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Health Board opposes move to contract out home care

A proposal to turn over the Niagara County Health Department's home care functions to private contractors went over badly with the county Board of Health last week.

A resolution directing County Manager Jeffrey M. Glatz to investigate the feasibility of privatizing the service is on Tuesday's County Legislature agenda.

It's sponsored by Legislator Peter E. Smolinski, but he told his fellow Board of Health members at their meeting Thursday that it really came from the Republican-led majority caucus.

"I would expect opposition from this board," Smolinski said. "My name's on this, but I'm not saying it came from me."

Smolinski, R-North Tonawanda, also heads the Legislature's Community Services Committee, which is where the resolution is expected to be referred.

Public Health Director Daniel J. Stapleton said the Health Department has two home care programs.

The text of the resolution says they are state-mandated, but Stapleton said that is untrue.

The programs are the Long-Term Home Health Care Program, sometimes called the "nursing home without walls," and the Certified Home Health Care Agency. The latter brings home care services to those in need of short-term rehabilitation or recuperation.

The county has a total of 540 patients in the two programs. About 35 employees spend some time in the programs, but Stapleton said that all the county's nurses are cross-trained in various functions and that no one is assigned exclusively to the home care effort.

Private companies also provide those services, but Stapleton said they are often highly selective as to which patients they take -- usually the best-insured.

"We have data to show the other entities don't accept the people we do. The term is cherry-picking," Stapleton said. "We take whoever comes to our door who wants care."

"We should do something to help the people who are falling through the cracks," said Board of Health President John Gotowko, a North Tonawanda pharmacist.

"It seems to me this [sale] will not be favorable to the people," said board member Susan DeLong of Niagara Falls.

"It could seriously compromise services to some people, but we need more information," said Dr. Thomas Hughes of Lockport, a board member.

Smolinski said it will take time to move the resolution through the Legislature and to obtain Glatz's report, and if the Legislature tries to sell the program, a proper request for proposals will take months to compile, Stapleton said.

Smolinski said the county will save about $40,000 in net costs if it unloads the home care programs. Stapleton said if the move is made, he would like to see the money redirected to some of the Health Department's other programs.

"I'd hate to think we're buying a garage for somebody," grumbled Wanda Smiley, director of patient services.

Smolinski said other efforts to save money can be expected. "It's every department. If it's not mandated, we're trying to cut down on it," he said.


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