Agenda - 03-01-2016 - 6-a - Minutes

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5 1 there is some disparity between fee-paying facilities and those available to those with lower 2 incomes, and that leadership turnover is a problem. She said Board volunteers try to be 3 supportive to the nurse administrators. 4 Commissioner Dorosin asked if there is a difference between this Board and the Nursing 5 Home committee. 6 Mary Frasier said the two groups are required by state statute, and it is at the county's 7 discretion whether to keep them separate or combined. She said a nursing home requires 8 skilled nursing, whereas an assisted living is more of a social model program where needs are 9 not medical in nature but rather connected to life skills. She said the work of the two 10 committees is identical. 11 Commissioner Burroughs said the work of the group is laudable. She asked if there are 12 enough volunteers for the Board. 13 Mary Frasier said if the committees are full, there are enough people to do the work 14 necessary of visiting the facilities quarterly. She said there must always be at least two people 15 on each quarterly visit, with three being optimal. 16 Commissioner Burroughs asked if there is a pattern to the timing of the visits. 17 Mary Frasier said visits are made at different times, in order to view different elements of 18 the facility's day, including meal times, evenings, leisure time, and weekends. 19 Commissioner Price visited a facility last year with this Board, and recalled its desire to 20 present to the BOCC about its work and what was going on in the facilities. She asked if such 21 a presentation could be added to a future BOCC agenda. 22 Commissioner Pelissier said a weakness mentioned is that staff have limited experience 23 with mental health issues, and she asked if local mental health providers have been contacted 24 to provide training of some sort. 25 Mary Frasier said the Committee has not done so directly. She noted that Cardinal 26 Innovations is involved in most of the assisted living facilities, as they now have a geriatric 27 education specialty team that is funded through the State. She said her concern is when young 28 people suffering from mental illness are placed in the same facility as elderly, frail patients with 29 the same conditions. She said this mixing occurs more in the Medicaid funded facilities. 30 Commissioner Jacobs asked if the number of beds in Orange County for nursing homes 31 versus assisted living is known, and if there is a waiting list. He asked if these numbers could 32 be forwarded to the BOCC. 33 Mary Frasier said yes, she can easily provide this information to the BOCC. She said 34 there are five assisted living facilities, all at a fairly low census and struggling financially. She 35 said Medicaid funded facilities are more full. She noted that there are few facilities that provide 36 both. 37 Commissioner Jacobs asked if there any models in counties across North Carolina that 38 work with people on government assistance to operate or subsidize nursing homes. 39 Mary Frasier said not that she knows of, noting that this is a big policy issue that 40 requires deep review. She said much depends on the federal government and for what 41 Medicaid and insurance will pay. 42 Commissioner Jacobs asked if this topic will be part of Master Aging plan update. 43 Mary Frasier she said it could be. 44 45 • Affordable Housing Advisory Board: Noah Oswald, Member 46 Noah Oswald said Chair Barbee had another commitment and had to leave, but he said 47 she did want to thank the Board of Commissioners for all that it has done, noting that the 48 Affordable Housing Advisory Board is at full capacity, which allows for more productive 49 meetings. He also expressed her thanks to the BOCC for including affordable housing as part 50 of bond referendum.