Thursday, September 22, 2016

Recent Board of Managers meeting

Ok guys, post this:

[ OK, here it is a day late. Sorry, I was out on service calls yesterday, and didn't get home until way late last night].

I went to the Board of managers meeting today at GRH4V. I inquired about the pop/vending problems, and the incident I had with a Dom Unit member 2 weeks ago. More on this later.

First, there was a lot of talk about what is being done behind the scenes, (in my humble opinion,) to clean up the mess left by the previous administration. I have been to many BOM meetings, including several under the former BOM group ran by Earnest Meyers, the disgraceful marine who was the chairman during the time I was at the home and while Sara Dunn was there.

This BOM is nothing like that one. These people had their act together and were very professional. We got reports on many things. Long term goals, of the Michigan Veterans Healthcare system (the new thing that runs the vets homes), reports on accountability of both Homes, actual numbers and costs. It was very refreshing to see a team of people who KNOW what they are doing, and are qualified to do it.

Remember what we said before? Before Leslie and Scott can rebuild, they need to clean up the mess?? Well the mess is all but cleaned up and now they are moving forward with plans for the entire state, not just GRH4V. They discussed a 6 phase plan for Michigan Veterans homes, with the GR home being rebuilt to actually be a usable viable place. Apparently the current design complicates health care and safe living conditions, or something like that. All new homes built will be on 1 level for residents. If there are 2nd floors, the upper units will be for staff offices, not living spaces.

A team of people including congressmen, veterans, and others took a look at other states programs and veterans homes that were Medicare/Medicaid compliant. Members of this team, individually came to the same conclusion and plan for the next Michigan Veterans home Model. The ones they looked at work well, and residents are happy with their living conditions. This is where Michigan wants to go. Ground work to reach that goal is already in progress.

A 6 phase program where 2 homes will be built first. Apparently they want smaller homes, 150 or so beds to each one. One in Downtown Detroit metro, one in Flint/Saginaw/Bay City thumb area, and one somewhere in north Central LP, and of course the 2 current homes in Marquette and GR will be rebuilt. All of this of course provided the state will give them the money to do it. Money will also come from the Federal VA and other sources and building the homes will create jobs.

Talk about SS Medicare compliant requirements. They are on track with getting this accomplished. Talk about a recent VA audit. DJ Home had 2 issues one of which was fixed before the auditors even left. GR still working on its issues, which have improved greatly.

The wording for the Ombudsman bill is done, and the Legislature expects to start interviewing prospects this coming Friday. They expect to seat the Ombudsman no later than 1st May 2016, earlier if they can.
GRH4V has a new Business manager. A lady. Didn’t catch her name. I also noticed they have a new numbers person. The guy had all the figures ready, and was at the top of his game. He had numbers, and policies both State and Fed, ready when asked about things, procedures, and possibilities of future spending’s, accounting's, and other such stuff. I was impressed.

The home got 2 letters from people who wanted problems addressed.

First was a visitor to one of the veterans. This visitor came all the way from Nevada. The guardian of the veteran refused to grant the visitor access. The visitor complained in a letter. Leslie told us that under State law, the guardian can prevent family members or others from being able to see a person if the guardian thinks the visitor will cause distress or harm to that person. And that this was the case in that situation.
They also got a letter from someone complaining about a staff member having a personal relationship with one of the residents, and why was the staff member not fired, when recently another staff member got fired for it (he was referring to the member bank Teller).

Both Leslie and Chairman Bob Johnson said with all the things the BOM has to do and the challenges facing the Administration that this problem would be way low on their list of priorities.

Since the letter was sent anonymously there was no way to respond to the writer, so the issue is now considered to be closed.

Now our Numbers guy was talking about REAL costs, assessed costs, and paid costs for members.
I was shocked when I heard him talk about the Dom units’ real cost. So after the meeting I talked to him and asked him for real numbers.

