HEALTH AND HUMAN SERVICES COMMITTEE MEETING AGENDA Date & Time of Meeting: Tuesday, March 20, 2018 at 6:05 p.m. Meeting Location: Employee Resources Conf Room, C-149, 500 Forest Street, Wausau WI 54403 Health & Human Services Committee Members: Matt Bootz, Chair, John Robinson, Vice-chair, Bill Miller; Orval Quamme; Katie Rosenberg, Maynard Tremelling, Todd Van Ryn Marathon County Mission Statement: Marathon County Government serves people by leading, coordinating, and providing county, regional, and statewide initiatives. It directly or in cooperation with other public and private partners provides services and creates opportunities that make Marathon County and the surrounding area a preferred place to live, work, visit, and do business. (Last updated: 12-20-05) Health & Human Services Committee Mission Statement: Provide leadership for the implementation of the strategic plan, monitoring outcomes, reviewing and recommending to the County Board policies related to health and human services initiatives of Marathon County. 1. Call Meeting to Order 2. Public Comment (15 minute limit) 3. Approval of the January 29, 2018 Meeting Minutes 4. Educational Presentations/Outcome Monitoring Reports No reports this month 5. Policy Issues Discussion and Committee Determination to the County Board for its Consideration A. Approval of Sue Gantner, Board of Health Member, to Attend Public Health Conference in May 2018 B. Review List of Quartile 3 and 4 Social Services Programs C. Status Report on 2018 Human Services Initiatives and Discussion of Priorities and Sequences 1. Aquatic Therapy Pool 2. Mount View Care Renovation 3. Drug Court 4. Drug Abuse (Heroin, Methamphetamines, Opioid) Study 5. Master Facility Plan for NCHC Campus 6. Senior Center Activity Center 6. Next Meeting Logistics and Topics: A. Committee members are asked to bring ideas for future discussion B. Next Scheduled Meeting: Monday, April 23, 2018 at 4:00 p.m. 7. Announcements 8. Adjournment Any person planning to attend this meeting who needs some type of special accommodation in order to participate should call the County Clerk s Office at 715-261-1500 or e-mail infomarathon@mail.co.marathon.wi.us one business day before the meeting. SIGNED /s/ Matt Bootz Presiding Officer or Designee FAED TO: Wausau Daily Herald, City Pages, and NOTICE POSTED AT COURTHOUSE FAED TO: Other Media Groups FAED BY: Mary Palmer BY: Mary Palmer FAED DATE: DATE: FAED TIME: TIME:
MARATHON COUNTY HEALTH AND HUMAN SERVICES COMMITTEE MEETING MINUTES Monday, January 29, 2018 4:00 p.m. North Central Health Care Board Room, 1100 Lake View Dr, Wausau WI 54403 Attendance: Present Absent Matt Bootz, Chair John Robinson, Vice Chair Bill Miller E Orval Quamme Katie Rosenberg Maynard Tremelling Todd Van Ryn Also Present: Lance Leonhard, Michael Loy, Joan Theurer, Kurt Gibbs, Brenda Budnik, Bill Metter, Jean Burgener, Peter Weinschenk, Jack Hoogendyk, Tim Buttke, Allen Drabek, Brenda Glodowski, Debbie Ostrowski, Brenda Budnik, Kim Gochanour, Carl Mullencamp, Mary Palmer 1. Call Meeting to Order The Health & Human Services meeting was called to order at 4:04 p.m. by Chair Matt Bootz 2. Public Comment - None 3. Approval of the December 11, 2017 Meeting Minutes MOTION BY ROSENBERG; SECOND BY QUAMME TO APPROVE THE DECEMBER 11, 2017 MEETING MINUTES AS MODIFIED. MOTION CARRIED. 4. Educational Presentations/Outcome Monitoring Reports None requested. 5. Policy Issues Discussion and Committee Determination to the County Board for its Consideration A. Resolution in Support of Increasing State Funding For and Expanding Access to the Treatment Alternatives and Diversion (TAD) Grant Program (Joel Lewis) Discussion: No discussion occurred because Joel Lewis was not in attendance and committee members did not have enough information to support a discussion on this topic. Action: None taken. Follow through: None requested. B. Review List of Quartile 3 and 4 Human Services Programs Discussion: Joan Theurer, Health Officer, described the quartile 3 and 4 programs administered by the Health Department: Child Health work with about 30 kids and families per year that need services beyond the scope of Start Right First Steps because of these factors:: Cognitive or physical disability Lead exposure Child Abuse and neglect Failure of child to thrive 1
