washington county human services board 3 · human services board may 13, 2015 page 2 of 2 1...

WASHINGTON COUNTY 1

HUMAN SERVICES BOARD 2

3

Public Agency Center, Room 1023 May 13, 2015 4

West Bend, WI 8:00 a.m. 5

6

Members Present: Michael Bassill, Leslie Borman, Kristine Deiss, Dawn Eyre, Sarah Follett, 7

Robert Hartwig, Dennis Myers, Patricia Strachota 8

9

Members Excused: Paul Ustruck 10

11

HSD Staff Present: Eric Diamond, Sandy Hoefert, Mary Knoeck, Jackie Moglowsky, Maureen 12

Murphy, Sandy Potter, Leigh Sanderson 13

14

Guests Present: Herb Tennies, County Board Chairperson, Joshua Schoemann, County 15

Administrator 16

17

Chairperson K. Deiss called the meeting to order at 8:00 a.m. 18

19

MINUTES 20

Motion by D. Myers, seconded by L. Borman to approve the Human Services Board minutes 21

from the April 7, 2015 meeting as distributed. Motion carried. 22

23

ORDINANCE: WASHINGTON COUNTY STAFFING PLAN – HUMAN SERVICES 24

DEPARTMENT – ECONOMIC SUPPORT 25

Presented by S. Potter, Economic Support Manager. An overview was given of the Economic 26

Support Specialist temporary positions, which help manage the workload associated with the 27

Affordable Care Act (ACA) implementation. The Economic Support Division requested 28

approval to extend the temporary Economic Support Specialists positions as long as there is State 29

and Federal funding to full support the positions. Washington County will have no financial 30

obligation. All costs associated with these positions will be covered with State and Federal 31

funding. Benefits of extending the positions was discussed. Questions and answers followed. 32

Motion by D. Myers, seconded by R. Hartwig to extend the temporary Economic Support 33

Specialist positions as long as there is State and Federal funding to fully support the positions. 34

Motion carried. 35

36

ELECTRONIC MEDICAL RECORD IMPLEMENTATION 37

Presented by E. Diamond, Client Services Director. An update was given on the implementation 38

of the electronic medical record, Lytec MD. Additional work must be performed by Health Care 39

Data Systems (HCDS) to facilitate implementation. Questions and answers followed. Motion 40

by L. Borman, seconded by D. Eyre for Washington County HSD to enter into an amended 41

master agreement to change the training line item of 50 hours and to enter into two Statements of 42

Work with HCDS to complete State reporting customization and billing modification. Motion 43

carried. 44

45

Human Services Board May 13, 2015 of 2

ORDINANCE: WASHINGTON COUNTY STAFFING PLAN – HUMAN SERVICES 1

DEPARTMENT – BEHAVIORAL HEALTH 2

Presented by M. Murphy, Human Services Administrator, E. Diamond, Client Services Director, 3

and J. Moglowsky, Behavioral Health Manager. An overview was given on medical 4

improvements proposed for the HSD Behavioral Health Division. Concerns were shared with 5

the rising need for behavioral health services in our community for children and adults, doctor 6

turnover and the staffing needed to meet the needs of mental health clients in Washington 7

County. Request was made to create a full-time Psychiatrist position, full-time Advanced 8

Practice Nurse Prescriber (APNP) position, a full-time Medical Assistant and increase an 9

existing Nursing position to full-time. Motion by M. Bassill, seconded by D. Eyre to permit the 10

Human Services Department to create a 1.0 Full Time Equivalent (FTE) Psychiatrist position, a 11

1.0 Advanced Practice Nurse Prescriber (APNP) position, a 1.0 Medical Assistant (MA) 12

position, and increase one existing .6 FTE Nursing position to a 1.0 FTE. Motion carried. 13

14

HUMAN SERVICES ADMINISTRATOR’S REPORT 15

M. Murphy presented the Human Services Administrator’s Report. 16

17

NEXT TENTATIVE MEETING DATE 18

The next HSD Board meeting is tentatively scheduled for Thursday, June 11, 2015, at 1:00 p.m. 19

in Room 3224 of the Public Agency Center. 20

21

ADJOURNMENT 22

Meeting adjourned at 9:35 a.m. 23

24

25

26

Leigh Sanderson, Recording Secretary 27

COMMITTEE REPORT

To: Human Services Board

From: Eric Diamond, Client Services Director

Date: June 11, 2015

Re: Behavioral Health Division Clinic Pharmacy

POLICY QUESTION:

Should the Behavioral Health Division award a three year contract to Genoa to provide a Clinic

Pharmacy on the second floor of the Public Agency Center in existing HSD space?

