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Saving the Genesee County Nursing Home: An Open Letter to the People of Genesee County

Saving the Genesee County Nursing Home:

An Open Letter to the People of Genesee County

By David A. Olsen,

Founding Member of the Genesee County Libertarian Party

Dear Friends & Neighbors:

           Dating back to the first half of the 19th Century, Genesee County has pledged to care for our elderly citizens who are not able to take care of themselves regardless of their wherewithal to pay for the care or not. This is a noble mission and a tradition worthy of being continued. It is the opinion of the author that this promise should continue to be kept and it is our generation’s responsibility to get the GCNH on a path of sustainability and self-reliance. Originally, the County Home was self-sustaining due to the farming engaged in on the same property. That has not been the case for over 50 years. Over the past decade, at least, it has become an increasingly expensive burden for the taxpayers, so much that it is now problematic. By now, May of 2014, it has become obvious to even the most casual observer that the Genesee County Nursing Home is on an unsustainable path. If the people of Genesee County want to preserve the promise made many years ago that care will always be available for those in need for their friends, family and neighbors, then we have to begin thinking differently.

A recommendation follows and I hope the Genesee County Legislature will consider this as a viable suggestion. This letter has been sent to each County Legislator.

           The Genesee County Libertarian Party motto is “Educate. Advocate. Choice.” Part of the Educate segment, in addition to clarifying the principles of libertarianism and proving that it is not a selfish philosophy is to show that we, the people can do good things for our fellow man and without the interference of government and without the immorality of theft by taxation.

           Last year 60,000 of county taxpayers’ dollars were spent with The Center for Governmental Research on a study to provide some recommendations on how to proceed with the GCNH. This was the second study commissioned. The same organization had already completed a study in 2010 at taxpayers’ expense. I am using one of the options from this earlier report as a base: Option 5, which begins on page 91 of the report titled Genesee County Nursing Home Assessment and Analysis of Future Options, November 2010. ( cite: http://www.cgr.org/reports/10_R-1624_Genesee%20County%20NH%20Final%20Report.pdf )

Why a second study was commissioned is unexplainable in my opinion and totally needless. Again, even the most casual observer understands that NY State and the U.S. governments are both broke and view Medicare/Medicaid & Social Security as “entitlements” and therefore a constant subject of debate on how to cut those expenditures back. In other words, they will not be paying more. The unpaid IGT (Inter Governmental Transfer) funds are a case of fool us once, shame on the Federal government, fool us again shame on Genesee County. The promise made will not be kept, so let’s stop expecting those funds in our budgets.

           So what can we do? Please read on.

Quoting Buckminster Fuller: “You never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.”

          I set a few goals for this project:

  1. Continue the mission of GCNH without county tax funds being added every year to meet the operating expenses;
  2. End reliance on Government funds outside of Medicare/Medicaid and Social Security;( ie: IGT )
  3. Preserve the jobs that actually provide patient care at GCNH;
  4. Place the home under professional management and off the county administration workload;
  5. Provide future nursing home care for those county residents who cannot afford it.

     The actual cost to the taxpayers is somewhat foggy. By amalgamating versions from the County Manager, County Treasurer, Nursing Home Administrator, various legislators and reports from the Daily News and The Batavian, I concluded: since 2002, County tax funds have been required to cover the GCNH operation yearly. The numbers have gone up and down apparently, and this year they are projected to be around $2.5 million in the red. The county has been forced to borrow at times in anticipation of IGT funds. I don’t know the accumulated cost in interest payments. Regardless, this is not sustainable and is not fair. While it is the author’s opinion that a moral obligation does exist to help provide for the least among us, it is also true that the County Legislature has the moral obligation to ensure that if taxes must be levied, they should be spent in the most efficient manner. Unfortunately, neither of those obligations is being met.

     The best situation, I feel, would be to lease the home to a private operator preferably a nonprofit, but for-profit corporations should not be excluded. The decision to enter into any privatization agreement and who the operator is ultimately should be decided by referendum of Genesee County voters. Currently the income of the GCNH is expected at $15.797 million per year, their budget runs at $18.2 million, about $2.4 million is expected in IGT Funds, which apparently have not been paid since 2011. Let’s just forget the IGT Funds for now; if the federal government decides to send it to us, great, but it’s looking like a write-off from here. It also appears that privately operated nursing homes receive a higher per patient payment from Medicare / Medicaid than do government run homes. Additionally, the home is running at less than full capacity and a new operator would surely try harder to fill the facility. This scenario is based on the info available regarding what the GCNH receives now, so any difference goes to the bottom line of the operator. I expect that the new operator will bring in substantially more revenue than does the current operation, due to the above. Any schemes of making money for the County’s general fund through rental income, sale of bed licenses or debt repayment are not being considered. The mismanagement of other county operations is a separate issue and I am currently only considering the future of the Nursing Home. All proceeds need to be earmarked for the future care of County residents.