Case management connects the family to community resources. Food Systems focused on the challenge of obesity. (37% levy) Healthy weight is an important health priority. Some of the methods used to improve healthy eating include: Healthy Eating Active Living (HEAL) Coalition. Promote local produce, community gardens, nutrition education. Farmer s market assisting in accessing food share. Farm to school to provide students with access to fresh, local food. National Public Health Accreditation to ensure that local services are provided at the highest quality standards. Northern Regional Children Special Health Care Needs works to improve systems of care from birth through 21 with a chronic physical, developmental, behavioral or emotional illness that requires specialized health or education services. (90% grant funded) Start Right (90% tax levy funded) provides support and parent coaching from pregnancy to age five. Start Right focuses on: Safe, healthy nurturing families. School ready children. Parents connected to community resources that support effective parenting. Tobacco Control (36% County levy) continuing education about tobacco use as products are changing/altered/innovative and new devices. Tuberculosis (TB) Case Management (96% County levy) follow up with people who have latent (non-infectious) and active (infectious) to prevent further spread of TB in the community. Water Testing Lab (53% County levy). Lab was discussed by committee at a prior meeting. Service benefits both rural families and municipalities. Immunization Clinic (71% County levy) prevent the spread of disease. Service now provided in the County Jail. Marathon County providers utilize an immunization registry so that opportunities for immunization are optimized. Sexually Transmitted Disease Clinic (93% County levy) provides screening, treatment and partner follow-up. Clinic at the jail ½ day per week. Committee members stressed the importance of finding some savings in lower priority programs to be the funding source for higher priority, expanding priority programs. Action: None taken. Follow through: Committee members asked that Social Services report on their quadrant 3 and 4 programs in February. Knowing whether the service was mandated at a certain level, how many people are served and any costs that are avoided as a result of the program are areas of interest. Also, at a subsequent meeting a refresher on how a County board member can navigate the Priority Based Budgeting data base is requested. C. Status of the Drug Abuse/Opioid Task Force in Light of the Educational Presentation to the County Board Intended to Suggest that the Task Force is Not Needed 2
Discussion: Before the Task Force can move forward with a comprehensive plan, an inventory of what we are currently doing needs to be compiled. The Task Force will not only be reviewing what s currently being done but looking for gaps. Without the inventory it will be a struggle to see what should be tackled first. There was also a mix of operations and public policy. Without the public policy it wouldn t be a good use of time. Identify best management practices, best practices already being done and an analysis of other opportunities out there. Marathon County is already ahead of the curve. This is the biggest crisis we have and it can t be dealt with in traditional ways. It needs to move forward sooner than later but we also need to know what resources are needed to get those in the 2019 budget. A decision will need to be made whether we need a Task Force or whether Health and Human Services and/or Public Safety should be the guiding committee(s). A joint meeting of the two should be set up in the future to talk about this. Action: None taken. Follow through: Have a discussion on this at the February Executive Committee. CONSENSUS EMERGED THAT AT 5:00 PM THE HEALTH & HUMAN SERVICES COMMITTEE WOULD SUSPEND THEIR MEETING AND JOIN THE JOINT MEETING OF HEALTH & HUMAN SERVICES, MOUNT VIEW CARE CENTER COMMITTEE AND THE NURSING HOME OPERATIONS COMMITTEE. AT 6:15 PM THE JOINT MEETING WAS ADJOURNED AND HEALTH & HUMAN SERVICES CONTINUED WITH THEIR MEETING. D. Timeline and Information that will be Needed in Support of a Borrowing Resolution for a Mount View Care Center Renovation Discussion: The committee agreed that it s premature to be talking about debt. Although NCHC would like the borrowing resolution to go before the current County Board it will be difficult to move it forward without a facilities plan. Suggested next steps are to take the Mount View Care Center Committee recommendations and develop a FAQ document/ brochure and then have MVCC make their recommendation to Health & Human Services, Human Resources/Finance and then County Board. Action: None taken. Follow through: None requested at this time. 7. Announcements: None 8. Adjournment There being no further business to discuss, MOTION BY ROBINSON; SECOND BY VAN RYN; TO ADJOURN THE HEALTH & HUMAN SERVICES COMMITTEE MEETING. MOTION CARRIED. Meeting adjourned at 6:18 p.m. 3
