:  Orth noted that over 150 county board members and directors from throughout the state attended the annual Legislative Day.  Four issues papers were presented.  One on multi-county nursing home agreements, another on 17 year olds returning to youth services, and several other on fundin gissues.  Orth met with two local representatives: Hilgenberg and Clark.  This was an opportunity to sensitize them to local issues.  It has been decided that Legislative Day will continue to be an annual event in the future.

The next meeting of the Sauk County Human Services Board is scheduled for Monday, April 5, 2010 at 5:00 p.m.

Motion by Bowers, seconded by Sinklair to adjourn.  Motion Carried.

Bev Vertein