EDITORIAL: We’re not getting younger

HERE’S SOME ADVICE. If your mother-in-law confides in you that “Getting old sucks,” believe her.

Some people age with few problems, but many of us will need help in their later years and nursing homes, now called skilled nursing facilities, are where we’ll get it. This applies to residents of Columbia County because we are the “oldest county in the state” when measured by the percentage of the population over 60. That works out to one of every four people who live here. Kary Jablonka, head of the county Office for the Aging, has been talking about this recently as his agency does what it can to meet the current needs of elder residents and to encourage folks to plan for the future.

If you aren’t already wondering who’s going to mow the lawn or do the shopping when you can’t, here’s another way to look at what’s happening: the median age statewide is 38; the median age in the county is a little over 45. And this aging business has a gender bias that gets worse as we grow older. The county has roughly twice as many women residents as men over the age of 85. Sorry, guys.

Many of us hope we can stay in our homes until the end of our lives, and technology coupled with consumer preferences may make that approach the model for care in the future. But the range of geriatric problems that require constant attention and the rural character of the county may also lead to an increase in the number of people requiring skilled nursing facilities.

The county has a handful of private nursing facilities and it has Pine Haven in Philmont, owned and operated by the county government. Pine Haven, with 120 beds, is over 40 years old and needs to be replaced or extensively remodeled. This is not news to anyone familiar with county government. In the middle of the last decade a committee of county officials carefully considered the options and concluded that a new facility with a few more beds made the most sense.

Earlier this month the county Board of Supervisors agreed to spend up to $1.2 million for architectural studies for a new Pine Haven, a facility expected to cost more than $33 million. In the past the state has reimbursed counties for much of the cost of construction for similar projects.

The contract for the studies gives the county the option of pulling the plug before all the money $1.2 million is spent if the preliminary information doesn’t look promising. And while that’s a prudent step, it’s not yet clear what might trigger a decision to abandon the plan.

It certainly can’t be demand. The county is a captive of our demographics trends. As the average age increases, ever greater numbers of older residents will need skilled nursing care. That pressure for care will continue over the life of a new facility.

It won’t be quality of care, either. Pine Haven has a strong tradition of professional service and effective management. Until now taxpayers have been satisfied that Pine Haven, which accounts for $9 million of the $159 million in line-item spending in the county budget. It’s a service worth having.
New Lebanon Supervisor Michael Benson (R), who voted for the architect’s studies, qualified his support by saying that the county should concentrate on maintaining roads and bridges and leave the care of older residents to private industry. Too bad the choice isn’t that simple.

This county already has many more private nursing facility beds than Pine Haven has now or would have if the county builds a new facility. Yet the state agreed that the new Pine Haven, with eight more beds, meets state criteria for a certificate of need, a recognition that the county requires more nursing facility beds than it has. The private sector isn’t stepping in to fill this need, and so it falls to government to close the gap. It’s possible too that having a publicly run option keeps the private players on their toes.

What’s really happening here is a debate over the maintenance of essential human services infrastructure. That’s something we cannot not delegate exclusively to market forces any more than roads and bridges. County supervisors have shown admirable caution in planning to replace Pine Haven. They’re right not to waste our tax money, but they would act irresponsibly if they do not devote public funds to build the best new Pine Haven possible.

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