Penny-Wise, Pound-Foolish: Conservative County Board Members Admit Responsibility for Crisis, Take It Out on Union

Penny-Wise, Pound-Foolish: Conservative County Board Members Admit Responsibility for Crisis, Take It Out on Union

By nightwatch

The latest round in the battle to save the Champaign County Nursing Home (CCNH) occurred at the County Board meeting on Thursday evening, May 22. Greeting the county board members at the door was a picket line organized by AFSCME, which represents the CCNH workers. Turning out in support of the nursing home workers and in support of maintaining the home as an essential public service were members of the local Jobs with Justice chapter, the Graduate Employees’ Organization – AFT/IFT Local 6300, the Illinois Education Association (IEA), and several other local labor organizations.

Approximately 30 AFSCME workers will be laid off in early June, as it seems that a majority on the county board may be ready to adopt a “blame it on the workers” attitude in a speculative move to resolve longstanding morale problems and mismanagement at the nursing home. The impending layoffs were suggested as a part of a plan to improve the finances at the home being put together by Management Performance Associates. MPA is a consulting and management firm that specializes in privatizing and then managing nursing home facilities. Why the county board implicitly seems to be continuing along this path is unclear, as previous opinions presented to the board on Illinois law indicates it will be politically impossible to sell the home – despite the News-Gazette’s and some local conservatives calling for this – because selling CCNH would require a two-thirds majority of the county board to vote in favor of putting a referendum to close it on the ballot. Even with the fractures in the Democratic Party and given the certainty that at least some Republicans would support keeping it as a public facility, such a motion is doomed to failure before it even gets started. Such a question would then have to be approved by a majority vote of citizens, who voted in 2002 by a 70% margin to support CCNH with tax revenue.

There seems to be many county board members who publicly claim to support the nursing home. But it’s important that citizens watch carefully watch what they do, not what they say. There are some who continue to happily nickel-and-dime the nursing home to death by the way they define the issues, in some sort of false and twisted economy that is penny-wise, but pound foolish.

It was the bad decisions made by a group known as the Beckettcrats – which was composed of a rump majority based on members of the Republican minority led by a few conservative Democrats – who set the home up for failure. First they decided to limit the 2002 tax question to just 3 cents, a decision that actually created the current crisis, even as Democratic party loyalists supposedly took charge of Champaign County politics. Then they shifted the retirement costs for these county employees out of the pool that had previously benefited all county employees. Singling this out as an extra expense has uniquely burdened the nursing home among other county departments. Thus, the Democratic revolution has been much less of sea change than News-Gazette could make of it, then or since. Rather, the county board’s policy direction has taken a very moderate, even conservative direction, much as party labels no longer match or much measure the traditional conflicts between the national parties.

Many had worked before that notably successful referendum to ensure that the nursing home would have a stable financial base. Among these so-called fiscal conservatives, no matter what their party label, it was known that 3 cents would be unlikely to sustain the home. Still they could claim they were supporting the home. Now , a few years later, the claim they make is that they have done all they could to help, but the nursing home, despite its century of support from the county’s citizens, simply was never a viable institution.

Despite the News-Gazette’s endless harping on the problems with constructing the new home, in many ways, the relatively state-of-the-art facility will make a wonderful sweetener to any deal to sell off the nursing home to the heroic and independent “investors” they imagine will take over the home in the editors’ wet dream of capitalist glory. There is simply no way that any motion to do so could make its way onto the ballot, instead of a referendum to save it – unless the Beckettcarts were to put together a two-thirds vote by finally convincing enough real Democrats that spending up the costs through bad management will eventually attract the wise manager that will arise from the ashes of a public nursing home to make a tidy profit on the home our tax dollars built.

It would have been far wiser if one was making its survival crucial to put a higher figure before the voters in 2002, when it could have been as high as 10 cents. This was especially so given what everyone at the time knew about the long-term trends in medical costs. Republican critics at Thursday night’s meeting noted that the borrowing from the county’s general fund in recent years needed to sustain the home had effectively amounted to another 3 cents anyway, for a total cost to county taxpayers of 6 cents. But these very same critics were among those who forced the choice to only ask for 3 cents in 2002. It does help if those who did so would own up to it. At least one non-Demoract was willing to partially own up to it, although Democrat Steve Beckett sat quietly aside from any significant comment during this discussion.

Republican Gregg Knott admitted that the whole board should take responsibility for the bad financial management at CCNH. However, Knott apparently didn’t want to go into detail about the bi-partisan cooperation underlying the decision of the Beckettcrats to ask for only 3 cents in 2002 that set the stage for the current financial crisis. Their leader, Mr. Beckett, remained mostly silent about his own role, while Republicans at least admitted that bad decision-making, and not the union, had led to the current crisis. Needless to say, if the 2002 referendum had asked for 6 cents, CCNH would have been breaking even now, instead of in crisis. If a higher number, up to the full 10 cents allowed, had been chosen in 2002, CCNH would have generated a comfortable operating surplus that would have helped cover the investment costs made in building the new facility it is currently operating out of, instead of being in crisis.