    So, here goes:

A..        Lease to be paid by the operator in the amount of $4,739.000 per year for a period of 10 years. This is equal to 30 of $15.797 million (current projected income). Standard business practice is to pay 20 percent of income for rent. This is a highly specialized facility with an existing customer base, so it is surely worth much more. I consider 30 percent to be a discounted rate, and should satisfy the NY Constitutional requirement of “Fair Market Value."

B.        During the 10-year period, the County will return to the operator $1.5 million per year for upkeep and maintenance, operator is responsible for any amount over that and can keep any funds not spent. The operator is responsible to complete needed upkeep and maintenance. Facility shall be inspected quarterly by the County for compliance.

C.        During the 10-year period the County will pay for the care of indigent or underinsured patients in the amount of 1 million dollars the first year and then decreasing by $ 100,000 each following year so that after the 10th year has passed, there will be no more funding from the County.

D.         This leaves $2.239 million remaining from the proceeds of rent payments. Of that 25 percent ($671,700) shall be placed into a contingency fund each year to be spent on Nursing Home issues only, at the discretion of the County Legislature. (Specific items allowed should be quantified in the lease agreement). The remainder, which would be $1,568,300 the first year and then increasing by the amount withheld from the payments described in C. above shall be placed into a permanent fund, which will accrue interest and will be used to fund the County’s share for care of the necessitous citizens of Genesee County after the 10-year period has ended. This will leave the fund with $19,500 in principle paid in. With an estimate of 2-percent interest being earned, the fund should have approximately 24 million dollars in it. That would be enough to have $300,000 to 400,000 per year removed for patient care and still be sustaining.

E.         At the completion of the 10-year period, the operator will cease lease payments and either the facility could be transferred to their ownership or the County can retain ownership. The facility would then be placed on the tax rolls, or if continued ownership by the county is desired, a payment plan would be drafted in lieu of taxes. Either way the result will be lower than $4.739 million per year. This should provide an incentive for a farsighted operator to take over the operations even if they may lose money in the first few years, which is why I believe that a nonprofit would be the best fit.

F.         The operator shall be offered to purchase County employee benefits for their employees, so as to continue the employment of the current staff for a period of 10 years. A benefit buyout plan should be established for any current employees who remain past the 10-year period and their pension converted to a 401K. I don’t think it wise to demand that wage levels be mandated for the operator, nor should we demand certain staffing levels. Those things are controlled by the State of NY anyway. We can however assist with the high cost of employee health benefits. A large majority (around 70 percent) of the GCNH budget as reported by the County is attributed to “Salary /Fringe” -- this could help alleviate those costs enough for the new operator to function at the reduced income of $12,558,900 (minimum) the first year (70 percent of $15,797 plus the $2.5 million refund from the County) without necessarily reducing the paychecks of employees. Especially in light of the fact that the operator will both earn more per patient and is expected to have more residents at the home.

            I’m sure there are laws and regulations which I am unaware of and are not factored in. I know the employees are represented by a union. Unions renegotiate contracts all the time, so that shouldn’t be an obstacle. This is why I am sending this to the Legislators so they can research those issues. This is a starting point and I believe the base premise used here is sound and workable.

      Thus the Genesee County Nursing Home is saved, the employees keep their jobs, taxpayers are no longer paying for the operation of the home, the County Administration is no longer spending time and effort on the home, a new private employer has come to town and most importantly the mission of the home to be there as a safety net for County residents will continue.

With Liberty and Justice for All,

David A. Olsen

Scott Ogle
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Some interesting ideas on unloading the nursing home. And making it self-sustaining wouldn't be wrong, but I'm dubious that it can be done. I really can't judge the viability of the plan here, and even the author admits to factors of which he may be unaware. But on a side note, Libertarians lose my respect entirely with this sort of cant:

". . .without the immorality of theft by taxation."

John Stone
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Poor fiscal stewardship has brought us to this point... I know that many people want to keep up the status-quo so badly that they will actually argue that it is on a sustainable path, but it is past time for reality to be acknowledged: The pork and patronage from years past cannot be continued.
As long as we have the same types of people running this home and this county, nothing real will change. The mentality of governance must change, and then we can see progress...

John Stone
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Why is that Scott?
America was building and growing extremely fast before the government started taxing us in the 1910's... Since then, it has only been in decline. Government is more problem than solution, and only ignorance of reality can allow for most other opinions...

Or... answer this for me: How much of the money I worked for do you believe you are entitled to take from me? How much can I take from you?

