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HomeMy WebLinkAbout2013-06-20 Commissioner Minutes THURSDAY, JUNE 20, 2013 The Franklin County Commissioners met Thursday, June 20, 2013, with the following members present: David S. Keller, Robert L. Thomas and Robert G. Ziobrowski. Chairman Keller presided and after calling the meeting to order, a Moment of Silence, and the Pledge of Allegiance proceeded with the business of the day. Commissioner Thomas participated by conference phone. On a motion by Robert G. Ziobrowski, seconded by Robert L. Thomas; unanimously approved to adopt the agenda. Jay Lightfoot provided Public Comment and stated that he was glad that we got rid of the weed and it looks beautiful. David Secor, Franklin County Treasurer, said as County Treasurer he is in support of the Commissioners’ efforts to seek a qualified purchaser of the Falling Spring Nursing Home. He has been a supporter of this effort for over seven years and discussed the issue with prior boards. He has talked with his peers in other counties who unanimously confirmed positive results in both cost savings and service. With state and federal aid in both Medicare and Medicaid, the days of the Alms or Poorhouse run by the County to care for the indigent are gone. There is a current operating deficit of $750,000 as well as pension liabilities that will be erased, thus easing the tax burden. Whether we like it or not, successful government needs to be run as a business and should not be in the nursing home business but leave it to professional private sector companies that have proven success. Carbon County sold their home 2 years ago with 200 beds and having a $1.3 million deficit. They sold the home for $11.5 million and the perceived services met or exceeded the prior. Lancaster County also perceived services being better after the sale. Ken Jones initially likes less spending and in the beginning this idea looked like a good cost savings measure. After Tuesday night, he realizes that there are a lot of people who can’t afford good quality care. He knows of other homes where certain wings are given less care than others. Residents want to be treated like human beings. People need reassurance that family members will be treated well. Ann Rowles, CNA at FSNRC, said she is not negative with what is going on but is keeping an open mind. The FSNRC has ranked high with state standards. Not every home will take Medicaid patients but Medicaid is rehab and that is what Falling Springs is about. The County is responsible for the seniors and need to stick by everyone. Sheri Morgan insisted that the County is responsible for the elderly and disabled but a buyer would not be responsible. They are only responsible to their shareholders. They have no reason to be responsible to the citizens and the County can’t write that into a contract because no business would accept that. There have been no suggestions of mismanagement at the home and there is no reason why the current management team can’t increase services and funding sources. Dave Secor said that normally the private sector gets a higher level of reimbursement of Medicare and Medicaid than the County. The county can write into a contract about the level of services and if the new owner violates the contract, it would be a court action. The County is currently taking taxes to subsidize the home and this is an additional burden on ourselves. On a motion by Robert L. Thomas, seconded by Robert G. Ziobrowski; unanimously approved all bills presented and ordered paid. Continued on page 2 On a motion by Robert L. Thomas, seconded by Robert G. Ziobrowski; unanimously approved the minutes of June 11, 2013 and June 13, 2013 meetings. The Board reviewed Department of Emergency Services matters. On a motion by Robert L. Thomas, seconded by Robert G. Ziobrowski; unanimously approved the contract between the County of Franklin and TriTech Software Systems to upgrade GPS and mapping software to the 911 Communication Center. This GPS mapping software will locate the closest available ambulance, allowing faster EMS response times and patient outcomes. Contract term is June 18, 2013 through June 18, 2014 at a total cost of $54,740.00, 93% of the total cost will be covered through a grant leaving a county portion of $3,999.99 for maintenance. The Board reviewed District Attorney matters. On a motion by Robert L. Thomas, seconded by Robert G. Ziobrowski; unanimously approved for the Chairman of the Board to execute the contract between the County of Franklin and MLB-Hagerstown- Chambersburg III, LLC. to access a tower site on Papermill Road in Chambersburg to be used by the Drug Task Force. This is a month to month contract beginning January 1, 2013 at a cost of $350.00 per month. Either party can terminate contract by giving 60 days written notice. The Board reviewed Grants/CJAB matters. On a motion by Robert L. Thomas, seconded by Robert G. Ziobrowski; unanimously approved the Grant application to Pennsylvania Commission on Crime and Delinquency (PCCD) for the 2012 Byrne Justice Assistance Grant Program to support offenders’ successful community re-entry through approved housing and life-skills to reduce recidivism among offenders, improve self-sufficiency and increase space at correction facilities. Contract term is October 1, 2013 through September 30, 2015 with a grant amount of $319,548.00 with grant coverage of $249,948.00. County portion of the funds are already obligated through New Hope and two master-lease apartments. The Board reviewed Human Resources matters. On a motion by Robert L. Thomas, seconded by Robert G. Ziobrowski; unanimously approved the Military Leave Policy, #322.00 for the purpose of communicating Military leave allowances (time, pay, benefits and notice requirements) and employments reinstatement procedures. The Board reviewed Human Services matters. On a motion by Robert L. Thomas, seconded by Robert