 Welcome to Sheboygan County Government. Working for you, my name's Adam Payne, Sheboygan County Administrator, co-host of this program with Chairman Bill Gearing. And today we're very pleased to have a special guest, Dale Pauls with us, who's Director of the Healthcare Centers. Dale has been on this program before, provided some valuable information before, but as we'll conclude in the program today, this will be his final TV8 program with Sheboygan County. Dale, it's good to have you with us. Thank you, Adam. Earlier this summer, the Healthcare Centers made a rather significant decision, and that was that Sheboygan County should look at the possibility of privatizing our Sunny Ridge Healthcare Center, either leasing it or selling the facility. There's been some work done to get some providers to possibly explore that option with us. And the first question I have is, please begin by providing a little background as to what's led up to this decision of possibly leasing our Sunny Ridge, especially if you look back at the last four or five years. Be glad to. Actually, if we go back five years, we go back to when the county had decided to close comprehensive and consolidate with Rocky and All. They invested approximately $6 million in a new building on that campus for the developmentally disabled, and we did some remodeling. So that was accomplished in July of 2002. By 2003, with the county taking a look at what the future might be for the Healthcare Centers, doing some 10-year projections, we were seeing right away there that tax levy was gonna be increasing due to a number of things, but one primarily with the additional money that we had been receiving through a federal program was diminishing significantly. We had $8 million in 2002. It was gonna drop to five, and so in November of 2003, Chairman Gehring appointed a Citizens Task Force, and their task was to explore and evaluate options for the Healthcare Centers, and it was due to, as I said, funding changing, but also what was going on as far as long-term care, escalating dollars that were needed from the subsidization by taxpayers and our increasing wages and benefits that were coming along. So that committee was established, as I said, in November, kind of simultaneously the, or not kind of, we were engaging Gunnison and Graham Healthcare consultants to look at an operational study of the two Healthcare Centers. By June then of 2005, the Task Force had brought forth recommendations to the Healthcare Centers Committee, including the recommendations from Gunnison and Graham, and basically we were looking at what were some of the alternatives that could be provided as fire services at Sunny Ridge, wage and benefits, whether there was ways to make concessions in those areas, and then downsizing the facilities. From there, the Healthcare Committee's virtually been working on that up until this point. Some headway was made in the area of wage and benefits. We approximately saved $1.6 million, or 1.4, I should say. However, trying to negotiate with the unions to maybe outsource laundry and housekeeping, have them contribute, all the county employees contribute more toward the retirement plan. Some of those things, there was efforts made, but just not headway made. So the challenge that the Task Force had laid out was that we should try to reduce the tax level by approximately 75% at the time, and that was $3.2 million. We know to date we certainly have not been able to reach that. During the time, the five-year period, tax levy has continued to increase. In 2003 it was like at 2 million, then it jumped to 3 million. In 2004 and 2005 it was at 5 million, and we know today it's at 6 million. So in the Gunnerson Graham report, they had recommended we go through the downsizing and we do look at alternate possibilities of the use of the North Building, which we went out with our request for information on. Didn't find anybody that was really interested in it. But in addition to that, they said, if you go through all of these processes, the other things that we should look at is potentially selling or leasing sonnage to see if there is interest in that. That request has been made. Which brings us up to 2006, and obviously Dale just covered a lot of ground at a very short period of time, and summarize your summary. I mean, we went from a tax levy in 01 of 1 million to a tax levy of 6 million as it stands today. We went from every department having no more than 2.83% increases county-wide, 23 departments to one department having over a 483% increase over that period of time. So it's just been a tremendous challenge that Dale and his team have had to contend with. And to the credit of the county board, there has been a lot of activity and a lot of alternatives explored. And I think the Health Care Center's Citizens Task Force, the advisory committee that Chairman Gearing recommended to the county board, and the full county board ultimately reviewed and appointed, that really I think started raising awareness in this community that some things have got to change. We have to look at some different options. And obviously there's been a great deal of work that's ensued, but as you said, in 06, we're looking at a situation now because of these escalating costs and the continuing decrease in revenue from the state and federal government and other factors. We're looking at the possibility of privatizing, leasing or selling Sunny Ridge. What's the status of the request or proposal at this time, Dale? Well, interested parties are to submit their proposals by tomorrow, September 22nd. To my knowledge, we have one definitely interested provider. There was a due diligence committee that was appointed made up of Bernie Romer, who's the purchasing agent and pretty much is the leader of that committee, along with Carl Beesing, the corporation council, Tim Finch, finance director, Mike Collard, the human resources director, Ken Conger, who is a member of the health care center's committee. Mike Van