Tuesday, January 9, 2018

Nursing Home Sale Inches Closer to Reality

[Update 1/10/2018 - Write up of the special meeting now below. Full video available here.]
[Update 1/15/2018 - Write up of the Committee of the Whole now below. Full video available here. Direct jump link to the Bail Reform Act presentation here (25 minutes).]

From the Special Meeting of the County Board tonight, that occurred prior to the regularly scheduled Committee of the Whole County Board meeting, the next step towards selling the Nursing Home, specifically to start getting bids through the brokerage firm has been authorized after two more Democrats joined the Republicans since the prior 11-11 tie vote that failed in October.

First things first, however, they swore in a new appointed board member, John Clifford (more information from his appointment announcement from the County Republican Party here):


I'll have more details in a write up on the special meeting and COW tomorrow, but for tonight I'll just link to the News-Gazette overview:
Board votes to put Champaign County Nursing Home up for sale

Champaign County Board members voted Tuesday night to put the county nursing home up for sale.

By a margin of 13-8, with Democrats Pattsi Petrie, C. Pius Weibel and Shana Jo Crews joining all 10 Republicans, the board voted to issue a request for proposals from private operators to purchase the county-owned facility in east Urbana. Champaign Democrat Giraldo Rosales was absent from the meeting.

Weibel, the chair of the county board, said he voted for the sale because continuing to operate the nursing home for a full year would threaten other parts of county government.

"If we were to keep the nursing home, we'd be struggling to find money for it," he said. "It's money. We don't have the money to do it. Either we keep the nursing home going or we lay off other people."

The vote came after about 45 minutes of public input from opponents and supporters of selling the nursing home, including nursing home advisory board member Cathy Emanuel, who said that there are "positive trends" at the facility and that the county could increase its value by keeping it open.

But Republican former county board member Scott Tapley contended the home has lost money for years and would continue to do so.

Jennifer Putman, a 30-year veteran of the county board, attended both the Republican and Democratic caucus meetings to plead with board members to not sell the home.

"The ship is turning around," Putman told the Democratic caucus. "We can continue to allow SAK (the private manager of the home) to turn the nursing home around and see the positive results that would come from keeping our public nursing home public."
The full article is worth the read for more details. One of the more important ones being that a final sale authorization will require 15 of 22 yes votes from the board and the approval of loans for the Nursing Home.


Special Meeting Write-up:

Public Participation:

Cathy Emanuel, Nursing Home Advisory Board member, led off the comments noting the SAK management of the Nursing Home has led to improvements. She pointed to postive numbers prior to state medicaid payment delays, improved survey results, new areas of possible cooperation with area homes and hospitals and ideas on discounted cash flow if it still goes up for sale.

Paula Lesse(sp?) said they should go back to the drawing board with more public input on the RFP and its conditions to start getting bids for selling the home.

Scott Tapley chimed in again, this time denouncing Cathy Emanuel for having no credibility and spreading disinformation and calling her claims the height of absurdity. He pointed to the state payments only being $1 million of the $7 million debt, losing money for 15 years and before, as well as including county tax money with $20 million in expenditures it has never recouped.

He called out Board members Hartke and Patterson's claims on medicaid payments as lies and compared Patterson's smile to former auditor Tony Fabri's smile. An extremely awkward, with additional awkward pauses, attempt to equate Patterson with the disgraced politician who had also been the chairman of the County Democratic Party. Flustered he called again for the sale of the home.

The next speaker admonished the trash talk and dragging the meeting into the gutter before emphasizing how ensuring the Nursing Home will be run well is critical whether or not it's sold and pointed to problematic private groups highlighted in the NY Times recently: Care Suffers as More Nursing Homes Feed Money Into Corporate Webs

The next speaker told of a horrible personal experience with his mother-in-law at the home that ended in tragedy. This elicited a later apology for their experience by former Democratic County Board member Jennifer Putman for their family having to endure such an experience, though, unlike him, she opposed the sale and favored keeping it as a county asset. She criticized Scott Tapley's disregard for taking care of the needy and warned that passing the RFP would hurt staff recruitment and patient enrollment at the home. She pointed out that not all government bodies are supposed to make a profit, especially a non-profit Nursing Home.

