Nursing home employees attending a forum Thursday on proposed layoffs at Cattaraugus County's two managed-care facilities jeered when administrators suggested that the workload could be handled efficiently with 29 fewer workers.
They also shouted out that the facility's residents fear the prospect of fewer people to care for them.
Meanwhile, some family members of patients wept.
Other employees assembled in the nursing home's filled-to-capacity dining hall suggested that a projected $900,000 deficit for 1997 could be met by cutting county legislators' salaries or eliminating the proposed addition of 12 full-time and two part-time sheriff's office positions.
"These girls can't work any harder," said a Napoli woman, who indicated she worked as a nursing-home aide for eight years and regularly visits her father-in-law in the Machias facility.
Other workers said patients need all the staff time currently available.
Others in attendance, family members of residents, said they are opposed to staff cuts and praised workers for the excellent care shown relatives.
Most said they would rather raise county taxes another 3 1/2 to 4 percent after County Legislator Sandy Wyllie, R-Delevan, asked if they would rather close or sell the homes, or cut costs and increase therapy revenues.
"You're hiding from the facts," said Mrs. Wyllie, who cautioned that a majority of county legislators would not approve a tax hike.
But Mrs. Wyllie later promised to take a look at an alternative budget for the county's two nursing facilities being drawn up by the Civil Service Employees Association. In an attempt to save all 29 jobs, a team of CSEA committees are tearing apart the 1997 budget proposal of $114 million unveiled this week by County Administrator Donald E. Furman and designing their own.
A CSEA member serving on a research committee made several suggestions, including separating the patients' pharmacy bills from the general budget to raise additional revenue, and halting the practice of billing for services six months after a patient's death to eliminate large write-offs in unpaid interest charges.
"There's bad information being given out," said Thomas R. Finger, a CSEA labor relations specialist, speaking at the close of the forum.
Finger suggested budget figures can be "massaged" to justify layoffs.
"If we could tie patients in bed and know where they all are we could cut staff," said one worker, who noted that nursing homes in New York state are prohibited from restraining patients. She said some patients have "gotten out the door."
Peter Lacari of Complete Care Services, hired by the county to manage the two homes, said all nursing homes will be restraint-free in two years. He added that poor training is the cause for patient falls, escapes and other accidents.
He said budget cuts are necessary because the government is downsizing and will continue cuts in Medicaid funding and reimbursements.
Lacari said Cattaraugus County's facilities average 4.3 hours of staff time to care for each resident each day, as compared to the industry's recommended staff time of 2.5 hours per day. In addition, most homes spend between $40 and $50 each day on every patient, while Cattaraugus County's homes spent around $60 a day.
He also promised a training program to assist workers in attaining the desired staffing level and said the hardest part will be the transition.