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HomeMy WebLinkAbout1980 Community Health Commission Minutes AGENDA EDINA HEALTH ADVISORY COMMITTEE Meeting March 25, 1980 Edina City Hall Conference Room, 7:30 p.m. Homer Kinney, Chairman I Roll Call II. Approval of Minutes: October 23, 1979 III. Announcements and Reports: A. Presentation of 1980 Officers B. Early and Periodic Screening; Dr. Walter Wilder; Dr. Richard Simmons C. 1979 CHS Evaluation; David Velde D. Senior Citizens Newsletter podiatrist advertising June Schmidt IV.- New Business V. Unfinished Business i VI. Next Meeting Date VII. Adjournment I MINUTES OF THE REGULAR MEETING OF THE EDINA ADVISORY HEALTH COMMITTEE HELD TUESDAY, MARCH 25, 1980, AT 7:30 P.M. EDINA CITY HALL CONFERENCE ROOM I. Members Present: Dr. Simmons, Mary Bang, Linda Bjerke, June Schmidt, Leroy Werges, Homer Kinney, Dr. Rockwell, Tully Stoppel Members Absent: Dr. Engstrom, Beverly Harris, Barbara Kresoya, Dr. Kraft Staff Present: David Velde, Colleen Paulus II. Approval of the Minutes: Mary Bang moved that the minutes of the October 23, 1979, meeting of the Edina Advisory Health Committee be approved. Dr. Rockwell seconded the motion. All voted aye; the minutes were approved. III. Announcements and Reports A. Presentation of 1980 Officers. The Nominating Committee reported that they nominated Leroy Werges as Chairman, Duane Engstrom as Vice-Chairman. June Schmidt moved that the nominations be closed and that the Board elect the slate as nominated. All voted aye; Leroy Werges was appointed chairman and Duane Engstrom as vice-chairman. B. Early and Periodic Screening; Dr. Walter Wilder and Dr. Richard Simmons Dr. Walter Wilder, a practicing pediatrician in Edina spoke on early and periodic screening. When the screening program started he was designated by the medical association to join the advisory committee which was made up of all the various people that would be involved with screening. Primarily the State Health Deaprtment and State Welfare Department but also nursing representatives, educators and consumers were on this committee. The screening programs include pre-school screening (which is a one time examination of children before they enter kindergarten) it also includes EPS-DT; f (which is early periodic screening and diagnosis and treatment, a welfare department program which provides screening throughout childhood up to age 21) also included is the Minnesota's State Health Department E.P.S. program (this program covers everyone until age 21 if they wish to participate) . All three programs are really the same basic type of program. There has been an attempt to combine them and make them all conform to the same regulations and provide the same type of services. Advisory Health Committee March 25, 1980 Page. 2 The intent of the original program was to provide a program for children who did not have any access to any other medical care. Dr. Wilder stated that this provision has not been maintained in Minnesota. Dr. Wilder stressed that separate screening is a waste of money and resources. He stated that everyone needs a physicians care, therefore, there is no point to separate screening, except in communities where there are few providers. Dr. Wilder gave average costs associated with screening and concluded that the cost of screening to society is double the cost of primary physician care. Average cost of screening per child $ 70.00 Average cost of referral per child 40.00 Total cost of screening and referral 110.00 Cost of abnormality 100.00 Total Cost $210.00 I If there is an abnormality in the developmental screening, the cost of resolving that will amount to $100.00. Usually 40% of all children screened need referral. Since the aim of the program is to insure children are receiving medical care, he proposed a modified program which should not cost the state over $50,000, which is 5% of the present budget. The program would be limited to: 1. Notification be given to the individuals involved that periodic medical examination or health maintenance by the patients personal physician is recommended. 2. Children should be sent to their own physician for examination. 