G. Ziobrowski; unanimously approved the contract between the County of Franklin and Main Line Broadcasting to promote information services available to Franklin County residents. Contract term is June 24, 2013 through July 6, 2013 in the amount of $1,980, which is fully be paid by the Franklin County Link Grant. In accordance with PA Act 14, 67, 68 and 127 notifications, Baker Co. notified the County of a Pennsylvania Department of Environmental Protection NPDES Permit application being applied by Norfolk Southern Railway Company for the design of an Industrial Lead Track to serve the Franklin County Regional Intermodal Facility located in Antrim Township. In accordance with PA Acts 14 notifications, NRCS notified the County of an application for a Pennsylvania Water Obstruction and Encroachment Permit being applied for by Micah Meyers for a property located in Peters Township. The Board held a public meeting on the possible sale of the Falling Spring Nursing & Rehabilitation Center. Chairman Keller announced that Jay Wenger of Susquehanna Group Advisors, Inc. is here today to answer any questions the public may have and he does have his presentation available if anyone would like to see it. Continued on page 3 Commissioner Keller opened the floor for public comments after asking Mary Beth Shank, County Solicitor, to address the question for previous meetings about whether this question could go to referendum. Mary Beth stated the following: 1. Citizen access to the ballot and use of referendum is limited in Pennsylvania, unlike many other states. Pennsylvania has a strong tradition of representative government and the use of referendum has been slow to develop. 2. Use of referendum is available in some cases. A number of PA laws authorize local referenda on specific matters; however the question of the sale of a county nursing home is not one of them. (An example of some of the questions allowed is boundary changes, debt authorization, fire protection, liquor licenses, library tax, to name a few). Beyond these laws allowing referenda on specific matters, there is general authority for referendum in only two places in PA law - the first is restricted to third class cities and the second source of general authority for referendum is found in the power of a county to adopt home rule charters. Therefore, neither of these general provisions apply. 3. For some time, nonbinding, advisory referenda were placed on the ballot without challenge as a means to involve citizens and allow them to weigh in on locally controversial measures. However the issue of the legality of an advisory question was addressed by the PA Commonwealth Court in the 90's. The Court held that a county lacks authority to place a nonbinding referendum on the ballot absent specific statutory authority for such a referendum. The Court opined that representative government and the legislative process demand such a result. This has been addressed three times by the Commonwealth Court with the same result and the Court further held that neither the Election Code nor any other statue provides any authority for placing nonbinding referendum questions before voters. The PA Supreme and the US Supreme Courts have declined to take this case on appeal; therefore this is the law. In summary, this is not a question that would be allowed to be placed on the ballot as a referendum since it is not provided for by PA law. In addition, advisory/nonbinding referendum questions cannot be placed on the ballot. Jay Wenger, in addressing the question raised on reimbursement, said that there is a slightly different reimbursement model for County Nursing Homes compared to private ones. There is a bed tax that non-County run homes can assessed. Sheri Morgan said that there have been no suggestions of mismanagement and this is not a money issue. She said that in reviewing a CCAP list of core County functions, it mentions both Human Services and long-term care. She believes it is a core function and a safety net service. It is a service that is always available. In the 1990’s there was an issue with quality of care but that has improved. Public services are intergenerational. People are forced to purchase and don’t have the time to search around. There is a place for public homes – a home of last resort and private homes have fancy services. We are not talking about widgets but about humans and their dignity. She hasn’t yet heard from the Human Services Director. She thinks a health impact assessment should be done. Should develop a long-term plan and create a task force. Nursing Homes are labor intensive and difficult to make ends meet. Management team should be able to address these issues. Continued on page 4 Ken Jones said that from listening to the accolades, the families know their loved ones are being well cared for and they have nothing but good comments. Private nursing homes staff less than 100%, sometimes as low as 50%-75%. Allen Piper encouraged the Commissioners to take the comments seriously. Agrees in part with Ms. Morgan that nothing has been heard from the Director of the nursing home. Who will be the oversight? Will it have the same oversight as with the County Commissioners? He has come to meetings for years and takes things serious as a taxpayer and veteran. He has nothing but absolute praise for the nursing home. If allowed, a referendum would probably not pass, like the building of a new courthouse. Would like to hear more from the Commissioners and Social Services. They need to be open and transparent. He doesn’t think the cost factor is that important. This is a personal issue since it deals with health. He stressed that he doesn’t want the Board to fast track this issue. Want it to be stretched out to get more input. He wants to hear and read more of the pros and cons. Dave Secor spoke again and said that he doesn’t disagree with Ms. Morgan about caring for the seniors. All governments must provide