Scott Ogle
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"before the government started taxing us in the 1910's... Since then, it has only been in decline"

John, I'm afraid we weren't in the same history class. Unless the Robber Barons and their Gilded Age was your ideal America. Sadly, we seem to be sinking into those times again. We need another Teddy Roosevelt to bust up some Trusts. (And banks) America's zenith, I believe, was in the tax-laden years after 1945 when G.I.s rushed home to a government guaranteed education, and banks were eager to make loans on the future. The middle class boomed, profits soared, and there were good jobs for everyone. (Whites, at least.) The sky seemed the limit.

Emma Morrill
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I agree, Scott. Frankly, when I read a line like, "...without the immorality of theft by taxation," it's difficult for me to take the rest of the proposal seriously.

Scott Ogle
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"Or... answer this for me: How much of the money I worked for do you believe you are entitled to take from me? How much can I take from you?"

I'm not entitled to take any money from you, nor you from me. We're each required to pay our taxes by law.

Scott Ogle
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". . .difficult for me to take the rest of the proposal seriously."

Yes, which is too bad because there may be some good ideas there, I don't know.

Don Lovelace
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". . .without the immorality of theft by taxation,"

I'm glad you found a place in this excellent letter to throw the baby out with the bath water.

Now you have an excuse for ignoring the fact that someone took the time to put forth an idea to stir debate and conversation on the subject.

I have been reading comments here for years and I have been commenting also. I read a lot of comments that say you are always complaining, you never say anything positive.

Well here is a positive attempt to change things, and you dismiss the entire letter because of seven words.

Fortunately people like myself are done taking you seriously and are moving on from your flat earth opinions.

Well done Dave, I may not understand all that you've said, but you can be sure that I will do some research to understand it.

Emma Morrill
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Very true, Scott. Admittedly, I don't know enough about this particular situation, nor about the accuracy/veracity of the information provided, nor about the particular expertise of the writer, to determine whether or not these suggestions seem viable. There may, in fact, be some good ideas here. I'm not certain. I only know that the ahistorical and inflammatory proposition that taxation is not only immoral, but that it is also theft, makes me question the validity of the agenda at hand.

Scott Ogle
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"Well here is a positive attempt to change things, and you dismiss the entire letter because of seven words."

It's hard to follow whom you were addressing, Don. If it's me, please reread my comments. I dismissed nothing.

"I'm glad you found a place in this excellent letter to throw the baby out with the bath water"

I presume this was to me, but while I expressed some doubt about the plan, I thew out neither baby nor bathwater. I am no libertarian, however. But I should have extended a pat-on-the-back to David Olsen for wrestling with the issue on a nice spring day. He deserves it.

Emma Morrill
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"Flat earth opinions," Don? I'm sorry, but you make no sense. I happen to know Scott. He is FAR from a "flat earth" type... nor is he particularly negative, unlike so many who regularly post on these boards. Scott admitted that there may, in fact, be some good ideas here. Scott's critique, however, is also valid. If the writer wanted to offer up a solid proposal, without being called out for incendiary remarks, perhaps he should have left those remarks out of the proposal. That's his choice.

Furthermore, just because Scott (or anyone else) doesn't happen to toe the Libertarian political line that so many of you long-time Batavian regulars seem to hold, it does NOT make him a "flat earther." Even you admit that you don't understand all of the pieces of this proposal, Don. Are you just going to take it all at face value, simply because it is written by someone who holds the same political ideals as you? That, to me, seems far more akin to behaving as a "flat earther."

I applaud people, like Dave Olsen, who take the time to try to hammer out solutions to difficult community problems. That, however, doesn't mean that I have to agree with everything that those good citizens state or propose. Honestly, there is an awful lot of undue hostility on these pages leveled against anyone who dares to question even the tiniest facet of Libertarian doctrine!

Mary E DelPlato
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privatize it...maybe st johns can purchase it....its allready sad that theyve fired some workers to only turn around and fill in those positions as part timers...the security guard is gone....which I dont agree with...felt secure for my mom...the switchboard operator hours have been cut...the cafeteria for employees and visitors is gone...sad that it has been mismanaged for years....otherwise it wouldnt be in dire straights...I do know this...if they bring in aramark i will be removing my mom....there are lots of great people that work there...management has a way of lowering morale and ruining peoples livelihood...sad

Bea McManis
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When we worked to save the nursing home, a few years ago, the Libertarians on this board were very vocal in their opposition. There are many residents, at the home, who paid taxes all their adult lives. To say they are now stealing services from current taxpayers is an insult to their lifelong contribution to our county.
How many of you are ready to accuse those who labored on farms, factories, shops, schools, etc as picking the pockets of county residents?
I'm curious about the change of heart. Why the sudden concern for the downtrodden? Aren't they in their present situation because they want to be? How about the complaint that the home uses taxpayers' money to wait on grandma hand and foot? What happen to the strong belief that the aged and infirmed belong with relatives and not be a burden to current taxpayers?
Genesee County does have a history of providing a safety net for those who need it. A few years ago the Libertarians did not join in the effort to find a viable solution. They did not join us when we addressed the legislature.
Could it be we have an election on the horizon?

