Despite dire warnings of sharply increasing taxpayer subsidies from Ulster County Executive Mike Hein, sentiment in the legislature seems to be leaning toward the county building and operating a new nursing home.
“I think we [meaning legislators in favor of county retention] have the votes,” said Minority Leader Jeanette Provenzano of Kingston at last week’s Health and Human Services Committee discussion of Golden Hill. Seventeen votes represent a majority of the 33-member legislature, but if Hein disagrees, 23 votes would be needed to override a veto. Republicans hold a 16-15 majority with two Conservatives joining their caucus.
Hein, in a report issued March 29 but not distributed to the committee at its meeting, again warned that this year’s $4.3 million operating deficit at Golden Hill could rise to between $6.5 million and $10.9 million next year and to between $18.6 million and $46.2 million (cumulative) between 2012 and 2016.
Hein, a Democrat seeking re-election this year, has refused to take a position on whether the county should privatize the 280-bed infirmary in Kingston. He has said that he wants those beds retained regardless of who owns them. Hein has called on the legislature for more than a year to make “a policy decision” on the future of public nursing care in Ulster County.
Hein, using an $84.1 million renovation figure produced by a legislative task force last year, estimates it would cost the county $39.6 million in construction over a 20-year period. Current state law allows up to 75 percent reimbursement.
New construction would cost an estimated $71.3 million with a total 20-year cost to the county of $25.9 million. Those capital costs are not included in Hein’s deficit projections of operating costs.
The facility is unique among Ulster operations in that it pays its expenses through Medicare and Medicaid and a few private-pay patients. The county subsidizes gaps between expenses and revenues.
Hein has said he wants the legislature to demonstrate where funding would come from should the solons vote to retain public control over nursing-home facilities. Responded Provenzano, “We’re paying $4.2 million with a zero tax-increase budget, aren’t we?” i.e., the county should raise taxes to support the infirmary. In round figures, each $800,000 in spending represents 1 percent on the tax rate.
But legislators speaking at a meeting of the Health and Human Services Committee last week seemed more concerned with what some called “moral issues.”
“When did money become more important than people?” asked Jim Maloney of the Town of Ulster.
Mary Sheeley of Ellenville said the county had “a moral responsibility to the elderly.” She wants the facility to remain county-owned and operated. If a new one is built, she wants some of the beds located to her area of the county.
Fellow Democrat T.J. Briggs of Ellenville expressed similar sentiments. “You can’t put a price tag on life,” he said.
Frank Felicello of Marlborough said that though “very few” of his constituents use Golden Hill the county should keep the facility. “It doesn’t matter what part of the county you’re from. We owe it to our senior citizens,” he said.
Carl Belfiglio of Port Ewen said the county had two choices: build a new facility or sell its license to operate a facility to a private vendor. He supports the county retaining ownership and operation. Delaying a decision he said would not be fair to residents or workers at Golden Hill.
Joe Stoeckeler of Ellenville said the county should not rule out the possibility of a non-profit organization operating the nursing home.
Don Gregorius of Woodstock said he was not satisfied with information supplied by the purchasing department on two requests for proposals and that the county should not rush to judgment on this issue.
Robert Parete of Accord, chairing the committee in the absence of Chairman Walter Frey of Saugerties, also advised caution as state reimbursement rates would in all likelihood go down this year. “Medicaid is under redesign. Everything will change again,” he said.
Parete spoke of more than 2,700 signatures on petitions to keep Golden Hill county-owned, with more than 1,000 signatures to establish an additional facility in Wawarsing.
More than 150 pro-Golden Hill demonstrators crowded the sidewalks in front of the county office building prior to the health committee’s 5:30 p.m. scheduled meeting last Tuesday. A few protestors advocated the county getting out of the nursing home business.
Of fiscal concern is that the executive used more than half the county’s $25 million 2010 fund balance to achieve its zero-tax-increase budget this year. County financial advisors have warned that Ulster “must have a financial strategy to offset significant increases in the tax levy [next year].”
The value of the county’s state license to operate its 280 beds has been estimated at more than $10 million, an amount that would restore most of the fund balance and hold property taxes in check.