HomeMy WebLinkAboutSenior Advisory Board - Minutes - 01/08/1986P
CITY OF FORT COLLINS
OFFICE OF EMPLOYEE DEVELOPMENT
Minutes for Senior Board Meeting
Members Present
Yetta Rollin
Mildred Arnold
Pat Long
Martha Bartlett
Paula Makowsky
Joe Campanella
Ruby Lynch
Patti Raco
Suzanne Jarboe -Simpson,
January 8, 1986
Members Absent
Dwight Saunders
Norman Wynn
Margaret Tremper
Guests
Kelly Ohlson, Assistant Mayor
Robert Bakken, Poudre Valley Hospital
City Staff Luanna Ackerman, Director of Eldertiaus
Susan Pedersen, Dir. Area Office of Aging
Charlotte Kanode, Handicapped Info. Office
Betty Moseley, Continuum of Care Coalition
Ed Chilcott, SILO Chairman
The regular monthly meeting of the Senior Advisory Board was called tc
order at 1:35 p.m. by Ruby Lynch, Acting Chair. Minutes of the previous
meeting were approved.
Kelly Ohlson had received a letter from the City street maintenance
department in response to previously expressed concerns about the new bus
shelter at the DMA Plaza. The shelter was built higher than the curb for
drainage purposes, but the slope will be modified for easier access and
kept cleared of snow and sanded for safety. The slope modification will be
done by the end of January. Additional concerns of snow removal and
blocked access to sideways from snow grading were addressed. Kelly will
inform City street personnel of blocked pedestrian access to some sidewalks
as a result of accumulated snow between streets and sidewalks.
DEVELOPMENT
I
Mildred Arnold introduced guest speaker, Bob Bakken, Administrator of
Poudre Valley Hospital since 1979. Mr. Bakken presented background
information about health care services in Fort Collins and then responded
to questions on several topics that had been addressed to him in an earlier
letter from the Board. He spoke of the rapid pace in the health care
field, which has moved from the family practice orientation towards
specialized or subspecialist orientation, e.g., cardiology, oncology. With
this focus, the community hospital has responded with less referrals to
Denver and with upgraded technological services. Following are specific
topics discussed by Mr. Bakken.
Hospital policy on treatment of the low income.
Poudre Valley Hospital does not discriminate against anyone of any race,
creed, residency or income status. All will receive medical care and the
hospital will worry about costs later. This is not to say that collections
are not aggressively pursued. In re: free care, government programs do not
pay the full share for medicare and medically indigent patients, but
whatever is paid is considered payment in full. Those not covered must be
"qualified" to determine if they fall under charity care. If so, the
hospital forgoes the bill. Poudre Valley Hospital has an $150,000 per
month deficit for charity, medicare, medicaid and medically indigent
patient treatment. Of these, patients who have assets but do not want to
pay, collections are actively pursued. The " no assets" guidelines is the
same guideline as the State for medically indigent, i.e., income, number of
dependent, on a time -by -time basis. Applicants must reapply for this
consideration each time they are admitted, or they can reapply as an
outpati ent.
Availability and Cost of Ambulance Service.
Ambulance service which emanates from the hospital is the responsibility of
the hospital, and users are changed for this service. However, subsidies
are required by the hospital as all charges received do not cover the cost
of qualified paramedics, ambulances, and related expenses. The changes are
based on different grades and seriousness of the user's illness. Medicare
does not pay the $60 flat fee that is charged those covered by Medicare.
If an ambulance is called, but is not needed to bring the person to the
hospital, charges are only for paramedic services used. The $60 fee for
medicare users compares is %5 of private ambulance services.
Hospital's Current Building Program, Laying Off of Skilled Nurses
The building program is a modernization of these areas:
a.) critical care unit, based on present deficiencies
b.) kitchen and dining room facilities enlarged and updated
c.) obstetrical area, because of increased number of births and treating
of more ill infants locally rather than transferring them to Denver.
The modernization also includes changing the front entrance of the hospital
to align with parking near the entrance. The elevators, admitting, and
gift shop will be relocated nearby. The modernization is necessary to
reflect the changing needs of the public that the hospital serves. The
nursing staff has undergone recent changes, with thirteen L.P.N.'s laid off
and an adjustment of more R.N.'s to cover the work load. Attrition alone
could not cover the gap, so because of the building modernization with
necessarily lower occupancy, this was
staff.