3. Medicade dollars be limited to only the poor. . A general discussion followed. C. 1979 CHS Evaluation; David Velde Dave Velde reviewed the CHS report. It is a required report that is sent to the State Health Department of the Edina Health Department's activities. It is composed of the statistics of the activities performed in the areas of Envionmental Health and Emergency Medical Services over the past year. The evaluation from Bloomington has not been received and it will be forwarded to the members upon receipt. A general discussion followed. D. Senior Citizens Newsletter podiatrist advertising; June Schmidt Advisory Health Committee ® March 25, 1980 Page 3 June Schmidt reported that the senior citizens had wanted a podiatrist to come and talk with them. Dr. Keester said he would come out and talkwith the seniors depending on the interest shown by the seniors. The note in the newsletter. is for informational purposes and not for advertising. It notifies the seniors as to the day and time he will visit them. IV. New Business: Vern Moss resigned. Mary Bang questioned the length of term a member on the committee is to serve. The maximum time a person can serve is three consecutive two year terms. V. Unfinished Business: There was not any unfinished business to consider. VI. Next Meeting Dater The next meeting date will be April 22, 1980. May 27, 1980 was chosen for the third meeting of the year. There are to be six meetings a year. VII. Adjournment: June Schmidt moved that the meeting be adjourned. Mary Bang seconded- the motion. The motion carried; the meeting was adjourned. I AGENDA EDINA HEALTH ADVISORY COMMITTEE Meeting April 22, 1980 Edina City Hall Conference Room, 7:30 p.m. Homer Kinney, Chairman I. Roll Call II. Approval of Minutes: March 25, 1980 III. Announcements and Reports A. Appointment Terms of Members; Dave Velde IV. New Business A. Nursing Service Delivery; Roy Werges V. Unfinished Business VI. Next Meeting Date VII. Adjournment "� "1 MINUTES OF THE REGULAR MEETING OF THE EDINA ADVISORY HEALTH COMMITTEE HELD TUESDAY, APRIL 22, 1980, AT 7:30 P.M. EDINA CITY HALL CONFERENCE ROOM I. Members Present: Mary Bang, Linda Bjerke, Dr. Simmons, Leroy Werges, Barbara Kresoya, Tully Stoppel, June Schmidt Staff Present: David Velde, Colleen Paulus Others Present: Yvonne Hargens Members Absent: Dr. Engstrom, Dr. Krafft, Beverly Harris, Homer Kinney, Dr. Rockwell II. Approval of Minutes - March 25, 1980 i June Schmidt requested correction of the statement regarding podia- trists. She requested the statement should read, "A podiatrist will provide treatment if there is enough interest shown by the seniors." With this correction, June Schmidt moved that the minutes be approved. Minutes approved as corrected. III. Announcements and Reports A. Appointment Terms of Members; David Velde Committee Members are appointed for two-year terms. A member may not serve more than three consecutive terms. Unless a.member formally resigns, that member will stay on the committee their full six years, unless indicated otherwise. David Velde will keep everyone updated as to their appointment. IV. New Business A. Yvonne Hargens - BPHNS The 1979 Report has been completed and did meet all of the requirements of the State. For home care services in the City of Edina, $26,000 in income was taken in for the services provided in 1979. Well over $31,000 in services was written off (service provided, but no money taken in). Less than 50% was collected. The majority of people that are collected for, as far as home services are concerned, no matter whether you're a public or private agency or a quasi-public, are from Medicare, Medicaid, Veterans, and a few select insurance programs that include that in their insurance benefits. That is saying that better than 50% of the patients in 1979 that Bloomington provided in-home skilled nursing services to were not eligible for Medicare, or had run out of Medicare. "� r Advisory Health Committee April 22, 1980 Page 2 More home care providers are starting up. Free-standing, non-profit agencies can get Medicare-certified by doing the appropriate paperwork. Anyone who comes into business new gets a 3-year exemption, so they can charge any amount that they can justify as their costs. Income is decreasing, and the amount of free services, because Bloomington is the public agency, is increasing. It has most dramat- ically increased in Edina in '77-'78 because Edina has an older popula- tion. This is related to the existence of the proprietary agencies that are taking only Medicare patients. It is creating problems all over the United States. 