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HomeMy WebLinkAbout2013-06-11 Commissioner MinutesTUESDAY, JUNE 11, 2013 The Franklin County Commissioners met Tuesday, June 11, 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. On a motion by Robert G. Ziobrowski; seconded by Robert L. Thomas; unanimously approved to adopt the agenda. Jim Wyrick provided public comment and asked if the Affordable Care Act goes forward how has the county projected the impact on the county? Allen Piper provided public comment and asked if Sheriff Anthony participated in the executive session on June 6. He also asked if a temporary sheriff deputy position was being added; how many positions are under Dane Anthony's department now compared to end of Mr. Wollyung's tenor; Why is this position needed; Will this be a permanent position? Chairman Keller responded that salary board was listed on the preliminary agenda but salary board was not approved on the official agenda. There was no salary board discussion last week and he will attempt to answer the questions Mr. Piper posed at a later meeting. Commissioner Keller also responded that Sheriff Anthony did participate in the executive session on June 6. The minutes of June 4, 2013 and June 6, 2013 meetings were reviewed. These will be approved Thursday, June 13, 2013. The Board reviewed Agreements, Contracts and Reports. The items will be approved Thursday, June 13, 2013. The Board recessed until 10:00 AM for the Human Services Block Grant Public Hearing. The Board held a Public Hearing on the Human Services Block Grant for Franklin County Plan and Process for 2013/2014. Richard Wynn, Human Services Administrator provided a presentation and gave the Board an update on the block grant process for the past year. He said the final allocation will occur in October but it all depends on the final State budget. Due to the Block Grant process the County avoided cutting programs. For the 2012/2013 budget the Committee recommended extra funding to homeless services which helped keep a few homeless shelters open. For the 2013/2014 Mr. Wynn asked staff what would it cost to maintain services in the new year and requests for additional funding came in at $170,112. The Committee then reviewed all requests and recommended funding $152,000. The following programs and funding were recommended: Drug and Alcohol — BHSI for $52,733; Children & Youth — Family Group Decision Making for $4,410; Homeless Assistance Program — Rental Assistance for $23,000; HSDF — Teen Intervene Program for $8,000; HSDF — Elementary Intervention Groups for $12,000; HSDF — Transportation Services for $10,000; HSDF — Intellectual Disabilities Apartment Program for $5,000; and HSDF — Intellectual Disabilities Life Sharing Program for $37,500. The Committee will next be working on having a subcommittee to work on outputs and outcomes and what the actual effects of the Continued on page 2 programs will be. There are committee members that have experience in this. Commissioner Thomas wanted to mention that the $152,000 that recommended be shifted is a small percentage of overall budget and that the vast majority of the dollars are staying in the categories where they started. The Block Grant is letting counties put consumers ahead of the rules which is the goal of the program. Mr. Wynn mentioned that the deadline is June 15th and the Board needs to approve the recommended adjustments. Chairman Keller opened the floor for public comments. Cody Reed asked what is line staff? Mr. Wynn responded line staff are people doing the work directly with consumers face to face. Mr. Reed said the Mental Health part of Block Grant is nothing added and nothing subtracted. Mr. Wynn responded that Mental Health projected $57,000 was available and not projected to spend. Sheri Morgan, Greencastle said although no reductions in Mental Health there was $57,000 not spent and was reallocated to someplace else and no reduction in services but no increases in services related to savings. Mr. Wynn responded that was correct. She said there was a list of committee members but no consumers were listed as committee members. Were these people forgotten on the slide? There was only one citizen on the committee, so they need more citizens. She thinks the county has an attitude problem in that it does not value people. Mr. Wynn responded there were a lot more members not listed on the slide and provided the following consumer committee members missing: Jeff Hoose, Homeless Advocate; Kim Wertz — Mental Health Consumer; and Anne Larue — Advocate of Intellectual Disabilities Kim Wertz responded that she's not worried about not being on list. She is more worried about having her input recognized. She is fine with recommendations being made. She wanted to make sure programs are funded at minimum operating standard and not losing staff. Megan Shreve, from SCCAP spoke about when first realized she was on committee she wasn't excited and thought it would be a very stressful process. This group is very amendable and they put all options and every service provider on table, it was an amazing process and they did amazing work. She said people left better friends then when started. Commissioner Ziobrowski asked if there was any empathy towards consumers and Ms. Shreve responded there was a lot of empathy for them and they looked at best interest of people they serve. Sheri Morgan said still need more consumers on this committee. Have known people that have stories of the life sharing program from State and did well with them. If have more consumers on Committee may hear more about the life sharing program. Commissioner Thomas asked when it was decided to give $32,000 to the homeless program did it go through the