der Steen, chair. Mike Van der Steen as chair of our committee is on that. Yes, I don't know if I'm... Yourself? Yes, all three administrators are part of that committee. I mean, our viewers might be wondering, well, what is a due diligence committee? What is the objective of this committee that you just described in reviewing the RFPs? What are they supposed to do? Well, first of all, those that were interested and there were several that were interested initially, we conducted tours of Sunny Ridge and interviewed the representatives from the interested parties. Once they submitted their interest, we were taking a look at, many of them have operations in the state or we were looking at how they staffed those facilities, how they were going financially. It basically, to take a look at what their operations were like and how solvent those organizations were. Because we certainly aren't gonna bring anyone in here that isn't gonna continue to provide excellent quality care. And I know you've mentioned and the health care center's committee have mentioned that first and foremost, our residents and their care and the quality of that care and what happens of them is number one. And in fact, along those lines, and certainly correct me if I'm wrong, but I believe the health care center's committee stated that no residents are gonna have to be relocated or moved out of Sunny Ridge if in fact we lease or sell Sunny Ridge. Is that correct? Yes, that's correct. That's always been the position. So the due diligence committee reviews the different providers. As you stated, it's down to one now and they're reviewing and getting more information about this provider and the potential for leasing or selling who ultimately will make the final decision on whether or not Sunny Ridge is privatized. Well, the county board will make that final decision. The due diligence committee will bring forth information to the health care center's committee with advice to them. They then would take their recommendation to the county board. So Bill's not gonna do this on his own. Chairman Gehring isn't just gonna say this is what we're gonna do or you're not gonna do that or I'm not gonna do that. Ultimately the full county board, 34 county board supervisors will make that decision. Yeah, that's been the decision that they would reach. When do you anticipate some type of decision being made one way or the other? If you follow the earliest scenario, it could, the decision could be reached as early as December of this year. The committee would bring forth, or the due diligence committee would go to the health care center's committee. They would bring it to the board by November. That would be referred to committee and then back to the board to make a decision in December. Probably an aggressive bit of optimism that is gonna happen that fast because there's still a lot of due diligence if in fact both parties are very interested in a sale. So my guess would be more like the first quarter of 2007. And I know that at least the three providers that we heard from, they had an open presentation at Sunny Ridge a couple of months ago. And I know all three providers said that if in fact they lease or purchase Sunny Ridge, they certainly wanted to maintain the majority of our staffing. Absolutely. Staff that are there and would need to work with them with a new bargaining contract, what have you. And all that takes time to work through as well. Does. Very good, thank you, Dale. Okay, Dale, we've been talking about either selling or leasing Sunny Ridge, but things also are happening at Rocky Knoll. And in fact, our viewers probably know that the ICFMR known as Woodland Village is closing. Could you explain what the ICFMR really is and why we're closing it? The acronym stands for Intermediate Care Facility for the Mentally Retarded. It's, as I said earlier, the building that we built in 2002, thinking that that was gonna be their home for the developmentally disabled. So that's where they have been living. However, in 2004, there were some statutory language that really changed what we're now looking to do in regards to where they will be living in the future. If I may, Chairman Gehring, I just wanted to make a comment there because this is a great example of how quickly the dynamics of this area can change. And perhaps that's where you were headed, Dale, but for the county board to make the decision to consolidate from three facilities to two, ultimately it was about an $8 million investment. I think it was $8.9 million at Rocky Knoll, six million of which were probably just for that wing and some of those amenities alone, as you mentioned earlier. And then two years later for statutory changes to occur that now are requiring a different approach and working with the community to relocate these residents to the community, which ultimately may be a wonderful thing to do for the quality of their lives. But if you're a county board supervisor, you've just made a decision to spend six, eight, $10 million on infrastructure improvements. And two years later, you're completely shifting gears. And sometimes I think people in the community may wonder, well, what is going on here? And that's an example of some of the dynamics that we're dealing with. Maybe I can add a little bit more to the closure piece. Statutorily, first of all, at the beginning in January of 2005, people could not be admitted to the ICIFMR unless it was determined by the court that they were in their most integrated setting. And the most integrated setting definition is is that these people will be able to live with people, the majority of the time, other than with their peers. So it basically led to people being able to be placed in group homes in the community. We knew that with admissions basically being frozen, it was gonna be a gradual decline. As you gradually decline, it's not a very efficient type of being able to operate. And so in December of 2005, the recommendation was the healthcare centers that