DISCUSSION:

The Behavioral Health Division would like to partner with Genoa, a Clinic Pharmacy Provider,

who would renovate existing HSD space and operate a clinic pharmacy on the second floor of

the PAC. A Clinic Pharmacy will improve information sharing and collaboration between a

client’s clinical team and his/her dispenser. It offers a convenient and client-centered pharmacy

option for clients. Further, partnering with an embedded Clinic Pharmacy Provider will allow

the Behavioral Health Division to task its Nurses with work consistent with their training and

licensure and directly improve client medication adherence and subsequently the Behavioral

Health Division’s financial outcomes.

FISCAL EFFECT:

Clinic Pharmacies bill clients’ insurances, which reimburse them for their work processing

scripts and dispensing medications. As a part of its business model, Genoa employs pharmacy

staff, and will pay for the remodel of HSD space. Genoa will pay rent (fair market value)

monthly for use of the space.

Behavioral Health Division Nurses will be able to provide services consistent with their expertise

and training and improve client and fiscal outcomes. Behavioral Health nurses can work to

assure improved client medication adherence, improve care coordination, attend client doctor

visits, improve client hospital discharges and transitions, and attend to other work that can

improve Behavioral Health fiscal outcomes.

ATTACHMENTS:

None

RECOMMENDATION:

Staff respectfully requests authorization to contract with Genoa, a Clinic Pharmacy Provider on

the second floor of the Public Agency Center in existing HSD space.

Schenck Business Optimization: Washington County - Human Services Accounting

Presented by: Cameron Yazdani, MBA, Director of Business Optimization & Six-Sigma Black Belt Randy Pinnow, CPA, CMPE, Practice Management Consultant Brian Zaletel MBA, BAcc, LNHA , Practice Management Consultant David Maccoux, CPA, Shareholder – Government & NFP

May 4, 2015

2 ● s c henc ksc. c om

What was and is still needed…

• Define/Improve Human Services Accounting Processes and Procedures related to billing, purchasing, accounts payable, financial reporting and grant reporting. Specific steps to include:

1. Clarify and define objectives 2. Organizational responsibilities and accountability clear and aligned 3. Policy and procedure development or updating of existing to actual

practice and to drive desired results 4. Standard processes to ensure clear reconciliation and audit trail 5. System (software) upgrade impacts on process 6. Support a culture of accountability and continuous improvement 7. Ensure sustainment of new processes


Our Focus

Start small with one project,

educate the team and implement

quickly

Move to the entire order process from front to back

Move to the entire company including Sales, Marketing, Accounting,…


Project Recap



quickly



• Step 1: Define department objectives and document current state utilizing a swim-lane process mapping approach to identify critical reports/processes/accountabilities related to Human Services Accounting and observe process. To include department personnel, Finance, Administration, and any other committee or board members deemed appropriate.

• Step 2: Analyze data/reports and define improvement opportunities captured in mapping process and from Schenck observations. Align improvement opportunities with future state.

• Step 3: Implementation Actions and Plan


Process Mapping

Team oriented process mapping exercises which fostered excellent collaboration and knowledge sharing between the 2nd and 3rd floor teams.


Process Mapping

Washington County, Human Services, Accounting Department, Outpatient Billing Process – Current State

Clai

m P

roce

ssin

gRe

gist

ratio

nD

enia

l Pro

cess

Paym

ent P

ostin

g

Day before service report – Review by

all Billing staff

Patient hasInsurance?