Under the current law, a resident veteran in Dom unit is assessed (charged) 53 percent of actual cost of care. The REAL cost to be in Dom, is just over 4k per month. WHAT?!!! Yes, 4,000+dollars a month. 53 percent of which is about 2300 a month. The Resident veteran, pays what he can of that 2300 a month. He is allowed to keep 100 dollars if he cannot pay it in full.

Now here is the part that most veterans do not know. The difference between the assessed 2300 a month and what the veteran does NOT pay for, accumulates on record, and if that veteran EVER comes into a large sum of money, the State has a lien on all future windfalls that veteran may get. Win the lottery, get an inheritance, etc., the state will send the veteran a bill for the unpaid portion of their assessed cost of care. So these guys with no income at all, are running up a big bill that some day might just be collected by the state.
What gets me, is most VA pensions, (unless you are 100 percent crippled, in a wheel chair, getting meals thru a straw) are less than 900 a month. Social Security Disability at 100 percent is about 1300 a month, of which 1200 goes to cost of care, leaving you with a balance of about 1,100 a month that starts adding up.
And I for one, GET SSDI, at just under 1300 a month and I live on this. I get help from other government sources, which brings my total to about 1700 a month, but even that is far below the 2300 a month they are expecting Dom Unit guys to pay. And even the 2300 does not cover the full 4,000+ amount it costs to have one person in Dom. The numbers guy told me the nursing units cost near or over 10,000 a month! (but again they only get assessed a percentage of that amount).

Like OMG, are you kidding me??!!! How can people afford to retire? This just blew my mind. And the 4k cost? That blows my mind. I look at this like manufacturing. The more you make of an item the cheaper it should be, right? Well, that’s not the case with the vets home apparently. 4k for an 8x10 area, 3 hots and a cot, and one full time nurse. Oh and they get to see the doc for sick call twice a week – If the home has enough doc’s to cover it, which at this time they do not.

Personally I think the cost of Dom unit is too much. It is a needed service for veterans. Its original purpose was as a Transition unit. And it was that way for many years. It will be going back to that. And that service is greatly needed.

And yes, there was discussion on getting more staff in the medical department (meaning more permanent (and qualified) doctors).

And finally at the end, during public comments. I inquired about the vending machine problem in Cozy Corners. Scott said he was working on it and that there is a process that has to be gone through because of the laws. First, prices are supposed to be set, according to local markets – which sell 20 ounce cokes for 1.75 or less, (1.75 and the 2nd one for 1 dollar, so 2 for 2.75 which means 1 should be about 1.35). Second, he got them to drop the prices on cans. And is working on getting the cost of the 20 ounce bottles dropped as well.

Also I mentioned about the machines set up to NOT refund money when an item was out. That you were forced to make another choice or lose your money. He is looking into that and was not aware that it was happening.

I think took up the matter about visitors having a form to write up an abusive resident. They said to report it to the residents nurse. I then said, in this case it would be Kathy up on Dom unit, what do you think would be done about that? Nothing. So after the meeting Scott and I talked about the incident with Don, and who witnessed it, and why there is a need for a form so that this kind of behavior can be tracked and checked.
Kim Olinger also mentioned the abuse she sometimes gets from residents. She is a volunteer, and an elder, and as such, can file a complaint of elder abuse against the resident. So between the two of us, I think we showed them that yes, we need a form for visitors and such to write up abusive residents. Since I am both a former resident, a veteran and a disabled person, I can nail ‘em for at least 2 things.

Overall, I think todays BOM meeting covered a lot of ground. I am very satisfied with what is going on in the background of the home. The old administration is gone. A new one is in place, and they have laid the foundation for the future of veterans care. They did quite a bit, and are moving forward. I think soon after the election you are going to see major changes and improvements at the home.

The old model of 1 big place is past history. GRH4V will be the last of the “big homes”, and will itself become the new standard for smaller, more efficient homes for veteran health care as we move forward into the new model.