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HomeMy WebLinkAboutCommunity Development Block Grant Commission - Minutes - 10/10/1996CDBG COMMISSION MEETING MINUTES October 10,1996 City Council Liaison: Bob McCloskey Staff Liaison: Ken Waido Commission Chairman: Dan MacArthur, Chair Home: 490-1574 Work: 667-2747 The meeting of the CDBG Commission began at 6:30 p.m. in the Community Planning Conference Room, 281 North College Avenue, Fort Collins, Colorado. Commission members present included: Chairman Dan MacArthur, Bill Steffes, Bill Bertschy, Dave Gordon, Holly Sample, Joe Zimlich. Viola Guthrie and Linda Coxen arrived after the start of the meeting. Staff members present: Ken Waido, Jackie Davis, Julie Smith, and Mary Hile. APPROVAL OF MINUTES Moved by Mr. Steffes, seconded by Mr. Bertschy: To approve the minutes as tendered. Motion passed unanimously. TRAC HOUSING Mr. Waido informed the Commission that TRAC requested their prior CDBG funding of $50,000 awarded for development fee payment be used for land acquisition. Applicants who reconsider the manner in which CDBG funds are to be used are to request permission from the Commission. This is a relatively minor matter and does not rise to the level of Council review. The land in question is across the street is an SID property across the street from the Parkway Townhome project. TRAC's bid is 400,000. There is no guarantee that TRAC will be the successful bidder on the property. Moved by Mr. Steffes, seconded by Mr. Gordon: To approve the request for change of funding use. In discussion, it was noted that the applicant has a good track record and is dedicated to home ownership. TRAC has made this type of request and reapportioned funds appropriately before. Motion approved unanimously. CHILDREN'S CLINIC/POUDRE VALLEY HOSPITAL DISTRICT Mr. MacArthur welcomed Dr. Stuart and Barbara Hinson and explained the purpose of the invitation extended by the Commission to the Clinic and Hospital District: To understand the relationship between the District and Hospital; to understand the funding and partnership possibilities among District, Hospital, and Clinic; all in an effort to realize the Commission's goal of maximizing the effect of its funding recommendations. Dr. Stuart briefed the Commission on the following: Several years ago, Poudre Valley Health Care, Inc., a 501(c)(3) entity, became the operating company for the hospital. The District became the landlord. The District, which receives lease payment and tax dollars, has been developing strategic plans over the past few years. The physical plant of the hospital, the property and equipment, is still owned by the CDBG Commission Meetint, Minutes October 10, 1996 Page 2 citizens that reside in the District. There is a bond indebtedness of $60 million to the District, and the funds that flow from the Hospital is sufficient to retire that indebtedness. The District receives approximately $2.2 million in tax funds. The District was in the process of devising grants and other options for spending those funds when the lawsuit filed by Mr. Haggerty resulted in a court injunction stopping the District from doing that. The lawsuit alleges that the District must spend its tax dollars to operate a hospital or health care facilities. The District has began operations such as the van and a clinic in town to support the van. They are also looking at other options, including an adult dental clinic. Dr. Stuart stated that he was not an authority on the District's spending plans. The Hospital operates a family medical center at which residents are trained. The clinic sees uninsured and Medicaid patients who cannot find doctors in the community otherwise. The Hospital is also in the process of building the North Side Health Center by the new Albertson on College. It will open in February. Last February through May, discussions were begun on combining the operations of Healthy Start, Inc., and Poudre Valley Health Care, Inc., as both were nonprofit entities providing a scope of health care. Both entities were interested in maximizing efficiency and effectiveness. The two operations have now merged. The District is not involved in Healthy Start, Inc. The Children's Clinic has a lot of assets, due to the generosity of contributors. They now have yearly expenses of over $800,000 and are opening a dental clinic upstairs. With that clinic, the yearly expenses will be about $1 million. Yearly revenues from Medicaid and patient payments are about $600,000. The shortfall is made up through contributions from the community, such as CDBG grants. The merger should allow the Children's Clinic to spend less money per visit through increased efficiencies. The following was stated in response to Commission and Staff questions: The employees of the Clinic will remain and be employed by Healthy Start. Healthy Start will be the sole owner of the Clinic. The economies are realized by consolidated, centralized, and improved business operations. The District, the Hospital, and the County hope to work together to weave a safety net to catch those in the community whose health care needs are not being met. The District operated the hospital for 30 years. In 1991, the Board of Directors, in order to meet the changing needs of managed health care, decide to privatize the hospital by establishing a 501(c)(3) corporation which leased the hospital and its operations from the District. Hospital districts are now called health districts and are allowed to do a variety of different health -related services within a community. The District Directors decided, after leasing the hospital, to: 1) increase access to health care for low-income people; and 2) initiate programs to increase the general health of the community. The District put out RFPs for such CDBG Commission Meeting Minutes October 10, 1996 Page 3 programs. Mr. Haggerty, a local attorney, disagreed with the propriety of the District's