For pharmacy technician Lesa Socha, residents of the Douglas County Health Center are more than just clients.
“We're not only their family,” she said. “They're our family.”
Attorney Mary Clarkson has found in the health center a place where her mentally ill clients can find “dignity, respect and very careful medical attention.”
And when it came time for Vickie Parks to get help with her mother, who has dementia, she found many health facilities that would not take her in. But Douglas County Health Center did.
“When people are in a facility like this, they need your understanding and your support,” she said.
In four hours of emotional testimony Tuesday, they and a few dozen other advocates persuaded the Douglas County Board to kill a proposal to consider outsourcing management of the century-old medical complex at 42nd Street and Woolworth Avenue.
At the packed meeting, which had to be cut short to accommodate the City Council meeting, some health center employees showed up wearing “Save DCHC” T-shirts.
Several voiced their concerns that a private company would institute disruptive cost-cutting measures that would diminish care for the county's most challenging patients.
Primary care doctor Cheryl Hinners predicted that an employee shake-up at the health center would increase behavioral problems of patients who have cognitive disabilities.
“This will really rock their world,” she said.
And Parks issued a challenge to the board: “Go up there and take some residents home with you for a while.”
In the end, the board listened, unanimously voting down a resolution that would have opened a request for proposals for an outsourcing plan.
Board member Mike Boyle, whose mother suffered from Alzheimer's and dementia, said he was swayed by the testimony, which “rang true with my own experiences.”
“You've got a convert,” he said.
As expected, the board also voted 7-0 against closing and selling the facility.
Instead, the board gave the health center some time to work through the recommendations of a $311,000 study by consultant Health Management Associates on how best to make up a $12 million budget shortfall.
The board did not specify a time limit, but managers asked for a year.
“As long as I have your commitment that that (review) occurs,” said Mary Ann Borgeson, the board chairwoman.
“You have my pledge on that,” said health center administrator Jim Tourville.
For years, the county has looked for ways to trim costs at the health center — home to 254 long-term care beds and two dozen in assisted living — and at the Community Mental Health Center, which has 16 inpatient beds and provides services for 1,700 outpatient clients.
Many clients cared for by the county are poor. Some have behavioral problems and were referred from health facilities that no longer would care for them.
Providing care is costly. Of an operational budget of $43.5 million for the health center and mental health clinic, $30 million goes toward salary and benefits for some 500 employees, said DeDe Will, the health center's finance director.
The county's $12 million subsidy has remained constant over the past five years as the health center's budget has been reduced or kept constant.
“Is there room for improvement?” Will said. “Absolutely.”
The key is finding ways to trim costs while maintaining quality of care, she said.
Douglas County Clerk Tom Cavanaugh, an outspoken advocate who is on the Douglas County Health Center Foundation board, put the center's share of the property tax burden for a median-priced home in Douglas County at about 2 cents a day — a worthy investment, he said.
Representatives of the Tea Party-affiliated Nebraska Taxpayers for Freedom spoke in favor of outsourcing. President Doug Kagan said a well-vetted private company can manage public facilities better than a unionized county workforce.
Kagan also suggested eliminating services at the health center and lobbying the Legislature to reduce the number of services that health centers must offer.
Clarkson said it's unlikely that an outside entity could do the job with the same dedication and professionalism.
“I am proud to pay taxes to provide a lifeline for our neediest citizens,” she said.
The board will discuss which of the consultant's recommendations to give highest priority at a meeting in two weeks.
Borgeson said the County Board has a moral obligation to provide care for its neediest residents. But it also must answer to taxpayers.
“The bottom line is, there's $12 million that's being spent at the health center,” Borgeson told the crowd. “And our job — our fiduciary duty — is to look at that.”
Borgeson said the board and the health center have a lot of work to do.
“When we start looking at these HMA recommendations, that does not take care of our shortfall. ... I want a budget without a tax increase, and that's what I'm going to strive for,” Borgeson said.
And if the health center doesn't become solvent, board member Pam Tusa said, “there's not going to be any patients for us to worry about.”
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