PreAuth obtained and

denoted in Lytec Determine

Employment Status

Patient Financial

Statement

Continue research on

payer source

Sliding Fee Scale

Payment Plan

Verify Insur Forward

Health Portal

Update Reg, demo info, sign release

Enter detail into Lytec

Verify Insur Passport

Note in Lytec if patient

need to see Billing

Collection Conversation if necessary

Revenue Management

Claim File

Breakdown Claim File for

BillingErrors?Run Claim

Check

All other Payments

Patient Responsibility

?All Checks go

on Spreadsheet

Medicare / Medicaid

Money Deposit into

Holding Account

Money Into Program Account

EOB’s

Payments Posted to

Patient Acct

SecondaryPayer

?

Confirm Patient Can

be Billed

Run Job to Creates

Statements

PDF file maintained

for reference

Statements printed after

hours

Stuff statements

and mail monthly

Payments Posted to

Patient Acct

Bill Secondary payer before

primary. Paper or web portal

Denial Reason Researched

Call payer, appeal, Lytec,

deduct, co-insur

Error Corrected

Post to a/c, chargeback, adjustment

File Sent to Clearinghouse

Next Day, HDS Reports after

11am

Claim FileClean

?

ClaimDenied –

Report from CH and EOB

ClinicalService

PatientScheduled

Yes

No

No

No

Yes

Yes

Yes

No

If Rebill needed

To Program

J/EHolding AC to Revenue AC’s

Reconcile Holding AC to

Patient Posting

No

Yes

ClaimProcess


Process Mapping Washington County, Human Services, Accounting Department, 3rd Floor Accounting Functions - Current State

Acco

unts

Rece

ivable

Clien

t Billi

ngAc

coun

ts Pa

yable

Paym

ent R

eceiv

edCL

TS

Soc Worker Letter of fee respons to

parents

Soc Worker sends income verification to

parents

Client Billing Calls

Statement Created Monthly

Deposit made daily into Shelter

or Supervision Account

After 6 Mon letter,

account to Collections

PaymentsLSS census

Patient in/out for billing

Statement

3 Mon – Reminder4 Mon – Past Due

5 Mon – Last Chance6 Mon - Collections

Supervision Bill monthly

until end date

Financials

Other Invoicing

ACH Energy

Cash / Check

Treas Office Verify Accounting of

deposit and how to process

Add ac #, match to invoice

George Payer, client #, Check

amt, check #, ac #, contract #

George Deposit Report Recon

deposit to postings in George

2 receipts Patty and attach to deposit report with back up

Report and Checks to Treasurer

Invoice signed by Manager

Assigned account #

Invoices Batched

Move to Finance through George

Entered into George

AuthContract

PO

All non WISACWIS

invoices

WISACWIS Childern and

Family

StateCAR, CORS,

Energy, Youth Aids

F/S sent, email, mail,

on-line

LSS Shelter and

Supervision

PaymentReceived

Payment posted to Billing Recon

and Child Statement

Payments Received from

Collections

Payment posted to

Child Account

MOU, Interagency agreement, Contract

Caseworker sets up

Authorization

CLTS Auth System

Submit to WPS

Insurance

Once approved, file

sent to Provider

Provider Bills based on this

detail

Case management

is billed to WPS

Federal program. Patient

screened by State

Shelter and Supervision

Check Register

received from Finance

Detail sent to Finance

Verify invoice / auth/

WISACWIS Auth

WISACWIS file uploaded into

George

If WISACWIS Finance sends additional file

Research with Social Worker

Variance?

File imported into

WISACWIS system

At end date, confirm with Soc Worker

New Vendor?

Invoice with Authorization

Request for PO with

Authorization

Finance creates Vendor in JD

Edwards

Vendor AC Number

PO Details in Purch

Recquisition

PO Processed through

Purchasing

Print PO from Imaging System

Attach all Back-up to PO

Yes

No

No

No

Yes

Yes

Purch

ase O

rder

Sue posts payments


Data Analysis Washington County HHS Annual Appointment Volume 4/7/14 - 4/6/15

The graph represents HHS annual appointment volume. The purpose was to try to determine which appointment reasons are requiring the accounting 2nd floor team members to have face-to-face meetings with clients at the highest frequency. These meetings have a high rate of daily variance in regards to the time spent with clients and away from their working areas addressing their core job responsibilities. Sue indicated that all reasons are causing meetings except Nursing.


