DATE: June 12, 2007
MEMBERS PRESENT: Paul Endres, Joan Fordham, Al Dippel, Terri Langer, Linda Borleske, Arthur Carlson, William Higgins, Henry Netzinger, Lowell Haugen, Scott Alexander
MEMBERS ABSENT: Larry Schroeder, Judith Stoeckmann
OTHERS PRESENT: Kathy Schauf, Ken West, Marty Krueger, Rick Moore, John Keefe, Sue Hebel, Media
Meeting was called to order at 6:08 p.m. by Joan Fordham. Open meeting law requirements were met.
Motion by Dippel, second
by Carlson, to adopt the agenda.
Motion carried.
Motion by Alexander, second by Netzinger to approve the minutes of the last meeting. Motion carried.
Motion by Endres, second by Carlson, to nominate Joan Fordham
to be chairperson for this meeting, that nominations be closed
and a unanimous ballot cast.
Motion carried.
Public Comment - Phil Craker from the Town of Winfield spoke in favor of building the new nursing home at the current rural site.
Communication - John Alt was unable to be here but will be at the County Board Meeting next week. Schauf spoke with him by phone and indicated that what the MATC partnership is looking for is creating a value added, community based opportunity. Many options would be available. 90% of graduates stay in the community. Hoping that this would fuel economic development. Krueger reported that the President of MATC will also be at the meeting next week. Langer reported on the Clarion Center at St. Clare Hospital. It provides inpatient and day treatment mental health programs for adults over the age of 55. This includes legally mandated admissions via county crisis unit or police. Inpatient stays are limited to 30 days. Carlson indicated that they would use us for clinicals regardless of our location - move would not benefit the HCC.
Review of goals for this meeting- need to decide the nature of the "behavioral unit", laundry issue, size, and site.
Agreed last time that we are talking about a continuum of care campus of which the nursing home is a part. Part of the eventual resolution will be to add assisted living or some other form of housing under a specific time frame to the long term plan. Schauf began drafting documents to give to the county board along with the draft resolution.
Moore reviewed 2003 resident mix which indicated that several
residents could be placed in a different setting from a regular
nursing home. The 80 - 82 bed facility would be necessary to
qualify for downsizing money. John Keefe indicated that the
amount could be $125,000 per bed. Not sure of the criteria
necessary to qualify for this money as of yet. Money is paid
out over a period of 35 years as a part of the MA rate. In
the past there was a short term transitional reimbursement
available, however that no longer exists. With fewer beds we
would be paying less in bed tax which is slated to go up to
$125.00 per bed per month. Under Family Care, whatever care
is needed becomes an entitlement - assisted living etc.
Services which will be provided in the new facility were reviewed.
Discussion of the "behavioral unit". After some discussion was decided that we would provide a semi locked "secure" unit for individuals with dementia and/or other related conditions, not a "behavioral unit" but what we currently have.
Laundry is a question. West indicated that he will be sending out a sample of flats to the jail to see how that works out. Also getting bids from other providers. Will have some answers in two weeks. Personal laundry will be done in the neighborhoods. Moore indicated that he could wait for the decision regarding laundry for a couple of weeks.
Discussion regarding number of beds. Recommendation of the Keefe Report and the WIPFLi Analysis both were for 80 beds. All rooms would be private with private bathrooms. Are looking at 10 bed households with 20 bed neighborhoods. Could go to 82 with two 11 bed households for dementia. Some discussion regarding baby boomers increasing the NH population and the fact that Alzheimer's is increasing nationwide. Keefe responded that other continuum of care facilities and Family Care will have an impact on the number of residents in the nursing home. Not all Alzheimer's individuals need inpatient care. Flexibility will allow us to respond to the needs as they arise. Nursing Home Relocation also is able to help some residents find alternative living arrangements. Resources are still a problem in the community. As entitlements move with the needs of the individual and money becomes available for services other than the nursing home, alternatives will increase.
Motion by Fordham, second by Netzinger that the combined
committees recommend the construction of a skilled nursing
facility with 82 beds based on the recommendation of the architect
and the WIPFLi reports. Carlson offered an amendment, second
by Dippel, to add a 6 bed assisted living unit to the nursing
home now.
Motion defeated.
Vote on the original motion -
Motion carried unanimously.
