CANTON Amid cries from St. Lawrence County Public Health employees that they had been betrayed, legislators voted 14-1 Tuesday to eliminate 32 jobs by closing the countys Certified Home Health Agency and Long Term Home Health Care Program and transferring the patients to one of its competitors in the private sector.
You werent given all the facts, Public Health employee Diana Caswell said. We know we, the employees, have not had a voice.
Despite the appeals of more than 50 Public Health employees and their supporters who forced the legislative budget review session to the state Supreme Courtroom where there was more room, legislators agreed to negotiate an agreement with Health Services of Northern New York, another certified home health agency.
The closure of the county agency, which was projected to have a net county cost in 2013 of $648,444, will likely not save the county much money next year because it will not be phased down for some months. Officials planned to spend the next few days determining which employees could move to other positions, how much the county could expect to pay for unemployment, and how much it might save on health insurance. Of the 32 employees, four are home health aides, 11 are clerical and 17 are nurses.
If the transfer is completed by April 1, there will be few changes in the total cost for next year. Some costs that had been reimbursable through the CHHA would have to be picked up by other Public Health programs.
This is an estimate based on assumptions, Public Health fiscal manager Debra L. Bridges said.
In March, legislators rejected an offer for $80,000 from Northern Lights, a nonprofit that is a partnership of Canton-Potsdam Hospital, Claxton-Hepburn Medical Center, Hospice and Palliative Care of St. Lawrence Valley and United Helpers Management Co. for the two agencies. Northern Lights, which was recently approved by the state to operate a CHHA, is no longer interested in the county agencies because it has developed its own business plan, County Administrator Karen M. St. Hilaire said.
Health Services, whose parent company is Hamister Group, Williamsville, previously offered $2 for the county agenciess two operating certificates.
More than the money, were looking for a smooth transition, Ms. St. Hilaire said. We have not met yet to talk about the particulars. One of the issues we will talk about is employment of our people. That will be a key issue.
After legislators turned down the offer from Northern Lights, they pledged to rebuild the county agency so it could compete.
Amy J. Simmons, president of the countys Civil Service Employees Union, said she questioned the purchase of computer software, money for outside agencies, the hiring of a trails coordinator and a lobbyist but thought the expenditures acceptable if county workers were not cut.
Unfortunately, it doesnt appear the CHHA has that same level of support, she said. Are you willing to put 35 workers on the unemployment line on ifs and maybes?
Other Public Health employees criticized Director Susan J. Hathaway for not believing the agency could succeed.
The promise of strong management and 100 percent support did not materialize, Public Health employee Mary Grady said.
We do not feel our true needs were brought by management, she said.
Ms. Hathaway said county legislators supported the CHHA by allowing the department to hire nurses, train them and take on patients, but that the financials were not in the countys favor because of state goals to cut Medicaid costs. The county CHHA receives a Medicaid reimbursement rate of $179 because its costs are higher based on its benefit package, while the rate for a visit by Health Services of Northern New York is $104.
We have done our job and done it well, she said. The bottom line is New York state no longer supports publicly-run CHHAS.
Earlier this year, the state lifted a moratorium on new CHHAs to coincide with a redesign of Medicaid. Health Care of Rochester and Visiting Nurse Service of New York CHOICE have also applied to operate in the county.
Rather than have the county CHHA wither away, Ms. Hathaway said it made more sense for the county to provide a transition under which its employees could seek jobs with the other incoming agencies so that they could have long-term security.
Legislator Frederick S. Morrill, D-DeKalb Junction, who raised questions about whether the private agencies would serve patients in remote parts of the county, was the sole nay vote.
Public Health was not the only department scrutinized by legislators Tuesday.
At the request of Emergency Services Director Joseph M. Gilbert, legislators also eliminated the position of his deputy, who was paid approximately $49,000. Mr. Gilbert had earlier sought a dispatcher manager but said he wanted to assess the department more before possibly returning next year to ask for the position.
Overall, the employee losses approved Tuesday, plus about 10 expected retirees and other personnel cuts made earlier, could bring the number of staff reductions to 50 for next year.
Legislators also approved cuts of $291,201 from the Department of Social Services proposed by Director Christopher R. Rediehs that do not include further staff reductions.
The tentative budget of $55,711,312 in county costs initially carried a tax levy increase of 20 percent, but reductions by legislators in recent weeks has cut the levy increase below 15 percent. Last year, legislators approved a tax levy of $46 million that carried an increase of 5.5 percent.