While County Executive Mike Breslin waits for the amendment to his plan for long-term care, which includes the construction of a new skilled nursing facility, to arrive on his desk, Breslin said the county cannot afford to operate and maintain the facility that Albany County Legislators are proposing through the amendment that was passed at a meeting on Tuesday, Oct. 13.
We must move forward to expand home and community based services to give people more choices in long-term care, Breslin said in a statement Wednesday, Oct. 14. `If the county continues to operate a nursing home, deeper cuts in these, and other county services and significant property tax increases would be needed.`
Last week, during Breslin’s 2010 Budget announcement, the county executive proposed laying off 74 nursing home employees as part of the plan to ultimately phase out the county nursing home and instead, bring more in-home care programs to the county as part of a long-term care plan he introduced last month.
But at the county legislature’s meeting on Tuesday, legislators showed their support for a new nursing facility when they approved the amendment which asks for a comprehensive study looking into the size at which a new nursing home should be built, including number of beds, and asking for a new nursing facility to be part of the county executive’s long-term care plan with a 36 to 2 vote.
Several people who spoke in favor of a new nursing home referred to a three-legged stool, calling assisted living care, home-based care and a skilled nursing facility the three pillars that are needed for a true comprehensive long-term care plan. But the two legislators who voted against the amendment, Charles Dawson, D-Glenmont, and Dr. Patrick Timmins, D-Latham, said that a strengthened home-based care can provide those pillars without needing a costly new facility.
`The major problem is that the building of a county nursing home will take away from the money that we need for community based resources,` said Timmins. From a medical standpoint, Timmins said that the difference between institutionalized care and home-based care is the one-on-one care.
`What happens is that at home, you get individualized care,` he said. `Patients do better when you adapt the care to their circumstances.`
Dawson said that the reason he did not support the amendment was because he does not think the county will be able to handle the fiscal responsibility without assistance from the state or federal government, and because he does not think the county has been managing the nursing home fiscally well.
`I don’t think we’ve done a very good job of running a nursing home. Fiscally, we’ve been hemorrhaging for years and it’s not just a question of our management,` he said.
Dawson said he thinks the county’s money would be better spent on strengthening home-based care and programs for the caregivers that administer that care. He also said he could not approve a new nursing home not knowing where the money to fund the facility would be coming from.
`I didn’t get up and speak because I respect where [my colleagues] are coming from. I’ve been thinking about this for a very long time,` he said. `My colleagues have very big hearts, I just hope that they have very big wallets to go with them.`
The legislators who introduced the amendment are not certain how much money would be needed for the new nursing facility, and, according to Majority Leader Frank Commisso, D-Albany, that amount could not be known until the county executive meets with experts to discuss plans and designs, as well as the costs of running such a facility.
`Until we get the professionals-which is the next step, the expertise, and until we get the design of what we’re going to build precisely, we can’t put a price on it,` he said.
Commisso said that he did assume the money could come out of the county’s $68 million capital projects fund, but Mary Duryea, spokeswoman for the county executive, said that funding the operation of the nursing home would not be able to be paid from that fund.
`In terms of the actual construction of the nursing home, the construction we would get state reimbursement for,` she said. `The actual cost is the operation of the facility year to year and that money wouldn’t be able to come out of the capital fund.`
The county did, at one point, have two operating nursing facilities at one time, but as per the Berger Commission’s recommendations, the Ann Lee Home was forced to close.
Commisso said it would be nearly impossible to renovate the Ann Lee Home, which currently is not being used as a nursing facility, into the new nursing facility without spending more money than to build new.
`That building is very old. It’s got walls that are probably 20 inches think before you go through them with jackhammers,` he said. It’s much cleaner to build new and secondly, it would not meet what we had discussed for the past several months.` One of the features the Ann Lee Home would not include that has been part of the discussion is private bathrooms for each of the rooms.
Duryea said the amendment would most likely reach the county executive’s desk sometime this week. She also said he does have the power to veto the resolution, and that the county executive has not yet made a decision on the resolution but would be looking it over very carefully.
If the county executive does decide to go forward with plans for a new facility, Commisso projected the project would not begin construction until a year from now at the earliest.
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