Scott Ogle
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"Bea: In 2010 there was no Libertarian Party in Genesee County. So its not possible for us to have opposed or supported anything before Jan. 21, 2013."

Goodness, Dave. Are you saying there were no Libertarians in Genesee County before Jan. 21, 2013? I believe Bea made no mention of a political party, only some individuals of a certain political bent.

Scott Ogle
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"Do either of you have anything constructive to add?"

We already have, Dave. We voiced our opinions. And thanks for the silly clarification.

Bea McManis
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Dave, are you saying with absolute certainty that there were no card carrying Libertarians in Genesee County 4 years ago? Furthermore, can you say with the same certainty that there were no contributors to this site who were card carrying Libertarians?

Based on the lack of support received from those who espoused the Libertarian point of few, at that time, II'm surprised that there is a open letter, under the banner of your party's letterhead looking for viable solutions.

Many of the hurtful comments made then still resonate in my memory as if it were yesterday. Ergo, my curiosity is piqued when your membership brainstorms to create a letter that goes against the prevailing thoughts of four years ago.

Our group was bi-partisan. It was never meant to champion one party over another. You are making it a one party political football. Yes, elections are coming up. Pardon me if there is skepticism regarding your motives.

Debbie Paine
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I am a member of the Genesee County Libertarian Party. I rarely post here, (or anywhere for that matter) as I find that the political opinions of the well indoctrinated that usually respond online are firmly entrenched. Most are more interested in what they will post next, and how they will insult the messenger of the opposing viewpoint, than having a true discussion of issues.

I am a friend of Dave's, and applaud his efforts to present a new way of looking at an old problem - how to preserve the services society provides to its most helpless members, while reining in an out of control tax burden. Dave has admitted to uncertainties in his plan - I'm certain there will be a few in any other potential plan or budget as well.

Just because something has been done a certain way for as long as we can remember, and we've been indoctrinated to believe it is the very best way, doesn't make it so. Likening taxation to theft is not that far a stretch - in fact, I hear Republicans and Democrats doing it all the time- depending on which of the other side's pet programs are up for debate.

The reference to "flat earther" might be a bit extreme. Perhaps its more like Dave's plan is akin to showing all the "round earthers" that maybe the earth is an oblate spheroid after all.

Jeff Allen
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"Dude, that was like 4 years ago" "What difference does it make?" Well done Dave

Bea McManis
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Dave, maybe you should care. I'm willing to listen to any possible solution, just as we were before. Where was your passion then? Why weren't you standing in front of the legislature pleading the case for our seniors? Where were the rest of the people who are now part of your organization?

By the way, a good friend just passed away in a facility in Rochester. His wish was to be back in Batavia, but l'm told there were no beds available.

It doesn't take much thinking to figure out the anonymous co-author. It was easy to see it was a collaborative effort. One has to ponder why that person is staying in the background.

Jeff, it might be four years ago, but leopards can't change their spots.

Jeff Allen
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Bea, those were a gratuitous use of two of many handy new narratives introduced in the last 6 years(I have an admitted problem with snarkiness that I can't seem to shake). You are correct, leopards can't change their spots, that would be evolutionary(dang it, there it is again). However, I fail to see why cursory statements made in the past by individuals in this forum in any way undermine the value of what Dave and the mystery guest put together. When a problem has run out of solutions, it's not wise to discount new ones solely because of who they came from.

Bea McManis
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Dave, not meant to be an insult. It just read as if more than one pen was involved.

Don Lovelace
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-Theft by taxation - government
-"National debt" - government
-Millions of casualties due to illegitimate wars - government
-Overpopulated prisons filled with innocent people - government
-Police brutality - government
-Welfare state - government
-Violation of: privacy, freedom of speech, property rights, right to self-defense, right to live self-sufficiently - government
What makes more sense - to spread ourselves thin and try to fix one problem at a time? Or do we wise up and work together to eliminate the one thing CAUSING the problems in the first place?
Let's stop attacking the symptoms, and start focusing on the common denominator.

From Josie the Outlaw on Facebook

Bea McManis
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One contributor noted, in 2010, that he didn't want his money supporting the nursing home residents. They will live longer and want more!
Another, in 2010, suggested that the old and infirmed should be with faamily and not in a county nursing home using his hard earned money.
This idealology embraced by the 'it's mine and I'm not sharing' generation may come back to bite them in their later years. It is your money and you may be successful in eliminating the theft of your money, but you may also find yourself in a position to need the skilled care and equipment most families can't provide at home. Then what? Don't for a moment believe that you are immune to changes of fortune. You may be solvent today, but that can change in a blink of an eye. That theft of your money to support our county home may, someday be your safety net.

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