we close it and work with health and human services on community placement. So how has this plan really been implemented? Moving 37 individuals is a major undertaking. What departments work together on that and how has it been coming along? Well, it's a combination of departments for sure. Obviously staff from at Rocky Knoll, but Health and Human Services has probably the biggest responsibility because they first of all had to find providers in the community that we would be able to transfer. So that process has been going on. They engaged four or three different providers to open up new homes and renovate. Along with our two departments, the state of Wisconsin has several individuals that are basically overseeing this along with the ombudsman and disability rights Wisconsin, which represents people under 65 in these meetings. We've been meeting, we began seriously the process in February with 31 residents. Today we have eight in the facility. So it has been really progressing well and those residents that have relocated positive responses back on how they're liking living in their new arrangements. Is there a specific date when Woodland Village will be officially closed? It is now gonna be October 31st of this year and I say now because we were hoping by September 30th, but due to some unforeseen problems, excuse me, in regards to one of the projects we've had to extend at 30 days, but it will be closed as of October 31st. The physical plant where Woodland Village was is a very nice place. What are our plans for use of that facility? The plan would be to transfer 37 skilled beds from Sunny Ridge to Rocky Knoll, replacing the ICFMR beds so that then we would have a complete total of 195 skilled beds there. Our goal is to operate those mainly as rehabilitation beds. Some emphasis on short term, but certainly not that if someone comes into Medicare and maybe their longer would be able to be there as well as those are all private rooms. So if other parties within the residents within the facility are interested, they could move to a private room in Woodland Village. Is there a greater benefit to the community for having more rehab beds in the area? Yes, I think this is where we see the demand growing more and more as we look at what the role will be for a long-term care facility. It's a little bit of a misnomer. There always will be some residents that aren't gonna be discharged back home, but more and more are being discharged to alternate placements, dollars are being provided in the community to maintain them. So rehabilitation is a strong emphasis. The other part of it is that we want to start doing a little outpatient rehabilitation where people can just come to the facility, get the therapy and go back home. So I see it two-fold. Filling a niche for short-term rehab as well as community involvement from an outpatient basis. How do we plan to market this shift in who we hope to have enter our facility? Several ways. We're just about to complete a brochure for all of rock and roll, but we will have a specific insert in that brochure that concentrates directly on Woodland Village and what we have, the services we have to offer there. Probably we're looking at opening that by mid-November. Within a month we would have an open house that we wanna invite the public and other key players to. We talked this morning in a meeting that we're gonna develop a PowerPoint presentation that we're taking to the community, to different groups, seniors, some of the other groups in the community. So kind of a combination of, and the key also will be to talk to discharge planners and physicians, and they'll be brought into this marketing plan. Okay, and Daly, I would just like to thank you on your final show of your 12 years of service to Shebaegan County. Well, thank you very much, Chairman. Drop the balloons, Dale. You've covered a fair amount of ground and obviously gotten into some detail about Sonny Ridge and the RFP and Rocky Null, and I think most people in this community after the five years of discussion really about our healthcare centers, I think most people now are recognizing, change is gonna happen, needs to happen, and as you well know, as well as anyone, there have been changes at the federal and state level with policy changes. There is more emphasis on providing alternatives to traditional nursing home care. We've seen a significant decrease in the funding that's been provided to own and operate two nursing homes. As you touched on earlier, IGT funds or intergovernmental transfer funds have gone from a high of $8 million to now about $2.5 million. We've seen skyrocketing costs associated with health insurance. It's gone up over 120% in five years, yet at the same time Medicaid to support our operations has gone up just a couple of percentages. I mean, we've really been dealt a difficult hand to play here and I think to the credit of you and your staff, all the residents or staff at Sonny Ridge and Rocky Null, but certainly the county board, we've been making some changes and one question our viewers may have is, well, what does this all mean? Sheboygan County is one of 72 counties. We currently have two facilities. If we sell or lease Sonny Ridge, we're gonna continue to own and operate Rocky Null. How many beds will we actually own and operate in comparison to other counties in the state? What's the state average? Could you shed some light on that, please? The capacity at Rocky Null would be 195 and the most recent statistics show that the average number of beds in county operated facilities is at 128. So we're considerably still above the average and probably will be ranked anywhere from second or third in the state with the number of licensed beds, even operating one facility. So despite some of the letters to the editor, people may read criticizing the county board or the healthcare centers or management about the changes that are occurring. Bottom line is as it stands today, we own and operate more beds than any