Speaking in the public participation part of the meeting, Nora Stuart, a newly-elected union officer at the home, noted the meager evidence that any turn-around could be based on undermining the level of service through the June layoffs, as they would likely negatively affect the current financial situation at the facility. The total yearly wages of the workers to be laid-ff – although at or barely above the Living Wage ordinance that the county adopted in 2002 – amount to only $219,000 in a year. Yet the agency temp nurses that the nursing home’s management relies on – instead of employing and retaining adequate numbers of permanent nursing staff – cost $279,000 in the last month alone.

Representatives from the Champaign County Health Care Consumers (CCHCC) noted that the reduction in staff could come at a high price for residents. Statistics indicate that there are 35% higher negative health outcomes for patients in for-profit nursing facilities in comparison to public ones such as CCNH. While MPA suggested in its report that the mix of patients could be changed to give preference to Medicare and private-pay patients over state-supported Medicaid patients, CCHCC observed that two-thirds of _all_ nursing home patients either are or will become Medicaid within a year of first being admitted. This is because most of our aging population, even those who’ve worked all their lives and own their homes, will be forced to “spend-down” their assets if they become dependent on nursing home care in the twilight of their lives. In large part, this harsh economic reality is likely a large part of the reason so many Champaign County residents supported the 2002 referendum. It’s sad that they were misled that the 3 cents voted on in 2002 would be enough to sustain CCNH. However, this is a problem that can be fixed by simply admitting that decision was flawed by short-sighted estimates, with only a modest increase needed to correct the board’s oversight.

The average voter might be thinking that any such increase will be a large amount of money. Checking my own property tax bill as a resident of Urbana, my entire county taxes amount to about $100 a year. True, I do pay more in total property taxes, about another $1,100 on my modest home. So if they county needs to ask for another $10 to make up for the cupidity of the jerks we’ve elected to higher office who are unwilling to support in old age the lives of those who are going before us, I don’t see a problem. In fact, that is all that is being argued over, so if it wasn’t for that savagely bi-partisan initiative on the part of the parsimonious that stands in the way of having an adequately funded nursing home, the solution would be at hand with concerted efforts to adequately fund the nursing home by adjusting the income through a referendum.

Gene Vanderport, who is involved in Jobs with Justice through his work as a regional official with the IEA, stated that he was disturbed by what he called the “anti-union animus” in MPA’s report. He noted that CCNH needed to “fill the beds” – instead of sitting partially empty – to be economically viable, as well as serve the goals the voters set in 2002 by their support of the referendum.

Brian Schale, who is at the nursing home daily with his wife to visit with his mother-in-law who is a resident there spoke persuasively about the quality of care she had found there. He noted that trying to market CCNH’s good reputation is going to be difficult if the staff that supports this reputation is laid off.

David Brayfield, a Democratic Party committeeman, asked the question that many other Democrats are now asking: If the county Democratic platform supports keeping CCNH public and supports unions, why is a majority on the county board acting against the wishes of the Democratic Party and its majority on the board? As several others noted, the morale problems with workers at the nursing home seem largely a result of “a hostile work environment.” Brayfield observed that board members knew where the management problems were, so he couldn’t help but wonder why it was good workers being shown the door. Instead, there are those in management who are aggravating the nursing shortages largely caused by CCNH’s inability to retain probationary employees so that they become the permanent employees that are so badly needed to continue quality of care for patients and to provide the basis for economical operation of the home.

AFSCME vice-president Ken Henry noted that the dominant media always casts problems as the union’s fault, when it’s abundantly obvious that the workers aren’t making the bad decisions of management. Robert Ward, noting that the board once again was avoiding engaging with the need to go back to the voters to support another referendum to make up for the financial deficiencies of the 2002 vote, arguing that another vote to support the home was “not an opportunity, but an obligation.”

Germaine Light, a teacher at Mahomet-Seymour High School, helpfully walked the board through a lesson on the basic information needed to deal with the crisis it had created. “Unions are good; privatization is bad; referendums can raise funds; and diversity is good” – with the last referring to the fact that the nursing home board that the county board recently appointed to take the pressure off elected officials was notable for its lack of representation of those county residents most likely to end up in the nursing home.

After the public had its say, Brendan McGinty, another Beckettcrat and chair of the county board’s Finance Committee, led the discussion that concentrated on MPA’s somewhat questionable solutions that it was making in an initial pro forma report – and away from discussion of the obvious need for a referendum that will provide long-term financial stability for the county nursing home.