Procedure Analysis

Reviewed a series of internal policies and procedures as well as state DHS rules and regulations. Determined that you may actually outsource collections which may be suitable.

10 ● s c henc ksc . c om

Data Analysis

This data represents overtime utilization over the last 12 months. It clearly indicates a significant increase in overtime utilization by Susan Peters. It appears that she has already exceeded the 2014 OT in the first quarter of 2015. Sue Peters appears to be wearing many hats and is controlling processes that need reconsideration in design and flow. The OT trend indicates that current work flow is not efficient and/or realistic for this employee.


Data Analysis

The accounts receivable aging is indicating a need address the current claims and billing processes. There are significant account balances over 60 days.


Data Analysis

The accounts receivable aging is indicating a need to address the current claims and billing processes. There are significant account balances over 60 days.


Improvement Ideas - Schenck

• Identified 20 consolidated opportunities for improvement categorized as strategic, operational, HR and IT

Number Priority Department Type Idea Recommendation Owner

1 Children & Families OperationsChildren and Families would like Accounting team to complete client financial analysis based on poverty level

Collectively review between department and accounting to determine where most appropriate to be performed. TBD

2General Accounting (3rd

Floor) Human Resources Communication between social workers and accounting team needs to improve.

To improve the billing/collection process and the patient experience, we recommend a weekly meeting between accounting and social work. The goal will be to discuss client activities that impact the process and the client. This information sharing will help the processes supported by both teams. TBD


Floor) Operations Better way to do billing for supervision fees? Reduction in postage and frequency?Collectively review between department and accounting to determine where most appropriate to be performed. TBD


Floor) Operations Calls from parents questioning financial responsibility Add this responsibility to a centralized Patient Accounting team. TBD


Floor) Operations Billing tracking and invoicing being completed in Excel - alternative option?Collectively review between department and accounting to determine if what is performed is necessary. TBD

6 HHS

Human Resources/Information

TechnologyThrough process analysis and review of job descriptions, several areas for basic training, over use of Excel and cross functional training became apparent.

Develop an onboarding process and training guide for new employees, determine cross training opportunities for key/critical accounting functions and develop a training plan for Lytek MD and JD Edwards. TBD

7 HHS Operations

Based on the data provided for April 2014-April 2015, 31% of appointments are cancellations, no-shows or reschedules. Reduce this number to improve the patient clinical outcome and the billing process.

Consideration and implementation for obtaining cell numbers and email addresses to remind patients should be evaluated. Overall, the process of scheduling, rescheduling and management of cancellations should be improved/tracked. TBD

8 HHS/County-Wide Strategy

To support the county LEAN and organizational improvement initiatives moving forward, an internal champion should identified that can be educated/trained/mentored. This individual can be actively or passively involved in all study's and implementations.

Assign Eric as internal LEAN champion to work with Schenck on implementation of required changes. TBD

9 HHS/County-Wide Strategy

Implementation of a dashboard containing metrics and associated key performance indicators (KPI's) related to cost, service, quality and operations, etc. Ideas (related to and outside the scope of this review) include collections aging, re-admissions, productivity, billed codes, CCS revenue, budget/actual for programs and departments. n/a TBD

10 HHS/County-Wide StrategyOrganizational Structure and associated locale of individuals can be modified to provide improved customer service, efficiency, accuracy and departmental effectiveness.

Develop a transition plan and new organizational structure incorporating a shared services model. Divide accounting into 2 teams including a general group and a patient accounting team. TBD

11 Outpatient Billing (2nd Floor) Operations/StrategyOutstanding collections need to be addressed and a process for future collections established.