1979 Financial Reimbursement - Cost in 1979 to put a nurse in the home"was $31.76, physical therapy $25.90, occupational therapy $21.91, and a home health aid visit $23.68. A nursing visit averaged 71 minutes; a home health aid visit averaged 90 minutes. The council did approve the proposal to charge $32.00 for a nursing visit (beginning May 1st) ; $24.00 for a home health aid visit. The maximum that you are allowed to charge in Hennepin County, if you're an old, established agency as Bloomington is, is $43.33. The maximum that you are allowed to charge for a physical therapy visit is $42.45, speech $46.60, occupational therapy $48.69, and home health aid visit $34.21. Bloomington is still considerably below the maximum limits. All information is going to Mark Bernhardson and the City Manager so that they can apprise the City Council. In process of punting all policies and procedures into some kind of order in a big book. B. Nursing Service Delivery; Roy Werges The Advisory Board should look to various things that are occurring in Edina (services, etc.) and from time to time do an evaluation. A study of the cost effectiveness of the program should be done every year. An attempt should be made to figure out the cost of starting up a program without the aid of Bloomington Health Services. V. Unfinished Business Letter from Judy Vierling with the Minnesota Health Department. . David Velde wrote a letter to Judy Fritz about Coordinated Home Care and: they did go out and go through the records. They also found that Judy Maloney, who is a Social Worker at Fairview-Southdale, who has been making refer- rals, is on the advisory board of the Coordinated Home Care Agency. From what they had seen, they could not find any improper activities, but there is some semblance of a conflict of interest. Our concern is the conflict �. of interest. Linda Bjerke requested that this Board send a letter to the Fairview-Southdale Administrator indicating our concern about the situation. David Velde suggested that the Health Advisory Committee recommend the Board of Health and City Council forward a letter to Kirby Erickson expressing our concern over this situation. ''"1 ".`� Advisory Health Committee April 22, 1980 Page 3 i i This inquiry must go through the Council. The issue is Judy Maloney being a Social Worker at Fairview-Southdale Hospital and being on the Advisory Board for Coordinated Home Care and the hospital's policy about what kind of an agency they make their referrals to. June Schmidt suggested that a letter be written up in what the Advisory Board is interested in saying so that the issue is properly stated as to how referrals are made. Mary Bang moved that the Advisory Board recommend that the Council send an inquiry. June Schmidt seconded the motion. Motion carried. VI. Next Meeting Date The next meeting date will be May 27, 1980 at 7:30 P.M. in the Edina City Hall Conference Room. VII. Adjournment Leroy Werges moved that the meeting be -adjourned. Mary Bang seconded the motion. The motion carried; the meeting was adjourned. r I ."'`� I ', '�! i EDINA HEALTH ADVISORY COMMITTEE AGENDA Meeting: May 27, 1980 Edina City Hall Conference Room, 7:30 p.m. Leroy Werges, Chairman 1 _ i i I. Roll Call: LI• Approval of Minutes: April 22; 1980 III. Announcements and Reports: A. Nomination for Appointment to Metropolitan Health Board Home Health Task Force; Leroy Werges IV. New Business: - A. Dayton Hudson grant eligibility; Leroy Werges V. Unfinished Business: A. Nursing Sbrvices Delivery; Leroy Werges VI. Next Meeting Date: VII. Adjournment I i i MINUTES OF THE REGULAR MEETING OF THE EDINA ADVISORY HEALTH COMMITTEE HELD TUESDAY, F MAY 27, 1980, AT 7:30 P.M. EDINA CITY HALL CONFERENCE ROOM I. Members Present: Mary Bang, Dr. Engstrom, Beverly Harris, Homer Kinney, Dr. Krafft, Barbara Kresoya, Dr. Rockwell, June Schmidt, Leroy Werges Staff Present: David Velde, Colleen Paulus Others Present: None Members Absent: Linda Bjerke, Dr. Simmons, Tully Stoppel II. Approval of Minutes - April 22, 1980 Mary Bang moved that the minutes of the April 22, 1980 meeting of the Edina Advisory Health Committee be approved. Dr. Rockwell seconded the motion. All voted aye; the minutes were approved. III. Announcements and Reports A. Nomination for Appointment to Metropolitan Health Board Home Health Task Force; Leroy Werges. The Metropolitan Health Board Home Health Task Force is looking for a nomination for an appointment to the Task Force. The Advisory Health Committee had no names to recommend. Dr. Krafft moved that the Committee accept the memorandum from the Task Force only as information for the Committee. Mary Bang seconded the motion. All voted aye; the motion carried. Dr. Engstrom arrived late and mentioned that a friend of his; Ann Moser, who is a public health nurse who is not currently employed, indicated that she would be very much interested in serving on the Task Force, but no firm committment has yet been made. She also indicated an interest in serving on the Advisory Health Committee when a slot opens up. Homer Kinney moved that the Committee tentatively nominate Ann Moser, pending her acceptance. Dr. Krafft seconded the motion. All voted aye; the motion carried. IV. New Business I A. Dayton Hudson grant eligibility; Leroy Werges_. The foundation is interested in several general areas, not the least of which is social action programs - 40% of the budget. 