McLean County Times

McLean County Health Committee met Dec. 5.

Here is the minutes provided by the committee:

Members Present: Chairman Susan Schafer, Members: Carlo Robustelli, Randall

Martin, Laurie Wollrab, Catherine Metsker, George Gordon and

George Wendt via remote attendance.

Members Absent:

Other Members Present:

Staff Present: Members Present: Chairman Susan Schafer, Members: Carlo Robustelli, Randall Martin, Laurie Wollrab, Catherine Metsker, George Gordon and George Wendt via remote attendance. Members Absent: Other Members Present: Staff Present:

Department Heads/Elected Officials Present: Ms. Cindy Wegner, Nursing Home Director; Ms. Michelle Welch, Adult Detention Center; Jason Tabb, Director Juvenile Detention Center; Ms. Camille Rodriguez, Administrator Health Department

Others Present:

Chairman Schafer called the meeting to order at 4:30 p.m. and declared a quorum. She informed the Committee that Member Wendt had requested to attend remotely under County Board Rules and asked if there was any objection. Hearing no objection, she approved Mr. Wendt’s request to attend remotely and declared him present.

Chairman Schafer presented the minutes from the September 18, 2018 special meeting and October 1, 2018 regular meeting for approval.

Motion by Martin/Gordon to approve the minutes from the September 18, 2018 special meeting and October 1, 2018 regular meeting.

Motion carried.

Chairman Schafer confirmed there were no members of the public.

Ms. Michelle Welch, Jail Medical and Mr. Jason Tabb, Director for Juvenile Detention Center presented their reports. Chairman Schafer asked if there were questions for Ms. Welch and Mr. Tabb, hearing none, she thanked him.

Chairman Schafer indicated that Ms. Rodriguez had one action item and asked if the Committee was ok moving it to later on the Agenda as it related to budget matters. The Committee agreed.

Ms. Rodriquez presented the monthly reports for the Health Department. Chairman Schafer asked if there were any questions or comments for Ms. Rodriguez, hearing none, she thanked her.

Ms. Cindy Wegner, Director of the Nursing Home presented for action a request to approve the 2019 Private Pay Rate for the Nursing Home. Ms. Wollrab asked if there was a survey done to compare these rates to private facilities. Ms. Wegner indicated she did review private facility rates and did research and found that 3% was the general increase. Ms. Wollrab asked what the average rates were for semi-private and private rooms. Ms. Wegner indicated semi-private rates from $223-232 and $258 to over $300 for a private room. Ms. Wegner indicated that these rates were used to determine her budget.

Motion by Robustelli/Metsker to recommend approval of the 2019 Private Pay Rate for the Nursing Home.

Motion Carried.

Ms. Wegner presented for action a request to approve a contract for Food Services at the Nursing Home with Cisco Central Illinois. Mr. Trevor Sierra provided a summary of the proposal and indicated Cisco had the lowest cost for the most services. He indicated they could not come to terms on a contract and decided entering into pricing agreement with Cisco would be just as beneficial. Mr. Gordon asked if we were planning to go into negotiations for the rest of the contract beyond the pricing agreement. Mr. Sierra indicated Staff was satisfied with the pricing agreement. Mr. Martin asked about the margin in schedule 2. Mr. Sierra indicated it is 7.5% above their cost. Ms. Metsker asked about renewal of this agreement. Mr. Sierra stated this was an indefinite price agreement with a clause that any party can exit with 30-days’ notice, so no renewal is required.

Ms. Wollrab asked him about provisions that had excluded in this agreement that would have been included in a contract. Mr. Sierra provided an example that the contract would have been required the Nursing Home to purchase 80% of its food and small wares from Cisco but pricing agreement does not have that requirement. He also indicated that Indemnity clauses were eliminated. Ms. Wollrab asked if we had any recourse if Cisco was unable to deliver any goods or if goods were spoiled. Mr. Sierra stated we would depend on the UCC provisions that apply to the sale and delivery of goods. He also stated that if Cisco could not provide a delivery, the nursing home could order from another vendor, as we are not under contract to order a certain amount from them.

Motion by Metsker/Gordon to recommend approval of a contract for Food Services at the Nursing Home with Cisco Central Illinois.

Motion Carried.

Ms. Wegner presented her monthly reports. Ms. Schafer asked about ACO admits and if these were the first ones. Ms. Wegner indicated they were and that there had been two more since this report. Chairman Schafer asked if there were any other questions, hearing none she thanked Ms. Wegner.

Ms. Schafer indicated the next item on the agenda was the Tort Judgement Juvenile Detention (0135-0077-0022) and Tort Judgement Risk Management/Correctional Health Services (0135- 0077-0073) budgets. Mr. Wasson indicated there have been some changes to contracts for Jail Medical based on the expansion. Ms. Metsker asked about reductions. Mr. Wasson stated that prescription and pharmaceutical service reductions were due to the issuance of an RFP and a contract that had a significant reduction in cost. Ms. Metsker asked about numbers at the Juvenile Detention Center. Mr. Tabb indicated that the numbers have been relatively even the last three years.