Ensure utilization of uniform fee system and consistency of fee scale. Additionally, consider utilizing WIDHS for collections per the policy. Additionally, the Schenck Medical Billing team could review records and processes. TBD

12 Outpatient Billing (2nd Floor) Operations Improve process of obtaining information from clients on the day of appointment Kick-off a team to improve the intake process. TBD

13 Outpatient Billing (2nd Floor) Operations Improve identification of claims errorsKick-off a team to improve the most error prone locations and implement a plan to mitigate. TBD

14 Outpatient Billing (2nd Floor) Operations Credentialing processes need to be documented to ensure future compliance. Kick-off a team to improve the credentialing process. TBD

15 Outpatient Billing (2nd Floor) Operations Improve client registration process on the day of appointment Kick-off a team to improve the intake process. TBD

16 Outpatient Billing (2nd Floor) Operations Implement front desk staff take payments from clients Kick-off a team to improve the intake process. TBD

17 Outpatient Billing (2nd Floor) Operations Stuffing of envelopes appropriate for Sue?Collectively review between department and accounting to determine where most appropriate to be performed. TBD

18 Outpatient Billing (2nd Floor) Operations Carol using Excel spreadsheets for payment receipts - alt system option for tracking?Determine whether the functionality already exists within the major applications currently utilized. TBD

19 Outpatient Billing (2nd Floor) Operations Statements processed and printed in off hours by Sue - appropriate?Collectively review between department and accounting to determine where most appropriate to be performed. TBD

20 Outpatient Billing (2nd Floor) Operations Statement issues still identified at point of stuffing envelopes - appropriate?Kick-off a team to improve the most error prone locations and implement a plan to mitigate. TBD

Washington County Health and Human Services5/1/2015

Red = Primary focus / High ROIYellow = Secondary focus / Moderate ROIGreen = Long-term or optional focus / Lower ROI


Improvement Ideas – Eric/Internal

• Reviewed and discussed 38 opportunities for improvement

Number Priority Department Type Idea Recommendation

1 TBD ACS Operations

Hospitals send paper invoices, which is checked against utilization (entered daily services), signed by program supervisor, and sent to financial staff, where it is checked again and entered to additional spreadsheets Phase 2 Project

2 TBD ACS/COP/CSP/LifeSpan Operations WIMCR process is unclear and there are concerns that this is not being done accuratelyPrimarily relates to mental health, which would fall under Dave's responsibility, per Mary.

3 TBD ACS Operations No monthly reporting that identifies external provider costs, utilization, trends, etc. Phase 2 Project

4 TBD AODA Residential OperationsNeed to assure that clients are connected with Economic Support workers to identify benefit options, eligibility for MA Phase 2 Project

5 TBD AODA Residential OperationsMonthly, financial staff need to assure clients have MA - communicate with staff when issues arise Phase 2 Project

6 TBD CCS Strategy Currently not billing for initial contact and assessment - leaving money on the table Sue says we cannot bill for this service

7 TBD CCS Operations

Service facilitators are unsure regarding what services are in provider network, what their availability and rates are, how to sign providers up for services - service auth and contracting process is deficient and unmanaged Phase 2 Project

8 TBD CCS OperationsLeigh and Eric get services on line and contracted which disconnects local supervisors from process Phase 2 Project

9 TBD CCS OperationsMonthly progress notes from external providers arrive via paper copies which are then scanned into folder - invoices and service notes often do not arrive at same time Phase 2 Project

10 TBD CCS OperationsPaper invoices are processed manually by financial staff; support staff enter billing units into Lotus BHSF which then flows to Lytec billing Phase 2 Project

Washington County Health and Human Services4/27/2015


Key Action Items



quickly

Begin to expand in the other related process and

educate while implementing



• Begin interviewing for an Accounting Manager position reporting to Finance with dotted line to HHS and seated in HHS offices. Owners: Josh, Sue and Maureen

• Appoint Eric as internal LEAN/Process Improvement Champion to work directly with Schenck step by step through various implementation efforts. Owners: Sue and Maureen

• Move third floor (and potentially second floor) functions to “Corporate” Finance using a low risk/high impact approach starting with highly transactional functions. Develop a plan focused on functions, who will perform, by when and who will review. Funding sources, grant reporting, collections, reconciliation, etc. Ensure a formalized transition and communication plan occurs. Goal is to focus on centralization of functional and transactional roles and decentralize strategic and advisory roles. Owners: Sue, Maureen, Eric