providing such programs and filed a lawsuit. The judge who heard the suit stated that the District could: 1) collect taxes; 2) provide health services; 3) provide health services in the District's own facilities. The Hospital is operating satisfactorily without the District. The District is looking for ways to best spend the tax dollars to enhance the health status of the community. The District cannot fund the Children's Clinic directly under the current status of the lawsuit, the Clinic being a separate entity. The District cannot presently operate outside the parameters set by the judge. The decision for the Clinic to merge with the Hospital rather than be absorbed by the District was a decision for the Clinic and its view of how best to achieve full operating efficiency and enhance its expertise in its approach to patient care. The Hospital has "deep pockets," but has to carefully manage its resources in order to be able to thrive into the next century. It would not have been able to survive in the status of being operated by the District. The Hospital anticipates less revenue in the coming years due to the changing nature of managed health care. The District estimates there are 19,000 people in the district with low income, not covered by insurance. It is unsure whether CSU students are included in that number; they generally are not. One intent of the mobile van and clinics is to provide health care to increasing numbers of people. Those people may ordinarily use the emergency room for routine health care; this concept also then relieves pressure on the emergency room and provides more timely care to the patients. When Healthy Start applies for future CDBG funding, its asset sheet will include just the Clinic, and not the Hospital entity. Administrative services will be merged with the Hospital, and some Clinic employees will be moved to the Hospital. The service level of the Clinic will rise and fall with the gift dollars from the community. One goal of the Clinic/Hospital merger is to increase services without increasing expenses. Lab fees are an examples: Fees that the Clinic must now pay will, in the future, be absorbed as part of the Hospital costs. Billing services will be done through one system. The family clinics being started will serve the entire family. The Children's Clinic will continue to serve the health needs of children whose families see a need for specifically pediatric care. The emergency room presently receives 40,000 visits per year. It is hoped that the addition of the family clinics will ease pressure off the emergency room. When the patients are triaged, those with routine illnesses have the lowest priority and will be served the slowest. These people will be better served by the clinics. The clinics' purposes includes improving the general health of the community through education and prevention. Hours of the North Side Clinic will be from about 6:00 a.m. to 7:00 or 8:00 p.m., seven days a week. Most emergency room patients are seen early in the morning or in the evening. The hours may be adjusted to fit the demand. Bilingual services will be provided. Workers Compensation patients have their own medical programs to follow. The District collects about $2.5 million in taxes per year. Money flows from the Hospital to the District; but the District, under the injunction, cannot fund other entities, including the Hospital. The injunction is being appealed. It is possible that another hospital CDBG Commission Meeting aAinutes October 10, 1996 Page 4 could be started in the community to provide competitive advantage and dilute the patient base; however, it is not anticipated that, with the bond debt that a new hospital would incur, rates could be kept lower than those currently charged by Poudre Valley Hospital. The most common reason that noninsured or Medicaid patients give for not having a doctor is not being able to find one. Many doctors are not taking patients on Medicare, Medicaid, or who have no insurance. The few doctors that do take Medicare/Medicaid patients are generally closed to new patients. The needs of the Children's Clinic will be as great as in the past. Funds that are contributed to the Clinic will have great effect now that the merger has taken place. Coordination also takes place among the Hospital, Children's Clinic, and County Health Department. The Clinic currently has an endowment of $102,000. Since services are growing, employees at the Children's Clinic will be absorbed into other Hospital services. An example of systems efficiency is the Children's Clinic information systems being run on the Hospital's million -dollar system that is being established. Centralized billing and administration will be done for the Hospital and all Healthy Start, Inc. clinics. Further information was volunteered by the speakers on the evolution and future of managed health care, physicians' responses to managed health care, the parameters of new medical information systems, and the acquisition of HSI by the Hospital. Carol Plock made a detailed presentation to the Commission, using slides, charts, and graphs, on the health picture of the community, the responses to that picture by the District, and the District's vision for the future. It was decided that this presentation need not be reported for purposes of the minutes. Scheduling was discussed. The November meeting may be canceled. The December meeting includes a dinner. January typically includes a public hearing and Council study session. Council is very busy with City Plan items. In light of Council planning and the upcoming Council election, it was decided to plan for a meeting at a more productive time. There will be a final report on the results at Pioneer and how CDBG funds were expended to aid the residents there. It was remarked from anecdotal accounts that the public does not seem to be very well-informed about the issue. The meeting adjourned at 8:50 p.m