In between there was David Laker, a familiar face at Nursing Home public participation who, in the interest of his wife, regularly ends his commentary asking the board to think of her welfare with, "What about Sue?" He pointed out that the County Board created the Nursing Home and with it many of its problems. He said the divisions and animosity were often driven, caused, or at least exacerbated problems at the Nursing Home. Selling the home would not wash their hands of their responsibility for it. He frowned on the limited accountability private homes have to state oversight, especially considering that Springfield is also a source of many of the home's problems. He again asked them to do right by Sue.

Also Claudia Linhoff of Champaign County Health Care Consumers asked that the minimum terms for the RFP's bidding process should have more public input on them as well as ensuring a proper evaluation (questioning the $11 million figure). She had concerns about what happened after the 10 year requirement that the home remain open and pointed to crises in three neighboring areas when homes went bankrupt or suddenly closed. She pointed to the need for public accountability and empahsized the importance of ensuring access for medicaid patients in long term care, even though many people may not be using medicaid now, they often end up having to rely on it in their future.

Kim Harden, another local victim of "Nasty Joe" addressed the board in the special session public participation asking for help from the board on how part of her property was sold out from under her due to failure to properly notify her and a broken system taken advantage of by vulture capitalists like "Nasty Joe." More information on that craziness here.


RFP Vote Discussion: 

What does it mean to authorize the release of the RFP (Request for Proposals) again? It is essentially to allow the brokerage firm get bids for the Nursing Home under various requirements to maintain so many beds, services, etc.


Stohr - D led off the debate by pointing to the county's 153 year tradition of caring for the elderly and noting recent improvements under the new SAK management. He held out 40 cents in change in his hand to make clear the tax burden he says it costs Champaign County taxpayers to run the Nursing Home per month. He said that's all it costs to ensure we protect the dignity of our elderly.

Hartke - D asked that the board stop looking at it as "losing money" and instead look at what benefits that money has provided the community. He argued this was far more important than just making a profit. He pointed to Republicans claiming to be concerned about ensuring the county has money to treat mental health care, but ignore the role the home plays in that with local residents, especially those treated in its dementia unit. He noted we never accuse the Sheriff's office of "losing money." He requested a roll call vote for the RFP which was quickly seconded.

McGuire - R argued the County Board doesn't have the expertise to run the home within today's complicated regulations and questioned how they were making money as reported when last month the board was discussing what cuts they'd have to make to fund it. He argued the county government could not afford the care the home's residents deserve. Not only is the home not going anywhere if sold, private owners can increase beds, jobs, and services.

Patterson - D pointed out the new mangement company SAK runs the home, not the County Board and that they operate it in the daylight with public scrutiny as opposed to what happens with private homes. He said we know what private nusring home companies do to turn a profit: they cut benefits for staff and/or quality of care for residents. He pointed that with county government subsidizing the care the home is now breaking even and any significant profits would necessarily come at a cost to quality service. He asked for members to look at it as a service the county provides and if a member supports selling it, to stop with the BSing on the hows and whys.

Esry - R argued in favor of selling and began with noting the services mandatory under the law versus the Nursing Home which is not, highlighting the non-optional cost of expert testimony in the COW agenda for court cases against sex offenders. The Sheriff may not make the county money, but is absolutely necessary and required by law. If the Nursing home depletes the county's corporate fund how will we pay for those mandatory services? He pointed out that the nursing home has been rarely ever been full or even close to full and insulting private nursing home companies makes no sense. Families choose to put their families in them over the county home. Voters have said they don't want sales or property tax increases to fund it both times it was on the ballot so unless people are willing to have a public fundraiser where will we get that 40 cents per tax payer per month? He argued that the best numbers still show the nursing home struggling in the coming years again. On the bid figure of 11 million he pointed out that the broker came up with that figure with the board and buyers are going to bid what they think it's worth regardless... higher if it's worth more.

