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Show of force: Advocates and opponents of a new nursing home gather at the Albany County Legislature’s monthly meeting.

Photo: Chet Hardin

Time to Build?

Proponents of a new nursing home in Albany County score a minor victory

On Monday, Albany County legislators Chris Higgins (D-District 6) and Lucille McKnight (D-District 2) were targeted with dinnertime candlelight prayer vigils by small groups of protesters in front of the legislators’ homes. These protests were organized by SEIU 1199 to put pressure on the lawmakers to support the construction of a new county nursing home.

Hundreds of fliers had been plastered throughout Higgins’ neighborhood in the days before the protest asking, “Where will the frail and elderly go if there aren’t enough County Legislators who vote to save our nursing home?” These fliers, which were sponsored by United for Quality Care, an SEIU campaign, urged people to call Higgins, as he “opposes the plan . . . to improve home care and assisted living, along with building a new [nursing] home.”

Higgins dismissed the protest, and the fliers, as misleading. In September, Higgins, along with McKnight and three other legislators, sent a letter to the chairman of the Legislature’s Nursing Home Facilities Committee, Gary Domalewicz. In response to the debate to determine if the county would move forward with the construction of a new nursing home, or instead it will adopt county Executive Mike Breslin’s plan to abandon institutional care and invest in home-based care, Higgins et al. wrote: “We must ask whether maintaining the county’s role as a direct care provider is the best way to accomplish our goal of providing essential and quality services to all persons need at the lowest cost to the taxpayer. In order to assist the committee members with their deliberations on this important matter, we have composed questions found below. . . . We believe that only when these questions are answered can the construction of a new nursing home facility be justified.”

The letter listed 15 questions, such as: “Do concerns exist with the trend of Medicaid reimbursement rates and how such trends impact county finances? How many patients in ACNH could be cared for in Assisted Living Programs or Assisted Living Residences were such programs available? Should we accept property tax increases to offset future increases in the cost of operating a new facility? If yes, to what extent? If no, what county expenditures should be eliminated or reduced?”

“I don’t understand how my colleagues can rush to form a decision before they have all the facts,” Higgins said. “This is going to be a very expensive decision either way. It’s not like anyone even wants to wait and see what changes will happen at the federal level with President Obama’s health-care reform that is being debated in Congress. Why don’t we wait until December to see what changes are happening at that level, how it’s going to trickle down and effect local municipalities?

According to the executive’s budget, Albany County is facing a 6-percent property tax increase in 2010, even after cutting more than 100 jobs—74 from ACNH. According to Mary Duryea, county spokeswoman, in 2011, the county faces an up-front $25 million budget hole due to increasing pension costs, and the loss of federal stimulus dollars and federal support for the nursing home.

Currently, the executive estimates that a new nursing home will cost $68 million to construct. Much of that expense will be offset by state and federal dollars. However, Duryea pointed out, the real cost of the nursing home is in its operating expenses, which cost the county $18 million a year to operate, or 30 percent of the property tax levy.

“If the county doesn’t take action to downsize the nursing home in 2010, we will be looking at a budget gap of $25 million in 2011,” Duryea said—a 34.7 percent increase from 2010’s levy.

On Tuesday night, hundreds of people crowded into the Legislature’s monthly meeting. The body was considering a resolution expressing support for the construction of a new nursing home and directing the executive to explore what size nursing facility the county should build.

The resolution passed overwhelmingly.

Duryea said that the executive would consider the resolution, and welcomed the opportunity to gather new information, however, she cautioned, “We think that the right size is zero.”

Dr. Patrick Timmins (D- District 22) was one of the two votes against the resolution. He said that he favors Breslin’s progressive views toward long-term care, and would like to see the county move away from institutional care.

“I support changing the system completely,” he said. “The problem with building institutions is that they consume valuable resources. Building a new nursing home is a step backward and not a step forward. To me, it is an intellectual problem. When you build an institution, the county has to fill more beds. The goal should be to keep people in the community. The county’s focus must be to do everything possible to keep people active members of the community. It is better for the community and it is better for the economy.”

This is an opinion shared by disability-rights activist Michael Volker, who is disabled and needs a fully mechanized chair to get around.

“The bigger this thing is, the harder it’s going to be for the entire long-term care system,” Volker wrote in an e-mail. “Building and filling that nursing home will drain resources from all the other line items in the long-term budget. They kept saying last night that it is not an either/or proposition. But with finite resources, that’s exactly what it is going to become. If both sides of the equation are going to be funded adequately, and the county is going to be forced to generate revenue in other ways in order to be able to cover all of it, will taxes have to be raised?”

Higgins was critical of the resolution prior to the vote.

“Have you read this resolution? Did you see how broad it is?” he asked. “It is incredibly broad. All it says is we support construction of a nursing home. Down the line, things could go perfectly here or things could go drastically bad. And if they go drastically bad, somebody could be stuck here with their pants down around their ankles, having voted for a 20-percent property tax increase or a 30-percent property tax increase. And then everybody will be backtracking.”

Although he has yet to receive answers to any of his 15 questions, Higgins voted in favor of the resolution. Not necessarily in support of constructing a new home, he said, but in the hopes of getting more information.

“I voted for the resolution because it authorizes the executive to bring in experts,” Higgins said. “I wanted to get as much information as we can to help the citizens of Albany.”

—Chet Hardin

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