Weeks after taking office, Albany County Executive Dan McCoy has found himself embroiled in a debate that his predecessor found impossible to close: the future of the county nursing home.
McCoy raised the issue in his State of the County address and came under fire for a perceived shift in his stance when compared to his time heading the Legislature. In a recent interview, the new executive said it all comes down to dollars and cents.
“I haven’t changed my values. I strongly support our seniors, that will never waver,” said McCoy. “What has changed is the 2 percent cap and the way we deal with budgets going forward.”
McCoy was also clear he’s not behind any one of the four options he’s outlined. He said once he has all the information in, he’ll present everything to the Legislature to decide which route is the most fiscally responsible and adequately serves Albany County seniors.
McCoy said the county can continue running the nursing home the way it’s been running it and build a new facility; professionalize it with an outside management company that would take over operations; explore a public benefit corporation option; or privatize it.
While he hasn’t chiseled in stone which scenario he would like to see play out, McCoy said there are some facts he can’t ignore.
“Where I’m at is, within the 2 percent cap, it’s going to be hard going forward to sustain a nursing home. I’m not against it, I just need commitment from the Legislature that they’re committed to giving me funds to run a nursing home,” said McCoy.
The amount of money the county would have to throw in to run the nursing home is a debated issue. According to McCoy, it will cost roughly $11.3 million to operate the nursing home in 2012. That number includes about $7.2 million the county pays into a nursing home fund ($3.7 million is written into the budget and the rest is retiree pension costs, workman’s comp and other expenses) and about $3.9 million the county must match locally to the IGT funding it receives (a combination of federal and state dollars).
For 2012, about $8.6 million in IGT funding is expected to come in, but the county will only end up receiving about $4.7 million in net revenue when taking the local match into consideration.
That doesn’t take into consideration the costs of building a new home, which the Legislature recently addressed. New York State Department of Health projections show building a new home would perform even more poorly at a $26.3 million operating deficit.
Chairman of the Legislature Shawn Morse released a statement claiming that number is inaccurate and some legislators are clamoring for clarity.
“I don’t know how you come to a decision on what is the best way to go without having some agreement on what the numbers actually are,” said Legislator Richard Mendick, R-Selkirk.
According to Morse, the DOH refused to accept numbers the Legislature presented in a certificate of need application filed to build a new nursing home facility.
“It’s very difficult to get anything done when the State of New York is playing games and trying to make this a difficult process. Trying to get information from them is very difficult when they won’t talk to you, so I think we have a plan, it’s just a matter of trying to get the steps put together,” said Morse.
Morse said while the legislative minority will “be respected and have a right to be heard,” the majority will ultimately make the final decision, which thus far is to build a new nursing home facility.
“Building a new nursing home will save money, period. Not because of the bricks and mortar solely, but because it’ll be the right size with the right size staff and it’ll save us money,” said Morse.
The current nursing home is a 250-bed facility, and the new one would house 200 beds. There are about 45,000 seniors over the age of 65 in Albany County.
“We’re spending so much money on that small population and I’m OK with that because I think we do have an obligation to our seniors but we have to service all 45,000 seniors and try to keep seniors longer in their house,” said McCoy.
Morse said the plan to build a new nursing home will allow the county to serve a larger chunk of that senior population, most of whom are “poor, underinsured” or have health conditions that require expensive care.
“It is incumbent upon us to make sure those people have the absolute best care we can possibly give them and that they deserve. In doing that, we need to make sure it’s done with a sense of understanding of who pays for the nursing home, which is taxpayers, and figuring out ways to offset the cost to the taxpayer,” said Morse. “We believe that having a nursing home that is the right size, that has the right size staff, that has ancillary services surrounding the nursing home on a campus-style setting, we’d be able to reduce the cost, create additional revenues to further reduce the cost and have a facility we can all be proud of.”