Site selection discussion. We are creating a Continuum of Care Campus. Important considerations are:
Access to the facility by the population, (staff, visitors
and vendors); cost of insurance; access and convenience for
physicians, ambulances; proximity to retail; visibility;
potential collaboration with MATC; ongoing operational costs
of facility; size of at least 30 acres; slope - fairly flat;
out of flood plane and buildable soil; convenient access; utilities
- cost, location; curb appeal; adjacencies - links to the community
to enhance community support.
Are now down to two properties. Current site and the Creekview
Estates property. Krueger site not acceptable because of
creek running through.
Moore showed preliminary site layouts of the two areas. Discussion followed. Moore indicated that they would recommend the Creekview site for programming and architectural reasons. Provides the proximity to services that allows the idea of the continuum to work best. Keefe indicated that western Sauk County location is important for the future when we will be mostly providing for the Medicare rehab population, dementia care and end of life care. Creekview would also be convenient for physicians. If located in the country, would leave yourselves open for competitors for assisted living type options to build in town and therefore take that market.
Netzinger suggested that if we were just building a skilled nursing facility, he would agree that the current site would work, however since we are talking about building a continuum of care campus would work the best in the future to be in town.
Motion by Netzinger, second by Higgins to support Creekview Estates as the future home of the continuum of care campus including the skilled nursing facility.
Borleske indicated that she felt the architect didn't know Sauk County as well as he could have. She sent a letter to the editor to several local newspapers. Received 48 calls all of whom spoke in favor of the current rural location for various reasons. Carlson asked to amend the motion to stay on site. Fordham indicated that was not possible. Carlson indicated that the taxpayers would be paying for this. Employees (by informal survey) voted 88 - 33 to stay on site, most people he has talked to said to stay on the site. Indicated that he was here to vote for the citizens of Sauk County and knows the majority of the people want to stay on site. Said he would vote no if the Reedsburg city site was chosen. Krueger indicated that MATC is not looking for anything, but are excited about the potential of partnerships. Received one phone call to stay on site. He also related a conversation with a developer who builds assisted living units indicated that he would build in town but not at current site. Also indicated that John Keefe was commissioned before he (Krueger) was on the board and recommendation at that time was to build an 80 bed facility on the west side of Reedsburg near MATC.
Keefe indicated that selling the current land would also be an option for use. Selling current site would lower the amount of money that would have to be borrowed - lower our debt service. Langer talked to about 20 people and the majority of that group said move to town. Made sure that the people all knew that we would be including assisted living or some other options at that site also. Transportation costs for a round trip to Reedsburg from the current location is $21 as opposed to $5.00 from one side of Reedsburg to the other. Outpatient rehab is also an option so transportation issues are significant. Fordham indicated that she has tried to remain neutral on the site issue. People she talked to in Baraboo prefer an urban site. We have to insure that the site is financially beneficial to Sauk County by maximizing the potential of the campus. We have paid experts for their opinion and their opinion is that an urban setting is best especially for upcoming generations. Endres went on record as supporting the Creekview site. With an urban location, employees will be able to get to work without driving so far and some could walk. Dippel indicated that driving 2 blocks or 5 miles was not that much difference. Residents would have to drive no matter what.
Roll call vote on the motion on the floor. (Vote on Creekview site) . Continuum of Care Planning Committee: Endres, aye; Borleske, nay; Alexander, nay; Dippel, nay; Haugen, aye; Fordham, aye. (Ayes - 3; Nays - 3) Board of Trustees: Endres, aye; Borleske, nay; Carlson, nay; Higgins, aye; Langer, aye; Netzinger, aye. (Ayes - 4; Nays - 2) Motion carried by Board of Trustees, defeated by Continuum of Care Planning.
Will check with Corp. Counsel to see if one committee can forward a resolution to the full board. Schauf will let members know if there will be another meeting. If not, the next regularly scheduled meeting will be on the 26th of June. The Continuum of Care Planning Committee will report to the full board, it will not be up for discussion. Fordham felt that our constituents do not need a poll. They do not have all of the information that this committee does. Also have the opportunity to hear from many experts and have made an educated decision. Board members were asked to study the information (many for 3 - 4 years) and have made up their minds. The committee now needs to supply the information to the other supervisors.
Closed session is not necessary at this time.
Next meeting on June 18 if needed and otherwise on June 26 at 6:00 p.m.
Motion by Haugen, second by Netzinger to adjourn.
Respectfully submitted: Al Dippel, Secretary, Continuum of Care Planning Committee