McLean County Board Health Committee met March 2.
Here is the minutes provided by the committee:
The Health Committee of the McLean County Board met on Monday, March 2, 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 Gordon, George Wendt, Randall Martin, Catherine Metsker and Sharon Chung
Members Absent: None
Other Members Present: Member Laurie Wollrab
Staff Present: Ms. Camille Rodriguez, County Administrator; Ms. Cassy Taylor, Assistant County Administrator; Ms. Jessica Woods, Assistant State’s Attorney – Civil Division, Ms. Julie Morlock, Recording Secretary
Department Heads/ Elected Officials Present: Ms. Jessica McKnight, Health Department Administrator; 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; Cathy Coverston-Anderson, McLean County Health Department; Ms. Rhonda Crowley, McLean County Nursing Home
Chairman Schafer called the meeting to order at 4:30 p.m. and declared a quorum.
Chairman Schafer presented the minutes from the February 3, 2020 regular meeting for approval.
Motion by Chung/Robustelli to approve the minutes from the February 3, 2020 regular meeting.
Motion carried.
Chairman Schafer confirmed there were no members of the public to appear before the Committee.
Ms. Michelle Welch, Adult Detention presented for action a request to approve the 2020 rates pursuant to our contract with Advanced Correctional Healthcare for Physician Services at the McLean County Adult Detention Facility. Ms. Welch indicated this changed the average daily population rate from 250 to 200 as the original number was too high and the Company had to provide a refund to us each quarter. She indicated the 200 figure is in line with the daily census numbers.
Motion by Martin/Robustelli to recommend approval of 2020 rates pursuant to our contract with Advanced Correctional Healthcare for Physician Services at the McLean County Adult Detention Facility.
Motion Carried.
Ms. Michelle Welch, Adult Detention and Mr. Jason Tabb, Juvenile Detention presented their monthly reports. Chairman Schafer asked if there were other questions; hearing none, she thanked them.
Ms. Jessica McKnight Health Department Administrator presented the Health Department’s monthly reports to the Committee. Ms. Schafer asked her to address the Coronavirus. Ms. McKnight went over telephone conferences with Illinois Department of Health and the CDC. She also indicated they are working to expand outreach to the public, community partners and agencies with information and encouraging them to be prepared if there is an outbreak here. Mr. Martin asked her to confirm we would not have any pods. Ms. McKnight indicated we did not have a vaccine, so pods would not be effective. Ms. Metsker asked about interaction with Universities and large employers who have international travel. Ms. McKnight stated the Communicable Disease staff at the Health Department is in regular contact with health services at Illinois State and Illinois Wesleyan and they are making plans for possible mass email distributions with information and regular phone calls to get information to everyone at once. Ms. Metsker asked if they had received plans from Universities and employers. Ms. McKnight indicated they have not received any but will be doing another push to have them put a plan in place and to contact the Health Department with questions.
Mr. Robustelli asked if we can test for the virus in McLean County. Ms. McKnight said it is available in Illinois but was not sure about McLean County and would check. Mr. Robustelli also asked if we were working with Nursing Homes and Long-Term Care facilities to be prepared. Ms. McKnight confirmed they are reaching out to those facilities. Ms. Metsker indicated she felt our nursing home should be an example to the community. She also asked if we have a plan in place for our employees. Ms. Schafer asked about fighting false information. Ms. McKnight indicated they are putting information out in press releases providing site and locations people should check for information. Ms. Schafer asked if radio stations offer free public service announcements. Ms. McKnight confirmed there is a monthly free radio spot at multiple stations they utilize. Ms. Rodriguez went over plans for County employees and for the services the County provides. Ms. Rodriguez indicated Staff is also working with Information Technologies to have a place and space on our website to discuss rumors and direct public to appropriate links. Chairman Schafer asked if there were any other questions, hearing none, she thanked her.
Ms. Cindy Wegner, Director, McLean County Nursing Home presented her monthly reports. She provided stated they were putting together an action plan for reducing costs, increasing census and improving quality measures and would present a spread sheet with that information next month. Ms. Wegner indicated the Blue-Ribbon panel met and discussed memory care and asked for financial information to be presented at the March Blue Ribbon meeting. Ms. Wegner provided an update on changes at the facility to address the life safety code matters. Ms. Wegner next provided information on reviewing past due accounts. She indicated a new accounts receivable person is actively reviewing past due accounts. She indicated they have found items that need to be written off, resubmitting bills and refiling and appealing some claims. Ms. Wegner stated they hoped to report results by April. Ms. Metsker asked about inspection waiver and not meeting deadline. Ms. Wegner indicated she would need to submit a request to IDPH to extend the current waiver. Ms. Metsker asked about the likelihood of getting that extension. Ms. Wegner said it was very likely they would get extension because of the scope of the project. She indicated she would also get written information from Farnsworth to submit with the request. Ms. Metsker asked her to confirm we were unaware of the scope of the issues prior to the inspection. Ms. Wegner confirmed. Ms. Metsker asked how that was possible. Ms. Wegner indicated inspections had been done for 40 years and items were never sited. She stated a new architect identified the generator issue and then during the follow up federal monitoring survey that person noted the fire extinguishing systems. Ms. Metsker said glad we know and are getting fixed.