county in the state of Wisconsin. And even if the county board chooses to lease or sell Sonny Ridge, we're still gonna own and operate more beds than the vast majority in fact be either in the top two or three in the state. I mean, rather remarkable frankly from a standpoint of all the challenges that are going on from a fiscal standpoint. You've been with us as Bill said about 12 years now and earlier this year, in fact I think it was the spring or early summer, you said that you're gonna start another chapter in your life and retire. And as you know, Dale, I'm certainly gonna miss you and the county as a whole is gonna miss you. But based on that experience you've had, not only in Sheboygan County, but your previous experience working with nursing homes, in your opinion, what do you think the mission of our healthcare center should be in the future? Where are we headed? Where should we be headed? Well, I think we need to head toward what was originally the mission of county facilities. How they started out, caring for the most needy, the most difficult. Over time we got into caring for residents that today can be cared for by the profits in the for-profit and non-profit sector. I think there always will be a need for us because of either they're not able to provide those services in those facilities or they choose not to. And I'm talking about behavioral people that may have an Alzheimer's diagnosis, the mentally ill, those kinds of residents. I think, as you said, talking about size, by doing that and knowing what the trend is, is that it's gonna continue, the need is gonna continue to drop, but for more specific needs, that's where our niche is, is a county facility. Now, having said that, the challenge still lies there as far as being able to maintain a tax levy that's reasonable. I see that ongoing at challenge. The things that are affecting it right now are gonna affect it in the future. We need to be very cognizant of getting the best contracts with our labor unions. We need, at Rocking Oil, hopefully to make it very successful on the revenue side with the Medicare population. So it won't be easy to fulfill that mission, but I think with, I'm hopeful that it can be because I do feel county homes, serving that purpose are needed. As I think about your tenure as our healthcare centers director, as I've shared with you before, if you look at previous directors, they haven't lasted as long. You've hung in there during some very trying, challenging times, and as you look at your career at the healthcare centers, what do you look back on as being what you deem to be one of your more impressive accomplishments or an area where you felt you made a difference and you think fondly of? Well, a knee-jerk reaction would be being able to survive for 33 years in the long-term industry. No, but as I look back, I think particularly I look at Schwoing County and being a part of a team that was able to make the consolidation of two healthcare centers, that was a major undertaking and it took a team to do that. And so I feel pleased to have been a part of that. But overall for my, the whole history is just feeling that wherever I've been, I've had a team that provided the best care that we could provide. And that's what we're in the business for, is to make those individuals' lives that are living with you the best. And I think that's probably my most memorable moment or of thinking about accomplishments. Well, Dale, we only have a few more minutes left and again, share some important information if folks do have additional questions or concerns. Certainly I know they can contact you directly or a member of your team, Gene Stark at Sunny Ridge, the administrator there, Kayla Renz, your assistant at Rocky Knoll or any member of our staff at the healthcare centers. But certainly on a personal note, as I look back at your track record, I can recall when I started here eight years ago, there was a tremendous amount of concern about comprehensive and going, as you said, from three facilities to two, consolidating that. A lot of concern in regards to the welfare of the residents and do we really need a new building? And after it was all said and done, we provided residents with a state of the art facility that meet today's codes and standards. And it just turned out to be a tremendous success story, but it wasn't easy. And you obviously provided a very important leadership role during that as you have with the healthcare centers advisory committee and everything we've done along the way. And I can tell you on a personal note that I'm gonna miss working with you. And I think you've been a tremendous asset to Shambuagon County. So I thank you. Well, I thank you very much for those words. I've enjoyed the 12 years, as you said, it's been challenging, but I think that always makes work more worthwhile too. So in many respects, we'll miss it. In other respects, it's time to devote some of my life to a grandchild and some of the other interests that and family in general that may have taken a back seat in my work life. So. Well, good to have Mr. Paul's with us today. If you wanted to touch base with Dale, just to wish him well. He's certainly not leaving tomorrow. I know his last day is gonna be in early January. So he's gonna be with us for a while. And as he said, he's got a good team in place and we'll continue to take on the challenges that present themselves and try to do the best we can for the benefit of this community. But until next week, or next month, rather, on behalf of Chairman Bill Gearing and the County Board, and again, my Adam Payne County Administrator, thank you for joining us. Next month, Mary Beth Emmerichs, the interim dean of UW-Shambuagon, Shambuagon filling the very large shoes of Dean Ray Hernandez, who departed that position a little while ago, is gonna be with us to talk about her vision and some of the real nice activities that are happening here at UW-Shambuagon. So again, until next month, thank you for joining us.