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HomeMy WebLinkAboutCounty Board 10-09-01 ST. CROIX COUNTY BOARD OF SUPERVISORS Special Session October 9, 2001 9:00 A.M. CALL TO ORDER: Chairman Thomas Dorsey INVOCATION: Supervisor Daryl Standafer PLEDGE OF ALLEGIANCE TO THE FLAG ROLL CALL CONSIDERATION OF MINUTES OF PREVIOUS SESSION ADOPTION OF AGENDA DATE OF NEXT SESSION: County Board Budget Review October 30, 2001 9:00 A.M. OLD AND UNFINISHED BUSINESS: (Consideration and action on matters tabled, postponed or referred to a committee at a previous meeting) NEW BUSINESS: 1. Nursing Home Study Report *2. 4 -H'ers Serving Ice Cream at 10:00 A.M. Break CORRESPONDENCE ANNOUNCEMENTS ADJOURNMENT r Special County Board October 9, 2001 ST. CROIX COUNTY BOARD OF SUPERVISORS Special Meeting October 9, 2001 Meeting called to order by Chair Dorsey at 9:00 a.m. Invocation given by Supr. Daryl Standafer. Pledge of Allegiance recited. Roll call: 29 present, 2 absent and excused - Suprs. Bieraugel and Raymond. Motion by Supr. King, 2 nd by Supr. Mortensen to approve the September 18 minutes. Carried. Motion by Supr. O'Connell, 2 nd by Supr. Krueger to adopt the agenda. Carried. Next meeting is October 30 for 2002 budget review. Nursing Home Study Report: Chair Dorsey announced this is the only item on the agenda and no decisions will be made today. Mr. Keefe will give his presentation, Board will take a break and then reconvene for a question and discussion period. He introduced Bob Stephens, Chair of Health and Human Services. Stephens called on John Keefe and Sandy Hayes from Keefe and Associates for their report. Keefe thanked the Board for making time for a special meeting and the Nursing Home Steering Committee members - Bob Stephens, Dick King, Esther Wentz, Ralph Swenson and Stan Krueger for their input during the study. The following minutes are taken directly from Keefe's report in a brief format. The complete report is on file and available from the County Clerk's office. The agenda today is review of County Home mission and current long term care trends, identify strategic options and discuss financial costs. The Home started in 1897 as an Insane Asylum, was renamed County Hospital or Poor Farm in early 1900's, in 1971 State ruled residents could no longer hold jobs in the County Farm and in 1982 the current 129 -bed Nursing Home was built. The County Holstein herd was sold in 1990. The next decade will have no significant elderly growth (75+ years). Major growth will hit after 2018. The bed need is decreasing, community alternatives are increasing and there are chronic shortages in staffing which may require higher wages and benefits to get workers. 1 •r Special County Board October 9, 2001 Medical Assistance reimbursement is tightening, private pay market is shrinking and consumers are demanding privacy, options and space. Ten percent of nursing homes in WI are in bankruptcy, 80% have operating deficits, all but two county homes get subsidies and due to budgetary fallout from the September 11 event, State and Federal aid will likely decrease. There are no easy answers for St. Croix County and tough choices have to be made. Priorities need to be set including minimizing losses and maximizing pluses. Keefe presented five options: 1. Status Quo - remain at 129 beds (minus banked beds); census stable at 90.7; current building maintained, not upgraded; revenues increase slower than expenses and County contribution increases. 2. Closing /Selling Bed Licenses - close and convert some beds to CIP (Community Integrated Program) slots or sell bed licenses only. Both options have significant cost implications. Requires re- location of all residents, allows conversion of some bids to CIP with estimate of 9 of 92 residents CIP eligible. Some costs related to closing would be decreased revenue from people leaving or not entering the Home during the interim; paying bonuses to keep staff until Home closes, payout of accrued employee leave, accrued sick leave and unemployment compensation, possible legal fees and court costs (30 to 35 current residents have a right to a hearing regarding their placement. Total costs at closing estimated from a low of $680,830 to high of $1,806,658. Continuing costs after closing including resident support in the community, building insurance, utilities and maintenance, building repairs, and county charge backs total $297,572. This does not include building disposition. 3A Downsize, Build New 72 bed facility - de- license 54 beds, new site, all private rooms and bathrooms, specific unit for dementia, more efficient. Minimizes MA losses, maximizes Medicare admissions, continue to serve 3o to 35 protectively placed residents, enhances private pay admissions, capital costs estimated at $8.2 million and reduces County contribution. 3B. Downsize, Build New 90 bed facility - de- license 36 beds, same as 72 bed except there would be more Medicaid residents 2 Special County Board October 9, 2001 whose subsidy does not cover daily costs, capital costs estimated at $10.2 million, more staff needed and higher County contribution than Status Quo and 72 bed facility. 4. Remodeling Existing Facility - downsize to 84 beds, address facility design issues, provide dementia unit, $3.55 million remodeling costs plus $858,000 for maintenance. Requires more staff to operate, County contribution about same as 72 bed and less than Status Quo and 90 bed replacement and still have an inefficient building. County Cash Requirements from 2002 to 2009: Option 1: Status Quo -$1.35 million increasing to $2.24; Option 3A - Replacement with 72 beds - $1.35 million to $1.99; Option 3B - Replacement with 90 beds - $1.35 million to $2.24; Option 4: Remodel with 84 beds - $1.35 million to $1.79. If Option 3A was implemented and adjusted by a $3 million equity, possibly from sale of County Farm Land, the range would be $1.35 million to $1.73 million. Employee projections in 2005 are: Option 1 - 111.6 employees; Option 3A - 80.32; Option 3B - 95.21 and Option 4 - 94.74. Keefe said there are two basic decisions for the County Board: Decision #1 - Do you stay in the Nursing Home Business? And Decision #2 - If you stay in business, what do you do with the Nursing Home? Re -build or re- model? 4 -H Ambassadors: 4 -H'ers Holly Stevens and Hannah Mason thanked the Board for their support of 4 -H. They commented how 4 -H has taught them leadership skills, public speaking ability, parliamentary procedure and better communication skills. During the break the 4 -H'ers and 4 -H Youth Agent Kim Reaman served ice cream. Before the meeting resumed, Supr. Grant presented an American flag to Chair Dorsey in honor of his birthday on October 8. The remainder of the meeting was devoted to questions and comments from Supervisors. Keefe explained the different pay ranges for Nursing Home residents: Medicare, over age 65, income no factor, post hospital discharge pays $313 per day; Medicaid, medical assistance for low income people pays $100 a day and private pay residents are charged $125. 3 Special County Board October 9, 2001 The moratorium on sale of beds may be lifted by the State and then there would be no value on sale of beds. Stephens thanked Keefe and Ms. Hayes and said a decision would be made at the County Board meeting on December 18 In answer to a question on selling the home, Keefe said it was doubtful if other private or nursing home chains would be interested in purchasing the home. Chair Dorsey thanked Keefe, Ms. Hayes and the Nursing Home Committee for the work on this report. Correction made at Oct. 30 meeting: Supr. Horne said this was an excellent study but more information is needed on selling the home and /or building. Perhaps DOVE or other private companies would be interested. Motion to adjourn by Supr. O'Connell, 2 nd by Supr. Berenschot. Meeting adjourned at 12:20 p.m. Thomas Dorsey, Chair Sue E. Nelson St. Croix County Board of Supervisors County Clerk 4