McCoy said his other three options shouldn’t be discarded. Switching to private management would bring county costs down and the county would remain the owner. A public benefit corporation option would see the nursing home manage itself with some oversight from the Legislature and essentially taking the county’s control away in terms of hiring or firing. The fourth option would be to privatize it entirely.
“What people don’t realize is if we close it down today, it would take two years for us to see any financial impact from the nursing home closing,” said McCoy.
Morse doesn’t see any option working outside of keeping the nursing home publically owned and run.
“I think any other option leaves a lot to be desired and I’m concerned that the people who would be at the mercy of the private industry would find themselves shipped out of our state like we’ve done time and time again, living in a foreign place,” said Morse.
Mendick, though, thinks the Legislature should explore those other options.
“It is clear that history has shown us that Albany County as a public entity is not adept at running a nursing home and that is substantiated by the sizable deficits that we’ve run over the years,” said Mendick. “… The legislature’s inability to get their arms around the numbers may be the strongest indication that we should not be in the nursing home business.”
Mendick said the Legislature should look at the option that will serve the most Albany County seniors while not breaking taxpayers’ banks.
“I believe that we have to look … at the best solution that’s going to provide the greatest possible benefit to the entire senior population at the least cost to the taxpayer,” said Mendick. “If the taxpayers have spoken through the ballot box and put Mr. Cuomo in the governorship, very clearly they’re looking for some tax relief.”
Mendick said legislative actions during the budget process suggest the body won’t be implementing a taxpayer-friendly nursing home plan.
“The legislature … voted to override the 2 percent tax cap. That gives the indication that the majority of the legislators are willing to pay the nursing home tab regardless of the cost,” said Mendick.
But Morse challenged the sentiment that footing the nursing home bill directly correlates to raising taxes.
“Raising taxes is just a scare tactic. We have more than just one service in the county government and if that means we have to balance the ability to fund all the services with less money, that may be an option. The other option is maybe we have enough money with these ancillary settings on our campus that generate revenues and offset the cost rather than have to raise taxes,” said Morse.
Morse said he’s weighing more “creative solutions” that would ease the taxpayer burden.
“We’re very concerned for the taxpayer but we’re also very concerned for people who would otherwise not have anywhere to go,” said Morse. “People need to start thinking outside the box. It’s not just about cut and tax, spend and tax; those days are over. It takes creative thinkers to come up with creative solutions … and those are what we’re seeking out right now.”
McCoy said the legislature needs to absolutely consider what impact raising taxes to fund a new nursing home would have on residents.
“I still would love to … build a state-of-the-art facility for our seniors because I believe in it. The problem I have is that people are suffering, people are having a hard time paying their rent, mortgage, putting food on their table, finding jobs and taxes are killing them,” said McCoy.
Speaking of taxes in general, McCoy said it’s unrealistic to think Albany County can live within a 2 percent cap, so tax hikes in some capacity are inevitable in the coming years.
“We can never live within the 2 percent cap in Albany County, ever, and it’s because of the unfunded (state) mandates,” said McCoy. “Until they get rid of all the unfunded mandates or give us relief from it there’s no way possible for us to live within.”
McCoy said he’s starting to consolidate services within the county to generate savings.
“We’re merging the Department of Mental Health and Department of Health, we’re going to consolidate internally, shared services. … Budget and managements we’re overhauling right now. We’re going to change that whole philosophy, centralize everything,” said McCoy. “If I can centralize it then I won’t need as much staff, so as people retire I can shrink the workforce a little bit more but continue the level of service that we’re providing and do better.”
He said he’s approaching his job as county executive with short- and long-term vision.
“I’m worried about the future of Albany County for my children and for everyone else’s children,” said McCoy. “We have to look at where do we want to be in 2020, 2025.”
To get a better handle on what concerns are weighing on residents’ minds, McCoy is planning a series of “town tours” where he’ll visit municipalities across the county. He’s also trying to spark economic development in the county by starting an “incubator” at 112 State St. in Albany with a local development corporation and office space for new businesses that pledge to remain in the county for a certain number of years