McLean County Health Committee met Aug. 5.
Here is the minutes provided by the committee:
Members Present: Chairman Susan Schafer, Members: Carlo Robustelli, George Gordon, George Wendt, Randall Martin, Catherine Metsker and Sharon Chung
Members Absent:
Other Members Present: Chairman John McIntyre
Staff Present: Ms. Camille Rodriguez, County Administrator; Mr. Eric Schmitt Assistant County Administrator; Ms. Cassy Taylor, Assistant County Administrator; Ms. Julie Morlock, Recording Secretary, County Administrator’s Office
Department Heads/Elected Officials Present: Ms. Michelle Welch, Adult Jail Medical; Ms. Tammy Brooks, Interim
Administrator Health Department; Mr. Mike Donovan, Interim
Director Court Services; Ms. Mandy Owens, Assistant Director for Juvenile Detention Center
Others Present: Sonja Reece, Board of Health
Chairman Schafer called the meeting to order at 4:30 p.m. and declared a quorum. She welcomed Cassy Taylor in her new position as Assistant County Administrator.
Chairman Schafer presented the minutes from the July 1, 2019 regular meeting for approval.
Motion by Robustelli/Martin to approve the minutes from the July 1, 2019 regular meeting.
Motion carried.
Chairman Schafer confirmed there were no members of the public to appear before the Committee.
Ms. Michelle Welch, Supervisor of the Adult Detention Medical Department and Ms. Mandy Owens, Assistant Director for Juvenile Detention Center presented their reports. Ms. Welch indicated they were getting ready to move into their new space. Ms. Schafer requested a tour after next month’s meeting. Chairman Schafer asked if there were any questions, hearing none, she thanked them.
Ms. Tammy Brooks, Health Department Interim Administrator presented her monthly reports to the Committee. Ms. Metsker thanked her for having a mother’s room at the County Fair, but indicated she thought the sign for the room should be larger next time. Ms. Brooks thanked her and said she would note that for next year. Ms. Schafer also said there was a good article in the paper on the collaboration with CHNA. Chairman Schafer ask if there were any further questions or comments for Ms. Brooks, hearing none, she thanked her.
Ms. Wegner’s presented her monthly reports. Ms. Wegner noted a difference on referral sources report. Ms. Wegner stated they receive a fax with mass requests from all over and that most of the time they turn down about 9 out of 10 of the requests. Ms. Wegner asked if they wanted her to continue to use those numbers as they skew the overall numbers. Ms. Schafer stated her definition of a referral was from a local hospital, assisted living facility instead of a blanket request to everyone. Ms. Metsker asked if we ever take any of these individuals.
Ms. Wegner stated they do look at each case and sometimes they take them, especially if there are family members here in area. Mr. Wendt asked of the current 89 residents how many lived in McLean County prior to coming to the Nursing Home. Ms. Wegner said about 98%.
Ms. Wegner stated they do get the occasional request from a family member who lives here and wants to bring family to this area. Ms. Metsker said they are separated on the report as out of area and while it skews it a bit, feels ok since it is identified separately. Ms. Schafer said the only 22% admitted looks like low admittance rate and that number affect that percentage. Mr. Robustelli asked if we separate into two groups in county and out of county, as he did not want to eliminate the information since they do take some of them from the mass request. Mr. Martin agreed because they are accessing them and accepting some. Discussion about how that would be reflected on the report. Mr. Gordon asked if they wanted to break down out of county further because there is already information on surrounding counties such as Peoria and Champaign County. Ms. Wegner said she did not consider referrals from Peoria or Champaign County the same as mass referrals from fax. Ms. Schafer said she was concerned about mass fax referrals and not the referrals that come from facility or hospital from Peoria or Champaign.
Mr. Robustelli stated he wanted to make sure the total number of admitted is reflective of real referrals. Mr. Martin asked if they could add in a chart that defines other counties where she receives direct referrals. Ms. Wegner confirmed that was possible.
Ms. Wegner next let the Committee know they had the annual survey for the Department of Public Health and she would have the results for the Committee next month. Ms. Wegner stated they are back up to a three star rating so are also reinstated for the three day waiver.
Ms. Schafer went over adding another column on the monthly expenses report that would show those expenses that are not operating expenses such as IMRF and insurance. Mr. Robustelli stated he felt it would be helpful as they discuss the budget to be provided a list of items that have been completed and those still outstanding and what might be funded in the budget proposal. Ms. Schafer agreed and said that after the tour she wanted to discuss that.
Ms. Rodriguez went over the new position hires and then provided as part of her general report information on a Medicaid audit that occurred in January of this year for the months of July 30, 2016 through December 31, 2017. She stated they found an overpayment from Medicaid. She said they looked at causes and it was discovered that the Medi database, which is the database that provides information on how much we can bill Medicaid based on individual’s assets, is not uploading information as fast as we enter it. She stated that because of that we are not billing at the proper rate because we have not received all of the information from the database.
Ms. Rodriguez stated that we now have to pay back a portion of the funds received. Ms. Metsker pointed out that we will probably receive those back later, but we will have to wait for those funds again. Ms. Rodriguez indicated that she, Ms. Wegner and Mr. Schmitt are working with the financial staff to make sure we are booking it differently. Mr. Wendt asked her to confirm dates of this audit and if there was a chance we would have to pay back funds from 2018 and part of 2019. Ms. Rodriguez indicated it is possible, but stated that they are correcting it so it will not happen in the future. Ms. Schafer asked if there were any questions; hearing none, she thanked Ms. Rodriguez.
