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Report is grim for St. Lawrence County’s CHHA


CANTON — A financial report on St. Lawrence County’s Certified Home Health Agency paints a gloomy picture for its future, but some legislators say they still have questions they want answered before they cast their votes.

The Board of Legislators could decide whether to sell the agency and the Long-Term Health Care Program to Northern Lights, a newly formed group made up of Claxton-Hepburn Medical Center, Canton-Potsdam Hospital, Hospice and Palliative Care of St. Lawrence Valley and United Helpers Management Co., at a Finance Committee meeting at 5:30 p.m. March 26 and a special meeting that will follow.

Legislators requested the financial report to help with their decision.

No matter the outcome, Public Health Director Susan J. Hathaway urged legislators to move with speed.

“This prolonged waiting is agonizing for people. There’s a lot of grief here in the department,” she said. “That is my request: please make a decision. We need to be able to move on. We’re just in limbo.”

According to the report, the county cost of running the agency was $1,096,321 in 2011, up from $617,929 in 2008. In 2009 and 2010, the county cost was less than $500,000, but the agencies face stronger challenges ahead because the state eliminated all of its aid, effective July 1, which amounted to about $200,000, and has cut Medicare reimbursements and made changes to Medicaid.

The trend across the state has been for counties to close or sell their CHHAs. As of November, 39 county CHHAs have closed or are in the process, and 12 county CHHAs, including St. Lawrence, are considering closing or selling.

The county was pushed into more rapid consideration of what to do by the state’s decision to lift a moratorium on new CHHAs that could put the county agencies out of business. County CHHAs tend to have higher Medicaid rates than private ones.

“That’s why we can’t compete,” Ms. Hathaway said. “The state is sending a strong message. The state is pushing to privatize.”

County employees have a more generous benefits package and work a seven-hour workday, contributing to the county’s higher cost.

Referrals and visits have been on the decline for several years, a situation made worse by staff numbers that have dropped, partly because the county chose not to replace them and partly because of uncertainty over the future of the agencies. That has not helped the bottom line.

“You need a certain level of visits to cover administrative costs,” Ms. Hathaway said. “You don’t have enough business to make a profit. It’s really complex.”

If the county sells the agencies, the county will remain responsible for $250,726, the portion of payroll costs allocated to the CHHA, and $246,831 in facility and technology costs until the space allocation of the remaining Public Health employees is determined. The county also could be liable for unemployment for a maximum of 34 employees, some of whom likely will be hired by Northern Lights or another agency.

Legislator Frederick S. Morrill, D-DeKalb Junction, said he was disappointed by the evaluation because it did not fully take into account budgetary shortfalls that could bring the county’s continued cost closer to $1.9 million.

“Just because you don’t account for it doesn’t mean it goes away,” he said. “That’s fine, but they shouldn’t then be saying it’s $500,000.”

Legislator Scott M. Sutherland, R-Pierrepont, asked for more information on unemployment liability. Mr. Sutherland said he prefers county employees provide the service, particularly as clients have told him they like the status quo.

“These are people coming into their homes. They trust those people and like them. They don’t want things to change,” he said. “It’s more like the numbers against everything else. I’ve swung back and forth.”

Legislator Daniel F. Parker, R-Potsdam, said he has also asked for more information on legacy costs, including pensions and unemployment.

“The third option is to keep it at some lower level,” he said. “Maybe there are functions we do particularly well. I don’t know what the finances of that would look like.”

Legislator Donald A. Peck, R-Gouverneur, who has a previous commitment on the night of the expected vote, said that the Civil Service Employees Association might be willing to talk about an eight-hour day for the agency staff, but that he was pessimistic about the overall chance of keeping the CHHA.

“I firmly believe we’re so far in the tank we can’t pull it out,” he said.

Legislature Chairwoman Sallie A. Brothers, D-Norfolk, said she may request an outside consultant review the finances and trends.

“I want to hear what everybody’s perspective is on it. I’m not sure where I’m going with it,” she said. “I’ve got a list of pros and cons. This is a big decision and we’ve got to be sure.”

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