• LytekMD – Re-focus and vendor management: Coming to agreement from a contractual standpoint on what has been completed and the open items. Clarification, scheduling and training planning and success measurement moving forward to ensure appropriate functionality/knowledge of user base. Owners: Maureen and Eric


Key Action Items



quickly

Begin to expand in the other related process and

educate while implementing



• Implementation of a dashboard containing metrics and associated key performance indicators (KPI's) related to cost, service, quality and operations, etc. Ideas (related to and outside the scope of this review) include collections aging, re-admissions, productivity, billed codes, CCS revenue, budget/actual for programs and departments. Owners: Maureen and Eric with Sue’s oversight

• Go-forward plan: Due to excessive unfiled claims and high patient receivables, further analysis of HS billing and collections processes is necessary to establish a revenue cycle that supports the goals of HS and is compliant with regulatory requirements. Owners: Maureen and Eric with Sue’s oversight

• Clean-up Effort: Address through a concerted improvement effort to close

previously billed accounts. This will address claims to be processed, denials to be reviewed and patient balances collected or written off. Train, evaluate, review, provide clarity and accountability. Owners: Maureen and Eric


Key Action Items

• Significant billing issues are caused by an inconsistent intake process. Patient-facing registration/reception staff roles need to be evaluated to improve patient onboarding to minimize back end billing clean-up and improve the patient experience. Owners: Maureen and Eric

• Based on the data provided for April 2014-April 2015, 31% of appointments are cancellations, no-shows or reschedules. Consideration and implementation for a more disciplined and effective approach including but not limited to wait time reduction, obtaining cell numbers and email addresses to remind patients should be evaluated. Overall, the process of scheduling, rescheduling and management of cancellations should be improved/tracked. Owners: Maureen and Leigh


Step 4 - Implement Improvement Plan

• Implement: – New process methods – New Procedures – New Training – New metrics


Step 5 – Sustain The Improvements

• Sustain: – New process methods:

• Process clarified and linked to procedures and training. – New Procedures:

• Updated and sustained – New Training:

• Training conducted as assignments or personnel changes • Effectiveness audited

– New metrics: • Retained metrics and new metrics in-place

– Ownership responsibility assigned – Posted and understood by those impacted.


Recommended Next Steps Recommended Projects (Can select any/or all items as desired) On-site

Timeline Cost Not to Exceed

Project 1 – Staff transition to Corporate Finance and associated integration plan 5 days $8,000

Project 2 – LytekMD re-focus and vendor management 2 days $3,000

Project 3 – Development of managerial dashboard and metrics 7 days $13,000

Project 4 – Go-forward billing and collections process 7 days $13,000

Project 5 – Clean-up effort on open billings and collections (contingent on #4) TBD TBD

Project 6 – Transformation of roles and responsibilities of Registration personnel 4 days $7,000

Project 7 – Patient cancellation and reduction of reschedules effort 2 days $3,000

Total not to exceed $47,000 (excludes project 5)

COMMITTEE REPORT

To: Human Services Board and Administrative Services Committee

From: Maureen Murphy, Human Services Administrator

Date: June 11, 2015

Re: Approve Creation of a Billing Supervisor Position

POLICY QUESTION:

Should the Human Services Board and the Administrative Services Committee approve creation

of a Billing Supervisor position?

DISCUSSION:

The past few years have seen tremendous transition within the Human Services Department

(HSD). At the beginning of 2014, the long-serving HSD Director retired. At the same time, an

Accounting Assistant who handled the medical billing also resigned. An internal Interim

Director was appointed to manage the department throughout 2014. An external permanent

Director was appointed on December 1, 2014. The transition continued into 2015. The

Accounting Manager resigned on February 28, 2015. With all of the staff turnover that had

occurred, especially within and affecting the Accounting Division, the County Administrator,

Finance Director and current Human Services Administrator brought in Schenck to perform a

top-to-bottom review of the Accounting Division. In both March and April of this year, the

Schenck Business Optimization team performed their review of the HSD Accounting Division.