Ms. Schafer indicated that the next meet would be on Wednesday, September 4, 2019 at 3:00 p.m. back at the Government Center.
Chairman Schafer presented transfer for Board of Health for approval
Motion by Robustelli/Gordon to approve the transfer for Board of Health.
Motion Carried.
Chairman Schafer presented for approval bills for the Board of Health with a prepaid and fund total of $217,456.91.
Motion by Gordon/Martin to approve bills for the Board of Health as presented.
Motion carried.
Chairman Schafer presented for approval bills for Jail Medical and JDC Medical with a prepaid and fund total of $21,568.36.
Motion by Robustelli/Metsker to approve bills for Jail Medical and JDC Medical as presented.
Motion carried.
Chairman Schafer presented the bills for the Developmental Disability Board with a prepaid and fund total of $60,667.43.
Motion by Metsker/Chung to approve bills for the Developmental Disability Board as presented.
Motion carried.
Chairman Schafer presented for approval bills with a prepaid and fund total of $233,870.82 for the Nursing Home.
Motion by Martin/Chung to approve bills for the Nursing Home as presented.
Motion carried.
Ms. Schafer said the Committee would next go on a tour of the facility and asked that the Committee come back to the room to discuss and answer questions after the tour.
Ms. Wegner started the tour by indicating the room they were currently in was a resident lounge that the Blue Ribbon Panel recommend updating for outpatient rehab. She stated that a large reason for that location is the entrance close by on the 200 wing where rehab patients could come and go without having to go through the entire nursing home. Ms. Wegner next pointed out the updated nurse’s stations. She then showed the Committee rooms on the 200 wing that would be converted to private rooms for rehab patients as well as rooms for speech and occupational therapy. Mr. Gordon asked how big the unit would be. Ms. Wegner indicated they were looking at the 200 wing. Mr. Wendt asked the difference between rehab services the local hospitals offer and what they would offer here. Ms. Wegner stated that patients receive an acute level of rehab at hospital and theirs would be a lower level of therapy and could even be outpatient therapy. Mr. Wendt stated he had to utilize therapy in Hammond Indiana as the therapy prescribed for him was not offered locally and asked if we could look into that type of therapy and offer it at the Nursing Home to meet a need in the community.
Ms. Wegner next pointed out the courtyards to each wing and stated they are not used because they need to have security key pads added to those doors. Ms. Metsker asked about access cards for residents that would give them different levels of access. Ms. Wegner indicated it would probably involve an expensive security system. Ms. Wegner next took the Committee on a tour of the current rehab section and explained current uses and proposed uses in the new area. Ms. Schafer stated they might want to provide a wish list for rehabilitation equipment based on what patients or hospitals ask for and then work some things into budget.
Ms. Wegner next took the Committee to the Front entrance. She stated the Blue Ribbon Panel had listed this area as one of their first changes. She stated they wanted an upgrade to make it more open and welcoming and add an awning to draw attention to the entrance and allow for cover when dropping off and picking up. Ms. Schafer recommended they return to the meeting room to discuss any further questions or suggestions.
Chairman Schafer asked for any suggestions from Committee members on physical priorities for the Nursing Home. Ms. Schafer also stated that Ms. Wegner and Admin are currently working on financials. She said the Blue Ribbon panel listed many options but wanted to start prioritizing. Mr. Wendt suggested they get in touch with Hammond, Indiana facility and figure cost to duplicate that type of rehab. Mr. Wendt stated he would get the name of the facility for them. Ms. Metsker stated the facility needs many updates, but felt they needed to consider pieces that would bring in revenue and take care of those first. She said we have already worked with hospitals on referrals and done things such as painting and nurse’s stations. Ms. Metsker felt rehab was important because if we could get people in for those services they would realize facility is a good facility. Mr. Robustelli agreed with Mr. Wendt and Ms. Metsker about focusing on what would help us improve the financial position of the facility. He stated he felt rehab and offering something that is not currently offered locally would help, but also wanted them to be sensitive to experience people have while here for long term care such as being able to access court yards. Mr. Robustelli then asked about process to get things accomplished. Ms. Schafer stated she marked on blue ribbon report the activities that fell under purview of each Committee. She stated that property improvements go through Property Committee and Finance Committee is involved with financial aspects, and the Health Committee was the Committee to determine priorities. Ms. Schafer asked Mr. Schmitt to confirm. Mr. Schmitt confirmed Property Committee needed to approve items over $2,500, operational matters would go to Health Committee and Finance Committee would consider financial status of the Nursing Home. Ms. Rodriguez stated that Finance Committee directed her last month to meet with Auditor, Treasurer and Nursing Home to develop a bad receivables policy and she had started that process. Ms. Metsker stated that if there are still cosmetic and financial improvements that would not cost much those needed to be considered first. Ms. Rodriguez stated she hoped to provide at the next Health Committee a 120-day plan and a 240-day plan for input from the Committee. Mr. Robustelli said this Enterprise Fund, is the most business like Fund of the County and we needed to handle it more like a business. Ms. Schafer said she would like to see a more detailed report that showed what has been done, what in progress, what has been delayed and why. Ms. Metsker asked if Mr. Schmitt could help with project timeline. Ms. Rodriguez felt he would help with that part, but work and overseeing work would need to be done by Facilities Manager at the Nursing Home and Ms. Wegner. Mr. Robustelli asked if Administration had gotten information they were looking for regarding direction on this project. Ms. Rodriguez confirmed they had.
Chairman Schafer asked if there was any additional business to come before the Committee; hearing nothing, she adjourned the meeting at 5:42 p.m.
The Committee went on a tour of the facility
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