Hospital Board Meetings
Board meetings are open to the public,
and even though they are open, there i
An agenda is available to the public on
from Mr. Bakken's office. The agenda is
but does not always appear.
e. Lack of Trained Personnel
good time to adjust the nursing
s
every third Wednesday at 1:00 p.m.
generally low public attendance.
the Monday prior to the meetings,
also distributed to the newspaper,
There are more professional staff with more R.N.'s on the nursing staff
than ever before, a 60/40 ratio of R.N.'s/L.P.N.'s. Critical Care utilizes
only R.N.'s. The hospital uses criteria specific evaluations and intensive
on -going training programs. The nursing staff receives highest ratings
from patients and staff. As patients are discharged increasingly earlier
from critical care unit by their physicians, there must be a corresponding
increase of on -floor staff to consider the activity of patients.
Early Dismissals
There is current debate on whether or not to dismiss patients earlier, as
the federal government changes medicare specifications and guidelines.
Medicare payments are based on a flat fee according to the diagnosis, and
hospital staff works with doctors as to whether a patient will be
discharged within or beyond the time limits of medicare coverage. Poudre
Valley Hospital has a staff person who daily visits floors and talks with
doctors about patients at "high end" of stay to check with their plans for
discharge and alternate care.
In discussion, Mildred spoke of a growing concern of the lack of
alternative places for some patients who are dismissed early. Mr. Bakken
pointed to the difficulty of judging "how early is too early" and of the
need to continue good communication between hone care agencies, such as
Home Helps and Visiting Nurses Association. Susan Pedersen offered the
services of the Health Committee from the Office on Aging to do a study for
Poudre Valley and McKee hospitals on patient discharge readiness and care
alternatives for a physical condition rather than the psychological
readiness to go hone and be able to care for themselves. Patti suggested a
senior advocate to work with the hospital's discharge planner as an ongoing
program. Mr. Bakken welcomed suggestions for further study.
Fees Charged by a Public Hospital
A public (community) hospital must realize a profit in order to buy
equipment, remain updated in training, supplies, and facilities. In
response to a question of members of a doctor's consortium refusing to take
Medicare Patients, Mr. Bakken replied that through the family practice
residency training program, the hospital will not turn down patients
requesting medical care. As a public hospital, there is no option of
whether or not to take patients. Joe remarked that Medicare funding seems
backwards, doctors should pay the hospital in order to practice there and
then charge the government for services rendered to Medicare recipients.
Mr. Bakken stated that there presently are no provisions to sanction
doctors for refusing patients. Furthermore he said, patients may to be
treated as inpatients without having a doctor. Without a designated
doctor, a patient cannot be admitted for inpatient treatment. A doctor may
treat someone but not accept medicare assignment and so will bill and
collect directly from the patient.
Other Business:
The Continuum of Care Coalition meets at 3:00 p.m. January 9 at the
American Baptist Church.
Ed Chilcott reported that the SILC Task Force feels that letter writing to
legislators was successful as there is a push in the direction of setting
limits on insurance awards in lawsuits. Suzanne told of a December 20th
concern and a new concerted effort to legally contain limits of awards and
place caps on insurance premiums. Mr. Chilcott also reported that the
REACH weatherization program has new information and qualifying guidelines
available in a brochure, and coautioned that old brochures contain outdated
guidelines.
Mild red reported that the Post Office/RSVP Carrier Alert program that
originated for elderly persons in rural mail areas has been extended to
city routes.
Pat Long reported that the CDRG meeting was postponed until Thursday,
January 9.
The Senior Citizen City Property Tax Work -Off Program will take
applications jointly with the County Program at the Courthouse from 9:00
J
t
a.m, to 11:30 a.m, the last week in January and the first week in February.
Printed information on guidelines is available.
Articles are needed for the Senior Service Finder.
Ruby reminded members to complete information for the LEAP packets and
return them to Public Service Company by January 15.
Paula will send a thank you letter to Mr. Bakken for speaking with Board
members and guests.
Meeting adjourned at 3:45 p.m.
Respectfully submitted by:
Paula Makowsky, Secretary