HomeMy WebLinkAbout2013-08-22 Commissioner Minutes
THURSDAY, AUGUST 22, 2013
The Franklin County Commissioners met Thursday, August 22, 2013, with the
following members present: David S. Keller 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.
Chairman Keller asked to include general discussion with Consultant Jay Wenger
for him to provide an update on the nursing home process following new business. The
Board will move executive session to 1:00 PM today so that Commissioner Thomas can
join since he is unavailable this morning. On a motion by Robert G. Ziobrowski,
seconded by David S. Keller; unanimously approved to adopt the amended agenda.
Michelle Jansen provided public comment but not about anything the County is
dealing with. Ms. Jansen mentioned the news report about the rodeo clown that put on
Obama mask and did a skit and then someone compared it to a Klu Klux Klan rally. It
was distasteful but no less different then what happened with other presidents. She is
concerned because of the fact that elected officials inserted themselves into the process
and put pressure to make people fear government when this is a first amendment right.
She would hope that the Board as oath takers thinks about what they would say in an
instance like this.
Allen Piper provided public comment about the nursing home rally on the square
this past Tuesday. He wants to emphasize that it’s critical, he wants checks and
balances and wants it to be open as much as possible and wants the dialogue to
continue. He does not want this fast tracked. Mr. Piper thanked the Public Opinion for
front page coverage several times and he thanked commissioners for doing their part.
There are a lot of people against this sale. He has stated many times that he’s against
the sale of the nursing home. He doesn’t mind tax money going into it because it’s
important to the people of Franklin County. He might have need for this nursing home
and protests the sale.
On a motion by Robert G. Ziobrowski, seconded by David S. Keller; unanimously
approved all bills presented and ordered paid.
On a motion by Robert G. Ziobrowski, seconded by David S. Keller; unanimously
approved the minutes of August 13, 2013 and August 15, 2013 meetings.
The Board reviewed Aging matters. On a motion by Robert G. Ziobrowski,
seconded by David S. Keller; unanimously approved for the Chairman of the Board to
execute the Waiver Request to PA Department of Aging (PDA) to reallocate $4,800.00
of the total $9,827.00 Title XIX grant of 75/25 funds towards assessments. This is a
one-time waiver to use 75/25 as 50/50 funding toward regular MA Assessment skilled
worker costs for FY2012-2013.
The Board reviewed additional Aging matters. On a motion by Robert G.
Ziobrowski, seconded by David S. Keller; unanimously approved for the Chairman of the
Board to execute the Waiver Request to PA Department of Aging (PDA) to utilize Aging
Block Grant Funding to supplement $50,000.00 in Medical Assistant Assessment Costs.
Continued on page 2
The Board reviewed additional Aging matters. On a motion by Robert G.
Ziobrowski, seconded by David S. Keller; unanimously approved for the Chairman of the
Board to execute the Waiver Request to PA Department of Aging (PDA) to increase the
expenditures of the Grandparenting Program by 10% or $10,238.10, to provide
assistance to eight grandparent households, which include ten grandchildren.
The Board reviewed additional Aging matters. On a motion by Robert G.
Ziobrowski, seconded by David S. Keller; unanimously approved for the Chairman of the
Board to execute the Waiver Request to PA Department of Aging (PDA) to utilize Aging
Block Grant Funding to supplement $50,676.00 in Waiver Service Coordination
expenses.
The Board reviewed Drug & Alcohol matters. On a motion by Robert G.
Ziobrowski, seconded by David S. Keller; unanimously approved for the Chairman of the
Board to execute the Year-end report for fiscal year 2012-2013 submitted to Bureau of
Drug and Alcohol Programs for a total amount of $1,113,445.00 and detailing how each
funding stream was used and reimbursements given to each provider for services
rendered.
The Board reviewed Fiscal matters. On a motion by Robert G. Ziobrowski,
seconded by David S. Keller; unanimously approved Form 8038-CP to the Department
of the Treasury to file semi-annually for the County to claim 45% reimbursement from
the Federal Government for the interest paid for the Recovery Zone Economic
Development Note. The County will receive a reimbursement in the amount of
$15,421.00.
The Board reviewed Human Resources matters. On a motion by Robert G.
Ziobrowski, seconded by David S. Keller; unanimously approved the Personnel File
Access Policy, #622.00 for the purpose of establishing contents, accessibility and
procedure to view official personnel files.
The Board reviewed additional Human Resources matters. On a motion by
Robert G. Ziobrowski, seconded by David S. Keller; unanimously approved the Franklin
County Tobacco-Free Policy, #623.00 for the purpose of providing a safe and healthy
work and living environment for our staff and citizens, by prohibiting the use of tobacco
inside county facilities or vehicles.