40% goes to the arts, and 20% to miscellaneous - critical community needs. Grants are rarely made to national programs, health organizations, educational institutions, or advocacy or research groups. P Advisory Health Committee May 27, 1980 Page 2 Mary Bang moved that the Committee accept the report for information `only. Homer Kinney seconded the motion. All voted aye; the motion carried. V. Unfinished Business A. Nursing Services Delivery; Leroy Werges. The Committee has a basic underlying responsibility to look at the provider services and to determine our evaluation of them. The first consideration is whether they are being provided as economically as possible; the second consideration is the quality of service. Dr. Rockwell moved that the report be accepted as is. Beverly Harris seconded the motion. All voted aye; the motion carried. VI. Next Meeting Date The next meeting date will be Tuesday, September 23, 1980 at 7:30 P.M. in the Edina City Hall Conference Room. VII. Adjournment Leroy Werges moved that the meeting be adjourned. Dr. Krafft seconded the motion. The motion carried; the meeting was adjourned. f { 4 j fjkk I EDINA HEALTH ADVISORY COMMITTEE i AGENDA i Meeting: September 24, 1980 Edina City Hall Conference Room, 7:30 p.m. Leroy Werges, Chairman { I. Roll Call: II. Approval of Minutes: May 27, 1980 III. Announcements and Reports: A. CHS Formula Adjustment; Leroy Werges, Yvonne Hargens B. Gerontology Workshop; Sue Weigle `-- IV: New Business: A. State Health Advisory Committee Alternate Member; Dave Velde B. Future Meeting Dates; Roy Werges V. Next Meeting Date: V1. Adjournment 3 d I I I i "'� "�1 MINUTES OF THE REGULAR MEETING OF THE EDINA ADVISORY HEALTH COMMITTEE HELD WEDNESDAY, SEPTEMBER 24, 1980, AT 7:30 P.M. EDINA CITY HALL CONFERENCE ROOM I. Members Present: Linda Bjerke, Dr. Engstrom, Beverly Harris, Homer Kinney, Barbara Kresoya, Dr. Rockwell, Dr. Simmons, Tully Stoppel, Leroy Werges Staff Present: David Velde, Colleen Paulus Others Present: None Members Absent: Mary Bang, Dr. Krafft, June Schmidt II. Approval of Minutes - May 27, 1980 Dr. Rockwell moved that the minutes of the May 27, 1980 meeting of the Edina Advisory Health Committee be approved. Beverly Harris seconded the motion. All voted aye; the minutes were approved. III. Announcements and Reports A. Gerontology Workshop; Homer Kinney. Workshop will be held on Thursday, October 23, 1980, from 12:30 P.M. to 4:30 P.M. at the Southdale Hennepin County Library. Different speakers will speak on various topics, such as youth drug use, physical changes. Bloomington will pay the speaker fees, Richfield will pay for transportation charges, and Edina will provide the refresh- ments. The space for the meeting is being donated by the Southdale Library. Barbara Harris motioned that the Committee sponsor the workshop in conjunction with the Bloomington and Richfield Advisory Committees. Dr. Rockwell seconded the motion. All voted aye; the motion carried. B. CHS Formula Adjustment; Leroy Werges, Yvonne Hargens. The State Health Advisory Committee determines the availability of funds by using the average income of the community. Real estate valuations are also used in conjunction with that. With the formula the way it is, nobody would be getting less money than they were already getting. The original formula in 1975 only had two factors: taxable income and land values, giving each a 50% ranking. The formula has a variable, from a low of $2.40 up to a high of $3.70 (approximate range) . All counties are ranked on this formula, which then determines whether the low or the high figure per capita is received. A third factor, expenditures, was put in as an incentive factor. The formula for the last four years has been that all counties are ranked on per capita income. ''1 '\ '� Advisory Health Committee September 24, 1980 Page 2 Hennepin County has the highest per capita income of the 87 counties, which is the worst ranking. Hennepin County has the highest per capita expenditures for the six areas of community health services, which is the best ranking. Hennepin County is #37 of the 87 counties for land value. The only factor to determine need is the per capita income. The ranking factors within the formula are the things that determine how each county falls on the scale. The State Health Advisory Committee will be meeting on October 24, 1980. Governor Quie needs any recommendations from the local boards by then. The resolutions that were offered are: 1. Totally eliminate the land value factor as a recommendation. 