Marathon County Department of Social Services Priority Based Budgeting Quadrant 3 and Quadrant 4 Programs Over $100,000 Quadrant 3 Programs Children's Community Options Program 110,660 100,000 10,660 Comprehensive Community Services Case Management 363,406 363,039 367 Out of Home Care - Group Home 788,430 300,998 487,432 Out of Home Care - Residential Care 2,170,381 858,438 1,311,943 Out of Home Care - Treatment Foster Care 710,005 281,245 428,760 Volunteer Drivers - Child Transport 149,392 47,962 101,430 Economic Support - Administration 137,457 126,168 11,289 Elderly Blind and Disabled - Long Term Care 242,797 222,858 19,939 Elderly Blind and Disabled - Economic Support - Medicaid 196,492 180,356 16,136 Family Services - Child Care 444,595 408,084 36,511 Family Services - Food Share 538,210 494,011 44,199 Family Services - Medicaid 761,347 698,823 62,524 Wisconsin Home Energy Assistance 367,767 332,338 35,429 Quadrant 4 Programs Education Training Voucher - DCF Scholarship 504,612 456,000 48,612 Residential Care Diversion 154,925 37,280 117,645
Marathon County Department of Social Services Priority Based Budgeting Quadrant 3 and Quadrant 4 Programs Over $100,000 Quadrant 3 Programs Children's Community Options Program 110,660 100,000 10,660 Description: Funding source used to provide for match on Children s Long Term Support (CLTS) service plan expenditures and services not covered under CLTS waiver. Comprehensive Community Services Case Management 363,406 363,039 367 Description: Social Work staff provide intensive case management services to youth in the custody of social services who have diagnoses of mental health issues. Out of Home Care Group Home 788,430 300,998 487,432 Description: Payment to group home facilities that are licensed by the State. Provides a higher degree of structure than foster homes. Out of Home Care Residential Care 2,170,381 858,438 1,311,943 Description: Payment to Residential Care Centers (Institutional Care) for children and youth who have significant behavioral or medical needs; high staff to resident ratio. Out of Home Care Treatment Foster Care 710,005 281,245 428,760 Description: Payment to treatment level foster parents, who are more highly trained to care for youth with complicated needs, but can be maintained in our community. Volunteer Drivers Child Transport Description: Contract for transportation, primarily volunteer drivers, to assist in youth and family transports for appointment and visits, pursuant to court ordered services. 149,392 47,962 101,430
Quadrant 3 Programs Economic Support Administration Description: Administrative 137,457 126,168 11,289 Support staff completing program requirements in place of Economic Support Specialists including child care alerts, child care provider audits, ES inbox and appointment scheduling. Elderly Blind and Disabled Long Term Care 242,797 222,858 19,939 Description: Economic Support Specialists and Lead Economic Support Specialist provide eligibility processing of applications and renewals for Institutional (nursing home) and Family Care (community based care) long term care. Includes Call Center responsibilities and in person interviews and fair hearing attendance for eligibility appeals. Elderly Blind and Disabled Economic Support Medicaid 196,492 180,356 16,136 Description: Economic Support Specialists and Lead Economic Support Specialist provide eligibility processing of applications and renewals for Medicaid. Includes Call Center responsibilities and in person interviews and fair hearing attendance for eligibility appeals. Family Services Child Care 444,595 408,084 36,511 Description: Economic Support Specialists and Lead Economic Support Specialist provide eligibility processing of applications and renewals for Child Care. Includes Call Center responsibilities and in person interviews and fair hearing attendance for eligibility appeals. Family Services Food Share Description: Economic Support Specialists and Lead Economic Support Specialist provide eligibility processing of applications and renewals for Food Share. Includes Call Center responsibilities and in person interviews and fair hearing attendance for eligibility appeals. 538,210 494,011 44,199
Quadrant 3 Programs Family Services Medicaid Description: Economic Support Specialists and Lead Economic Support Specialist provide eligibility processing of applications and renewals for Medicaid. Includes Call Center responsibilities and in person interviews and fair hearing attendance for eligibility appeals. Wisconsin Home Energy Assistance Description: Contract for eligibility determination for heating and electrical assistance throughout the heating season and crisis assistance throughout the year. 761,347 698,823 62,524 367,767 332,338 35,429 Quadrant 4 Programs Education Training Voucher DCF Scholarship Description: Funding source for Department of Children and Families Education and Training Scholarship program. Marathon County is the fiscal agent for the state. A 5% administrative rate is charged. 504,612 456,000 48,612 Residential Care Diversion Description: Funds that are used flexibly to support families in maintaining children and youth to avoid out of home placements in high cost settings such as residential care. 154,925 37,280 117,645