The writer is a Douglas County Board member.
Douglas County taxpayers should be aware of proposals being considered by the Douglas County Board regarding the privatization or outsourcing of services at the Douglas County Health Center. The facility’s primary functions are the Community Mental Health Center and long-term care (with assisted living), as well as a pharmacy and Primary Health Clinic.
Long-term care needs $3 million of county support annually. Federal Medicaid support covers 94 percent of the costs. Our population in the 254 long-term care beds is younger, more predominantly male, with more health care needs than typical nursing homes with long-term care. More than half the population also has behavioral issues. Many have come from other nursing homes that can no longer meet their needs.
The Community Mental Health Center requires approximately $6 million of county support. The Mental Health Center has 1,600 outpatients, most of whom are provided medications and follow-up management. About 60 percent of these patients are indigent and 40 percent are on Medicaid. The Mental Health Center also operates a day treatment program, a 16-bed inpatient unit and the mental health diversion process for the courts.
In an effort to reduce the tax support for these services, the Douglas County Board engaged Health Management Associates (HMA) to conduct an operational assessment of the Health Center. HMA determined that the staffing is appropriate for the population the facilities serve and that the quality of care is exemplary. It said that the wages were in line with the community and that our turnover was half of the industry average, saving training costs and providing more stable care.
HMA was asked to determine community alternatives for the residents of the long-term care facility and those served at the Community Mental Health Center. It concluded that there are no facilities or programs in the area that will provide care for either of these groups, largely because of unreimbursed costs.
The primary recommendation of Health Management Associates is to improve financial reporting and to engage our community caregiving partners and the public in discussing exactly what we want for the future of the Health Center.
HMA then recommended a set of important actions whereby the commissioners invest in other cost efficiencies and enhancements to the Health Center and its activities. HMA also recommends working with other caregiving providers in our community to see if we could better coordinate and consolidate services.
In its closing remarks, Health Management Associates said we had a great staff with many good ideas and that we should work with them to address our problems. HMA did not recommend privatization or outsourcing.
Unfortunately, and perhaps disastrously, the commissioners’ agenda next week will include a vote to move forward with a request for proposal to privatize the entire Health Center operation. The County Board directed staff not to implement any changes yet and is now ready to begin the process of outsourcing the 425 employees.
Instead of listening to the experts we hired for more than $300,000, some commissioners now claim that we will let the management and staff work on these improvements while simultaneously going through the process of outsourcing their jobs. Why this premature haste on the part of some commissioners, when it is not recommended by the thorough, expert and expensive report from Health Management Associates?
Since March 2012, there has been one company courting the county’s business of privatizing the Health Center. I fear that we are trying to pave the way for it to take over any part of our operation it wants. My fears are heightened by the process and timeline we are following.
As chairman of the Douglas County Health Center’s Board of Trustees, I am very proud of the facility and its staff. The Health Center is given the highest rating by the Center for Medicaid Services. The quality of care provided for so many of our neighbors in need is something that we can all be proud of. This is a vital caregiving facility with a wonderfully dedicated staff.
County government is, by law, the caregiver of last resort. This is our most important job.