Motion by Robustelli/Martin to recommend the Tort Judgement Juvenile Detention (0135-0077-0022) and Tort Judgement Risk Management/Correctional Health Services Budget (0135-0077-0073) budgets. Motion Carried.

Ms. Schafer presented for review and approval the Nursing Home (0401 – 0090) budget. Mr. Wasson stated that nursing home budget was partially driven by the goal to increase utilization of the two ACO’s within the community. He said the OSF ACO was in place with referrals coming in and negotiations continue for the ACO with Advocate. Ms. Wollrab asked if there were changes to the FTEs from the recommended budget. Mr. Wasson stated there were not. Ms. Wollrab asked if money was budgeted for marketing of the Nursing Home as recommended by the Blue Ribbon Panel. Ms. Wegner indicated no money was budgeted for a study, but money was budgeted for marketing brochures, admission coordinator, nurse liaison and senior fairs. Ms. Wegner stated they are working to get the licensure changed to relocate therapy to the other side of the building which would allow them to offer outpatient therapy services. She stated it had been decided to wait to change brand until after that was completed. Ms. Wollrab asked about timing. Ms. Wegner indicated in 2019 they would work to change the therapy unit and then planned rebranding in 2020. Ms. Wollrab stated she thought the Blue Ribbon Committee had indicated they felt it was very important to change the branding sooner rather than later. Mr. Schmitt stated that in the last few Blue Ribbon Panel meetings they discussed holding off on rebranding until there was a final product. Mr. Schmitt indicated the Nursing Home has started building up services as recommended by the Panel. Ms. Wegner provided examples including recently achieving wound care certification and starting a COPD program.

Ms. Wollrab asked about the increased amount budgeted for Medicare reimbursement. Ms. Wegner indicated the numbers were based on current trends and the addition of the ACO and the three-day waiver that would allow them to increase the Medicare census more rapidly. Ms. Wollrab questioned the decrease in FTE’s since the Blue Ribbon panel recommended an increase in staff and decrease in agency staff. Ms. Wegner indicated that in the FTE’s they budgeted for were never all filled, so they reduced FTE count to a more accurate number. Ms. Metsker asked her to confirm they made the budget more realistic. Mr. Wasson confirmed the budget presented was based on the general census over the past year and on the current employment market. Ms. Metsker asked them to confirm we are offering full-time at 30 hours a week with benefits and still could not always fill positions. Ms. Wegner confirmed. Ms. Schafer asked about therapy equipment and if this was based on need. Ms. Wegner confirmed request was based on the needs of patients.

Motion by Wollrab/Martin to recommend approval of Nursing Home (0401 – 0090) budget.

Motion Carried. Mr. Wendt voted no.

Mr. Wasson indicated the first budget being presented for the Health Department for approval had been presented last month, but the Preventative Health Program Grant Fund had recently received an additional grant. Ms. Dreyer went over the changes indicating they received a tobacco grant in the amount of $41,000 so moved.64 FTE from the 112.0067 Fund into this 105 Fund to perform the duties of the tobacco grant. Mr. Robustelli asked them to confirm how much that saved the 112 Fund. Ms. Dreyer indicated it saved $41,000.

Motion by Metsker/Martin to recommend approval of the Health Department Preventative Health Program Grant Fund 0105.

Motion Carried.

Mr. Wasson stated the second set of budgets for approval were the 112 Funds that were also discussed last month. He stated that the Committee had moved Ms. Rodriguez’s action item to this point in the meeting since it could affect the Health Department’s budget and turned the floor over to Ms. Rodriguez.

Ms. Camille Rodriguez, Administrator of the Department, presented for action a request to approve an Amendment to McLean County Code Article XVIII: Miscellaneous Code Fees Chapter 205: Section 205-90 Chapter 216 Food Service Fees. Ms. Rodriguez indicated there had been discussion about changes to this at last month’s meeting but she did not change the amounts because she wanted to respect the Board of Health’s decision to pass those amounts. She indicated that during 2019 they would provide information to both the Board of Health and the Health Committee on what happens in the McLean County and not other Counties, so they could appropriately discuss any changes to the fee structure. Ms. Rodriguez stated this would also give them time to analyze how changes implemented by the Food and Drug Administration would affect time spent on inspections. Ms. Schafer asked about the $41,000 saved in this Fund and whether they had considered using part of that to eliminate the increase in Food Service fees. Ms. Rodriguez indicated that if the Committee did not agree to increase the fees, they would hold off on the purchase of equipment in that Fund. Mr. Robustelli said that he did not understand why they did not purchase equipment if there was $41,000 more dollars in this Fund. Ms. Rodriguez indicated they would incur expenses as a result of receiving the grant, so they wanted to keep the funds available for those possible expenses. Ms. Wollrab thanked them for offering to look at data, but provided existing data from the Labor of Statistics showing a 2.2% increase, which led her to question the requested 3% increase. Ms. Metsker asked if fee increase was included in the budget. Ms. Rodriguez confirmed fee increase was included.

