Office of County Administrator
Memo To: La Crosse County Board of Supervisors
From: Steve O’Malley, County Administrator
REMINDER Monthly Reporting by roughly half the organization every other month. While you will receive this report each month, the reports do not cover every department each time.
LEC Addition Tours Reminder
CARE Center Neighborhood
Meeting: 4pm January 21st All Star Lanes Banquet Room
If you have any questions, feel free to contact me by phone or e-mail as soon as possible.
County Administrator direct line: 785-9789, cell phone 608-385-3316
or e-mail email@example.com
Aging & Long Term Care
Lakeview Health Center
2009 has been a year with significant challenges in long term care. The state and federal deficits contribute significantly to our continued under-reimbursement and the tone of our regulatory environment and its enforcement actions have become increasingly difficult.
2009 has also been a year of success in long term care, and in this report I’d like to focus on a few of these successes in our organization.
Success #1 – The continued referrals and financial support from our partner counties in Mississippi Valley Health Services.
Success #2 – The revenues we generate in all of our other entities – i.e. our community programs and especially Ravenwood Behavioral Health.
Success #3 – A very positive survey outcome in all of our programs in 2009. Of the annual surveys we have in all six of our licensed entities, we have had four perfect (deficiency free surveys) and two surveys with limited low level deficiencies that constituted no harm and no forfeitures.
Success #4 – Finally, the continued support of our County Administrator, The Aging and Long Term Care Committee, and the entire County Board.
Looking forward to continued success in 2010.
La Crosse County Aging Unit
· The Aging Unit now has weekend and holiday frozen meals available at all sites for all Home-Delivered participants.
· The Home-Delivered participants each received a lap robe and a book about staying healthy for the holidays. Many have expressed their gratitude.
· Initiated a campaign to recruit volunteer drivers to deliver meals and provide rides for those needing extra assistance.
· Waiting with anticipation for the announcement from the DOT regarding our funding for 2010 for the STRAP Grant (Supplemental Transportation Rural Assistance Program).
Hillview Health Care Center
Carroll Heights Census has only one opening to date. Carroll Heights had many people discharge to nursing homes or to assisted living facilities. Very few tenants discharge other apartments, 95% of discharges go to a nursing home or assisted living from Carroll Heights. We continue to budget for improvements and updates to the building that is over 50 years.
Hillview Health Care Center
Admissions and Census Our average census in 2009 has continued on track as estimated in our 2009 budget. We admitted 320 residents in 2009, the average stay in a nursing home is getting shorter. The percentage of private pay and Medicare residents higher than other area nursing homes; we receive higher reimbursement from those two pay sources then Medicaid. Almost all admissions are Medicare; many of the Medicare admissions can become private pay residents, which is ideal. We do get more private insurance, which is also a better pay source; however, it is takes a significant amount of staff time. Currently we have about 20% of our residents from Western Wisconsin Cares. Like most government programs, we are being asked to do much more with less. The state budget gave a 2% increase to nursing homes for fiscal years 2009 - 2010.
Flu shots About 75% of Hillview employees received flu and H1N1 shots this year, which is about the same last year. It is still a personal choice to receive a flu shots but our education and encouragement defiantly helped. Nearly 100% of residents of Hillview receive flu shots.
Market Study Updated in Progress A market assessment for the possibility of assisted living senior housing on Hillview Campus is being updated from the one complied over two years ago. Wipfli assisted us as to look at the current market conditions for senior housing in the La Crosse area and to estimate the market potential for assisted living (including memory care) senior housing in our market area. The recommendation is that the will be a need for more senior housing with memory in the most need. Hillview and La Crosse County staff are continuing to study the financial feasibility of an assisted living senior housing on our campus. Wisconsin’s Long Term Care System has undergone a dramatic rebalancing In 1995, the majority of people receiving publicly-funded long-term care, 61%, were served in institutional settings, and the minority, 39%, were served in community settings. By 2008, those ratios had reversed: the majority of people, 66%, are now served in community settings and the minority, 34%, are in institutional settings. In addition, over this time period the number of people served through the public long-term care system increased from 49,000 to 60,000. The trend and the reimbursement revenue from the state is the community settings (assisted living) now and the future of long term care.
Health & Human Services
Human Services Department
Development of the Crisis Assessment (CARE) Center:
In December, the Department and its contracted vendor Tellurian, out of Madison, selected its site for the new Crisis Assessment Center. The site will be located on the south side of La Crosse across from Wal Mart on Morman Coulee Road. The location has been used as a temporary site for a church and prior to this was a day care center. The location was selected by a team from the community involved in looking at a number of potential sites within the county. There will be need for some renovation to make the site suitable for the purpose of a psychiatric/detox center. The county also received a generous grant from the La Crosse Community Foundation to assist with some of the remodeling. The goal is to have the site completed and ready for program implementation by the first quarter of 2010.
As this project gets implemented, several counties in the state will be working with the State Department of Health Services (DHS) and UW Madison on ways to reduce dependence on the use of state institutions for people with mental health crisis issues which are not only the most restrictive type of placements but also the most costly to the state.