high level of services at the lowest cost. Over half of the counties have already sold their nursing homes and unanimously they received a higher level of service. There are good firms out there and it could be a win-win for both sides. There is a lot of emotion in this discussion. Need good quality information when making decisions. He also stated that there have been no regrets from the other counties that have done the same thing. Susie Barrick said her mom had been employed at FSNRC. She asked if Commissioner Thomas was aware of what was going on and Commissioner Keller assured her that he was on the conference phone listening. Her mom worked in the old home before moving to the new home. Her mother is now a resident and a member of the Franklin County Choir and Resident Council. She plays bingo, sells hot dogs on Friday and plants tomato plants. She asked the Commissioners to think this decision over seriously since it is her mom’s home. The staff is her extended family. This is about people’s lives and this home is their heritage. Jay Lightfoot expressed how his wife died in a nursing home. The Commissioners have to listen because they are elected into position. They need to take this information to heart and take their time. Allen Piper thanked Mr. Secor for his comments. He feels very strongly that this should not be fast tracked but proceed at a slow pace. He wants Mr. Wenger to give pros & cons in future meetings. Would like more hearings, more of Mr. Wenger and Mr. Secor’s input. We will learn from each other. He was always treated very well by staff when visiting the home. He summarized, “If it isn’t broken, don’t fix it.” Commissioner Ziobrowski asked Mr. Wenger if private homes normally staff at 50%-75% and if there was any oversight if this was the case. Mr. Wenger responded that any home is subject to the same regulations. With different shifts there are different staffing levels but all need to staff appropriately. With call offs, vacations, etc., they are required to fill to meet the minimum levels. In responding about oversight, he said that in a sale, while we give up the ability to hire and fire employees or accept new residents, the new owner would be subject to annual surveys and Department of Health does come unannounced. Continued on page 5 Commissioner Thomas stated that he had many years overseeing the nursing home and he fully understands the concerns of the families. We now rely on a management team for oversight. He asked if nursing homes realize a cost savings when they are merged together. Mr. Wenger responded that there would be some economy of scale, unlike a bank merger. Two facilities can’t be totally blended together. You still would need two Administrators, two Director of Nurses, etc. plus you can’t be understaffed. Commissioner Thomas responded to the statement that private owners would not care about the nursing home. He emphasized that a new owner would want to keep the residents and employees happy and provide good quality care. Mr. Wenger reinforced that this has normally been the outcome. He sits on the school board and it is normally the few bad employees that get the press attention, not all the good ones. Commissioner Ziobrowski questioned what percentage of patients are Medicaid patients and are they normally put in separate wings of nursing homes? He also stated that in some private nursing homes, day one Medicaid is not the practice but a level of assets is required before acceptance. Mr. Wenger responded that he is not aware of any facility that has different wings or different levels of care for different patients. There are dementia only wings that are locked down for safety purposes. Private pay populations are very low in most nursing homes. Not many are totally private pay models and if they are, they are normally very small. Menno Haven’s private pay residents may equate to 30% with Medical Assistance being 70-80% and Medicare eligible making up the rest. Commissioner Ziobrowski said there have been a lot of misconceptions about private versus county nursing homes. Their resident mix is not as different as some might think. Commissioner Thomas brought up that in an earlier presentation, there are a number of nursing homes within a short distance of Falling Spring. He urged his stepfather to put his mother at FSNRC but realized that families had other options. He asked what percentage of nursing home residents in the area are housed at FSNRC. Mr. Wenger calculated that approximately 2.3% of the market actually resides at FSNRC. This is based on 80 facilities at an average of 120 patients which equates to over 8,000 beds. Commissioner Thomas confirmed that times have changed and it is now a level playing field. With Medicaid funding, you can almost choose where you want to go. Commissioner Ziobrowski said the resistance to changing ownership of the nursing home consists of families of residents concerned about service, employees concerned about job security, and those who question whether a private facility will take day-one Medicaid patients. All are legitimate concerns and the board of commissioners will seek answers to them. There are some others who think that even if the three conditions can be met, that the nursing home should remain with the county. He gave examples of situations in which county and state governments have discontinued services that are not federally funded. He said the Commissioners' job is to constantly look for opportunities to make government more efficient and less costly. Continued on page 6 Commissioner Thomas shared his appreciation of how supportive the Commissioners have been with his health condition. He pointed out that anxiety is fear of the unknown and he understands the fear of the unknown that the employees, loved ones and residents have. He would want the public to have confidence in the Board and hopes they know that the Commissioners would NOT do this