2. Modify or reduce the land value factor. Dr. Rockwell made a motion that if anyone made any recommendation for any changes that we are now considered opposed to the present formula unless added factors are obtained that will improve the relative status of each county. Homer Kinney seconded the motion. All voted aye; the motion carried. IV. New Business A. Future Meeting Dates; Leroy Werges. A change in the Minnesota Statutes states that Advisory Committees shall meet at least three (3) times per year, as opposed to the previous six (6) times per year. Since the Committee has already accomplished the three meetings for 1980, no more meetings are required until 1981. If needed after the October. 24th meeting of the State Advisory Board of Health, an Edina Advisory Health meeting may be held if anything of real serious consequence comes up. B. State Health Advisory Committee Alternate Member; Dave Velde. Changes in the State Health Advisory Committee now permit us to have not only one member, but an alternate member. With an alternate member, there would be more flexibility in trying to attend the meetings. The Committee meets four (4) times per year, as per the State requirement. i No names were submitted at the meeting. Mr. Werges will discuss this with Dave Velde and the City Council would have to approve any suggestions. i V. Next Meeting Date I The next meeting will not be until January 1981, unless there is some i material that turns out from the October 24th meeting that should be I reviewed. A nominating committee must be appointed to consider the officers of the Advisory Health Committee for the coming year. Dr. Simmons, Dr. Rockwell i G ""� '1 '1 Advisory Health Committee September 24, 1980 Page 3 L and Linda Bjerke consented to serve on the nominating committee. They will present their report at the January meeting. V. Adjournment it was moved that the meeting be adjourned. All voted aye; the meeting was adjourned. 4 I .""� '� "�'1 MINUTES OF THE REGULAR MEETING OF THE ADVISORY HEALTH COMMITTEE HELD WEDNESDAY, DECEMBER 10, 1980, at 7:30 P.M. EDINA CITY HALL CONFERENCE ROOM I. Members Present: Dr. Krafft, Homer Kinney, Beverly Harris, Mary Bang, Dr. Rockwell, Linda Bjerke, Dr. Simmons, Leroy Werges Staff Present: Dave Velde, . Colleen Paulus Others Present: Yvonne Hargens, Mark McGarraugh, John Urbach, Commissioner Richard Kremmer, Representative Mary Forsythe Members Absent: Dr. Engstrom, Barbara Kresoya, Tully Stoppel, June Schmidt II. Approval of Minutes September 24, 1980 Under III A, third paragraph, "Barbara Harris" should be changed to "Beverly Harris.' Under III B, last paragraph, Dr. Rockwell's motion should be changed to read: "If anyone made any recommendation for any changes that we are now considered opposed to the present formula unless AFDC and other factors are added that would improve the formula." III. Announcements and Reports A. CHS Formula; Mark McGarraugh. At the State meeting, formal action was not taken on the formula. A change in the formula will create a change in the flow of funds to Hennepin County. It was decided that a constructive change should be made, one which would be good for all counties in the State. Funds should flow to the areas of need. The formula is based on equal expenditure per capita and taxable land values per capita (assessed valuation) . The counties would not be getting less money than they are getting now. If a county's relative rank drops just a couple of places, the amount of money that is freed up by that would mean more money to spread out with other counties. The first concern, from the county department's perspective, is that the formula is too complicated. Each health department does not know how much money they will be getting because the relative ranking, or assessed valuation per capita, can change. • The second concern is that the formula was complex enough and the information was esoteric enough that someone could, if they wanted to, manipulate theiinformation. It wasn't straightforward and obvious. It had to be done with ranks and mathematical formulas and it required a lot of work to insure that you were getting what you ought to have. Y Advisory Health Committee December 10, 1980 Page 2 The final concern was that these formula factors bear little resemblance to real need. The department is asking for $2.2 million more overall for the next biennium for new money for counties. This works out to $600,000 per year for 1981 and 1982 for the whole State. For Edina, that may be $2,000 or $3,000. If new monies are to be expected, the counties must come in unified with unanimous voices for changes to be made in the formula. Money is needed to make these changes. It was found that those counties that have relatively high farm value would do very well by changing the formula and vice versa. The departments' position right now is that they feel that the formula should go from a current minimum of $1.94 to a new minimum of $2.70 and should go from a current maximum of $3. 