McLean County Times

McLean County Health Committee met Jan. 6.

Here is the minutes provided by the committee:

The Health Committee of the McLean County Board met on Monday, January 6, 2020 at 4:30 p.m. at the Government Center Building 115 E. Washington Street, Room 400 Bloomington, IL.

Members Present: Chairman Susan Schafer, Members: Carlo Robustelli, George Wendt, George Gordon, Randall Martin, Catherine Metsker and Sharon Chung

Members Absent: None

Other Members Present: Chairman McIntyre

Staff Present: Ms. Camille Rodriguez, County Administrator; Mr. Eric Schmitt Assistant County Administrator; Ms. Cassy Taylor, Assistant County Administrator; Mr. Trevor Sierra, Assistant State’s Attorney – Civil Division, Ms. Julie Morlock, Recording Secretary

Department Heads/Elected Officials Present: Ms. Tammy Brooks, Interim Administrator Health Department; Mr. Mike Donovan, Court Services Director; Mr. Jason Tabb, Juvenile Detention Center Director; Ms. Michelle Welch, Adult Detention Medical; Ms. Cindy Wegner, McLean County Nursing Home Director; Ms. Trisha Malott, Behavioral Health Coordinating Council Supervisor

Others Present: Diane Cochran, Director of Nursing, McLean County Nursing Home; Tom Anderson, Environmental Health Director, McLean County Health Department

Chairman Schafer called the meeting to order at 4:30 p.m. and declared a quorum.

Chairman Schafer presented the minutes from the December 2, 2019 regular and November 17, 2019 special meetings for approval.

Motion by Chung/Gordon to approve the minutes from the December 2, 2019 regular and November 17, 2019 special meetings.

Motion carried.

Chairman Schafer confirmed there were no members of the public to appear before the Committee.

Ms. Tammy Brooks, Health Department Interim Administrator presented her monthly reports to the Committee. Ms. Brooks indicated the new Administrator would start January 27th and they also have a new Board of Health President and Secretary. Ms. Metsker asked her to provide definitions of a couple of acronyms. Ms. Brooks provided. Ms. Metsker asked if we only finding out about discharge of illegal waste through Real Estate transactions and if there were any fines or penalties being assessed. Mr. Anderson came forward and indicated they find out through complaints and real estate transactions. He indicated banks will not loan money for a real estate transaction if there is an issue. He explained process if they receive a complaint.

Ms. Metsker asked how they make sure correction being made. Mr. Anderson indicated an evaluation can be requested. Ms. Metsker asked about recourse. Mr. Anderson said with real estate transactions the Bank won’t loan the money to the borrower. Mr. Anderson stated that if it is a complaint, they follow up with the State’s Attorney Office. Ms. Metsker indicated she was concerned because she wondered how many other problems existed that we do not know about and asked if there was a way to be more proactive. Mr. Anderson stated they are being as proactive as they can with the staff they have and provided permitting history. Ms. Metsker asked if charges have ever been brought for illegal discharge. Mr. Sierra indicated there was one in 2016. Ms. Metsker again stated that she is concerned about this and would like to see us be proactive instead of reactive.

Mr. Robustelli stated this is not unique to McLean County and he also provided example of if not being unique to rural areas of the County by stated that there are areas in the City of Bloomington where there are 100 plus old houses and buildings with sewer systems that go directly into the runoff water. He stated that when the City ran a line on his street, the City offered residents the ability to hook in to that line if they paid $10,000 and no one took that option so continues into run off. Mr. Robustelli asked if the County tests drinking water. Mr. Anderson indicated the Health Department does not, but the Illinois Environmental Protection Agency does require testing and reporting. Mr. Robustelli asked about statistics provided and if they are reported to Illinois Environmental Protection Agency. Mr. Anderson indicated they are reported to Illinois Department of Public Health. Mr. Robustelli stated he felt that since they have the data the Illinois Department of Public Health can look into efforts to make sure drinking water is safe.

Mr. Gordon stated that several years ago the Illinois Environmental Protection Agency did not have enough staff to complete the inspections mandated by law and asked if that employment status had improved. Mr. Anderson indicated staffing has gone down. Ms. Schafer asked if they get notified when water is tested. Mr. Anderson indicated they do not. Ms. Metsker thanked Ms. Brooks for the reports and thanked Mr. Anderson for his information. Mr. Gordon asked for clarification on numbers that did not add up for services. Ms. Brooks indicated she would follow up to make sure updated. Ms. Schafer also noted the Board of Health meeting dates for 2020. Chairman Schafer asked if there were any other questions or comments; hearing none, she thanked her.

Ms. Cindy Wegner, Director, Nursing Home presented for action a request to approve a Medical Advisory Committee Agreement between McLean County Nursing Home and Advocate Health and Hospitals Corporation d/b/a Advocate Medical Group. Ms. Wegner indicated this was a continuation contract for the Medical Director position with Dr. Ingalsbe.

Motion by Martin/Robustelli to recommend approval of a Medical Advisory Committee Agreement between McLean County Nursing Home and Advocate Health and Hospitals Corporation d/b/a Advocate Medical Group.

Motion Carried.

Ms. Wegner presented for action a request to approve a First Amendment to the Agreement for Inpatient or Respite Services between Meridian Hospice d/b/a Advocate Hospice and McLean County Nursing Home. Ms. Wegner indicated this was an addendum regarding reimbursement rates that have gone up. Mr. Gordon asked for clarification on prior reimbursement amounts. Ms. Wegner went over the rates.