MPA was asked if loans from the county could be ended – instead of what financial resources it would take to sustain the home as a public facility in the future. MPA was at least honest enough to admit that current revenue, even assuming recent trends and provided its suggestions could be implemented, would still be insufficient. The funding gap would likely remain as much as $150,000. However, MPA was quick to suggest that better performance might happen if the board would only buy a software package from it, called “CareWatch,” which it promotes as a way to implement improvement in care facility revenue despite recent changes that have negatively impacted reimbursement from the state. The payback term on this cost would be “three or four years” – avoiding the question of how, without new income from the needed referendum, the facility would still be around as certain politicians try to strangle the nursing home in its bed as the best thing for everyone?

McGinty then inadvertently drew more attention to the Beckettcrat’s blocking of placing the appropriate amount needed for long term stability of CCNH on the ballot in 2002, when he noted the home had lost money in 13 of the last 15 years. Ironically, the couple of years right after the 3 cent 2002 referendum vote were good ones, with the home operating in the black. This temporarily positive news was cited in the immediate aftermath of the vote as among the reasons no more than 3 cents was really needed. In reality, it was more random good luck on the part of fiscal conservatives, who were unwilling to address the twin realities of political support among Champaign County voters and the need to ensure long-term financial stability through an adequate funding mechanism. These vultures of fiscal conservatism are now circling CCNH, when they were the very ones that limited the resources it now survives on.

MPA’s argument is basically that CCNH can skim the cream of Medicare and private-pay patients in order to become financially (almost) sustainable, under the assumption apparently that there would be no other new funding available. On the face of it, that assumption flies in the face of the fact noted by CCHCC – most seniors eventually become Medicaid patients after they sepnd down their resources, even if they initially enter the home as private pay patients.

In a somewhat stunning statement at that point, one which reveals what motivates McGinty, he asserted this meant the union needed to agree to reopen labor negotiations (the union and the county just agreed to a new contract last winter) since the contract was now too costly. MPA actually came off looking like friends of labor by comparison, as their representatives refuted McGinty’s gambit by noting that wages were not the issue McGinty thought them to be. True, they were higher than for-profit nursing homes, but were comparable to other public nursing homes. This was an interesting admission, though, one that reveals the “profits” that privatization brings is largely at the expense of employees and patient care.

The surprise in MPA’s report was their assertion that a public facility could “select” private pay patients, as long as it was also careful to not turn away Medicaid patients. The way to do this was to get the private-pay patients into open beds quickly, before Medicaid patients could get there. This suggests some legally fictional sleight of hand in the application process may be at hand, perhaps putting temporary obstacles in the way of admissions of the poor, while greasing the skids to get more well-off patients into beds before the poor know what’s happening. It also sounds as if this type of facility is not what the voters have supported over the years, in other words, one that is a public nursing home where they always knew it would be available when they might need it – and that anyone was equally eligible.

McGinty emphasized his concerns about placing the referendum needed to solve the deficiencies of the previous 2002 measure on the ballot again, saying he doesn’t “want to just throw money” at the problem.

Despite the clear preference of Beckettcrats, Republican or Democratic, to gently put into play a number of actions and inactions that will cumulatively snuff out the ability of the nursing home to survive, it was also clear that resistance to the dog-and-pony show put on by MPA was building among the board’s Democratic majority. Carol Ammons called MPA on the anti-union rhetoric in their report, after they’d denied any such intention. Ammons quoted chapter and verse from the report, making it clear that it put a strongly worded emphasis on undercutting workers and demanding sacrifices from them, while preserving or even extending the same managerial prerogatives that have resulted in the present morale problems. She stated, “We know not everything has been done…” that was needed to save the home, lending credence to the recent charge made by McGinty’s opponent in the general election, Mike Lehman of the Green Party, that CCNH was being subjected to a “death by a thousand cuts.”

Fellow Democrat Lloyd Carter asked when an audit of the nursing home’s books would be ready. After stumbling around the answer, the best that management could say was that they “are working on it.”

One member of the newly-appointed nursing home board, Mary Ellen O’Shaughnessy, then took the mic and chastised everyone for not getting to work on a list of measures they could all agree were needed to fix the problems at CCNH. Nearby Republicans seemed to take this in stride, since her anger was apparently directed most specifically at the union, as she then trivialized labor’s concerns as guff she wouldn’t have to take from her own children.

