DATE: February 1, 2005
PRESENT: Arthur Carlson, Linda Borleske, Larry Volz, Tom Bychinski, Paul Endres, Al Dippel, Joan Wheeler, Joan Fordham, Lowell Haugen, Judith Stoeckmann, John Earl, Jeanne Leeck, Carol Jeffers, Sue Hebel, Diane Keylock, Lisa Buttonow, Gene Wiegand, Kerry Beghin,
Joan F. asked that on page 4 for the December 1 meeting Michael Thomas of Manitowoc County be listed since Mike Roraff of Juneau County was named. Change made.
Tommy asked if we could list the number of people that testified at the public hearings.
Joan W. questioned the finding stated that "the services provided...are provided to populations which would be difficult to care for in other settings." Felt the case wasn't proven that the residents at the HCC are actually too difficult for other nursing homes to care for. Gene indicated that there was a statewide study done several years ago which compared the case mixes at county facilities Vs private facilities. Was partly used as documentation to continue with the IGT program. Study showed clearly that county homes statewide on the average dealt with residents with a higher level of acuity than the private facilities. Gene could provide information from that report to justify the statement. Discussion followed. Jeanne indicated that in a previous presentation to this committee our six county nursing homes acuity levels were compared. Joan W. had copy of part of the SCHCC and Greenway Manor surveys to compare. Joan asked if we could use the figures to show comparative care levels. Jeanne asked if it is important to do. Joan F. felt it was one of our primary arguments for maintaining the HCC operated by the county is that we take care of people that would find it difficult to find care in Sauk County in another nursing homes. Finding the data would be difficult because the acuity levels are also based on the behaviors which aren't reflected in the Survey. Joan W. felt we need to be clear on the type of behaviors we are talking about. Gene voiced some concern with getting involved in identifying specific behaviors especially from a marketing perspective. Judith supported Joan and indicated that if we say that we take care of difficult residents that other agencies will not accept, we have to substantiate that with data. Jeanne reiterated that nursing homes can't publicly say that you won't admit a certain kind of resident. Ombudsmen has made it clear that it would be discrimination. Our biggest supporting data is that it is acknowledged by the federal government that county homes generally take higher acuity cases than private nursing homes. Gene indicated that other nursing homes are not mentioned in that statement - range of other community options. Joan still felt if we aren't going to state what those cases are that we take that other places won't we shouldn't even mention it. Document should reflect a consensus of the committee. Paul felt the IGT study Gene was going to use to substantiate the statement in general along with the addition of C and D to page 6 would suffice. Show of hands - Unanimous.
Finding No. 4 - Joan W. questioned the first sentence "..cares for a broader spectrum of..." Gene rephrased the sentence to read - "...while some of the residents of the Sauk County Health Care Center could be cared for in the community or other facilities, there are some whose care is beyond their ability and would require special arrangements for placement." Art felt the statement should remain as written. Judith asked if FDD statistics were included in this. Gene focused on SNF. FDD unit has laws already in place for how to deal with those beds. Art asked for a show of hands and Gene suggested we need a document that everybody can support. IGT report could again be referenced if that would satisfy any questions. Sue suggested changing the first sentence to read "...cares for residents with a broad range of health care needs." Takes out the comparative tone of the sentence. Will also add the sentence previously discussed about some of the residents could be dealt with in the community while others... Also changed residents to citizens in the next sentence.
Question regarding Section 7 Item #2 - Paul asked if should be another item which addresses remodeling? Gene added it in item 2 to point out that the structure is not sellable in it's present form. Currently could not sell the beds and structure at one time - would be a bigger liability than asset. Also in item 2 Joan W. questioned the legitimacy of saying that ..."it has been a widely reported deliberative process." Felt it wasn't reported widely enough and the understanding that beds might be for sale was not fully understood by potential buyers. Rest of the committee felt the statement should stay as written.
Finding No. 7. Joan asked for clarification of defined population. We are required to care for the court placed residents. The HCC is required to come up with a reasonable discharge plan for all residents currently in the HCC if we would close the doors. The HS department would have to be involved closely. Not all residents would be a cost to HS. Would go to other Nursing Homes. HS would have to be involved in non nursing home settings which would be a cost. In resident study was found that large number of residents would have to go to another nursing home, however found that the cost to place the 48 residents in the community would be greater than if they stayed in nursing homes. Gene eliminated the first phrase and started ...if the Sauk... some of the costs will shift to the HS Department and not necessarily result in a reduction of the levy to county taxpayers.
Conclusions and Recommendations:
Supervisor Gaalswyk asked to speak. Advised to wait for the full County Board Meeting.
Linda suggested the first recommendation be that the county stay in the nursing home business.
Motion by Bychinski, second by Haugen that this Committee recommends that Sauk County stay in the Nursing Home Business. Roll Call Vote - Ayes (10) - Dippel, Endres, Volz, Earl, Borleske, Haugen, Bychinski, Carlson, Fordham, Stoeckman. Nay (1) Wheeler.
Motion carried.
Dippel suggested using the proposals set forth by Joan F. be included as a part of the resolution.
Joan W. felt that Sauk County does not belong in the nursing home business and could not support the resolution.
Board put together a resolution using the findings and items put forward by Joan Fordham and discussed at the last meeting. Finding #4 regarding the facility not able to meet current needs was excluded in the resolution as well as finding #7 regarding financial estimates. Also suggested changing the name of the next committee from "Building" to "Health Care Services and Planning Committee" and to include the Property and Insurance Committee as well as the Health Care Committee. Gene read the proposed resolution combining the findings and Joan Fordham's items. Discussed deadline for the next committee and will be set prior to October 1 with the understanding that it can be extended. Will give a copy of the resolution and findings to the full board members as soon as possible in the hopes of getting a vote scheduled for the February meeting. Resolution will be left in County Clerks office for signatures. Simple majority vote is all that will be needed since there is no financial impact at this time.
Motion by Bychinski, second by Fordham to approve the resolution as read and present it to the county board at the next meeting stipulating that the vote may be postponed until the March meeting if necessary.
Motion carried.
Respectfully Submitted: Paul Endres, Secretary