The Fight Against Privatizing Willow Point ContinuesPosted: August 3, 2015
The effort to prevent the county-owned Willow Point Nursing Home from privatization or closure took another step on May 19th with a speak-out at the Johnson City Senior Citizen Center. Forty members of the community came together to challenge the recommendation of an accounting firm which earlier this year called for privatization. Nursing home workers, those who had or have loved ones residing in Willow Point, and concerned citizens relayed their concerns over the possibility of the facility’s closure. All praised the care their loved ones received at the facility and the commitment and caring of the staff. Others reported that without Willow Point their loves ones would have spent their final months and years in Scranton or Rochester, due to financial constraints. Being a public facility, Willow Point provides much needed bed space for low-income people, especially low-income seniors. Below is one piece presented during the event entitled “Questioning Privatization” and another presenting the economic argument for keeping the facility. Both call for continued investment in the Willow Point.
The personal stories narrated during the event proved a powerful rebuttal to the strict financial logic of the aforementioned report, compiled by accountants. Calls for “people who work hard and paid taxes their whole lives to be comfortable and cared for in their own county regardless of financial ability” encapsulate the moral center of the keep-Willow-Point-public campaign. While this sentiment makes a strong moral case for public responsibility of the indigent, elderly, and infirmed, it does not challenge the economic argument for closing Willow Point. As The People’s Press documented in our last issue, the idea that Willow Point is losing buckets of county money, thus needed the beneficent and intelligent hands of corporate raiders or NGO executives who are indistinguishable from Wall St CEOs, is fundamentally flawed. We showed that the amount of money Broome County puts into the nursing home is part of a New York State fund sharing program. A formula determines how much money each public nursing home in the state is eligible for, and counties front 50% of the that amount to receive said cash. The program is designed to ensure that public nursing homes are in fact public and are adequately funded by stingy county legislatures.
There is no doubt that deceitful and/or ignorant county legislatures have deployed the language of economic efficiency to call for selling off Willow Point. There is also little doubt that selling Willow Point would hurt workers, residents, and the soon-to-be residents of the facility. What’s less clear is how selling Willow Point will cost Broome County in the future. Despite the rhetoric of Willow Point’s financial instability, the facility and all publicly owned facilities in the state help keep healthcare dollars local. Willow Point is not a liability for the county, but a potential net reducer of the county tax bill. Unfortunately, our county government is more concerned with making the case for closing this important piece of the county safety net, rather than performing a balance assessment. We ask: how much does Willow Point save and make for the county?
That question is indeed difficult to answer with the resources at hand. But there is good reason to believe the economic net benefit to the county and its cost-saving effects for the county budget are significant. Unlike other states in the US, New York mandates that counties pay roughly 15% of all Medicaid costs, while the state picks up 35% and the federal government pays 50%. This means 15% of costs associated with providing healthcare to low-income persons comes directly out of the county property tax levy. In 2012, 67% of the property tax levy, or $43.7 million, went to pay for the county’s Medicaid costs. State efforts to reduce counties’ share, including state takeovers of administrative costs and some programs, and payment freezes, has done little to temper Medicaid cost growth for Broome County. Population change is one driving force: our population has been getting older, poorer and consequently sicker overtime, forcing a greater reliance on programs like Medicaid. As a result, the number of persons on Medicaid in Broome County has doubled from 1997 to 2012, jumping from 23,000 to 46,000. With Broome County’s population falling over 2% during that same time period, a full 24% of the county’s population is now on Medicaid, up from 11% in 1997. The county has done nothing to meet these challenges and has even cut public services, notably the mental health clinic, making matters even worst.
Willow Point, in turn, takes in large numbers of people on Medicaid. Seventy eight percent of all days spent in Willow Point were paid for by Medicaid, about ten percent more than all county nursing homes. That means that Willow Point’s revenue is closely tied to Medicaid reimbursement provided by the federal government, the state, and the county. These Medicaid dollars will be spent whether Willow Point is public or private. What will change if the nursing home is privatized, however, is where the money goes. Now, those public dollars are controlled by our county government, which is supposed to work for the public good. While those dollars are spent on facilities, staff, and medical supplies, these dollars, right now, do not go into the pockets of private nursing home operators or Not-for-profits which are much less accountable to the public. In a public facility money is used to ensure quality care and pay for staff, with surpluses going back into the mission of the nursing home. Under a private model, those same dollars, originating with the county, state, and federal governments, pay for running the nursing home and CEO bonuses and shareholder dividends. Surpluses are increased by reducing expenditure, often translating into worse care for residents, and small salaries and fewer benefits for workers, and that surplus is turned into profit for the already very wealthy. Going from a public to private facility shifts the nursing home’s main mission from providing the best care possible for current and future residents to making a profit for the 1%.
Rather than turnover even more tax dollars to private entities we should invest in our existing nursing home. Now is the time for public investment in residents, not dis-investment!
Andrew J Pragacz
Question 1: In the past few years, the politics at the county level has been detrimental to assuring the best possible care for the Willow Point Nursing Home residents. Saving taxpayer dollars has been the driving force behind decisions to close or privatize the facility without concern for maintaining the level of care the residents deserve, regardless of their personal financial status. We all know that long term health care is expensive and every effort had been made to ensure quality care by dedicated professionals who felt valued and respected. With the privatization of the rehabilitation department, several long time employees left. Promises were made to the county that income from Medicare and Medicaid reimbursement would rise considerably. How much income will be generated from this privatization?
Question 2: What will happen to the nursing home population who are receiving Medicaid and require long term skilled care? There are few facilities in the area that will take these residents and loved ones may have to travel 90+ miles to visit.
Question 3: Bottom line: It concerns me that we as a society do not value our elderly or those whose mental and physical conditions require 24 hour care. Health care should not now or ever be a money making endeavor. Why generate county income on the backs of our most vulnerable population? The model of a newly constructed county facility that was developed many years ago was state of the art and what elder care should look like! Broome County could make a name for itself if it decided to move in this direction. It might actually be something that the County voting population would support. It is the ethical thing to do!