Federal review of Child Welfare Services in Wisconsin:
In December, the county was informed that it has been selected as a site for the federal Children and Family Safety Reviews to be done by the federal government in April of 2010. Milwaukee and several other smaller counties were chosen with La Crosse to be part of this week long intensive review of child welfare services and outcomes in the state. This review will involve the county, courts, providers, foster parents, parents and children in the child welfare system. The first meeting to plan for this review was held in December. The Department will keep the Health and Human Services Board informed of developments as they proceed.
Along with this review of child welfare, the University of Wisconsin Madison and the WI Children’s Trust Fund has asked the Department to be involved in a research project designed to look at linking families referred for child neglect into more intensive financial planning, job search, etc. in one of the first experimental studies of this nature in the state. This project is designed to begin in the first quarter of 2010 and will be a nice part of a comprehensive approach to child welfare that better links families to the services that they need with less reliance on the courts and out of home placement of children.
Health Department activities in November and December 2009 have been dominated by
1. Preparing applications for funds to federal, state and local governments and private funding agencies for the 2010 funding year. Of the Health Department’s annual budget of about $5,000,000, over $3,000,000 comes from non local tax levy sources. Most of these funds are allocated through competitive funding cycles.
2. Delivering disease prevention, education and vaccine to prevent H1N1 illness spread in the County.
Below is an excerpt of selected items from the 2009 3rd Quarter Health Department Report to the Health and Human Services Board.
County Clerk Office
Ballot Placement: By now you have probably all filed your papers for the April election. Since January 8th is the deadline to challenge papers, we will draw for name placement on the ballot on January 11th.
February Primary: There will definitely be a February election in the Bangor School District for two referenda questions. As of this writing (12/28/09), it looks as though we may have a primary in County Supervisor District 23. Three candidates, including the incumbent Tammy Gamroth, have taken out papers, but only two of them have turned in signatures so far. There are also three potential candidates for the District 4 Court of Appeals Judge, one of which is our Branch I Circuit Court Judge Ramona Gonzalez. We don’t have any information on the City of Onalaska Alderpersons, the Village Trustees or the Towns of Campbell, Holland or Onalaska Supervisors contests yet. They have until January 12th to give us that information. We have also read that the City of La Crosse intends to fill the vacancy in Council District 2 this Spring. After the January 12th deadline, comes the daunting task of creating all necessary ballot proofs, having them approved by the School District and the State and any applicable municipalities and getting them to the printer so the ballots get back to us for testing and subsequent delivery to the Municipalities by January 25th.for the February 16TH Primary Election.
Supervisor Candidates: To date 8 County Board Supervisor incumbents have competition. They are districts 3, 5, 10, 15, 23, 30, 31 and 34. Not all of the candidates have filed the nomination papers (signatures) yet. All County Board Supervisor candidate filings are published to the internet daily at: http://www.co.la-crosse.wi.us/countyclerk/Election/2010%20SUPERVISORY%20INCUMBENTS%20&%20CANDIDATE%20FILINGS.pdf
Early Voting: After much input and many listening sessions, the Government Accountability Board (GAB) will recommend to the State Legislature that Wisconsin refine the no excuse absentee voting procedure instead of implementing “early voting”, which was also considered. This is good news because true early voting would have meant significant additional expenses for equipment and staffing, likely at the County level as well as the Municipal level. In addition, most clerks feel that there would be significant security risks in the early voting proposals.
Election Training: We are planning a training for the Municipal Clerks and Election Inspectors in February. As election requirements get more stringent and detailed, there is a lot for these part time employees to remember from election to election.
We issued 48 marriage licenses and 3 domestic partnership certificates in November and so far in December. In 2009, to date (12/23/09), we issued the following:
721 Marriage Licenses, 11 Waivers (This waives the 5 day waiting period), 8 Reissues (Lost, had cross outs or wrote in blue ink) and 33 Domestic Partnership Declarations
We are making progress on the automated meeting program (agendas & minutes) that our I.T. Department is creating for us, and continue to discuss and move forward on the new voting system. We are looking at early 2010 for implementing the agendas/minutes program. This is not anything that will affect you the Supervisors; it is to make the creation of the agenda and minutes more efficient and uniform, with less room for error.
Preliminary figures indicate that 10,788 dog tags have been sold county wide (NOT including the City of La Crosse), of which 800+ were late tags sold from our office and 7 were issued free to service dogs. There were also 28 multiple licenses issued for a total of 233 dogs/tags.
COUNTY CLERK REVENUES FOR 2009 (Per Finance as of 12/17/09)
Directory Book Sales............................................................................. 476.92
Dog Late Fees................................................................................ $13,079.50
Wisconsin DNR & Iowa DNR................................................................... $339.05
Domestic Partner Certificates................................................................... $1305
Marriage Licenses, Timber Cutting Permits, Parade Permits, Copies, Misc....... $18,440
(note that marriage license fees will have its’ own separate account in 2010)
December preliminary figures indicate that while some revenues are down, expenditures are as well so we should remain well under budget in all 3 departments (Board, Election, Clerk)
Linda A. Stone, County Clerk