Motion by Chung/Metsker to recommend approval of a First Amendment to the Agreement for Inpatient or Respite Services between Meridian Hospice d/b/a Advocate Hospice and McLean County Nursing Home.

Motion Carried.

Ms. Wegner handed out and went over information on the new payment system for Medicare. Ms. Metsker asked how this impacts our billing process and processes in place to make sure appropriate billing is done. Ms. Wegner indicated reimbursement is focused on diagnostic code and so we have checks in place to make sure our code matches the code from the hospital. Ms. Metsker asked how star rating impacts this. Ms. Wegner stated the star rating does not impact reimbursement rates directly. Ms. Metsker asked about indirect impact. Ms. Wegner stated star rating could affect the census. Ms. Schafer asked her to confirm this is only for Medicare and not Medicaid. Ms. Wegner confirmed. Ms. Schafer asked her to confirm we can have Medicare patients. Ms. Wegner confirmed. Ms. Metsker asked her to confirm that Medicare patients are temporary. Ms. Wegner confirmed. Ms. Schafer asked her to confirm we have seen increase in reimbursement through this method. Ms. Wegner confirmed. Ms. Schafer asked about diagnosis confirmation. Ms. Wegner stated that diagnosis comes with paperwork from the hospital, but they also call to confirm the diagnosis. Ms. Schafer asked if these could be rejected by Medicare. Ms. Wegner stated they could, but they have not had that happen. Ms. Metsker asked her to discuss check measures to make sure we bill correctly. Ms. Wegner indicated they have a weekly Medicare meeting and went over individuals who attend and information that is shared. Ms. Metsker asked about process if diagnosis changes. Ms. Wegner indicated there is a document they complete to get that changed.

Ms. Wegner went over information she provided on the Star rating comparing other facilities in Bloomington/Normal. Ms. Wegner indicated McLean County Nursing Home’s focus is on the quality measure rating as the star rating will increase if we get that number up as well as the staffing number up. Ms. Diane Cochran indicated the staffing number was down because there was no Director of Nursing in the facility at the time and now that she is in the facility that should increase. She indicated they have put in place a review every week of quality measurers and are also double-checking new admissions to make sure they have correct information. Ms. Metsker asked if they could provide a historic record of star rating for the nursing home and impact on census. Ms. Wegner indicated could provide that information. Mr. Robustelli stated at the last meeting they went over survey results and he had asked if tags were life threatening and had been told at that time by Ms. Wegner that they were not. He stated he read through the report over the holidays and the titles and specific descriptions lead him to believe otherwise. He said he is concerned about the care being received and he would like to have a report showing what is being done to make sure tags do not happen again. Ms. Schafer asked if we could also get a history of tags. Ms. Schafer asked why the focus is only on quality measures and staffing and not on health inspection rating. Ms. Wegner stated they would also be working on that rating, but that rating is cycled out over a several years.

Ms. Wegner presented her monthly reports. Mr. Gordon asked about revenue numbers compared to aging report numbers. Ms. Wegner indicated that aging report is not all 2019 expenses, but it is the current outstanding balance. Mr. Gordon noted that the current outstanding receivables would help cover difference in expenses and revenues. Ms. Schafer asked about status of write offs and collections. Ms. Wegner indicated the office manager has been working on those, but put in resignation, so with a new hire they will update process. Chairman Schafer asked if there were any further questions or comments; hearing none, she thanked her.

Ms. Michelle Welch, Adult Detention Center presented for action a request to approve an Agreement between the McLean County Board and Dental Clinician – Adult Detention Medical. Ms. Welch indicated they were pleased with services. Ms. Metsker asked if he provided preventative cleanings. Ms. Welch indicated that he does not do preventative care, it is restorative care.

Motion by Martin/Chung to recommend approval of an Agreement between the McLean County Board and Dental Clinician – Adult Detention Medical.

Motion Carried.

Mr. Jason Tabb, Juvenile Detention Center presented for action a request to approve a contract for counseling services between McLean County and Cathy Vogel for the Juvenile Detention Center. Ms. Tabb indicated it is annual agreement with no increase in funding. Mr. Donovan pointed out the contract now contains automatic renewal language.

Motion by Martin/Metsker to recommend approval of a contract for counseling services between McLean County and Cathy Vogel for the Juvenile Detention Center.

Motion Carried.

Ms. Welch and Mr. Tabb presented their monthly reports. Ms. Schafer asked Committee members to set up an appointment with the Sheriff to go and see the new Jail Medical Unit before the next meeting. Ms. Metsker asked for the difference between dental service and dental nursing. Ms. Welch indicated dental nursing when nurse talks to person to find out what is wrong and put on the dental list or call the doctor if there is infection. Chairman Schafer asked if there were questions; hearing none, she thanked them.

Ms. Rodriguez presented her new positions report and indicated she had nothing further for the Committee.

Chairman Schafer indicated the next meeting would be on Monday, February 3, 2020 at 4:30 p.m. Chairman Schafer then presented for approval Nursing Home bills with a prepaid total $218,999.81.

Motion by Metsker/Chung to approve prepaid bills for the Nursing Home as presented.

Motion carried.

Motion by Gordon/Martin to approve prepaid bills for the Developmental Disability Board as presented.

Motion carried.

Chairman Schafer presented for approval bills for Jail Medical and JDC Medical with a prepaid total of $59,342.40.

Motion by Martin/Metsker to approve prepaid bills for Jail Medical and JDC Medical as presented.

Motion carried.

Chairman Schafer presented for approval bills for the Board of Health with a prepaid total of $196,799.58.

Motion by Robustelli/Gordon to approve prepaid bills for the Board of Health 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 5:28 p.m.

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