By JUTTA A. RAWCLIFFE
Imagine you and your wife are 70. You have worked hard all your lives. You have a $75,000 home and $10,000 in savings. Both of you have health problems. Then your wife develops an unexpected illness requiring a stay in a nursing home. This stay and associated medical costs depletes the $10,000 as your HMO decides the condition she has is not recoverable.
After she is discharged, you struggle at home, helping your wife with daily tasks like showering until you become too frail to assist her.
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Are the workers willing to negotiate to keep the County Home under county control?
You are forced to enter an assisted living facility at an average cost of $3,400 a month. You sell your home to cover the cost. It pays for less than two years of assisted living. As you no longer can pay privately and have to apply for Medicaid, you are politely asked to leave the facility. Then you have to find a nursing home with a Medicaid bed.
The only other option is to stay with your son and his wife who barely have room for you and who live outside the county. Will you get enough help to allow them both to keep working? Will you be allotted sufficient hours of home health care to allow you and your wife to be safe and comfortable? Will you be lonely and without your friends?
Many elderly Chautauqua County longtime residents require care. Though many are not fortunate enough to have relatives who can take them in. When they do have relatives who can have them, they are often out of the county. Fortunately, at present, there is the Chautauqua County Home.
Established in 1832 to meet the need for longterm care for area elderly, the County Home provides a full range of on-site services including physician, dentist, in-house lab, X-ray, podiatrist and optometrist.
Residents are admitted for care regardless of age, disability or source of payment. Many private facilities that are geared toward making a profit limit the number of Medicaid beds. In fact, they often only choose a Medicaid patient to prevent open beds when there are no other payor types available. The Chautauqua County Home consistently has more than 80 percent Medicaid patients. This means our county has a steady stream of Medicaid patients needing care.
What will happen to all the Medicaid patients needing help in the future? Maybe they will be sent out of the county where they will be far from their friends. Or alternatively, they will be forced into one of the new Medicaid programs designed to keep people in their homes. Although this option sounds good, it can often have tragic results.
Six years ago a friend of mine got a tearful telephone call from a desperate elderly lady. The lady was unable to get to the bathroom by herself and her health care aide had not shown up again. She called a number of people before she got a hold of my friend. Upon arriving at the scene, my friend found the situation had been managed for that time. As a nurse, however, she was obliged to inform social services. The upshot was the lady was placed in a nursing home.
Marcus and Millichap, the firm hired to find a buyer for the County Home, said in Senior Housing News of the financial losses in county nursing homes: "That's because of union contracts that are extremely onerous and cuts to Medicare and Medicaid reimbursements. ... The contracts' terms. ... feature high wages, rising health insurance premiums and expensive legacy pensions ... (that) are draining the profit from a facility that could quickly become accretive to earnings."
How does our County Home's staff wages and benefits compare with those of other county homes? How do they compare with what LPN's and nursing assistants can earn elsewhere? Also, how does income become "accretive" producing profits? Not just by cutting staffing and benefits, but also by limiting the number of Medicaid beds. And will cutting employee benefits really save county taxpayers money?
No, because employees without health insurance apply for Medicaid and other tax funded programs. Additionally, shrinking Social Security funds are having to cover more and more retired people.
All of us will need retirement income additional to Social Security. Chautauqua County Home employees are working for their retirement benefits. And are "high wages, rising health insurance premiums and expensive legacy pensions" to blame or is the problem primarily due to "cuts to Medicare and Medicaid reimbursements?"
Additionally, assuming profits are made (at least in part at residents' expense), where will these profits go? To investors and owners outside the county! Employees that are earning a decent wage buy groceries and services locally. These employees' wages and spending attribute to our local tax base. They also have a right to decide where their tax dollars go! And how do you think the residents of the County Home would vote if they could get to the voting booths?
I find it outrageous that a real estate firm from outside our state has been chosen to decide what our people should accept and what our elderly deserve! The firm's focus is to get a higher percentage sales commission. It is not out to represent the people of this county and their needs.
So what other options are there? We could negotiate with the County Home employees. I know a number of retired County Home employees. They have spent a good number of years caring for people from all walks of life. They have tried to provide a quality of life with much deserved dignity and comfort in their last years.
This caring is why so many of them are willing to make concessions over and above those currently on the negotiation table to keep our county facility.
For them this not a union issue. What are we not trying to come up with an equitable agreement that will save our county home? Why are we not willing to meet them halfway?
Jutta A. Rawcliffe is a Fredonia resident.