committee. Mr. Wynn responded yes. Commissioner Thomas said it sounds like process is working. Kim Wertz said the reason why they moved money was because shelters were about to close and need to keep them open so don't have people using the shelter out on the street. Cody Reed asked who do consumers talk to about requesting services and how do we get word to the Board? Mr. Wynn responded about the Act of 1966which created the MH /ID Advisory Board. The advisory board is independent and willing to hear about any request. New clients have to go through the intake case management system. Mr. Reed can go to any Human Services staff if he has an idea. Continued on page 3 Chairman Keller asked the Board if they were ready to move forward. The Board agreed to approve the recommendations as presented. On a motion by Robert G. Ziobrowski; seconded by Robert L. Thomas; unanimously approved the recommendation of Human Services Block Grant Planning Committee. Chairman Keller said based on prior discussions by the Board of Commissioners in executive sessions, the Board is prepared to consider authorizing a Request For Proposal process for the purpose of identifying prospective buyers for Franklin County's Nursing Home. In short, the Board has determined that it is not necessary for the County to own and operate a skilled nursing facility. If a buyer can be found that shares the County's philosophy in terms of quality of care, commitment to Medicaid eligible residents, and commitment to our employees, then the Board would consider a possible sale of the nursing home. Chairman Keller introduced Jay Wenger of Susquehanna Group Advisors, Inc., Harrisburg who is here today to present the information that has led the Board to decide to formally consider moving forward with an RFP to sell the nursing home. Mr. Wenger recently assisted Adams County in the sale of their nursing home in 2010. The presentation is the same information that was presented to the Board in executive session. The information reflects input from the Board about the RFP process and the essential goals that would need to be achieved before a sale of the nursing home would be authorized. Mr. Wenger summarized the reasons why it is no longer necessary for the County to own and operate a skilled nursing facility. In particular, counties are not obligated to operate a skilled nursing facility, the County does not compete with the private sector in any other business or service, it is likely that a private owner can be found that will provide the same or better quality of care in conjunction with existing staff at the nursing home, and the county's residents are well served by numerous privately owned facilities. Mr. Wenger also noted that the nursing home is a financial liability to the County, and that selling the home would limit taxpayer obligation and eliminate healthcare industry related liabilities. Mr. Wenger also noted that 31 Pennsylvania counties do not own and operate a skilled nursing facility. In recent years, Adams, Cambria, Carbon, Dauphin, Lancaster, Mercer, and Northumberland Counties have sold their skilled nursing facilities. Several other counties are evaluating the merits of selling in this market of higher prices for skilled nursing facilities and difficult cash flow. Mr. Wenger stressed that the buyer will not dump the residents and there will be opportunities for advancement of employees. It is unlikely that a buyer will significantly reduce staff or cause a lot of turnover. He expects little turnover but some employees may choose to move on. Mr. Wenger said there is an active market to acquire nursing centers. He has a list of quality buyers that have already expressed interest, these include profit and nonprofit entities. The County is not obligated to sell to the highest bidder, the Board will also consider reputation, quality of care and price when making a decision. Chairman Keller asked Mr. Wenger about the timeline of the RFP process and Mr. Wenger responded that will take five to six months from start to finish. Chairman Keller made the following statement: "At the outset, I think it's important to say that the county's employees have done an admirable job of running the nursing home. They have distinguished themselves — particularly in recent years — by providing a high level of care, and that level of care has been shown in surveys by the Dept. of Health and in direct feedback from county residents. Having said that, I agree Continued on page 4 with the reasons that have been covered by Mr. Wenger as to why it is no longer necessary for the county to own and operate a skilled nursing facility. In particular, counties are not obligated to operate a skilled nursing facility, the county does not compete with the private sector in any other business or service, it is likely that a private owner can be found that will provide the same or better quality of care in conjunction with existing staff at the nursing home, and the county's residents are well served by numerous privately owned facilities. In this context, given that the nursing home is a financial liability, and carries with it other liabilities unique to the healthcare industry, we would be remiss if we did not consider the option of selling. But, I want to make it clear that I would only support a decision to sell as the result of an open and transparent process that ensures that the new owner has a proven track record of sharing Franklin County's philosophy in terms of our commitment to the quality of care for our residents, our commitment to Medicaid eligible residents in particular, and our commitment to our employees. " Commissioner Ziobrowski made the following statement: "My first reaction to the idea of selling the nursing