The Board reviewed Human Services Administration matters. On a motion by
Robert G. Ziobrowski, seconded by David S. Keller; unanimously approved for the
Chairman of the Board to execute the State Food Purchase Program Expense and Data
Report for Fiscal Year 2012-2013 reporting on the different types of food South Central
Community Action Program (SCCAP) purchased for the food pantries in Franklin
County. $137,500.02 of State funds was used to purchase the food supplies mostly
purchased from South Central Food Bank which is bulk purchases at $.18 cents per
pound.
In accordance with PA Act 67, 68 and 127 notifications, Century Engineering
notified the County of a Pennsylvania Department of Environmental General NPDES
Permit application being applied by Pennsylvania Department of Transportation, for
bridge rehabilitation on SR0081 over Leitersburg Road, located in Antrim Township.
Continued on page 3
In accordance with PA Uniform Environmental Covenants Act 68 notifications,
Ronald G. Gipe notified the County that PA Department of Environmental Protection has
granted and Environmental Covenant to 2800 Buchanan Trail East, located in Antrim
Township.
Jay Wenger, Consultant with Susquehanna Group Advisors was present to
provide an update on the possible sale of the Nursing Home. Chairman Keller
announced the Board concluded interviews of four potential buyers of the nursing home
and asked Mr. Wenger to explain further the process. Mr. Wenger said last evening they
finished the last of the four teleconference interviews. The other six potential buyers
were informed that not on the short list. The firms provided feedback that disappointed
but understood why they were not included. They were not included based on corporate
culture reasons and how they presented themselves on the tours. It was evident that
price was not taken into consideration, because the high bid did not make the short list.
Mr. Wenger said the goal is to reduce to two firms and go tour their facilities.
Chairman Keller said the main concern he is hearing is whoever would buy it
would sell it to someone else or close it or that residents who are currently there would
be told to go elsewhere or be put out on street but he came away from interviews feeling
good and comforted that he doesn’t think these scenarios are possible.
Mr. Wenger said that neither he nor the county are not interested in making this a
quick sale to a firm that will flip this and resell it. No one will come in and discharge any
residents and it wouldn’t make sense to buy it and get rid of it. Anyone coming in and
willing to spend 1 – 2 million to just flip the building, he doesn’t see this happening due to
the industry in Pennsylvania. They want the labor force and they will try to reduce the
use of agency staff which is the most expensive workforce. Mr. Wenger said they will
find ways to treat the existing labor force fairly as opposed to paying outside labor but
they will not reduce the current labor force. When walking through Falling Springs there
is genuine care of the residents. He is not saying people who provide contract labor are
not good people but they are going to where the need is as opposed to being invested in
the culture of Falling Spring. Agency labor is more expensive, quality of care is better
with Falling Spring’s own staff.
Chairman Keller said not one of the firms they spoke to have sold any of their
facilities. He added that the Board’s eyes are on the ball and the board is not willing to
consider selling home to someone who will turn around and sell to someone else. He
said all firms they talked to are accepting day-one Medical eligible residents and are
providing a high quality of care to Medicaid residents. The percentage of Medicaid
eligible residents at the facilities operated by the firms that the board has interviewed is
higher than the Medicaid census at Falling Spring. The quality of care of the short-list
firms compares well to Falling Spring as well.
Mr. Wenger said these firms have greater economies of scale than Falling Spring
because they manage more facilities and therefore can operate more efficiently because
of greater purchasing power, buying power, and hiring power. They become more
efficient without compromising the quality of care. He doesn’t see anyone coming in on
a short term basis. This is their livelihood and good for their business.
Continued on page 4
Commissioner Ziobrowski said the issues most folks talked about from the start
were resident care, care for day one Medicaid eligible residents, and employee
retention. The firms that submitted proposals appear to meet these criteria. Now a great
concern appears to be what happens 5-10 years down the road - will their loved ones
have a place to go if the county sells. Folks are so concerned that they would have the
county turn down about $10 million in purchase price, and invest possibly half a million
per year in operating costs, plus another couple million in capital improvements, just to
insure against that possibility. Many of them think an assisted care facility, like Menno
Haven, would purchase the nursing home and turn it into private pay. This is highly
unlikely this would happen here. He asked what Mr. Wenger can tell the public to be
sure their loved ones will be taken care of.
Mr. Wenger responded that we can’t guarantee anything ten years out. The
purchase sales agreement will mandate they manage the home for ten years, maintain
Medicaid census, which every single firm has done with homes they currently have.
They don’t shy away from Medicaid reimbursement, there general rule is baby boomers
will need care so they are looking at market place where there is moratorium on nursing
beds, have to buy existing business today in order to be in business, or establish a
private pay nursing facility. There are only a handful of fully private pay facilities in
Pennsylvania but they are attached to nursing facilities in affluent areas. They know
there is a large portion of population that needs this type of care. The need for in house
care will not go away. There will be reimbursement in some fashion so they are willing
to pay 9-10 million for facilities. If they spend 10-11 million in Chambersburg they are
making a huge investment. Financing will be for at least thirty years not ten years. Can’t
guarantee it but will do best to tie their hands to Falling Spring for a long time, but can’t
handcuff them to it.
