Fiscal Court - Regular Meeting

Sheriff Hillbrick, would you pray for us, please? Sure.

Bow with me. Heavenly Father, we thank you for this day, Lord. We thank you for your many, many blessings on our life. God, we particularly thank you for the air conditioning in this time of year, Lord. God, we ask for your hand of protection about our men and women serving the military and our first responders. God, we ask for your wisdom and your direction amongst people here at this court as they make decisions for the community, Father. And we ask that you give them your leadership in your name we pray. Amen. Amen.

We call this Marshall County Fiscal Court special called Meeting to Order, August 17, 2026. And our first guest today is Keith Travis with Life Coordinated. They've got a lot of great things going on over there. And Keith's going to share a little bit about what that is with us.

Well, I appreciate it, Judge and Court, for the opportunity to address you. It's a little bit of a daunting task to explain this program in a way that is understandable with all the benefits that exist, but I'm going to do my best, and then we'll talk about some of the, if you have questions, be glad to answer those. We're located at 201 East 11th Street, which is 100 yards to your northeast. We've been there two years and three months. And it's a program that's probably little known about outside maybe this court. I know some of the court members have had a chance to tour. But it's a very interesting program. My involvement has been about a year with the company. I really didn't plan on being involved this long, but I have to admit, as a retiree, as a senior citizen, I fully align with what they're doing, and I believe in their mission. And their mission is very simple. Simply stated, their goal is to help seniors live a longer, more productive life in their home. All of us have to care for elderly at some time. I don't think I ever visited my loved ones that were in nursing facilities that My mom didn't ask me when I left to take her home. As good as they are, and this is not a reflection on any caregiver, but home is the best place that people want to be. And so the goal of Life Coordinated is to provide that as a resource. So how do we do that? I'm going to explain some of the things we offer, and then I'll answer the $64 question, how do you pay for all this? So if you become a member of Life Coordinated, the brochure that you have tells you the qualifications. You have to be 55. You have to live in one of the six counties that we serve, Marshall, McCracken, Calloway, Graves, Hickman, or Fulton. If you become a member of that organization, final entry is approved by the state of Kentucky. So it's a duly accredited. So if you're on Medicare or Medicaid, duly accredited. We will pick you up at your home, provide you transportation to our facility five days a week. We'll provide you lunch and breakfast. We have an activities director. We have a OT, a PT to help you with physical needs. We have a technical room where they'll help you with your internet access. And for some of us seniors, they'll help you use your cell phone and get it straightened out. The interesting part is we also have a nurse practitioner on staff five days a week, and starting in November, we'll have a medical doctor, internal medicine, five days a week available. On the off-shift, what I would call the off-shift evenings and weekends, there's a nurse on call. We provide you your pharmaceuticals. We have our own pharmacy system. We provide those. We will help you. If you come to the facility, if you're a senior and your home environment is not safe for you to perhaps take a shower, you're concerned about babies falling, we have shower facilities. We help do your laundry. We will come to your home, help keep your home clean. we will get you to all your doctor's appointments. So if you need to see a specialist at Baptist Health, we will provide that transportation. And at the end of the day, the question is, what did this cost me? This cost you absolutely nothing as a senior. The company's real name is Commonwealth PACE. PACE is an acronym for Providing All-Inclusive Care for the Elderly. So if you've been on a cruise, it's all-inclusive. You don't pay anything extra. So now the question comes, if I pay nothing for it, who pays for it? Am I going to lose my social security? Am I going to lose my home? Am I going to lose my car? And the answer to that is you will not be charged any of those. You can keep your social security. You keep your home. You keep your car. There are some income limits that are applicable each month. There's some resource limits that are there. But basically what happens, and I have to admit I'm probably not a fan of many government programs, but this is a program that is actually working with government health care to provide better options. What we do is each month, if you're a Medicaid, Medicare participant, the government sets aside an amount of money for your care. And that amount of money is based on your severity. So they look at your health condition, and they assess it, and they say, here's what money we set aside. When you become a member of Life Coordinated, they send that money to Life Coordinated. And on the Medicaid side of it, they take 15% off what they would have sent. So the state is saving 15% off what they would have paid. That money comes to Life Coordinated. Wherefore, it was directed to me as an individual. It's now in a group setting. And so Life Coordinated becomes your primary care provider and your insurer. We only take new members on the first day of each month. So if you started the first day of September, the second day of September, you had to go to the hospital for a chronic health condition. Those costs are paid by Life Coordinated. Now, we do carry stop-loss insurance. We are audited regularly. Next month, we will have a CMS audit. We get four audits a year of our facilities, of our records, of our finances. But basically, what we're doing, and it's a fairly, if you think about the process, it's a fairly straightforward, simple process. If, Jason, we give you better health care than you've ever had, you'll be healthier. Many of our seniors we find live alone. They live with a dietary need that's not met. Some of them have no transportation. And so they're in an isolated environment. And if their health declines, they have one option. That's pick up the phone, dial 911, have an ambulance take them to the hospital. They go to the emergency room. They get treated in the