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CROW WING COUNTY BOARD: Split vote rejects adding hours that would bring more revenue

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news Brainerd, 56401

Brainerd MN 506 James St. / PO Box 974 56401

Crow Wing County commissioners split in a vote with the majority opposing a request to make make one part-time job full time with staffers reporting the change would bring in revenues. 

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Board Chairman Paul Thiede told Beth Wilms, Community Services director, his concerns weren’t satisfied after numerous conversations on topic and he didn’t have enough information to support the request. 

The board voted 3-2 Tuesday, with Commissioners Thiede, Rosemary Franzen and Phil Trusty opposed and Commissioners Rachel Reabe Nystrom and Doug Houge in favor. 

At issue was making a part-time employee full time again by going from 32 hours a week to 40. The bulk of the work is providing case management for senior citizens 65 and older on medical assistance. Blue Cross Blue Shield, Medica and UCare contract with the county to for the case management of medical care. Blue Cross Blue Shield pays an hourly rate of $96 per hour and UCare and Medica pay a flat fee of $133 per client per month. 

With the billing, the additional staff cost reported at $20,000 with revenues of $27,000 for a net gain of $7,000, Wilms said adding that was a conservative figure for revenues coming in to the county. Wilms said the individual staff members manage caseloads of 78-85, higher than the recommended 65 cases for long-term care. The bulk of the work is case management workers of Minnesota Senior Health Options managed care. The department has six full-time social workers and one part-time social worker. The part-time social worker was recently temporarily working full time to cover two maternity leaves.

Thiede said in this economy he didn’t know if he wanted to spend another $20,000 on staff when the county should be in a contraction mode, not an expansion mode. 

Wilms said the county’s population is aging with a growth in an older, retired demographic here. At some point in the next few months Wilms said they will have  to establish a waiting list and that will mean a reduction in revenue for the county. She noted cuts she is anticipating making for the department and the goal to capture as much revenue reimbursement as possible. 

Thiede said what got him going on the issue was attending a meeting during the weekend with an estate planner. Thiede said he was significantly distressed after hearing human services is doing a better job recapturing money from people who are hiding assets and depending on the system and the number of innovative ideas to make that easier. 

“If ever I had a place in my political career where I felt like I was sitting on a balloon — here is one of them,” Thiede said. “It’s always hard to have these discussions and not have it seem to reflect that I want more out of my staff because they are not doing enough. That’s not my intent once again.”

But Thiede said he looks at other counties and a federal government he said is “going bankrupt” and a state government $6 billion in the hole. 

“We’ve got to fix this system,” Thiede said, saying he had a problem adding staff hours when the state and federal governments were “going broke” even when he was sympathetic to staff dealing with case loads exceeding the guideline.

Thiede questioned if the county was creating a magnet for older people to come here and divest themselves of assets before they get here to have the county pick it up. 

“I don’t have an answer to that,” Thiede said. 

Administrator Tim Houle said the funds to support the position don’t come from the state or federal government as case management money comes from Blue Cross Blue Shield, UCare and Medica. Houle said he couldn’t agree more regarding a cottage industry of hiding assets and would feel differently about the request if it were relying on government dollars for case managment, but it isn’t. 

Thiede said the case management portion  for a regulated industry gets him. He asked if case managers were there to make sure individuals were paying all they could. Houle clarified the case management is to make sure the medical services are coordinated for an indivual for a health care plan. 

Houle said the larger issue for him was moving an employee from part time to full time six years earlier, noting that has come from a desire for parenting leaves in the past. Houle said that move seems to have been costly however as the county appears to have walked away from $27,000 in revenue when it reduced a staff member from 40 hours to 32. That was an expensive price to pay to be family friendly, Houle said, noting during six years that amounted to a revenue loss of $80,000.

“In my mind that’s the larger problem here,” Houle said. “We want to be a family friendly organization but it has to be in the context of what is the cost.”

The vote outcome for the social worker was unclear until Thiede asked for a roll call. 

RENEE RICHARDSON may be reached at renee.richardson@brainerddispatch.com or 855-5852.

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