After that blow-up, Gregg Knott then took at least a small share of responsibility onto the board as a whole. He admitted that the county board as a whole is responsible for the crisis at the nursing home, stating “we should have fixed it in 2002.” However, since Knott was among those who tend to argue for the smallest tax rate possible, he was being a little disingenuous. It’s clear now that the 3 cents requested in the 2002 measure was inadequate, that relying on it since has thrown the nursing home well into the red, and that the need to transfer general funds to support CCNH actually threatens the county as a whole with bankruptcy. If Knott, most of the other Republicans, and the Beckettcrats had supported at least a 6 cent rate in 2002, the county board would not have been spending the time, energy, and money on trying to fix things financially now. What they created was a mandate they could not deny, because the public demanded it, but which they were unwilling to properly fund. By not admitting you want to kill it off now gets just as much mileage as it did then.

One has to wonder if, given the realities that most Americans face in the twilight of their lives, whether or not the county board was whistling past the graveyard in 2002. But it’s also entirely possible that these short-changers of the public’s trust intended all along to precipitate this crisis in hopes of killing off the nursing home by either closing it or privatizing it. Those controlling the county board’s process certainly ignored the problem until very close to the next election, possibly in hopes of creating a stampede effect to end the nursing home’s 100-year run. The ideological bent of the Beckttcrats – composed of a few Democrats and many, but not all, Republicans – is “I’ve got mine.” That may be, but the voters of Champaign County spoke up loudly and clearly in support of the nursing home in 2002. They not only may need their nursing home at the end of life, but they want to make sure through their lifelong investment in it – a younger generation sustaining the older generations need – is because they may one day find a need for it, too, and is what is at stake here.

Update: Late on Friday afternoon, a bombshell that surely must have been known last night (which was reportedly discussed in a closed meeting according to the News-Gazette), but which was conveniently shoved under the rug at the time, has since hit home at the nursing home. WILL AM580 news is reporting that CCNH has been prohibited from taking in any new Medicare or Medicaid patients since the middle of April. This stems from an investigation into care at the facility after a patient was injured in January.

Was it this problem that precipitated the recent layoff notices, and not any other need for cuts? Perhaps. It certainly explains why exhortations from some on the county board to fill more beds were ignored. Inquiring minds certainly want to know what the source of the problem was, even though management insists that everything is OK now. Due to the closed nature of last night’s meeting, more details will likely be sketchy, but this does again call into question whether or not a management change is needed at the home. It certainly raises the question of whether the layoffs will further impact patient care, as members of the public spoke of in their comments.

The public should demand answers, demand accountability, and demand that the nursing home be fully funded, instead of making do on a wing and a prayer. Many of us may need the Champaign County Nursing Home. We’ve supported it for years. It would be a shame and a tragedy if it failed, due to the intransigence of those using it for political gain, rather than treating it as something the public has supported as a necessary part of government’s role in our society.

Throwing money at a problem isn't a solution

The public should definitely demand answers and accountability (in particular for the insane legal fees we're paying to a semi-competent firm in Chicago), but I don't understand why a facility that was just handed a brand new (if moldy) facility by the taxpayers should need continuing funding to compete with for-profit homes. If we want to serve Medicare patients, then we should provide the level of service that Medicare pays for and fight for higher reimbursements if needed. I'm also disturbed by the amount of time the County Board seems to spend dealing with this one, pretty standard service, while the rest of county government coasts on autopilot.

Get Your Facts Straight

Medicare patients are not the problem. Compensation for their care is adequate. The issue with the current crisis is the state has cut reimbursement rates for Medicaid patients.

Medicaid patients are those too poor to otherwise qualify as either private-pay or Medicare. Why is there a higher percentage of Medicaid patients at CCNH? Because it is the last resort for the elderly after they have either exhausted their other options -- or because they worked their whole lives and had little in the way of resources in the first place. If CCNH was like Clark-Lindsey Village, catering to the relatively well-off, it would not have a problem financially. Unless you're willing to throw Granny out in the street -- or force for-profit care facilities to care for them -- it provides the care these older people need. It is also the care they paid their entire lives for and they have a right to expect it and not have it destroyed because of the short-sighted political goals of a few.

It pays to remember that continuing the care of the elderly and indigent was never a significant issue when the Republicans controlled the county board. It has always required infusions of cash and principled Republicans stepped up to the plate an provided it. Now a few conservative voices want to force the closing of CCNH as a way to attack the Democrats -- and a few Democrats want to join them in this invidious action.

As for throwing money at a problem not being a solution, you should be asking management why they throw a quarter a million dollars a month at temp agencies, when they could pay a permanent -- and more efficient -- staff considerably less. You could ask how the cut of 30 positions whose annual salaries total less than one month's worth of agency nurses will help solve management's problem with wasteful and profligate spending. But that makes the issue more complicated than your simplistic, cheap shots do.

So is a tax hike in the works?

Is there any possibility the voters will be given a referendum to vote for the needed funds?

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