Crews - D and Weibel - D briefly discussed whether the bid requirements were standard or boilerplate briefly, which didn't really seem to have a good answer.

Fortado - D criticized the derogatory comments of Scott Tapley towards Cathy Emanuel in the Public Participation. She noted a view among board members wanting to "get beyond philosophy and act" before arguing that "philosophy matters" in defense of public transperancy and valuing the assets we as a county have. She questioned that those on the board saying they support the home by selling it were being honest with one half of the board rowing in the opposite direction of the other half all the time. She argued for-profit nursing homes make a profit by exploiting workers, forcing them to give back benefits, and that this disproportionately affects minority workers due to the makeup of the workforce in an already dangerous field.

Goss - R highlighted what he believed were the facts that needed to be accepted by others on the board. He pointed to previous budget projections the home didn't reach, $5 million it has in debt, and how the county is down to only enough money to fund the next 32 days of county government operations in the bank (if I was understanding him correctly). The home has a cash flow problem and he has been through the budget line by line with SAK... and the home won't be able to pay off its debt for years. It has no way to pay that $5 million back right now. He also pointed out the nursing home is not a mandatory function of the county government and argued that it being privately owned will not make it any less special.

Petrie - D was upset at assumptions she had already made up her mind on how to vote on the RFP, which didn't make a whole lot of sense since she's given no indication that she's changed her mind since the last time she voted for it just a few months ago. She criticized those asking for more community input ignoring that there has been plenty of opportunity over the last several months to do so. She then said she'd support keeping the nursing home if she could be shown how it's possible financially. She said that sticking with county ownership of the home "come hell or high water" isn't helpful when we don't really know what that means. She again argued that a vote for the RFP to allow the bidding process to begin is not a vote to sell, but rather to see what our options are, which Mitchell - R soon took issue with again. Mitchell once again argued that the RFP needs to be passed with a serious intent to sell and not a "fake sale" that won't bring in credible bids. He went through years of News-Gazette articles on the Nursing Home's budget woes and the tough decisions the board was facing time and time again that he argued could just as easily be applied today. He pointed out that voters have demanded we break the cycle in referendums where they voted for selling the home and against raising taxes.

In between, Harper - R, stated his general agreement with Goss' points and added a point about the general corporate fund balance at $3.2 million needing to be at $4 million by law. He argued that we can't sacrifice the rest of the county for the nursing home. He also compared us to McLean County with its similar agricultural, twin-cities, University town, etc traits having a $15 million fund balance and a nursing home that's also losing money. Unlike Champaign they want to sell their home to avoid being like other troubled counties, with the implication they were talking about Champaign.

Marsh - R argued the recent reports that the nursing home made money were incorrect and that it really just lost less money. He pointed out that if sold the home could reduce costs, including costs on debt and other ways if sold as opposed to hurting staff or quality of care. This includes raising bed usage with competition and investment that the county can't afford. He argued that higher paying jobs there won't be in danger because of market forces and the low wage ones already suffer from high turnover anyways. He claimed he also had a negative personal experience, referring to the public participation story, but not expounding on his own. He concluded he supported the RFP because the money going to the nursing home for the elderly would be better spent helping young people who need help earlier in life to overcome obstacles. I was a bit shocked at how cold that sounded.

Rector - R also noted his respect for Cathy Emanuel and David Laker, but stated he believed that voting for the RFP was the best way to help improve the situation for everyone.

Petrie - D pointed out the problems pre-date the new nursing home building and again argued that we must change the paradigm.

In the Roll Call vote the News-Gazette summed it up concisely:
By a margin of 13-8, with Democrats Pattsi Petrie, C. Pius Weibel and Shana Jo Crews joining all 10 Republicans, the board voted to issue a request for proposals from private operators to purchase the county-owned facility in east Urbana. Champaign Democrat Giraldo Rosales was absent from the meeting.
The rest of the agenda on the nursing home (resolutions on loans, tax anticipation warrants and such) passed with voice votes without any significant discussion.


