Health care cost on county agenda

Mary Perham
Mark Alger

Public health services in Steuben County could change by the end of 2012, with county legislators considering selling the county’s home health care certificate when they meet in regular session Monday, Dec. 19.

County Administrator Mark Alger said legislators will take a look at proposals from two western New York agencies for the county’s public health operating certificate. The proposals are the result of a search by the Legislature’s special health services committee.

Legislators will be asked Monday to OK negotiations between the county and the potential buyers, with the final decision expected in a couple of months, Alger said.

The state’s recent lifting of a ban on new home health agencies will likely encourage more competition and could reduce the price the agencies will offer the county, Alger said.

“That’s kind of thrown a monkey wrench into it,” Alger said. “We’ll have to wait and see.”

The county’s share of public health services ranges between $100,000-$200,000 every year, amounting to less than 1 percent in property taxes. If the agencies don’t come up with a reasonable offer, the county could keep its operating license and absorb the overage, Alger said.

A major concern for legislators is ensuring anyone eligible for home health care in the vast, rural county receives it.

While Steuben is required to provide help to residents in the more far-flung regions of the county, a private business does not have to serve everyone.

But once the county has sold its certificate, it loses its oversight of the program, Alger said.

“We are looking at that, at what we can do,” Alger said. “That is definitely something to look at.”

Public home care in the state is becoming rare, with nearly every county in the state now selling its certificates or contracting with private agencies.

For many, the issue is another example of how state mandates, combined with the 2 percent property tax cap, restrict the optional services the county provides.

“That, what is it, $100,000, $200,000 has to count toward the tax cap,” said county Legislature Chairman Joe Hauryski, R-Campbell. “And not only that, (the state) changes their formulas as to how much money they give us. One year it’s 90 percent, a couple years later it’s 70 percent. We never know how much they’re going to give us.”

Hauryski formed the special committee earlier this year, asking it to find ways to reduce Steuben’s cost of health care services, including home health care, the health care facility and mental health services.

The special committee’s recommendations on mental health services and the nursing home are expected some time next year.