home was negative. I have strong feelings about the nursing home - it was my paternal grandparents last home 40 years ago. And historically, care of the indigent has been a county responsibility. However, as a commissioner I must put aside my personal feelings and consider how the nursing home fits into the core functions of county government. What I have seen so far is that there is reason to believe that whether the county owns the nursing home or not, the facility will continue to operate, the residents will have good care, and the employees an opportunity to continue their noble vocation. If so, the decision to retain the nursing home becomes a business decision, and whether it is the role of government to compete with the private sector. Thirty years ago the county had less than 400 employees. Now it has over 900. We've grown partly because of population growth, but mostly because of new responsibilities, many of which were mandated. For example, in 1989 the 911 system was added — we now have roughly 40 people in that department alone. Since my grandparents were in the nursing home we've added drug and alcohol, children and youth services, aging services. We organized into departments: information services, human resources, fiscal, risk management, purchasing. Government is the only option for many functions, and we do a darn good job. The courts, the jail, 911, elections - we wouldn't think of privatizing these duties. But government can't continue to grow as duties are added. Government must be dynamic, and the changes have to include discontinuing functions that are not the core responsibility of the county. So I welcome this discussion. The way I look at it, the question is not whether Franklin County should sell the nursing home. What I'll be trying to ascertain is whether nursing homes are part of the core functions of county government, and if not, whether it makes sense for the county to be in the nursing home business. To summarize: 1: government is dynamic, constantly changing. And those changes can't involve only taking on new responsibilities - it is our job as commissioners is to right size government to fulfill our core responsibilities; 2: Nursing homes are highly regulated, and care is almost exclusively paid for by the federal and state government. Whether the county should be in the nursing home business is a question we need answer; 3: (And this trumps all others) Before I will consider supporting the sale of the nursing home, I need to be convinced that the residents will be well cared for and the employees treated fairly." Continued on page 5 Commissioner Thomas made the following statement: "Counties have been given the sole responsibility of providing certain core services and infrastructure. The only 911 center, the only Judicial Center, official keeper of land and marriage records, the only Jail, inspection and maintenance of bridges, the list is long. Nursing Homes, providing care for the indigent and elderly, was once a core function and duty of County government. At one time, the county was a sole provider. However, changes in the federal payment system have caused the county to become not just a provider, but also a competitor. That said, I believe it is our responsibility to look close at a potential sale. But I would not nor will I agree to a potential buyer that does not concur with our present policies and responsibilities for Medical Assistance support and endurance of quality care for the residents and commitment to employees." Chairman Keller said he is very much in favor of proceeding with the RFP process. However, given the nature of a decision to do so, he thinks it would be prudent for the Board to defer a final decision until such time as the public has had an opportunity to comment on the proposed course of action. He recommends that the Board invite the public to comment here today following any further comments by the Board. In addition, the public would be invited to comment at regularly scheduled meetings on Thursday, June 13, Tuesday, June 18, and Thursday, June 20, and at a special meeting in the evening of June 18. Based on that proposed schedule for public comment, Chairman Keller would be comfortable scheduling a final decision on Thursday, June 20, at the Board's regularly scheduled meeting, as to whether to proceed with the RFP process. Commissioner Ziobrowski said if at any point in the game that he doesn't feel comfortable even after receiving proposals then no final decision will be made. He said maybe the public will tell the Board some thing's that they haven't thought about. Commissioner Thomas said he will have some conflicts with the schedule but will follow the process along closely. Chairman Keller opened the floor for comments. Ken Jones said he agrees that governments shouldn't be providing these services but his mother spent last 6 years of her life in a nursing facility. He noticed in private facilities staffing is normally 50 -60 %. With county facilities staffing is probably better than that. He sees this as the only drawback versus a private facility and county facility. Sheri Morgan said she is versed in Affordable Care Act and it is biased in nursing home care. The private entities would not purchase nursing homes if not profitable. She agrees that need to have conversation if this is a core function of the county. The disability community is up in arms because ACA has cut a lot of programs. Would be great to have this conversation but need to keep in mind, there is a reason they have potential buyers lined up and it's not because it's a money loser. The meeting was adjourned at 11:38 a.m. with a motion by Robert G. Ziobrowski; seconded by Robert L. Thomas. FRANKLIN COUNTY COMMISSIONERS