The Division currently has seven positions: one Human Services Accounting Manager, one

Accounting Supervisor and five Accounting Assistants. As mentioned in the previous paragraph,

the Accounting Manager position is currently vacant. The Accounting Manager position

managed six employees and was responsible for the financial affairs of the entire HSD as well as

handled the day-to-day fiscal affairs of three Divisions within HSD, Administration, Accounting

and Behavioral Health Divisions. The Accounting Supervisor position oversees the financial

affairs of two Divisions within the HSD, Children and Families and Economic Support

Divisions. Two Accounting Assistants handle accounts receivable and accounts payable for the

entire HSD. The remaining three Accounting Assistants process medical billing for the

Behavioral Health Division.

Schenck issued its report on May 4, 2015. The Schenck Team’s recommendations included

seven recommended projects that required immediate attention. As the management team began

to dig into project 5 – Clean up effort on open billings and collections, it was determined that

there currently is not a person within HSD that has the extensive knowledge necessary to

efficiently and timely work within the two systems (George and Lotus) and three databases

(Vern, BHSF, Checkbook) that constitute the HSD billing network. Since much of HSDs

revenue must be billed within one year of service, each day that billing goes unprocessed is

revenue uncollected.

Also as part of the report, Schenck recommended moving forward with centralized financial

management. Given this recommendation and the need to have a hands-on Billing Supervisor to

maximize revenue collection, the management team is requesting that the Accounting Manager

position be downgraded into a Billing Supervisor at this time.

FISCAL EFFECT:

The position will be created by under-filling the already budgeted Accounting Manager position.

ATTACHMENTS:

Billing Supervisor Position Description

RECOMMENDATION:

Staff respectfully requests approval to create a Billing Supervisor position at Pay Grade 8 of the

Washington County Staffing Plan within the Human Services Department.

of 2

WASHINGTON COUNTY, WISCONSIN 1

2

Date of enactment: __________ 3

Date of publication: __________ 4

5

2015 ORDINANCE ___ 6

7

AN ORDINANCE to amend Sections 7.02 and 7.03 relating to: Washington County Staffing 8

Plan – Human Services Department – Administration and Washington County 9

Classification and Compensation Plan. 10

11

The people of the County of Washington, represented in the Board of Supervisors, do ordain as 12

follows: 13

14

SECTION 1. Section 7.02 of the code is amended to read: 15

7.02 WASHINGTON COUNTY STAFFING PLAN. (AM 15- ) Washington County 16

maintains a Countywide Staffing Plan listed by department. Such plan shall indicate the type and 17

number of positions currently authorized by the County Board together with the existing pay grade 18

for said position. County departments are authorized to fill only those positions listed in the 19

Countywide Staffing Plan. Any changes to the staffing plan shall be determined by the 20

Washington County Board upon review and recommendation of the Administrative Services 21

Committee consistent with sec. 7.04(9) of this chapter and sec. 2.44 of this Code. Position title 22

changes with no fiscal impact and Fair Labor Standard Act (FLSA) changes may be made by the 23

Human Resources Director. The Human Resources Director shall provide a report to the 24

Administrative Services Committee, with a copy to the County Attorney for implementation. 25

26

HUMAN SERVICES DEPARTMENT – Administration 27

28

Pay Authorized 29

Position Grade Positions FLSA 30

31

Billing Supervisor 8 1 E 32

33

SECTION 2. The list of pay grades established in Section 7.03(1)(a) shall be adjusted to 34

