HUDSON–The full county Board of Supervisors approved a contract last week authorizing a $1.2-million contract with the architectural firm of Fontanese, Folts, Aubrecht and Ernst to begin preliminary site studies for a new facility to replace the current Pine Haven Nursing Home in Philmont.
The process of studying alternatives to Pine Haven began in 2009 and created controversy from the beginning between a faction on the board committed to a new facility and another group of supervisors who believe the county should not be in the nursing home business.
The successful passage of the resolution at the June 12 meeting to move forward with further site and development studies represents a compromise between the two camps. While the board supported the resolution, some who did not, namely Canaan Supervisor Richard Keaveney (R), Hillsdale Supervisor Arthur Baer (R) and Gallatin Supervisor Thomas Garrick (R).
Although in previous meetings New Lebanon Supervisor Michael Benson (R) voted against the plan, on June 12 he voted to support the current resolution, which will contain provisions for the county to back away from any further expenditures should preliminary reports suggest that the site development costs present problems.
“This is not over tonight. We are not committing to spending $32- to $46 million on the facility. What is happening is that we are committing to do the necessary due diligence and thereby determine a more definitive path forward,” Mr. Benson said. In subsequent comments, he added, “Our roads and bridges need nearly $100 million and that is an obligation that we cannot escape. The private sector can build and manage senior care but not our infrastructure. Not now, not ever!”
Commenting on his vote, Mr. Baer said, “The county needs a financial plan to justify spending this kind of money without a road map.”
Supervisor William Hughes (D-Hudson 4th Ward) countered, “Due diligence and thought went into [the decision]. The Pine Haven Committee did a good job.”
Supervisor Sara Sterling (D-Hudson 1st Ward) expressed some concern, saying, “I am voting to support doing the due diligence. But, can we pay for this? We cannot afford to lose $1.8 million.”
The state Department of Health has issued a Certificate of Need, a determination that makes the county eligible for support for funding a new facility. The county now faces a deadline of October 15, 2013 to begin pursuing the project. Nearly all members of the Board of Supervisors agreed in previous meetings that changes at Pine Haven were necessary, but how to go about making them continued to divide the group.
On May 22, the Board of Supervisors approved the measure to retain the architecture firm contingent upon receiving written confirmation from the Department of Health that it would reimburse the county for all but $14,000 of the fees should the county opt not to move forward with the project. But on May 31 the county received a 25-page response from health department saying the department would not commit to reimbursing the county.
Then, on June 4, a special Pine Haven meeting was convened at which Don Evans, a consultant with KPMG, who has been working with the county on the project since 2009, noted that historically the state did reimburse over a five-year period, with some restrictions, among them the right to determine whether the reason for abandoning the project meets state criteria. The committee passed a resolution to proceed with the plan to hire the consulting architects, and the same resolution was passed by the Finance Committee, which met immediately afterward.
Those supervisors who remain opposed to the measure expressed concern that under the
Patient Protection and Affordable Health Care Act (Obamacare), no one can predict with accuracy what level of reimbursements the county may expect from the government going forward. A new facility to replace Pine Haven is expected to cost $33 million plus an additional $13 million in interest, based on an estimated 2% financing costs. Currently, the state reimburses at a rate of $239,000 per bed. The new facility will have 128 beds, so state reimbursement for the new project is capped at $30,592,000. That leaves a shortfall between the estimated cost and the expected reimbursement, an amount county Controller Ron Caponera set at $1.8 million.
Those same supervisors believe that other options could be considered, including rebuilding on the existing site, which they say would save between $5- and $6 million in costs. Another option is to build at the Ockawamick School building on Route 217 between Claverack and Philmont, a site that the county has already paid for and is not being used. Supporters of that approach believe it would require lower development costs than a new building at the Philmont site because the structure could be rehabbed sufficiently to comply with Department of Health requirements.
County Attorney Robert Fitzsimmons is drafting the contract with the architecture consulting company to ensure the county has an early “out clause” should the preliminary results of the studies suggest that it would not be viable for the county to move forward with even the balance of the $1.2-million contract for the site studies.
Regardless of what the studies show that county still faces the need for nursing home services. As Board of Supervisors Patrick Grattan (R-Kinderhook) put it, “Many of Columbia County’s older taxpayers always believed that when their health care needs required significant nursing care, that a modern facility would be available to meet them. A new Pine Haven will meet the needs of these older residents.”