County To Further Scrutinize Options For Health Care Programs

OSWEGO, NY – A resolution to initiate a request for proposals to explore alternatives for home health care in the county was sent back to the committee level at this month’s legislature meeting.

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

Prior to the start of the regular meeting, Janet Clerkin, president of the Oswego County Professional Association. It’s the labor union that represents many of the middle management, supervisory staff and several departments of county government.

“We recognize and respect that the county is being forced to adapt to many economic and legislative conditions and factors that you have no control over,” she told the legislators.

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 May, the Health Committee examined there options relating to the matter, discussing the advantaged and disadvantages of all of them.

The committee recognized that the phase out over two years of the state’s funding meant that the full negative impact that would have to be mitigated would not be known until the 2012 budget is developed.

The committee directed the Health Department to pursue “Option 1,” 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. And, it requires final state approval.

These steps have been completed, the administrator pointed out.

If the county decides to sell its certificate, 18 employees would be laid off, including nurses and support staff.

However, the RFP would require they buyer to offer employment to all former county CHHA and LTC staff, so no one would become unemployed, except by choice.

The former employees would be removed from the NYS retirement system.

“Several of our members would be affected if these two programs were outsourced,” Clerkin said. “They supervise and oversee the health care of fragile and vulnerable patients in our county. Many of their functions cross over into other programs such as quality control, monitoring the Health Department emergency management function and working in public health emergencies and immunization clinics. If their jobs are eliminated, these vital programs would also be affected.”

When people fear they are going to lose their jobs, they start looking for other employment, she said, adding that when one staff person leaves, it jeopardizes the program’s ability to safely maintain patient care levels and that in turn jeopardizes the revenue that the program is able to generate.

They are also concerned about the impact on residents in the rural areas of the county who don’t have access to private sector nursing services.

She asked the legislature to give the Health Department more time to demonstrate the continued viability of the programs.

The staff members live in the county and have families here, she pointed out.

“They care for the residents of Oswego County and they spend their paychecks here in Oswego County,” she said.

Legislator Jake Mulcahey noted that the estimated amount of lost revenue had changed since the matter was discussed in committee.

“I’m just a little concerned that everything has changed,” he said.

The numbers are “continually” changing in regard to this issue, Legislator Shawn Doyle explained.

“The numbers are always changing. They’ll be different next week,” he said. “We could actually be able to see a profit. So I think it is entirely pertinent to pull this resolution until we do get a better look at the figures.”

The matter will likely be back on the committee agenda next month for further discussion.