WASHINGTON COUNTY HUMAN SERVICES BOARD. Public Agency Center, Room 3224 June 11, 2015

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1 WASHINGTON COUNTY HUMAN SERVICES BOARD Public Agency Center, Room 3224 June 11, 2015 West Bend, WI 1:00 p.m. Members Present: Leslie Borman, Kristine Deiss, Dawn Eyre, Sarah Follett, Robert Hartwig, Dennis Myers, Patricia Strachota Members Excused: Michael Bassill, Paul Ustruck HSD Staff Present: Eric Diamond, Sandy Hoefert, Mary Knoeck, Jackie Moglowsky, Maureen Murphy, Sandy Potter, Leigh Sanderson, Renae Zagel Guests Present: Matt Berry, Genoa a QoL Healthcare Company, John Bloor, Executive Director, The Threshold, Inc., Sue Haag, Finance Director, Bill Kurer, Purchasing Manager, Joshua Schoemann, County Administrator, Chase Woods, Genoa a QoL Healthcare Company Chairperson K. Deiss called the meeting to order at 1:00 p.m. MINUTES Motion by L. Borman, seconded by D. Eyre to approve the Human Services Board minutes from the May 13, 2015 meeting as distributed. Motion carried. WISCONSIN DEPARTMENT OF CHILDREN AND FAMILIES CERTIFICATE OF EXCELLENCE PRESENTATION Presented by K. Deiss, Human Services Board Chairperson. On behalf of the Human Services Department, Sandy Potter, Economic Support Manager and Renae Zagel, Economic Support Supervisor were presented with an Award of Excellence from the State of Wisconsin Department of Children and Families for meeting all performance standards in the administration of the Wisconsin Shares child care subsidy program. BEHAVIORAL HEALTH DIVISION CLINIC PHARMACY CONTRACT Presented by E. Diamond, Client Services Director. An overview was provided on the benefits of contracting with Genoa a QoL Healthcare Company to operate a clinic pharmacy on the second floor of the Public Agency Center (PAC). Questions and answers were addressed by M. Berry and C. Woods from Genoa. Genoa will renovate existing HSD space, employ pharmacy staff, and pay rent (fair market value) monthly for use of HSD space. Motion by D. Myers, seconded by S. Follett to authorize contracting with Genoa, a Clinic Pharmacy Provider on the second floor of the PAC in existing HSD space. Motion carried. SCHENCK BUSINESS OPTIMIZATION RECOMMENDATIONS FOR HUMAN SERVICES DEPARTMENT ACCOUNTING DIVISION Presented by S. Haag, Finance Director, M. Murphy, Human Services Administrator, J. Schoemann, County Administrator. In May 2015 HSD contracted with Schenck to conduct an internal review of HSD Accounting operations. Recommendations from Schenck were shared

2 Human Services Board June 11, 2015 Page 2 of with proposed corrective action. Questions and answered followed. Updates regarding these items will be provided at future meetings. ORDINANCE: STAFFING PLAN MODIFICATION BILLING SUPERVISOR POSITION Presented by S. Haag, Finance Director, M. Murphy, Human Services Administrator, J. Schoemann, County Administrator. In response to the Schenck Business Optimization Recommendations to move forward with the clean-up and collection process of HSD open billings a request was made to approve creation of a Billing Supervisor position. Questions and answers followed. P. Strachota motioned, D. Myers seconded to approve creation of a Billing Supervisor position at Pay Grade 8 of the Washington County Staffing Plan within the Human Services Department. Motion carried. HUMAN SERVICES ADMINISTRATOR S REPORT M. Murphy presented the Human Services Administrator s Report. NEXT TENTATIVE MEETING DATE The next HSD Board meeting is tentatively scheduled for Wednesday, July 8, 2015, at 8:00 a.m. in Room 1023 of the Public Agency Center. ADJOURNMENT Meeting adjourned at 2:19 p.m. Leigh Sanderson, Recording Secretary

3 Summary of Out-of-Home Care for Children 2015 (5/31/15 Financials) 2015 Budget 2015 as of 5/31/15 Balance Remaining % USED Reg. & Treatment FC $ 490,000 $ 298,960 $ 191,040 61% Group Care $ 250,000 $ 15,014 $ 234,986 6% Residential Care Cnt $ 627,983 $ 429,736 $ 198,247 68% Inpatient CC $ 20,000 $ - $ 20,000 0% Sub-Total $ 1,387,983 $ 743,710 $ 644,273 54% State Corrections $ 250,000 $ 97,934 $ 152,066 39% TOTAL $ 1,637,983 $ 841,644 $ 796,339 51% State Aid CLTS $ 27,000 $ - $ 27,000 0% Parental Fees $ 168,000 $ 67,531 $ 100,469 40% $ 195,000 $ 67,531 $ 127,469 35% As of May 14 As of May 15 Regular Foster Treatment Foster 9 15 Group Care 4 0 Residential 12 6 Corrections 3 3 (2-corr.sanc/1 group) 2014 Budget 2014 as of 5/30/14 Balance Remaining % USED Regular & Treatment $ 507,655 $ 190,529 $ 317,126 38% Foster Care Group Care $ 217,000 $ 19,932 $ 197,068 9% Residential Treatment $ 623,368 $ 377,398 $ 245,970 61% Center Inpatient $ 20,000 $ - $ 20,000 0% CC Sub-Total $ 1,368,023 $ 587,859 $ 780,164 43% State Corrections $ 270,000 $ 118,839 $ 151,161 44% TOTAL $ 1,638,023 $ 706,698 $ 931,325 43%