most expensive care provider in the United States. If it's where they need to, you're put in the hospital for a day's observation. And if they can, you're discharged back home or to a skilled nursing facility. And that cycle goes on and on and on. Our goal is to help you stay out of that cycle, to stay healthier than what you would have been under without being a member of PACE. This article that I gave the judge is one from the National Conference. I think it was in April, posted in June. And it shows that members of life-coordinated have a longer life expectancy and fewer admissions than those in non-integrated programs. Senator Carroll toured the facility the other day, and I learned a lot about Senator Carroll. He had more interesting questions about health care and the benefit programs that are out there. I mean, he was really thorough. Our CEO answered every one of them, and one of them was, what are you going to do if you have Medicare cuts? And the response was, we won't be cut because our efficiency numbers are so much better than the other providers'. that will leave us to be utilized while others that don't have that efficiency may face cuts. So our goal is not to, we're not here to criticize anybody. We're not here to be competitive with anybody. We're here to offer a service that has not been offered previously. We do have statistical information. Even working with the judge a little bit, we have this dream. The CMS administrator is Dr. Oz. And I don't know that he's ever toured a PACE facility. And Benton seems like a good place to invite, and we'll see how that goes. But CMS is the biggest insurer in the world, and they cover more lives than probably any other organization. And his interest in it, if you get a chance to read the article, his interest is quite an endorsement of what they're doing. And the reason is it's providing longer lives and lower cost. I don't know where else you can get that combination. Now, there's challenges of facing this. Number one, when you go in and you talk to someone about this program, they say it's a scam. And as a senior who's been scammed, once you've been scammed by somebody, you're more attentive to all the details. It is not a scam, but in the same virtue, seniors are very reluctant to change. I know I am. Somebody comes in, I'd like to change your provider. If you sign up with Life Coordinated, you start the 1st of September. If the 15th of September, you don't think this program's for you, you can get out the 1st of October. It's a month-by-month contract. People are reluctant to change. We are not allowed. You will never hear me calling you on your cell phone offering you a $300 gift card for all the Medicare advantages. We're not allowed to cold call. So the only way we reach people is through the community knowing that we're here and through references. And so if you call us and say, I'd like for you to, if you know somebody that's interested and you give us their name, it's a seven-step process. Every person that we interview is tracked from the initial entry until either they enter the program or the reason they were not entered into the program. So accountability for what we do is pretty thorough. But we can't go knock on doors. We are working with some partners very thoroughly, and I'm excited about it. Mark Donahue from Marcella's is doing 400 meals a day and still has people on the waiting list that need assistance. Even Mark told us that in their program, they put meals on the doorknob. If they're not there, if they come back the next day, then they're going to do a wellness check to see about that person, but he said, we don't check on their physical condition. We don't check on their pharmaceuticals. We don't know what other issues are going on in that senior's life. So starting in November, our members can go see a doctor five days a week. They can see therapists. You know, if you break your hip, you're going to get a PT or an OT prescription for 15 visits. They're limited. In our environment, they're not limited. You can see them as long as you need to see them. We will provide you that transportation across the street. Every day you probably see three Fulton Transit buses parked down here at the Five Star. They are part of our transportation fleet. We have two of our own vehicles that we operate. That number is destined to grow. This facility can probably accommodate between 500 and 700 members. As we speak, our organization is opening another facility in Winchester, Kentucky, and another one in Springfield, Kentucky. All of these are destined to be rural health areas. There's 3 million Americans who are eligible for this program. About 4% of that population, 120,000, use it. It's really a challenge to market. I began as a driver, helping them out part-time, going to do that about a month ago. the CEO said, would you help us with marketing? Well, marketing isn't my forte, but I know a lot of people, and a lot of it's just communication, telling you what we do and why we do it. And I will tell you this. If you'd like to see the facility from the inside, you're welcome to do that any day of the week. We'll schedule a tour, take you through, let you see it. Seeing it is more impressive than my presentation because it's a little bit overwhelming sometimes to see all the things that are actually going on. But I see seniors that I've transported that we're not going to stop the aging process. That's not capable. But I see seniors that have stabilized and their life has become more orderly and their health is better. And I think, gee, that's what I'd like to do. And so that's the reason I continue my role with them as a retiree. And I encourage you to learn more about it if you've got individuals, churches. We've talked to churches as a group, individual churches. It's a matter of getting the message out. And again, we're covering six counties. But my goal is to really get as much started right here in Marshall County as I can because transportation costs are easier. And we can get the nucleus started and get it to the point we have. We're approaching 50 members now. But 50 is a long way from the 500 to 700 that could be using it. So we're going to be increasing that market presence, inviting people to Benton, to Marshall County, to see what the program is about. So that's kind of a 40,000 foot overview of it without taking too much time. I do appreciate your interest in the senior population in this county. It is, it is a significant part of our community and I appreciate your interest in their wellbeing judge.