Motion by Metsker/Gordon to recommend approval of Amendment to McLean County Code Article XVIII: Miscellaneous Code Fees Chapter 205: Section 205-90 Chapter 216 Food Service Fees.

Motion Carried 4/3. Voting Yes – Gordon, Metsker, Wendt, Schafer; Voting no – Martin, Robustelli, Wollrab

Ms. Schafer indicated even though the fees had been approved, she hoped the Health Department would do as indicated and look into the fee structure so this same discussion did not occur again next year. Ms. Rodriguez confirmed. Ms. Metsker asked them to confirm it could mean a restructure of the fee system. Ms. Rodriguez confirmed. There was discussion about how often they would bring reports to the Board of Health and Health Committee. Ms. Metsker asked them to confirm that every County follows the same criteria for inspections from the Food and Drug Administration. Ms. Rodriguez confirmed that currently and in the future all counties follow same inspection criteria, but have different fee structures.

Ms. Schafer presented for review and approval Health Department Fund (0112) Programs; Mental Health (0060), Environmental Health (0061), Personal Health Services (0062) Administrative Support (0063), Immunization Program (0064), Health Promotion (0067), Problem Solving Courts (0069), Community Outreach (0096) TB Care & Treatment Program (0111) budget. Ms. Schafer asked them to confirm that the changes from the grant funds in 0105 are in this budget. Mr. Wasson confirmed. Mr. Robustelli asked them where expenses referenced with the grant were or if the $41,000 was going into a reserve. Ms. Dreyer indicated the $41,000 was originally to be pulled out of the unappropriated fund balance so they adjusted amount from unappropriated fund. Mr. Robustelli asked them to confirm that $41,000 was added to the 112 unencumbered fund balance. It was confirmed.

Ms. Rodriguez next discussed another grant the Health Department received. She stated they had been included as a partner in a HRSA federal grant with Illinois State University and Mennonite College of Nursing to work with several not-for-profits to provide on the job training to nurses to increase the public health work force. Ms. Metsker asked if FTE’s had changed. Ms. Dryer indicated it was all in the 96 sub-department fund and there was an increase in FTE count.

Ms. Wollrab asked Ms. Rodriguez to describe their contract with the East Central Area Agency on Aging. Ms. Rodriguez indicated the Agency on Aging had approached the Health Department with a need for home visits to administer medication, so the Health Department provides those services through a grant. Ms. Wollrab indicated she did not see that contract in the minutes for the Board of Health. Ms. Rodriguez indicated it was not presented to the Board. Ms. Wollrab asked her to describe the process for approval of contracts with the Board of Health. Ms. Rodriguez stated that because of timing it was not presented but indicated they are currently evaluating how they can better address contracts that come up between Board meetings. Ms. Wollrab said they are approving financial information and was uncomfortable with the idea the Board of Health had not been able to consider contracts this funding covered. Ms. Rodriguez appreciated that and assured her they are working to make sure the Board of Health is aware of all contracts and assured her that contracts are reviewed by legal staff. Ms. Wollrab said she appreciated the legal review but felt that officials should have the opportunity to review the contracts. Ms. Schafer stated it had been discussed numerous times at Board of Health meetings and they were looking at developing an ad hoc committee to address.

Motion by Martin/Metsker to recommend approval of the Health Department Fund (0112) Programs; Mental Health (0060), Environmental Health (0061), Personal Health Services (0062) Administrative Support (0063), Immunization Program (0064), Health Promotion (0067), Problem Solving Courts (0069), Community Outreach (0096) TB Care & Treatment Program (0111) budget. Motion Carried.

Mr. Wasson went over the employment activities under the purview of this Committee. He also indicated that the Blue Ribbon Meeting minutes had been included.

Chairman Schafer indicated the next meeting would be Monday, December 3, 2018 at 4:30 p.m. There was discussion about the holiday meetings and it was determined they would determine date/time of meeting after the reorganizational meeting. She asked if there was any other business to come before the Committee; hearing none, she moved to the payment of the bills.

Chairman Schafer presented for approval bills for Jail Medical and JDC Medical with a prepaid and fund total of $64,006.82.

Motion by Gordon/Wollrab to approve bills for the Nursing Home as presented. Motion carried.

Chairman Schafer asked if there was any additional business to come before the Committee; hearing nothing, she adjourned the meeting at 5:50 p.m.

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