incorporate the changes proposed in this ordinance. 35

36

SECTION 3. EFFECTIVE DATE. This ordinance shall become effective upon passage 37

by the Board of Supervisors and publication as provided by law. 38

39

SECTION 4. SUMMARY. Ordinance amending staffing plan for Human Services 40

Department - Administration. 41

_________________________ 42

43

VOTE REQUIREMENT FOR PASSAGE: 2/3 of the members elect 44

45

of 2

APPROVED: Introduced by members of the HUMAN SERVICES 1

______________________________ BOARD, ADMINISTRATIVE SERVICES and 2

Kimberly A. Nass, County Attorney FINANCE COMMITTEES as filed 3

Dated_________________________ with the County Clerk. 4

Considered_____________________ _________________________________________ 5

Kristine M. Deiss, Chairperson 6

Adopted_______________________ Human Services Board 7

Ayes_____ Noes_____ Absent_____ ________________________________________ 8

Voice Vote_____________________ Peter I. Sorce, Chairperson 9

Administrative Services Committee 10

Countersigned: _________________________________________ 11

______________________________ Raymond W. Heidtke, Chairperson 12

Herbert J. Tennies Finance Committee 13

County Board Chairperson 14

15

(The funding for this position is from the vacant position of Accounting Manager. The analysis 16

below is based on a full year. The Accounting Manager has been vacant since 3/31/15. The 17

annual cost of the Accounting Manager is approximately $88,500. No additional funding is 18

necessary. The annual cost of the Billing Supervisor is shown below. The cost assumes family 19

health insurance. 20

21

Billing Supervisor – Pay Grade 8 22

23

Salary & Wages 50,710 24

Retirement 3,448 25

Social Security 3,879 26

Health Insurance* 22,061 27

Total 80,099 28

29

*Assumes Family Insurance) 30

333 East Washington Street

Post Office Box 2003

West Bend, Wisconsin 53095-2003

(262) 335-4600 FAX (262) 335-4709

WASHINGTON COUNTY

HUMAN SERVICES DEPARTMENT

MAUREEN MURPHY, Administrator

DATE: June 11, 2015 TO: Washington County Human Services Board FROM: Maureen Murphy, Human Services Administrator RE: MAY HUMAN SERVICES ADMINISTRATOR’S REPORT The Wisconsin County Human Services Association (WCHSA) spring meeting was held this month. Children and Families Manager Hoefert attended with me. We had an opportunity to spend a significant amount of time with the Area Administrator for the State of Wisconsin Department of Children and Families. This one-on-one time is extremely valuable as we have a case that has been very challenging for both the State and the County systems. The conference allowed us to work together in a less formal, more productive manner.

Accounting Division

With the assistance of the Finance Department Assistant Director Dave Owens, HSD has gotten up-to-date on an important program reconciliation. Assistant Director Owens is in the final stage of reconciling the Comprehensive Community Services (CCS) Program for 2013. Kudos to Dave for his assistance.

Unfortunately, as one problem is addressed, another issue within the Division has unfolded. It appears that the Division has fallen significantly behind in collecting revenue. The management team is working diligently to fix this problem because for many programs revenue must be collected within one calendar year or the opportunity to collect is gone. There is a recommendation on the agenda that will remedy the problem permanently.

Behavioral Health Division

With the promotion of Jackie Moglowsky to Behavioral Health Manager, the Outpatient Supervisor position was left vacant. An internal candidate “knocked it out of the park” during her interview and has been selected to fill the vacancy. The new Outpatient Supervisor is Alicia Leslie. Please join me in congratulating Alicia on this new opportunity.

As of this writing, HSD has five clients in State of Wisconsin Institutes for Mental Disease (IMD.) This is the most restrictive and most costly type of court-ordered care.

Children and Families Division As mentioned above, an internal candidate has been promoted. Unfortunately for the Children and Families Division, the candidate was a unit supervisor within this Division. In

addition, another unit supervisor announced her retirement effective in early June. There are currently four units within the Division and with these two departures, the management team met to brainstorm the Division’s structure. At this time, due to the incredible workload and line staff vacancies, HSD will move forward with filling both positions. Economic Support Division The Washington County Economic Support Division received an award for excellence. At the June meeting, the management team would like the Human Services Board to share in marking this achievement. Next year’s Income Maintenance contract with the State of Wisconsin is currently being renegotiated with WCHSA and our partners in the Moraine Lakes Consortium taking the lead. Updates will be provided in future reports.

Office Support Division This Division has been working diligently to improve the scheduling process and reorganize duties in response to several recent staff departures.

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