On May 5, Northampton County Council tabled Executive Lamont McClure's $15.5 million plan to turn things around at Gracedale. Although all Council members generally supported the idea of investing in the county's embattled nursing home, they wanted more detail. They got it last night.
The $15.5 million is part of about $30 million that NorCo will receive this month from the American Rescue Plan Act, enacted by Congress in response to the pandemic.
McClure's original plan called for the following: $2.5 million for nursing agencies to supply manpower; $2 million to build an on-site Daycare for Gracedale staff at no cost to them; $5 million for bonuses paid to keep and recruit staff over a two-year window; $1 million for capital projects; and $5 million to replace revenue lost as a result of the reduced census.
Bonuses - $5 million
In response to Council's concerns, McClure dropped his proposal to set aside $5 million to replace lost revenue. He has instead added that money to extend the bonuses proposed to keep and recruit staff for four-years instead of two years. Every person hired or working at Gracedale, from Housekeeping to Administrator, will be entitled to a $2,500 annual bonus paid annually over four years.
"If you're a CNA [certified nurse's aid] within the sound of my voice, it would be a really good time to come to Gracedale," he said, and repeated it several times.
With the exception of member John Brown, County Council was generally supportive. Council member John Cusick initially suggested that the bonuses be limited to those workers who work directly with residents. But he was swayed by McClure's argument that all workers are "absolutely critical." He was the Council member to move the bonuses for consideration by the board tonight.
Brown complained that, despite multiple requests, the administration has failed to provide him with a breakdown of the workers employed at Gracedale. he observed that the county has offered similar incentives in the past, to no avail. He said the county "was throwing money at something, and then you're going to make it up as you go along, but I don't see that as functionally being a plan."
Brown's dig brought McClure to his feet. He turned the tables on Brown, and the two sparred.
"What's your plan? What would you do with the $10,000," he asked. "We're all ears."
- "I would have to have more information to be able to take a look at that."
"What information would you need, Mr.Brown? You had my job for four years. What information would you need, sir? I understand you're opposed to the efficient and long-term success of Gracedale, but you said we don't have a plan. What's yours?
- "No I did not say that I'm opposed to the long-term and efficient plan, again, I don't have enough detail to move this forward. ... I don't even know how many full-time employees we currently have. And what is the long-term impact? And if you do provide this and you're able to begin ro sustain some recruitment or retention overall, what does that do to Gracedale's budget and how are you going to make up the revenue then to maintain this going forward once this goes away? ... ."
"Well clearly we would not be able to offer $10,000 bonuses forever. This is an emergency measure to deal with an emergency. We need to be able to hire, we need to be able to get people in the door. There is a very good plan top get people in the door. There is a marketing plan. And the best piece of that marketing plan is this $10,000.
McClure went on to say that "questioning the plan to death" will only further endanger the home. "Not allowing us to do this is setting us up to fail."
-"The reality of this, Mr. McClure is that the home is failing, has been failing for an extended period of time. ... You're not addressing the management issues that I feel are part of the problem. ... ." Brown added that Gracedale employees are the ones telling him that management is the real issue.
"My suspicion is there'll never be enough detail for you," continued McClure.
Unfortunately, just as things were getting good and I thought Steve Lynch might pop in with boxing gloves and challenge everyone to a duel, Council President Lori Vargo Heffner gave them both a time out. "I don't think anyone up here needs or wants the antagonism."
Speak for yourself, Heffner!
"Why the rush?" she asked McClure. He likened Gracedale to a tanker (hopefully not The Titanic) ) that needs a lot of time to turn around. "If we don't start now, we won't turn it around."
Tara Zrinski said these bonuses will be a Godsend, not just to Gracedale staffers, but to "vulnerable people" who have nowhere else to go.
"Tara hit the nail on the head as far as I'm concerned," added Kerry Myers. But he said that as soon as he leaves, he'll be getting calls from other county workers asking, "What about us?"
McClure later explained that he hopes the hiring and retention bonuses will yield 54-60 nursing staff, and at that point Gracedale will be able to provide the required 2.7 hours of daily nursing care per resident.
Capital Projects - $1 million
Council members Lori Varho Heffner and Ron Heckman both noted this money is needed for converting four-resident rooms to two-resident rooms. This is currently under consideration by the federal government. "I think we're going to end up needing more money," noted Heckman. Administrator Jennifer Stewart-King said that the majority of rooms at Gracedale (about 300) are for four residents.
Council member John Goffredo said that the bonus money is a "no-brainer," but he has reservations about how much money is needed to change the occupancy of 300 rooms.
McClure then stated that, if the room occupancy is reduced, the county will have to decide whether the home can even continue. If it does, the county will probably need to borrow.
Council will vote on this tonight.
Nursing agency staffing - $2.5 million
Because of staffing shortages, Gracedale brings in outside nursing agencies to provide staff. The hourly rate paid for agency nurses is much higher than what is paid to workers.
Council member John Cusick had a problem with using these agencies. "If we were paying substitute teachers more than we pay our regular teachers, I would probably quit and become a substitute. We're almost incentivizing it by paying it. This is one I'm gonna' be a No on."
McClure said he feels the way Cusick does, "but I can't get to the numbers I need without it." Administrator Jennifer Stewart-King noted that the higher salary is paid to the agency, not the nurse. She indicates she's been able to recruit few agency nurses who are looking for homes.
Daycare - $2 million
McClure presented detailed plans to Council. "If it's done right, I think it could be great, said Council member John Goffredo. "Some of the staff would like it tomorrow," said Jennifer-Stewart King. The daycare could be operational by year's end.
It will start out for Gracedale workers only, but it could be extended to others. The total cost of construction might be as low as $200,000. It will be located next to the chapel,and there will be interaction between residents and children.
Lori Vargo Heffner indicated she'd like to wait until June 2 to take action on the plan.
"This is the single biggest piece of the recruiting puzzle,: said McClure.
Heckman said his concern is that this will be a continuing cost.