Well, first of all, I'd like to say, uh, we're very fortunate and proud to have this facility in the county. And I remember the first time I came over and, uh, I think my response was, well, this sounds too good to be true. I was waiting, okay, there's going to be a catch to this. And then I thought, okay, how long a contract are they going to have to enter into? I was expecting a year or something like that. But 30 days at a time, they've taken away really any reason not to try this out and see if it's a fit for them.

We have several adults that are trying to care for their elderly at home. They're trying to work a job and provide that care. So we provide them that transportation over here. They're under our care during the day. We take them back home. But just getting them to the doctor's appointment. As an insurer, you might ask, we use Marshall County Hospital and Baptist Health as our network. One issue that comes up, sometimes people say, well, I don't want to change doctors. Well, our primary care doctor will be your primary care doctor. However, we will pay for two visits a year to your original doctor if you want to go back and see them. Why do we stipulate that our doctor is your primary care? Because you would be amazed at how many people come in with how many meds, and there's no coordination. And so for you to get better, Somebody needs to be looking at your health care plan on a regular basis. We have a team that does that for every member. I will brag a little bit on them. In January, when the snowstorm hit, they had a driver. They called every member every day to see if they had their medications, if they had food, if they had heat. And that might not seem like a huge task, but when you're a senior living in an isolated area of a remote county, That's a pretty big, and they had a four-wheel drive, and those that did not have were taken care of. And it got to where during the day, by the end of the week, they were looking forward to the call, expecting a call from life coordinator to check on them. We often say we do that in our churches, and we try to care for people, but it's hard to do that on a personal level, and to the point of medications and management to that degree. And so this is a different option. It's a different way of health care. And I hope it has a long future here in Marshall County. I think it will. I think it has a great opportunity in the state Commonwealth of Kentucky. Any other questions?

Is there a phone number people could reach out to?

