Health Care

County Operated Health Services & How We Got Here

February 16, 2012 County

County operated nursing homes have a long history. They haven’t kept up with the changing environment. So even if a bit oversimplified, it’s worth taking a long view. First Generation. Non-Medical, Primarily County Funded Long before Medicare and Medicaid were established in the mid-1960s, county government provided classic public health and backstop services. Indeed, long […]

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Sell it Now!

February 14, 2012 County Government

So if New York does the right thing and tells Albany County that no, they cannot build a new money-losing nursing home, what happens next? And before the State acts, if the odds are say 50/50 or higher that the State will reject the application, what should be done in the meantime? Sell it. Sell […]

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Reader’s Digest Version on Albany County Nursing Home and Interactions of State Policies

February 13, 2012 County Government

Short version of previous posts, particularly here, on State Health Department practices and Albany County’s application to build a new nursing home that the County itself acknowledges is a money loser. The County’s own consultants projected a 52 percent operating loss in the third year of operation of a new facility. That’s $26 million per […]

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Albany County Nursing Home, Why New York Needs to Change How it Reviews Subsidized CON Applications

February 13, 2012 County Government

It’s time to end the practice by New York’s Department of Health of allowing county “commitments” to using local property tax increases to subsidize nursing home losses as a means to meet the financial feasibility criterion in the certificate-of-need process. This practice contradicts and undermines the State’s policy of slowing growth in property taxes. Such […]

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Remember “Stages of a Project”?

February 8, 2012 County Government

It appears that Schenectady County is moving ahead with building a new nursing home. Too bad. If it gets done, it will be just under the wire. The closer Schenectady has gotten to re-building, the more County leaders have made their discomfort explicit. Many will now say in private that it’s a mistake, but having […]

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What Will the Client Transition from Fee-for-Service to Managed Long Term Care Look Like?

December 20, 2011 Forecasting

We’ve already talked a little bit about how New York is undertaking a fundamental change in its Medicaid program. Similar changes are underway in many states. As part of this change, Medicaid clients in long term care are being transitioned from fee-for-service programs to various forms of managed care, including managed long term care. How […]

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The Albany County Nursing Home Soap Opera Continues: Episodes 4,564, 4,565, 4,566

December 16, 2011 County Government

Episode 4,564: When we last tuned in, the New York State Public Health and Health Planning Council had politely suggested that Albany County might want to re-evaluate its plans to build a new, ridiculously expensive Nursing Home. The rationale was that the State was about to issue new nursing home rates based on an entirely […]

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Home Care Workers to be Assured of Minimum Wage, Overtime and Pay for Travel Time

December 15, 2011 Federal Government

SInce 1974, based on their characterization as “companions,” much like babysitters, home care workers have been exempt from provisions of Federal Labor Law regarding minimum wages, overtime and travel time. Evelyn Coke, a home care worker Long Island sued her employer regarding these, ultimately her case reached the US Supreme Court. (Here’s a video from […]

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What Happened to Health Coverage Around 1980, What happened the Last Dozen Years and Why it Still Makes a Difference

December 12, 2011 Economics

Interesting chart (the second one) posted by Lane Kenworthy today and some interesting debates and here on when the US healthcare system performance began to look different from the rest of the world. Kenworthy’s chart depicts the relationship between health expenditures per capita and life expectancy. Here’s my contribution from a while back, while I […]

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Another NY County Shedding its Nursing Home

December 9, 2011 Budget

No budget detail yet, but as part of its budget process, Ulster County has determined to get out of the nursing home business. They’ve established a county-run limited development corporation (LDC) as an intermediary to smooth the process. More details later.

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