By Mary Alice Murphy
Jeremiah Garcia, Gila Economic Development Alliance Board president, asked for introductions around the table. One was a surprise to many. County Manager Jon Paul Saari announced he had two more weeks after the April 25, 2014 meeting, as he had resigned the prior day. See http://www.grantcountybeat.com/index.php/news/news-articles/15454-grant-county-manager-resigns for more details.
As an introduction to the featured speakers, Garcia said people move into the area, want to stay in the area, but sometimes have to leave because of health issues. "That's my introduction to Bridge Community. In southwest New Mexico in the four-county area, we have no facility such as the one they are planning, which will go from independent living through hospice."
The featured speakers at the April 25 Gila Economic Development Roundtable meeting were board members of Bridge Community, a planned continuum of care facility.
The group recently received its long-awaited feasibility report, which confirmed the need for such a facility in the area. Josh Kalish, Bridge Community Board chairman, introduced the two that have been instrumental in pushing through the planned facility—Don and Marti Trammell.
The mission and vision of the group include a continuum of care that starts with independent living, to assisted living, memory care, adult day care, skilled nursing care through hospice care.
"We want people to move in while they are still independent," Kalish said. "The feasibility study shows the four-county area is high poverty, with a large amount of seniors. We plan 34 units for independent living. Assisted living will house those who have two or more daily activities they need help with. We will accept those 55 years and older, but also the handicapped below that age. The area has a large number of seniors living alone and seniors needing assistance.
"The plan anticipates that 85 percent of the residents would come from Silver City," Kalish continued. "Assisted living would be primarily for those 75 years old and older. The population of those older than 65 years in the state is projected to increase by 20.4 percent by 2025. In New Mexico senior care costs are high, with the monthly cost at $2,795 to $5,000. For a year, $31,000 is low, $39,000 is the average and $53,000 is the high. With couples, the price ranges would vary. In Grant County, 15 percent of the county, 1,661 people, are seniors living alone. Luna has 1,365; Hidalgo, 246 and Catron 622.
In the state, 41 percent of those older than 65 years have some ambulatory difficulty; 28 percent with independent living difficulty; and 44 percent have diabetes.
"Right now, there are 46 assisted living beds in Grant County," Kalish said. "Hispanics go into assisted living later because their families take care of them. About 13 percent of the primary market area will have memory problems by 2025. To accommodate all these needs, the feasibility study says 77 units are needed. In skilled nursing care, the estimate is that we would capture up to 65 new residents. In adult day care, it is common for one in a couple to be independent and one needs care. That need has been added to our goal, with the recommended capacity for 10 participants a day.
"In Phase 1, we want to begin with independent living, assisted living and memory care," Kalish continued. "Phase 2 would include skilled nursing care, adult day care and hospice services by local hospice providers."
The next steps are to create a request for proposal for the community-care campus facility. For the final steps, Kalish has suggested holding a charrette or town hall meeting to invite everyone to provide input.
Grant County Planner Anthony Gutierrez asked if a developer or contractor were involved and if the developer fees were included, to which Kalish said yes.
"Given that such facilities are highly regulated, it will not just be building a building," Kalish said. "It requires a lot of expertise. We will find a firm willing to participate and partner with us. We were told the plan is not feasible unless we bring in a developer."
Melanie Goodman of U.S. Sen. Tom Udall's office asked if the group were looking at private, as well as non-profit funding.
"Yes, the bottom line is it is a business, whether it is profit or non-profit," Kalish noted.
Don Trammell said the group wants to keep it non-profit to keep costs down.
Tom Vaughan of FeVa Fotos asked if the group has in-house expertise on its side.
Kalish said Bridge Community has ongoing relationships with local architects, people with construction experience and people with medical expertise. "It is critical we have partnership of the entire community."
Gila EDA member Skip Thacker asked that local banks be involved in the process.
Don Trammell said that one of the board members has a Ph.D. in geriatric studies.
Garcia noted it would have an impact on nursing. "How many employees do you anticipate? And I know the cost of infrastructure will be high."
Kalish replied that 45-50 employees would be required initially, but he didn't remember the number of skilled nurses needed.
Marti Trammaell said one full-time nurse is required to be awake at all hours in assisted living and an additional one for every 15 residents. "In skilled nursing care, an RN would be required on duty all the time, plus another three to five for every 15 residents. These are based on state regulations. At any given time, not all rooms will be filled."
"That is needed because for the continuum of care, it needs for a resident to be able to move easily to the next level of care, so we need some excess capacity," Kalish said.
Chelsea Hotchkiss of Insurance First, to a question, advised people to purchase long-term care insurance, instead of using all their assets to qualify for Medicaid. "Once a person is in long-term care, the average is five years or less. Get the policy before it's needed."
Joel Schram of AmBank said banks could be involved in bonding or through trust departments.
Pam Archibald of Western Bank said such a facility could possibly qualify for grant money and state money through the finance authority.
Goodman said she would do some research. "I commend you all for how far you have come. This is jobs. I have a question about the workforce. It's an issue New Mexico deals with, especially in rural areas. You need to have these conversations with the university and the chambers."
Marti Trammell noted one of the board members, Sherri Bassi, has experience in elder care. "We could also use the facility as a clinical experience for student nurses, who would then perhaps stay in the community at the facility. Both hospice groups would cover our needs."
Cissy McAndrew, Southwest Green Chamber of Commerce director, said her mother is in assisted living and the challenge is workforce.
Arlene Schadel, Gila EDA member, said she was very glad to see adult day care, because that was in issue with care for her mother-in-law.
Marti Trammell concurred that respite care for caregivers is very important.
"If this were easy, someone would have already done it," Kalish pointed out. The need is here; the demand is here; and the community will make it possible."
Vaughan asked if it were large enough.
"It is designed for expansion," Kalish replied. "We are designing the infrastructure to allow for expansion. It will have a core to which we can add wings."
Gutierrez said that keeping the facility non-profit could bring in issues. "If you are bringing in a water line, for example, and it is a public/private group, it can qualify for Colonias Infrastructure funding and such."
Thacker said the group has had conversations with the city and county.
"We have to, one, support it; two, get marketing from insurance agents on long-term care policies; and three, make sure people in the banking industries start thinking about it," Garcia said. "It brings us together as a team. It's time to get the word out. We're getting older and there is a need in the Southwest New Mexico area. We all have stories. We want to keep our family members here with a good quality of life where we can visit them. The community has to come together."
Don Trammell said Bridge Community has had excellent community cooperation.
"I would like to thank Freeport-McMoRan Community Investment Fund for its grant for the feasibility study," Kalish said.
Schadel commended the group for its monthly fundraising dinners. "You have worked so hard."
"We don't make much on the food, but the tips are great," Marti Trammell said. "We have received $1,000 donations and one couple gave us $10,000 and they came only for a bowl of soup, and then they leave this check."
Thacker noted that May 6 is Give Grande NM Day, with about 40 local non-profits vying for donations "including Bridge Community. The website is givegrandenm.org. Wi-fi hotspots for donating are at the Silver City-Grant County Chamber of Commerce, the visitor center, Javalina, and other areas around town."
The rest of the meeting will be covered in a future article.