The Saline County Commission Tuesday reviewed home health care statistics and acted on several Health Department matters. Earlier, the City-County Building Authority discussed the impact of removing the signs banning handguns from the building.
Home Health Care Discussed
Armed with data, Health Department Director Jason Tiller supplied Commissioners with 17” x 11” spreadsheets of information about the other entities that provide home health care services in Saline County. Most other providers operate on a for-profit basis. If forced to decide between delivering community-focused, safety net services or maintaining the financial bottom line, most provide only those services that are adequately reimbursed. Tiller said that while most other providers take Medicaid and other forms of insurance, they may limit how many of these clients their agency takes.
Chairman Monte Shadwick repeated a concern mentioned by absent Commissioner John Price about whether the County should be in competing with private industry. Commissioner Luci Larson noted that the County’s home health agency does “what no one else wants to do”. Tiller said that without the service “some won’t be able to stay in their homes”. Tiller then contrasted the cost to society for an individual with limited means who needs home health care versus having to place that individual in a long-term care facility.
Shadwick wondered if the agency’s capacity was sufficient, given the County’s aging demographics. In contrast, the group noted that Concordia recently sold its home health agency to a hospital.
While a handful of interested citizens attended, the Commission did not allow public comment. Commissioners asked for additional information on income streams and what other counties are doing.
EXPO Center Director Rick Lamer reported that at last week’s EXPO Center committee meeting, some expressed interest in improving the appearance of the grounds near the Greeley Street Bridge. Others wanted to see the County outline what kinds of improvements might be made over the timespan of the desired fifty year lease. Commissioner Jim Gile cautioned on the need to keep the scope of proposed improvements within the budgets of the entities that wish to use the EXPO Center. Shadwick said he was excited that the City appears willing to discuss planned improvements and the possibility of extending the Kenwood lease.
Gile attended a meeting last week where new juvenile justice requirements were discussed. Gile cited the newly opened Martin House as a place to “make a better home for a child”, as opposed to juvenile detention. Gile reported that in three years, the Drug Court program has had a 95.5% success rate.
Larson reported that the new commercial air service, with direct flights from Salina to Denver, had 285 enplanements in the first month of operation. She said the goal is to have 1,000 people each month use the service. She noted promotional fares are still available.
The County Commission also:
- Signed a contract where the City will pay the County $631,268 annually to house the City’s inmates in the jail. This is an increase from $584,886. Commissioner Dave Smith expressed concern that the County would be responsible for a City inmate’s medical care, if that individual has no insurance.
- In a 4-0 vote, increased the rate charged by the Health Department’s home health program for skilled nursing, physical therapy, occupational therapy and speech therapy from $140/visit to $150/visit. The rate charged for home health aides will remain $80/visit. This change was recommended in the County’s audit and is expected to generate $38,280/year in additional income.
- In a 4-0 vote, signed the Universal Contract with the Kansas Department of Health and Environment along with the Ryan White Treatment Modernization Grant, the Maternal and Child Health Grant, the Family Planning Grant and the Children and Youth with Special Health Care Needs Grant. Smith questioned a non-discrimination statement in the Ryan White grant (that treats individuals with HIV). The contract states a same sex spouse will be treated the same as spouse of an opposite sex. Smith said, “I’d hate to think the Health Department was promoting that lifestyle.”
- Reappointed Gwenda Philbrook and Amanda Michaelis to serve three-year terms on the Health Department Advisory Council. Terms of all appointed members were initially staggered.
- Accepted a reduced budget from the Kansas Department of Corrections for Community Corrections’ Behavioral Health Grant. The budget had been reduced by $46,810 to $203,954.
- Approved budget line transfers for the Juvenile Services budget for Community Corrections.
Building Authority Concealed Carry Discussion
Charged with implementing by July 1, 2017 the Personal and Family Protection Act, the Building Authority discussed the possibility of permitting individuals to carry handguns on the first and second floors of the City-County Building. The third floor, which houses the District Court, is exempt from PFPA’s requirements. While the City and County Commissions have individually discussed the matter, the Building Authority–with joint representation of each Commission–will ultimately be responsible for complying with new requirements.
The City-County Building has five entrances. These can be reduced and all visitors can be directed to one entrance, though this may impact parking. The Fire Code requires all exits to remain as exists.
Building Manager Duane Grace estimated the cost of securing one entrance at $121,500 to start with and $91,000 to provide annual security from law enforcement officer(s). To secure two entrances, the initial costs would be $222,000 and then $182,000 annually. Grace spoke of the possibility of providing employees with key card access.
County Commissioner Dave Smith said, “If you have honest citizens with guns, I’m more secure”.
City Manager Jason Gage said the law allows for separate entrances for employees. He also noted that violence in the work place often involves the employees themselves. Gage said the Municipal Court and Salina Police Department are exempt from PFPA. Gage said the City Commission must still decide what to do with the Salina Fire Department #1 and the Bi-Centennial Center. Gage said that due to changes in the law, security guards must now be armed.
Ray Hruska said, “This is a taxpayer funded building and we are making it difficult for them to come in.”
Larson said venues are increasingly restricting what individuals can bring inside; she noted that for a Blue Angels performance, people who brought coolers to the gate had to leave them at the gate. Larson predicted, “There will be more and more restrictions”. The Courthouse has a place for individuals to secure cell phones if they are going to the third floor, and individuals who arrive in a vehicle can return to it to secure a weapon. Larson asked about the individuals who might arrive at the City-County Building by bus or taxi.
City Commissioner Trent Davis said he grew up in Washington DC. He said law enforcement officers often have a hard time knowing when to shoot. He said, “One wrongful death suit is expensive”. He said, “More guns on the street will lead to more discharges”. This reminded the group of the accidental discharge of a handgun in a local Salina cinema.
Gage said that employees have the right to carry, unless permitted restrictions are posted. Gage said, “Employers don’t have the discretion to use different rules with employees”.
Court Administrator Todd Heitschmidt noted that rural counties won’t have the money to secure their buildings. He said larger cities will have security.
County Commissioner Monte Shadwick wanted to hear what other counties are doing. Smith said he wasn’t sure that it mattered what others are doing. Shadwick agreed, but said “we’re not an island”. At least two people in attendance have been in an active shooting situation.
Don Merriman, County Clerk reviewed electioneering protocols. Anyone seeking to vote while wearing a political button or shirt will have to remove that item or turn their shirt inside out if they are within 250 feet of a polling place. This same prohibition exists for yard signs and vehicles. Because the 250 foot requirement potentially could affect properties that are “across the street” from a polling place, Merriman said that come Election Day, he may remove candidate signs that are too close.
The Building Authority also considered:
- Changing providers of elevator maintenance.
- Moving its election of new Building Authority Board Members from July to January, to parallel when both City and County Commissions will take office.
- The possibility of applying a protective film to windows on the south, west and east sides. At a potential cost of $14,000-24,000, window screens could then be removed. This would simplify the need to rent equipment when staff wash windows, once a year.