There's one on the back of this brochure. And if you look at the brochure, it's got a little funny number on the corner. Every brochure we do is approved, first of all, by CMS. So this number is the front desk over at the Life Coordinated Center. My business card is on there. I have no clinical skills, and neither am I an expert in Medicare or Medicaid. But if you call, we'll get someone in touch with you that can help your loved one or someone you know do that. We are not a hard sell organization. When you go through the seven-step process, it's a pretty thorough review of finances, everything that goes on in your personal life. before Medicaid approves that. Eventually, the state of Kentucky approves every member. So you can call my number. You can call the number there on the brochure. But that is one that CMS has approved for us to use. And somebody will be there to answer it.

Yeah, that number is 855-209-5451. So, Keith, anyone can come in and tour the facility at any time? Do they need to make an appointment or anything for that?

It works a little better. We like to know if they can because, obviously, and then what I'm trying to do is four days a week I try to have a tour and invite some people through. So Mr. Thorpe's coming through tomorrow from the Marshall County School System. You might ask why. Well, because they see families and environments that we don't see. Mr. Kirtner's been through. Mr. Kotzinger from the ambulance service, the police, the fire department. Why? Because they make emergency calls. They see home settings for situations that you and I might not see otherwise are made aware. So it's a referral process, and we're open to anyone. I would like to schedule as much as possible. If you just walk up and knock on the door, it's secure. You'll have to wait there for the door to get an entry. But if you can make a schedule, I'd like to do that in an orderly fashion where we can get you through and let you see those facilities.

Okay.

Anybody have any more questions?

Thank you again for your support.

Well, thank you for coming in and sharing this with us. We appreciate it. Okay. Under old business, I need a motion to approve the minutes from the August 4th meeting. So moved. Second. Second. Any discussion? All those in favor? Aye. Any opposed? Motion carries. Ordinance 202605, budget amendment. Mr. Pagel is going to give us a second reading on that.

OK. So we're looking at an increase of revenue accounts. State grant $79,000. Grant fund cash balance July 1, $733,460.56. General cash fund balance July 1, $27,829.15. Road fund grant reimbursement $413,000 for a total of $1,253,289.71. The increase of expenditure accounts. Park Crumb Rubber Grant Project, $79,000. Bryant Road FEMA Project, $733,460.56. The Aurora Packaging Plant, $27,829.15. And paving, $413,000 for a total of $1,253,289.71. That's the second reading on this 17th day of August. Thank you.

I need a motion to approve and adopt. I'll move. Second. Second. Motion second. Any discussion? All those in favor? Aye. Any opposed? Motion carries. Day use parks, unless anyone has anything they want to add to that, I think we'll just postpone that after I'm just talking my opinion here. You all are certainly welcome to chime in. I think we probably experienced, hopefully, a one-time isolated incident. And I think it'd be hard to put something in place to cover everything. Unless we have other problems. Jason, you got any thoughts to add to that? Anybody else? I know Andy had reached out to some of the other facilities. I talked to Josh at Moore's. And I guess if we have something else come up, we'll deal with it then. OK, advertise for bids. Need a motion to advertise for a road department truck. We had one that was recently totaled in an accident. Thankfully, the occupant was not injured. Don't move. Second. Second. Motion second. Any discussion? All those in favor? Aye. Any opposed? Motion carries. Flex funds need a motion to approve and sign. So moved. Second. Second. Motion second. Any discussion? Glad. Yeah. I'm very glad. I want to thank Roy for all of his work on that. And, uh, I believe we'll soon as I can get everything coordinated, correct me if I'm wrong, but I believe we'll be using that pay bill road. That's correct. As soon as we get the letter back, they have gone in and replaced, uh, all the culverts down through there. I think there were 22 of them, uh, get everything trimmed and ditched and, uh, So we're very excited to be able to do that. Our flex funds come in a little less than normal. We were anticipating that. So it kind of is what it is. But we're very appreciative for getting that and being able to complete that project.

They're a billion dollars ahead, but 13 million behind on road funds. Imagine that. Anyway.

All in favor? I've got a lot I could say, but I'm not. Okay, did we have a motion on that already? All those in favor?

