Continuum of Care Committee Meeting Minutes

PRESENT: Linda Borleske, Joan Fordham, Joan Wheeler, Art Carlson, Paul Endres, Larry Volz, Kathy Schauf, Kerry Beghin, Jeanne Leeck, John Earl, Lowell Haugen, Judith Stoeckmann, Al Dippel, Sue Hebel, Bill Orth

ABSENT: Tommy Bychinski

1. Called to order at 6:00 p.m. by Paul Endres. The open meeting law requirements were met.
2. Motion by Borleske, second by Volz to adopt the agenda. Motion carried.
3. Motion by Dippel, second by Carlson to approve the minutes. Motion carried.
4. Public Comment - None
5. Communications. Committee members were given a written response to Mr. Kriegl's questions. This will also be given to members of the full board. Response was put together by Kathy, Jeanne and Kerry.
6. Updates - None
7. Tommy Davidson canceled and will be on the agenda for the December 29th. meeting.
8. Continue with discussion of alternatives. Asked the group to look at the summaries for alternatives 1 & 2 and make changes/recommendations. Some changes were made and terminology explained. Kathy explained that converted SNF beds would mean you are capturing the dollars and placing them elsewhere in the community or opening up a different type of bed somewhere else. The amount of funding received from the state for down sizing would depend on the number of beds down sized and whether or not we could be a part of the conversion project. Also under down sizing it would not free up CIP and COP dollars but may capture some additional CIP II slots. Also deleted "may allow for change in payor mix."

   Alternative #3 - Close the Health Care Center

   Two bullets include invest savings in long term care system and invest savings in other county priorities.

   Cost - Savings of 3M (assuming all residents would be placed in other nursing homes or the community.) 48 residents placed in the community and 55 in other nursing homes at no cost to the county. Felt range of savings/cost should be included. Costs could range from a cost of 16.5M to savings of 7M - client cost of care only. Kathy will make additional copies of detail for members. Demolition costs are set at 2M. Did not include cost to residents, their families or employees - loss of jobs, health care etc.

   Future consequences - Lose nursing home beds for the area. Loss of reliability. Gain CIP II money. Lose control. Possible lack of ability to place residents in our county/state. More difficulty finding a nursing home placement for more difficult or MA funded residents. Lack of resident choices.

   Constraints and Political Feasibility - Public outcry. Burden to families. Putting 150 people out of work. High cost and inappropriate alternative placements.

   Stability - No

   Reliability - No

   Invulnerability - Very vulnerable

   Flexibility - No

   Risk - Chronic inability to serve Sauk County residents in Sauk County.

   Communicability - Difficult to communicate (rationale behind decision). Communicating to State would also be difficult.

   Merit - No, creates more problems.

   Compatibility - No

   Reversibility - No

   Alternative #4 - Privatization:

   Cost - After some discussion decided to split privatization into two alternatives - one in which we sell beds to another entity and they would build the facility and the second alternative would be an arrangement where we would fund the facility initially with the expectation of being repaid. Also, expectation is that the "partner" will keep the beds in the county for an agreed upon period of time. Kathy will develop costs for the two alternatives and present at the next meeting.

   Future Consequences - Ability to go out of business or relocate, number of beds and who they will take, economic impact, free up tax levy for other resources.

   Constraints and Political Feasibility - Public outcry, need for education, public policy balancing, trends in demographics and shifts in service provision sites (this item will be included in all scenarios), market, time constraints.

   Stability - Yes

   Reliable - Yes (maybe)

   Invulnerability - Could be vulnerable

   Flexibility - Lose control over residents in nursing home and more control over residents in community.

   Risk - Some risk, possible that if private home goes out of business we could have the burden of serving residents again.

   Communicability - Easy to communicate however some educational issues.

   Merit - Yes

   Compatibility - Yes

   Reversible - Potentially

   Alternative #5 - Build new right sized Health Care Center, with additional services.

   Cost - $15M

   Future Consequences - Adaptability to changing needs, significant commitment to one piece of service provision, provide a variety of services in one institution, more marketability, concern over the bond issue,

   Constraints and Political Feasibility - Concern over the bond issue, window of opportunity in bonding structure

   Stability - Yes, however change in funding, demographics, state laws may effect this. Change in funding/laws will be included in all scenarios

   Reliability - Yes

   Invulnerability - Yes

   Flexibility - Yes

   Risk - Limit growth in other areas of service provision

   Communicability - Yes

   Merit - Yes, with some limitations (doesn't provide full scope of services)

   Compatibility - Yes

   Reversible - Yes

   Paul indicated that at the next meeting will look at starting to draw recommendations. Resolution was read to clarify charge to the committee. Task is to give a report to the board and make a recommendation. Paul indicated that this committee should get a rough draft of the information to the board and then call a special meeting of the board to discuss the information contained in the report. Much of the discussion of the committee has been around the continuum of care and some members felt the decision to build or not build the HCC is premature. Others felt it is the biggest problem and needs to be addressed. Some misunderstanding about the current condition of the HCC and how long the systems may last. Needs clarification. Some felt the committee is not taking into account the age of the HCC and disability resource center and what that may mean to the continuum of care. Paul indicated that the committee has to make a decision and recommendation but that it doesn't have to be unanimous

9. Next meeting will be on December 29 at 6:00 p.m.
10. Motion by Carlson, second by Borleske to adjourn.
    Motion carried.

Respectfully Submitted: Joan Fordham, Secretary