Human Services Committee

DATE: December 11, 2006
TIME: 5:00 p.m.
PLACE:
County Board Room
Baraboo, WI

Members Present: Alexander, Dippel, Fordham, Fabisiak, Vertein, Endres, Zowin, Stoeckmann (arrived at 5:30 p.m.)

Members Excused: Bowers

Members Absent: None

Others Present: Orth, Brattset, Horkan

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

Motion by Zowin, seconded by Fabisiak to adopt the agenda.
Motion Carried.

Motion by Dippel, seconded by Vertein to approve minutes of the previous meeting.
Motion Carried.

Communications:

Replacement CMHC Server Purchase:

Horkan distributed information from MIS (please see attached). Horkan noted that with discussions with MIS the recommendation is to purchase the new server for Human Services from Netsmart. The bid came in at $800.00 over some other bids, but the discount for installation will be given and therefore this vendor is the least costly. There will be a meeting before the next County Board meeting on 12/19/06 to make a motion to approve this purchase.

Business Items:

  1. Review and Approval of Monthly Vouchers: Horkan distributed monthly vouchers report (see attached) and it was reviewed by Endres. Endres noted that salary and benefits were up because there were three pay periods. In addition, contracted labor was down due to a psychiatrist resignation and transition. Community Living and Support line was up due to payment on a REM contract. Institutions were down, particularly Mendota, because the bill was late this month. Income Maintenance was up slightly due to an increase in burials. Energy Assistance was high this month due to beginning the energy heating period. Motion by Endres, seconded by Fordham to approve the vouchers in the amount of $2,006,285.86.
    Motion Carried.
  2. Review and Approve 2007 Rates: Horkan discussed the new rates for Human Services for 2007 and distributed the Human Services Rate Resolution (see attached). Horkan explained that they were primarily minor adjustments, some slight increase in psychiatrist fees as well as a small increase in AODA master level counselor. There was a slight increase in other areas. Motion by Endres, seconded by Vertein to pass resolution as written.
    Motion Carried.

Department Updates:

  1. Long Term Care Redesign: Orth spoke about Long Term Care Redesign and the November 2006 state meeting. Endres discussed having the impression after leaving that meeting that there would be an elimination of the need for nursing homes. Zowin indicated that she was not sure this was the concept, but rather that there needs to be an increase in versatility in using a variety of options rather than just nursing homes. Orth reiterated that there needs to be a variety of services available to this population. Fordham spoke about having received some constituents advocating to do certain actions regarding either cutting or not cutting Health Care Center staff. She indicated that she hopes the County Board will allow there to be a professional dialogue to include Human Services staff and assist in the decision making for future processes. Fordham agreed to forward to Orth some of the written correspondence that she had received. Orth spoke about the variety of presentations given on November 2006. For example, the need to expand a full continuum of services. He noted that LaCrosse County has done an excellent job of this thus far. Orth further spoke about the governance options being presented in the FPSMC and discussions taking place between these coalitions throughout the state and Wisconsin Counties Association. In summary, there are several models being discussed. Orth referenced handouts in packets which review governance models, specifically related to Long Term Care Redesign. These models include potential legislative changes with new statutes being necessary to amend Family Care districts and rurals as well as 66.0301 Regulations which allow partnerships, but at this time do not allow private/public partnerships. These considerations will continue to be discussed and there are efforts to draft potential legislation which potentially could be presented in the next State budget cycle. Orth spoke about Sauk County Department of Human Services continuing to be involved in both the FPSMC and Southwest Coalitions. In respect to the Southwest Coalition, Orth spoke about utilizing that structure for aging and disability resource center development (ADRC). At this time, there has been progress with the Southwest Coalition in developing ADRC's in a regional structure of either four or eight county clusters. It is yet to be determined how the fiscal considerations will be centralized with a fiscal agent. There will be some centralized functions such as telephone and perhaps computer programming. Orth noted that in developing Sauk County's ADRC, there has been good discussions between the Commission on Aging and Human Services and that the majority of the ADRC staff will be supervised and retained within the Commission on Aging and that the exception to this will be the specific social workers that work on eligibility and currently work within Human Services. These social workers will maintain their Human Services Department assignment due to the level of technical necessity regarding these job duties. Orth noted that there are continued discussions regarding the structure of the ADRC and a work group which is chaired by Kathy Schauf. Orth also distributed a handout from the packet which reviewed the Southwest Coalition summary for board members to review in the future.
  2. Crisis Bed Update: Brattset reported on the crisis bed adult family home. Brattset indicated that the current contract with the adult family home that had been handling crisis for Sauk County Department of Human Services, had expired and this vendor had resigned. There is currently a search for a new adult family home to utilize for crisis clients. In addition, Lutheran Social Services has been contacted to consider providing adult family home crisis setting.
  3. Personal Care Program: Orth reported that information will be forthcoming in the January 2007 meeting about the Personal Care Program as a formal presentation to the Human Services Board.
  4. Monthly Report Form : Orth reviewed the Monthly Report (provided in packet) and indicated that the outpatient measures are noted through the end of September 2006. Orth further reiterated that it is projected that these will exceed 2005 service numbers. In regards to the outcome efficiency measures, several programs had greater than 90% satisfaction and 95% ratings as services being effective. Orth noted that there will be a year end summary as data is available. Orth noted that next year, there will be a program by program satisfaction and effectiveness outcome results.
  5. Psychiatrist Update: Orth noted that Sauk County Department of Human Services has offered a contract to Dr. Chris Nevers. Dr. Nevers has adult and adolescent experience and is comfortable seeing some children with supervision. Dr. Nevers will begin with Sauk County in May of 2007. In addition, Orth noted that there is consideration for hiring a part-time child psychiatrist, Dr. Kwam, who is currently retiring from Mendota. This would be on a one day per week or such scheduled to be determined. At this time, Orth reported that there is a need for an interim psychiatrist so Sauk County Department of Human Services will be contracting for a locum tenens physician to fulfill that need.
  6. All Staff Meeting: Orth and Brattset reported on the all staff meeting which occurred in November. Staff indicated a very favorable impression of the review of departmental changes and goals. It was impressive, noted Orth, to see staff being active participants in discussions that affect direct client care and services. Brattset and Orth noted that they plan on continuing these staff meetings twice per year in the future and on occasion they also involve specific training agendas.
  7. Quality Service Reviews: Orth noted that he has participated in a number of Quality Service Reviews for child protective services throughout the state. In summary, Orth indicated that the reviews are quite comprehensive, interviewing parents, providers, and social workers. There are numerous indicators to judge child protective service quality. Orth indicated that this has increased his understanding of child protective services and quality concerns. In addition, these dialogues occurring between counties and quality service reviewers is quite constructive. Orth noted that there is a focus on teams and integrated services in the reviews, and that he feels Sauk County Department of Human Services is well situated in that these methods are employed quite regularly. Orth further noted that Sauk County Department of Human Services is scheduled some time in early 2008 for a quality service review.

Motion by Zowin, seconded by Endres to adjourn.
Motion Carried.

The next meeting of the Sauk County Human Services Board is scheduled for Monday, January 8, 2007.

Respectfully Submitted: Judith Stoeckmann