Ms. Metsker asked about the Avility booking system and if that was new. Ms. Wegner confirmed new to the nursing home. Ms. Metsker asked if that helped us identify accounts receivable issues. Ms. Wegner confirmed it did and indicated Ms. Rhonda Crowley was there to answer any questions they might have. Ms. Metsker asked for clarification about timing to receive payment from Medicare and Medicaid when someone passes. Ms. Wegner explained they apply for Medicaid then it is up to Medicaid to decide when approved but then they also have to be entered into the long-term care system. Ms. Metsker asked her to confirm this is a state system. Ms. Crowley went over process and indicated that approval for Medicaid is usually quick but then have to wait on the case worker to put individual into long term care and until that is done, we do not get paid. She indicated they constantly call case workers to try to get residents in the long-term care system. Ms. Metsker asked what happened to those in the past. Ms. Rhonda confirmed many have been approved for Medicaid but have not been put into long term care. Ms. Metsker stated she felt members needed to bet legislators involved. Ms. Schafer indicated there have been conversations but need to continue to make them aware.
Ms. Metsker then asked about the write offs and if we were doing it correctly in the past. Ms. Crowley indicated that it was not. She went over the system of verifying payment and then marking remainder that will not be received as a write off. Ms. Metsker asked when they would expect accounting of write offs would they need to work with Treasurer. Ms. Crowley indicated they hoped to have a report by April and that she sends everything to the Treasurer and the Auditor.
Ms. Schafer asked if State quicker about approving Medicaid. Ms. Crowley said she has seen them get approved quicker, but delay is getting them entered into the long-term care system. Ms. Schafer asked her about write-offs versus adjustments. Ms. Crowley indicated when individuals are approved for Medicaid the system adjusts it, but that is not considered a write off. Ms. Schafer asked if the report would include reasons for written offs. Mr. Robustelli asked them to confirm we billed, were paid, that did not cover costs, but we did not adjust for that. Ms. Rhonda confirmed having software system in place has helped.
Ms. Metsker stated the County had to pay money back to Medicaid and asked if they were finding more instances of that. Ms. Crowley stated that resident’s liability is determined and if people’s income changes then have to report it to the State, but if State does not update their long-term care system when the payment is remitted then it is going to be wrong. Ms. Metsker asked if we know we have received an overage and if we can’t take that amount and set it aside on the books. Ms. Wegner stated that according to the OIG there is no other way of reconciling until their system catches up. Ms. Metsker again stated that we know there is an overpayment, so we need to work with Auditing or the Treasurer to get it set aside and not touch it because we know we are going to have to pay it back. Mr. Robustelli stated identifying receivables that were collected but not adjusted and asked if she had found services that were rendered but not billed. Ms. Crowley said she had not.
Ms. Schafer asked her to confirm getting in long term care system takes a long time. Ms. Crowley confirmed. Ms. Schafer asked her confirm example where State does not get someone in the system for a year, money comes in that we should not have gotten then State updates the system and we have to pay money back. Ms. Crowley confirmed. Ms. Metsker asked her to confirm we know we have been over paid. Ms. Crowley confirmed. Ms. Metsker said she felt there had to be a way in the accounting system to hold that money. Ms. Rodriguez indicated it was her understanding from a Committee conversation several months ago that there was a system in place. Ms. Wegner indicated they were working with the Auditor on that at the time, but no plan has been put in place. Ms. Wegner indicated this is just a handful of residents. Ms. Schafer stated after getting consensus from the Committee that they would like for a plan to be put in place with the Auditor as soon as possible. Ms. Metsker stated she would have liked to have known the system was not in place. She stated if she had not asked that pointed question they would still not have known.
Ms. Schafer asked if there were questions about the monthly reports. Ms. Metsker asked about VA patients and payments. Ms. Wegner stated system is simple, but rate of reimbursement is much lower. Ms. Metsker asked her to confirm we do not get overpayments. Ms. Wegner confirmed. Ms. Schafer invited Ms. Wollrab to the table. Ms. Wollrab asked about Coronavirus preparations. Ms. Diana Cochran stated they are handling same as flu season with signs posted at entrances asking people to not visit if have symptoms of flu and increased cleaning and disinfecting at the facility. She indicated if they have an instance of virus, they would contact health authorities. Ms. Cochran indicated they are also monitoring those residents coming into the facility. Ms. Metsker asked if we ask new residents if they have been out of the country or around anyone that has been out of the country and recommended, they start asking those questions. Ms. Schafer indicated there was a facility in Washington State that had several residents infected and agreed with need to add question to intake. Chairman Schafer asked if there were any questions or comments; hearing none, she thanked them.
Ms. Camille Rodriguez, County Administrator presented her new positions report. Chairman Schafer asked if there were any questions, hearing none, she thanked her.
Chairman Schafer confirmed no other business.
Chairman Schafer then presented for approval the Nursing Home bills with a prepaid total $214,895.35.
Motion by Gordon/Chung to approve prepaid bills for the Nursing Home as presented.
Motion carried.
Chairman Schafer presented the bills for the Developmental Disability Board with a prepaid total of $2,242.43.
Motion by Metsker/Robustelli 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 $81,126.88.
Motion by Chung/Robustelli 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 $93,983.83.
Motion by Gordon/Metsker 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 5:14 p.m.
https://www.mcleancountyil.gov/ArchiveCenter/ViewFile/Item/7217
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