4 COMMITTEE REPORT To: Human Services Board From: Jackie Moglowsky, Behavioral Health Manager Date: July 8, 2015 Re: YTD Use of Hospitals POLICY QUESTION: None - Update of 2015 hospitalizations and inpatient budget. DISCUSSION: In 2014 the inpatient budget was $795, and total expenses were $944, In 2015 the inpatient budget is $800, Through April 2015, $487, (61%) of the budget has been used. Attachment A identifies each hospital we contract with and the number of days we have used for each. Also shown is the payment source for each facility. Whenever possible, placements are facilitated at a hospital that is in-network with the identified insurance. Factors that can prevent this are legal holds, aggression levels, or bed availability. Fond du Lac County Acute unit (FDL) is our facility of first choice for uninsured and non-hmo Medicaid admissions. They are also used in an effort to prevent admissions to the institutes for some cases that involve legal holds or aggressive behaviors. Winnebago Mental Health Institute (WMHI) and Mendota Mental Health Institute (MMHI) are used as last resorts and only accept involuntary admissions. Acute Care Services (ACS) staff has successfully diverted 156 hospitalizations so far this year. The most significant diversion plan includes the use of Calm Harbor (CH). Calm Harbor is an 8 bed licensed Community Based Residential Facility (CBRF) owned by Elevate, Inc., and serves as a short-term stabilization facility. Hospitalizations are prevented and shortened by the use of CH which provides 24/7 awake staff. Attachment B provides some additional information regarding the admissions to WMHI. As shown, bed availability is a significant problem, especially for adolescents. The recent opening of Rogers Memorial in Brown Deer added 16 adolescent beds and 16 adult beds to our area. We expect this to have an impact on the number of admissions we have been having at WMHI.

5 FISCAL EFFECT: With one-third of the year complete and 61% of the budget utilized, there is obvious concern. Revenue is expected from MMHI and WMHI, however amounts or timeframes are not known and can vary greatly. Attachment C shows 2014 Revenue/Expense data and Jan-Apr 2015 Revenue/Expense data is shown in Attachment C. Inpatient trends of revenue and expenses for the past five years are also included. ATTACHMENTS: Attachment A: January April Placements Attachment B: January April Institute Admission Data Attachment C: Revenue and Expenses RECOMMENDATION: None update only.

WASHINGTON COUNTY HUMAN SERVICES DEPARTMENT MAUREEN MURPHY, Administrator DATE: July 8, 2015 TO: FROM: RE: Washington County Human Services Board Maureen Murphy, Human Services Administrator JUNE

12 WASHINGTON COUNTY HUMAN SERVICES DEPARTMENT MAUREEN MURPHY, Administrator DATE: July 8, 2015 TO: FROM: RE: Washington County Human Services Board Maureen Murphy, Human Services Administrator JUNE HUMAN SERVICES ADMINISTRATOR S REPORT The Human Services Department has created an internal communication tool to keep the 135 or so employees informed and engaged. The news brief will feature new employees and recently transitioned employees too as well as program and project updates. Program Assistant Amy Marx is assisting me with this project. The Program Specifications were sent to our providers this month. The specs are requesting that our providers submit requests at 97% of last year s HSD budget. Accounting Division The new Billing Supervisor (under-filled Accounting Manager) started on June 15. Anita Olson had ten years of service with HSD prior to her re-arrival. She is charged with assisting me in addressing the billing and collections within HSD. Her main focus will be to clean up past collections and keep HSD up-to-date on all future revenue collections. She will be introduced at the July Board meeting. After the discussion and concerns raised at the June meeting, staff revisited the Schenck report and discussed ways to pay for implementation of the recommendations. As a result of the Accounting Manager position vacancy and the new Billing Supervisor being paid at a lower rate, there are funds available to use for implementation of the recommendations. Behavioral Health Division After the Human Services Board approved the Medical Team (psychiatrist, APNP, nurse and medical assistant) position creation package last month, the Administrative Services Committee concurred at its meeting on May 21. The package was also approved by the Finance Committee on June 24. The full County Board will take action at the July 14 meeting. The Clinic Pharmacy lease arrangement was approved by the Administrative Services Committee on June 12. Behavioral Health Manager Jackie Moglowsky will be the point person for HSD for implementation of this project. When Genoa is moved in, we will have the Board tour the facility. 333 East Washington Street Post Office Box 2003 West Bend, Wisconsin (262) FAX (262)

13 The BHD staff have begun training on LytecMD. LytecMD is the new software that replaces two systems (George and Lotus) and three databases (Vern, BHSF, Checkbook.) We plan to go live in July. Children and Families Division As presented in this report last month, the Children and Families Division has had two of its four unit managers move into other positions one within HSD and one to another agency. The Division Manager has spent the month interviewing candidates with Human Resources. I am pleased to announce that offers have been made to two candidates to fill the two vacancies. As of this writing, one has accepted. Both Supervisors will be introduced at the August HSB. Economic Support Division The County Board at its June meeting, approved keeping the temporary Economic Support Specialists. You may recall that when these positions were created, the positions had a sunset date of June The new language states that The positions are authorized on a limited-term basis while federal and state funds meet the full cost of the positions. No County levy shall be used to fund the positions. Flexibility is given to allow the full-time positions to be filled as part-time positions. Office Support Division The Office Manager is working to train all of the support staff on LytecMD. In order to streamline the billing process, the outside service providers are being retrained about billing submittals. Finally, the Division is revisiting our employee orientation process to ensure that HSD is doing our best to onboard new employees.

Courthouse - Government Center February 24, Present: Dawn Eyre, Raymond Heidtke, and Daniel Stoffel. Excused: Robert Milich and Gerald Schulz.

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