if employees would be fired, residents displaced, etc. The Board will insure that any change would be positive for the employees, residents and taxpayers. We need to look at our options; our County is not on the cutting edge with this proposal. History has proven that this can be done successfully. He fully understands the passion that people are expressing. Ken Jones said that it is not a question as to whether the Commissioners will make the right decision. He agrees that change allows you to grow and learn. The point being made is that families are happy with their loved ones’ care and that may change. He spent 6.5 years going to a nursing home and he has seen the Medicaid wing. He knows what he saw and what was told to him. Therapy consisted of 5 minutes on the parallel bar and the other 55 minutes watching others for the first 100 days. Commissioner Thomas agreed that nursing homes may have certain areas/wings where there is a higher level of care. Mr. Wenger said that providers aren’t looking to move patients from one room to another. Change is very hard for the residents. Rooms have been personalized with pictures on the wall, etc. and are home to the patients. They may need to be moved to be closer to a nursing station if their health demands it. Allen Piper quoted that at times he considers the Commissioners his opponents. CRG has been around for 38 years and they are adaptable to change. They love change. With the nursing home situation, he would like the discussions to be stretched out and every bit of information put into it. The CRG is a non-profit and non-partisan organization and they have a voice in this area. He also hopes the media presence stays in-tuned and hopes they get it correct and cover both sides. He wants it to be fair and balanced. Commissioner Thomas reiterated that Commissioners are elected to make decisions based on facts. Those who have transferred homes have had positive stories. The Board would not consider this if there had been a lot of negative reactions. Sometimes you have to do things that are not politically correct. Elected officials are elected to make difficult decisions when needed. Sheri Morgan said she had no doubts that Commissioners from other counties would talk positive about the sale of their homes. If the County would do a health impact assessment, then policy would be driven by facts. Most private homes do a fine job but some are bad apples. Some residents are afraid to ring their call bell. The County should offer a public option for those that fall through the cracks. Commissioner Keller stated that the expectation is whether we will move forward with a RFP to look at companies that share our values. He appreciates the comments from the visitors, the emails and phone calls received. He likes to hear the stories. His own father had a positive stay in 2009 at FSNRC and he saw the love they have there. He has heard about the residents and their fear of losing their caregivers. He heard the same concerns about contracting out MH/ID case management and every consumer retained their caseworker. The Commissioners made a commitment to the employees and all 47 employees were offered a job with the new company. He has spent a lot of time over the years dealing with the nursing home. The County has replaced windows and boilers. The Board has been committed to the home and worked with staff to Continued on page 7 improve things. Employees are concerned with pay, benefits, seniority and pensions. Employee’s rights to their pensions are secure. Employees won’t lose what money is paid into pension if they have less than five years. The Board will look at special circumstances and will do what they can and what is right to take care of the employees. The quality of care is equal to financial considerations. He has heard stories about bad care and this will be addressed in an RFP and with prospective buyers. There are family members concerned with private pay going forward. He agrees with Mr. Piper that this subject should not be fast tracked but it will be a very deliberate process and there will be opportunities for the public to review the background of prospective buyers. The expectation is that this will be a 5-6 month process and at any time the Commissioners have the option of pulling the plug if the process is not yielding the expected results.. The nursing home is not a huge drain on the County budget and we can keep it if we need to. He would like the Board to consider moving forward with the process of a RFP. Commissioner Thomas said that Commissioner Keller’s words were well stated and he doesn’t disagree. No one is hurrying the process. Due diligence is the key word. All conditions must be met before proceeding. He would not say yes if all conditions are not met. He is depending on Commissioners Keller and Ziobrowski and Mr. Wenger will be a tremendous asset. Commissioner Ziobrowski noted that some people who have addressed the board have commented about Jay Wenger's self-interest and potential fees. He acknowledged that Mr. Wenger will earn money if the county sells the nursing home. He noted that Mr. Wenger is providing a service for which he is very well qualified, and invited the audience to "google" Mr. Wenger to see his credentials and experience. He said this issue is emotional for many. He noted that the easiest and least politically risky path would be to do nothing, but studying the issue and considering a sale was the right thing to do. On a motion by Commissioner Thomas, seconded by Commissioner Ziobrowski, unanimously approved to proceed with the RFP process for the purpose of identifying a potential buyer for FSNRC. They directed staff to bring a contract to the Board at the earliest time to engage Mr. Wenger’s firm in assisting with the process. The meeting was adjourned at 11:45 a.m. with a motion by Robert L. Thomas; seconded by Robert G. Ziobrowski. FRANKLIN COUNTY COMMISSIONERS