Gracedale was one of the topics discussed at last night's NorCo budget hearing. The good news is that county spending for the home has been downgraded from a projected $12 million to $9.9 million next year. Budget Administrator Brandon Dunstane told County Council that he was able to shave $2.1 million by using a more realistic census figure of 445 residents instead of the projected 475.
A $2.1 million reduction in the budget would translate to about 0.2 mills in real estate taxes.
Unfortunately, most of the rest of the meeting was marked by an inability to answer some pretty basic questions.
The bulk of the $9.9 million contribution to Gracedale is $7 million for the annual IGT transfer.
The IGT is basically an accounting gimmick under which county-owned hospitals and nursing homes pool together money and send it off to the state Medicaid agency for matching federal funds. They usually receive more money in return. Council member Dave Holland warned at the end of the meeting that changes in the IGT are on the way.
The IGT payment that the county must make to kick things off is based on the number of licensed beds, which is 688. But the money htat trickles back is based on the actual census, which is only 445.
Zrinski acknowledged that the county wants to sell 88 bed licenses, but it will take time.
During the hearing, Council member Dave Holland noted that Gracedale would be entitled to Medicaid bedhold money if it was at 90% of its max 688-census. Budget Administrator Dunstane acknowledged that the last time Gracedale was at 90% was pre-COVID.
Noting the large number of problems at Gracedale has received since Michelle Morton became Administrator (deficiencies, one-star rating, provisional license, threatened removal of Medicaid reimbursement), Council member Jason Boulette said he is "blown away" by a budget proposal that includes payraises for the home's top administrators and nurses. There was no response.
Boultette wanted to know how many "back office" workers are employed at Gracedale. He noted that in 2016, Gracedale was at near maximum capacity with 670 residents. Now that census has dipped to 445, he asked whether there has been a commensurate drop in the number of back office workers. No one was able to answer immediately.
In response to a question from Council member Kelly Keegan, Continuum of Care Director Tom Carson said that Gracedale has 339 employees and 401 vacant positions that are budgeted. Budget Administrator quickly clarified Carson to explain that only 40 of those 401 vacant positions have actually been budgeted.
Keegan also wanted to know how many holidays have been added by Executive Tara Zrinski for career service employees. Zrinski answered, "I think we added five." When Keegan asked how much these holidays have cost the county, Zrinski 's response was, "What do you mean?" Keegan explained that the county would still have to pay these employees and might need to add in holiday pay for some.
Zrinski argued that the holidays are a trade off for subsistence pay. She said she is trying to change a "culture" (translation appears to be bad morale) that has been established "over the last eight years,"i.e. under former Exec Lamont McClure. She told Keegan that this "culture" has already shifted among deputy sheriffs and is improving at Gracedale as well.
Administrator Mark Aurand was unable to answer a simple question posed by Council President Ken Krqaft, asking approximately how many of these employees are career service, i.e. nonunion. He said it should be fairly easy to determine how much money the county spends in salaries for employees with five new holidays. Aurand said he'd like these questions ahead of the meeting. "I'm hearing all these great things about making people feel fuzzy and warm, but what is the cost? demanded Kraft.
During the hearing, Carson acknowledged that agency nursing at Gracedale is still very high, at about 65%. This is much more than Morton had stated at the oversight committee meeting a few weeks ago.
Most amazing of all, the county administration is still unable to answer a question posed first at the oversight committee and again last night by Council member Lori Vargo Heffner. "Based on the census to date, and the employees that you have, where would we have a break even?"
"We've been trying to find that answer, I've been asking, " responded Carson.
