The Daily Freeman reports that the town boards of Esopus and Saugerties each voted unanimously to keep the Golden Hill Health Care Center, a Kingston nursing home under Ulster County ownership and control. These were the latest salvos fired in a debate that has included organized protest as well as web networking and commentary by members of the privatization pro and con camps.
Golden Hill in many ways seems to be a prime exhibit in the national debate over private and public ownership of health care facilities. It is operating at a seven-figure loss -- $4.3 million in 2011 according to state estimates -- that many fear might swell to eight figures in a few years. The cost of upgrading the existing facility, or building a new one, attaches some enormous pricetags, between $71 and $84.1 million according to various sources. The county would be reimbursed for a large percentage of those costs.
On one side, moral arguments voiced by many county and town legislators presume that the best care of the eldery and infirm is public care. Anti-privatizers point to Golden Hill as a well-run institution that is a source of good local jobs where seniors get the attention they need. In an April meeting, several Ulster County legistlators affirmed that the county has a responsibility to look after its own.
The other side speaks directly to the wallets of Ulster County: an upgrade or a new facility would mean more taxes for county residents -- estimates vary between hundreds and low thousands per year -- and declining revenues, since Medicare and Medicaid payments might decline in coming years, and they pay for the bulk of the Center's expenditures. Others argue that the Center's budget already is bloated by overstaffing and operating costs and that a private concern could operate more efficiently while providing a similar quality of care.
On Wednesday, Saugerities resolution came down firmly in the camp of moral obligation:
"[Saugerities] has a direct and vital interest in retaining a local institution that provides skilled-care nursing to as many as 280 elderly and infirm fellow citizens, at a level of professionalism and compassion widely recognized as exemplary. . . [Saugerities] has a direct and vital interest in retaining a local institution that employs more than 350 professional caregivers, with a local payroll totaling more than $15 million annually.”
The next move likely will come from the county legislature, which is controlled by Republicans at an 18-15 majority. Minority leader Jeanette Provanzano last month criticized the Ulster Republican County chairwoman Robin Yess -- herself a former member of the legislature -- for getting into the scuffle by urging the county to sell off Golden Hill. From the Daily Freeman:
Provenzano called Yess’ remarks “an insult to all legislators” and said the Republican chairwoman should “stick to her business of politics outside the Legislature.”
In a year of belt-tightening and budget slashing, this debate might become a show-stopper.