Any opposed? Motion carries. We were waiting on Monty to kick the horse. Yeah. Let me see here.

Let's see if I got that letter up here. I know you gave it to me. Now you gave it to me and I didn't make it up here with it. Okay.

I've got it in front of me.

Oh, you do? Okay. This next one is a grounds policy. I'm just going to let Andy. Read that to you real quick. Sure.

It's addressed to the fiscal court from August 7th of the day. Benton Partnership and Lake Kim are hosting a harvest fest on November 7th, so it's still a few months out, from 3 to 5, a two-hour block on the court square. Currently still in the planning phase. We hope to have activities on all four sides of the court square. Lake Kim is going to bring a Try to bring in a petting zoo and would like to use some courthouse space for this. Try to clean up any mess they have when they're done. A couple of hours on November 7th. There's a number to reach out to at the City of Benton. We can reach out to Beth Cooper if we need to for more information.

That would be courthouse lawn. I know you said courthouse, but it is courthouse lawn. It will not be in the courthouse.

The petting zoo, that would actually save us on fertilizer.

It would. And it might save mowing, depending on if they've got goats, you know, or something. Weeding can cut out on the weeding. We did check with a county attorney to make sure we didn't have any issues with that.

I move we approve. Second. Second.

Any discussion? All those in favor? Aye. Any opposed? Motion carries. Mr. Pagel, if you'd please notify Beth on that. About to happen. Board appointments. I need a motion to postpone to the next meeting. So moved. Second. All those in favor? Aye. Any opposed? Motion carries. We have no transfers today. I'm going to need a motion to pay the bills. There is one bill. We're going to have to add to that, and we got that all sorted out this morning, and this is budgeted. It's $125,000 to Miracle of Kentucky and Tennessee. That's for the completion of the playground. So moved. Motion to pay the bills including that. Is there a second? Second. Any discussion? All those in favor? Any opposed? Motion carries. Pertaining to the playground, playground is complete. We've got fencing scheduled. I think we're still... Couple weeks out on that. Once that's done, we've got a little bit of landscaping and curbing to do on the outer perimeter of the fence. And then we're going to do some sod. And we're working on getting things in order on the retaining wall down the side of that so we can add an additional 15 or 20 parking spots. So it's still kind of a work in progress. But I'm very excited to get the majority of it done. First game of the fall season is 29th. So they'll be able to see that and enjoy that while they're there. So very, very proud of that. I think it's turned out great. And we'll keep moving on to the next phases. OK, let's see here. Executive session, litigation, personnel, and economic development. Need a motion to go into executive session to discuss those per KRS-61810, 1C, F, and G. So moved. Motion to second. All those in favor? Any opposed? Motion carries. We'll call the meeting back to order. Hopper burial, all efforts have been made to locate family of the deceased. There's one estranged family member unable or unwilling to pay for burial or cremation.

Excuse me.

The new Senate bill, SB 27, amends KRS 72-451A and allows the fiscal court to order cremation or burial. With that said, cremation amount, $750.

I move we, I hate to, that seems like a crazy move to cremate as this pauper burial. Second. Second.

And pay the invoice also. And pay the invoice. Go ahead and include that. Yes. So we can get that covered in the bills. Second. Okay. Motion second. I want to thank our coroner, Kenny Pratt. He put a lot of work into this. It's everything he does. He's very thorough. So I want to thank him for his efforts on this. So I have a motion and second to cremate and pay the bill. All those in favor? Aye. Any opposed? Motion carries.

Just need a motion to adjourn. I'd like to make a motion to give Judge Spragues the authority to sign a letter of support to join the state in an economic development proposal for Project Meteor.

OK. Second. Any discussion? All those in favor? Aye. Any opposed? Motion carries. We've got a lot of momentum right now, economic development-wise, so we should have some really good announcements coming soon. Appreciate everybody's work, Elizabeth's work, and everybody's on getting these things done, looking forward to the announcements. Okay. I just need a motion to adjourn. So moved. Second. All those in favor? Aye. Any opposed? Motion carries.