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September 22, 2018

County Continues To Debate Health Programs


OSWEGO, NY – A resolution to initiate a request for proposals to explore alternatives for home health care in the county, which legislators sent back to the committee level, will languish there a while longer.

Legislators still have several questions about how this will impact the county’s employees and budget.

New York State is no longer providing state aid reimbursements to counties for their Certified Home Health Agency (CHHA) and Long Term Care (LTC) programs, explained Phil Church, county administrator.

Last spring, the health committee directed the Health Department to pursue to refine its reform and efficiency plan and report back to the committee. They would continue the programs, giving the department the opportunity to make adjustments in personnel assignments, service delivery and claiming practices to minimize the net county cost.

The committee also directed the administration to examine budgetary and cost report data and prepare a draft RFP (request for proposals) to sell Oswego County’s certification to a licensed home care provider. That is a state-monitored process that can take about two years to complete. If the county decides to sell its certificate, 18 employees would be laid off, including nurses and support staff.

That request was tabled at the last legislature meeting and sent back to committee.

It received further discussion at this week’s committee meeting.

Legislator Jim Karasek asked Dr. Dennis Norfleet, director of public health, whether the program would break even at the end of this year or maybe next year?

That is what they are working toward, he noted.

“What we are looking at is one aspect of the primary mission of this department, that’s to provide and enhance the health of our constituents as much as possible,” said committee chair Jack Proud. “There may be some programs that do not run balanced (between costs and profit); this may be one of them. There may be some programs that are important enough that we may need to put some money into them; they may not have what we consider a favorable balance. I think we really need to consider that word favorable. What does favorable mean? Does favorable refer to the financial picture? Or is favorable referring to the condition of some of the most needy people in our county? We need to think about that long and hard.”

He said the legislators must explore all aspects of the program so they understand what it needs, what its costs reflect and “as a legislature where do we stand?”

“This discussion started because I felt very strongly, and still do, that the county should not be in the business of competing with private enterprise they can do it just as efficiently or more efficiently. We have reached that crossroads and where we’re at in our county in this state at this time,” Karasek said. “This isn’t about disrespect for the doctor or the (health) department. This is about every single program we looked at needs to have that kind of analysis whether it is the health department, DSS, anything we look at is there an opportunity for us to not be doing this when private enterprise can do it?”

“The information may tell us this is not a good idea to follow,” he continued. “It’s simply about if these numbers can be moved from county budget to private enterprise. We are at that point. If we continue to delay looking at these programs, that point may come up to bite us in the butt at a point where we don’t have options and choices any more. We could be in here in another year or two saying, ‘look, the bottom line is we are not going to fund this.’ That’s when it becomes tragic.”

“Jim, I understand perfectly where you are coming from. Your point is perfectly legitimate. We are going to continue to look at this,” Proud said.

A motion by Karasek to send out requests for information regarding private enterprise interest in how they might take over the program was defeated.

Dr. Norfleet will continue to report to the committee on the progress of the program.

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