Commissioner Ziobrowski asked if any of the nursing homes sold in other
counties have changed their model by not taking Day 1 Medicaid eligible resident.
Mr. Wenger responded Clarion County has been sold for ten years or more and
in last six years the for profit operator actually paid the county to never take it back.
Lancaster County sold theirs in 2005 and it’s still being operated by the buyer and all
reports are all positive.
Commissioner Ziobrowski said some folks are adamant to not sell the nursing
home and want the Board to turn down offers to insure the nursing home will never go
private. He said that is a very expensive "insurance premium" to protect against a highly
unlikely consequence. Given the track record of the companies that have proposed, he
is now searching for a reason for the county to stay in the nursing home business. He is
looking for some reason to not go forward.
Mr. Wenger said it is human nature to worry about what change will bring,
change raises level of anxiety and concern to a higher level but change from county
owned to privately owned is a positive model. The new buyer will be prepared to invest
a lot more money than what the county can invest in next couple years.
Continued on page 5
Chairman Keller said all firms spoke to another concern that has been raised
from the beginning concerning employees and desire to not see much turnover of
caregivers. All four firms provided information of what they have done at their existing
facilities. He asked Mr. Wenger to share his perspective on that.
Mr. Wenger said it is improbable there will be high turnover; they spoke to point
of investing in their employees, for educating and training employees.
Chairman Keller said he was impressed with the percentages of employee
retention at nursing homes purchased by the prospective buyers.
Mr. Wenger said in Adams and Lancaster County in year one there was only 3%
turnover. If an employee has been underperforming they try to get them to be positive
employees, it is easier to change a person currently on staff and improve their
performance rather than needing to train new employees. Mr. Wenger wanted to
mention the survey deficiencies as well as Medicare five star rating that was discussed
on site visits of all nine firms that came to visit. Five star rating doesn’t fully account for
the full campus so it doesn’t tell the whole story; there are always reasons behind those
dashboard indicators. We have a high comfort level with the firms under consideration
that they are fully qualified and have outstanding reputations in the market place.
Chairman Keller opened floor for comments from the audience:
Allen Piper said it was a great presentation by Mr. Wenger as a consultant and
he took to heart everything he said. He has a wide array of interest; he is concerned
about closing of nursing home which he has said before many times. Mr. Piper said
whenever Mr. Wenger gives a presentation he mostly does for his own interest. Mr.
Piper hopes the Board takes into consideration to continue to have a dialogue and they
are being open with the public and he thanked the Board for holding another public
hearing next Tuesday. He doesn’t feel the Board is fast tracking at this point. He
knows the Board can’t guarantee years down the road the home won’t be sold. He is
not exactly against the sale of the nursing home but he doesn’t want this home sold, he
is split on this relating to cost factors and knows costs will be enormous down the road.
Hopefully magic pen will be a balance, knows the Board is weighing in that want to sale
the home and audience knows that. He is against this because he has family in
healthcare.
Michelle Jansen said she does appreciate the discussion. She has not been
following this as closely as she should, and knows there are no guarantees but sounds
like the Board is doing their homework. Overall this has been a fair discussion today
and she hopes they see the benefits of people rallying on the square. Kudos to all
parties involved and finding a solution to care of elderly residents.
Continued on page 6
Jay Lightfoot said he has worked in facilities around here and there are great
differences in all of them. Some he wouldn’t want his pet dog in them. He hopes he
doesn’t have to use any of them but someone may put him in one someday.
Commissioner Ziobrowski said it’s been mentioned if it isn’t broke don’t fix it, but
his job as an Elected Official is to recognize that government cannot be stagnant - it
must be nimble enough to change with changing times. If there was a private nursing
home operating with all the conditions the county has set, and the commissioners came
to the public with a proposal to buy the nursing home for $10 million, invest half a million
per year in operating expenses, and another couple million in capital improvements, just
to make sure that the nursing home did not change its entire method of operations and
stop admitting day one Medicaid sometime down the road, the taxpayers, especially the
Citizens for Responsible Government, would be "up in arms".
Jay Lightfoot said people put their family in nursing homes and then don’t even
visit them, they forget about them.
The Board recessed until 1:00 PM to enter into an executive session to discuss
Nursing Home proposals.
Commissioner Thomas participated in the executive session by telephone at 1:08
p.m.
On a motion by Robert G. Ziobrowski, seconded by David S. Keller; unanimously
approved to enter an executive session at 1:08 p.m. this date for the purpose to review
nursing home proposals. The Board reconvened into regular session at 2:00 p.m. No
action was required after executive session.
The meeting was adjourned at 2:01 p.m. with a motion by Robert G. Ziobrowski;
seconded by David S. Keller.
FRANKLIN COUNTY COMMISSIONERS