Committee of the Whole Write Up:

Most of the fireworks on the nursing home occurred in the special session. A summary and write up of that is available here and above.


No one took the second opportunity for public participation having the same board members as the special session before, but just for reference the speaker whose comments were intended for the COW:
Kim Harden, another local victim of "Nasty Joe" addressed the board in the special session public participation asking for help from the board on how part of her property was sold out from under her due to failure to properly notify her and a broken system taken advantage of by vulture capitalists like "Nasty Joe." More information on that craziness here.

The meeting substantively began with the Nursing Home management delivering their report. Overall they gave an impression of gradual improvement with some recent positive cash flow. Petrie asked for a sort of prospectus to get a better grasp of the home's financial situation for making decisions on its future and SAK agreed to work with her on some additional budget models/scenarios to work out with her one on one.

Rector - R was upset by the postive local media coverage that he felt was misleading. He wanted to know what media policy or gatekeeping could help control the message to the community. Weibel confirmed that there isn't any and due to the nature of the board, with anyone able to talk to the media, that it wouldn't be realistic to try.

McGuire - R questioned the positive numbers given the dire overall financial situation and previous budget concerns. SAK pointed to the overview they gave to Goss - D, who was similarly upset with how presenting short term gains didn't mesh with the overall budget problems they're facing. SAK stated their mission was to turn the home around by slowly improving the cash flow, not erasing 15 years of historically accumulated debt that predates them. They made clear there are no magic solutions. That it will take time.

King - D asked about maintaining affordability to which SAK defended their value under the circumstances, the size of the committment, and their flexibility with the board's situation. The home, they pointed out, deals with individuals with individual needs. It's not a widget game. They argued they treat themselves more like a vendor than employees.

King also asked about the challenges with the RFP that just passed. SAK pointed out that Nursing Home staff had been in the audience during the special session and heard the arguments and comments of the board and to think about what they heard and what they'd be thinking after all that. They've recently lossed 6 nurses. It's difficult to fill beds when the future of the home is uncertain.

Marsh asked for a one page of inlays and outlays to better track progress with specific areas of interest that the agency agreed to work with him on after Weibel suggested it to move things along.

The board then moved on to the Bail Reform Act presentation by States Attorney Julia Rietz and Sheriff's Office Chief Deputy Allen Jones. It is state legislation that affects the county in some ways, but in others the county had already implemented reforms on their own. The presentation video is twenty five minutes (direct link here) followed by questions from the board beginning at roughly the hour mark here.

https://youtu.be/wajUWY1fE6E?t=34m48s


The board moved on to its appointments and reports after the presentation questions. One unusual note was with the new federal tax law many people paid their property taxes early in case it may help with their tax liability which has brought a surge of early tax revenue that would normally be around $2 million to an early haul of $11.3 million.

A parcel of land, not yet sold, in another "Nasty Joe" acquisition attempt was returned to the owner (another case than the public participation from earlier whose property was already sold).

The remaining reports were submitted without anything highlighted or unusual.

The budget amendments on the agenda passed with voice votes and no discussion other than a quick question about what a WestLaw subscription entails and wanting to look into what "abandoned bond payments" referred to. The question was dismissed for later considering the budget item was a paltry $660 total.

There was some discussion about the Nursing Home Board's compensation with questions of fairness compared to other appointees to other boards, while others advocated for travel per diems to ensure access to local government by lower income citizens. The amendment striking the mileage language passed with a voice and then hand vote (11-9 on the 2nd hand vote double check).

McGuire had a couple questions about SAK's contract notice to renew and dealing with the ADA requirements for the old jail. Weibel said he'd get back to him on the former and the latter would be dealt with next month at the facilities meeting.

Adjourned at 10:26pm

No comments:

Post a Comment