14 to a new maximum of $3.75; that assessed valuation should be reviewed, but that no county should be allowed to move more than 250, per capita per year in terms of their overall change; and that the 50,000 population bonus should be shifted from 25G to 40(,,. The department has asked for $8.7 million for the new program increase. $3 million is categorical money for home health. $3 million, which is referred to as full-funding, is the money the department says it needs to assure that previous budgetary shortfalls won't happen again. Only $2.2 million of that is guaranteed cash for the counties. This is not an increase for 1981, it is an increase for the biennium. Mary Forsythe stated that the bill is presently on the Governor's desk, but it has not been approved. It is her understanding that the bill increases the per-capita to those counties of over 50,000 to 40(". It affects Hennepin County this way - in 1981 there will be $3.11 per capita, which amounts to the full figure for Hennepin County of $2,989,814. If the new formula is installed, Hennepin gets the maximum, which is $3.36 in 1982. The total dollars for Hennepin County under the bill will be $3,021,984 in 1982 and $3,048,966 in 1983. It is not sure at this point if the bill will be put into the Governor's budget simply because the 22% increase that this would involve. There is no effort in this bill to protect the population changes and if the bill does not pass, Hennepin County will lose more money than they will if it does pass. If the formula is not changed at all, we are looking at real cuts. The department's proposal, going from $2,989,814 to $3,021,984, is approxi- mately a 12% increase from one year to the next, whereas Statewide that annual increase would be 4.9% and about a .8% increase for the following year. On the other hand, we have had a population loss. r"1 "\ "� Advisory Health Committee December 10, 1980 Page 3 The least densely populated counties in the State, the ones who need the money the most, are the ones who in the long run are going to get hurt the worst by the change, such as Itasca, Aitkin, Koochiching. They're the ones that are going to end up at the bottom of the range come 1986 because their taxable value, their land value, is worthless. These three counties do have a 3-county Board of Health and they get some bonuses. Each time you have a county, two or joint powers, you get $5,000 per county bonus and when you get over the aggregate population figure of 50,000 - which is what the State wants to aim at - you get another 25C per capita; next year you get 400. Commissioner Kremmer stated that they will follow this very closely from the County point of view. The two chairmen of the inter-Governmental committee are Randy Johnson and Jeff Spartz and when a bill comes up and has got some offers and is under discussion in the legislature, they will see where it is, when the hearings are being held and so on, and they will have people there to testify for or against it, depending on what the Board's position is. If the City of Edina had some comments, or passed a resolution and sent it to the Board, all those things would enter into their deliberations and they would tell staff to lobby for or against it. Jeff and Randy will go one-to-one to the legislators and they will try and lobby for the Board's position, and they will also, in some cases, have group meetings with the Hennepin County delegations and lobby for the Board's position, and at some of those meetings the whole Board may participate. Mr. Rosland would advise the Advisory Board, before doing anything, to find out the true figures. The City of Edina usually loses anything but per capita. Homer Kinney moved that we take no definitive action at this point. The motion was seconded by Mary Bang. All voted aye; the motion carried. IV. New Business A. Nominating Committee - Officers for Coming Year Dr. Simmons submitted the names of Dr. Engstrom for Chairman of the Board and Barb Kresoya for Vice-Chairman. Dr. Rockwell moved that the nominations be approved. Dr. Krafft seconded the motion. All voted aye; the motion carried. V. Next Meeting Date It was decided to change the meeting night •to Wednesday as opposed to Thursday. No definite date was set for the next meeting. The Board will be notified when a date is scheduled. f Advisory Health Committee December 10, 1980 Page 4 VI. Adjournment Dr. Rockwell moved that the meeting be adjourned. Linda Bjerke seconded the motion. All voted aye; the motion carried. . I � "1 � : - -