Henry County Home Health and Hospice services have been halted as the program is restructured.
The program, which is part of the Henry County Health Department, has been evaluated for the past 18 months due to deficit spending that occurred over the past three years. Passport Program services were recently removed because the department was losing money providing those services, and staffing positions have been reduced over the course of this year.
The department announced the change Wednesday, and Henry County Health Commissioner Mark Adams said when the home health and hospice program started around 35 years ago, it had three part-time employees and there were no similar agencies providing those services to the residents in the county.
“There were no outside competitors. Companies that exist now did not exist back then,” Adams said. “It was designed back then to fill a gap because that’s what our role is — we’re supposed to fill gaps in needs and care.
“As many hospitals, private agencies and nursing homes have expanded into this field of work, the need for the health department to fill the gap began to diminish,” he added. “We’re proud of the fact that we did exactly what a health department should do to fill needs where they exist.”
With the home health and hospice program already in deficit spending, Adams said upcoming cuts in reimbursements for Medicare and Medicaid would cause additional financial strain and noted the program is self-sustaining and does not receive levy funds collected by the health department. In addition, Adams said laws introduced over the years have also required additional staffing.
“The laws almost make it so expensive because of the multiple layers of staff you have to have,” he said, adding that includes a medical director and clinical manager.
Adams added numerous health departments in the area at one time offered home health and hospice services, but there were only three left including Henry County while Ottawa County offers home health and Putnam County still has home health and hospice. Adams added they investigated surrounding counties to see if there was room for an expansion of services, but those facilities already have established relationships with other agencies and companies.
The home health and hospice program had seven part-time employees from 2007-09, according to Adams, but was seeing more of a need for services and so more staff — nearly 21 — were hired, many of which were full-time.
“We really had a patient base to still just have seven to nine people,” said Adams, who joined the health department in 2018. “Eventually, over time, expenses caught up. What we need to do is get back to the original business model, and if there is still a need in Henry County, it needs to be set back up to the way it was 35 years ago.
“This decision was not made lightly,” he continued.
Adams said the home health and hospice program is not closing as the department will keep the license. All but one of the 19 patients have already transferred to other agencies, according to Adams, and four of the seven remaining staff are transferring to other divisions within the health department while the remaining are searching for other employment.
“Almost everybody will be able to filter into re-accreditation roles, into helping out with WIC (Women, Infants and Children), into expanding our BCMH (Bureau of Children with Medical Handicaps) and community health worker programs,” Adams said.
The program’s fund does currently have a positive balance and will able to cover the existing debt for the program which totals approximately $467,000, including an electronic medical records system and vehicles.
“It will end up walking out solvent,” Adams said, adding funds leftover will be transferred into the general health fund. The vehicles will be transferred to other departments whose personnel travel, such as Help Me Grow, and Adams said that is a cost savings for programs compared to reimbursing staff for mileage in their personal vehicles.
Adams said the department will be monitoring the community for at least the next six months to determine if there are unmet needs related to home health and hospice and if the department can provide any of those services. However, if they determine there is a need for some type of services from the department, Adams said it would not be a separate program and would likely fall under the nursing department and the general fund, with the assistance of the operating levy.
“It really needs to be a package of care that we provide as a program rather than as a separate business of the health department,” he said, adding there’s too many fluctuations in the number of patients in the program to have it be self-sustaining. “But first we have to determine if there’s still a need.”
Bethany Wachter, health communications specialist/accreditation coordinator for the health department, said the department will be more selective with the services it provides based on the needs they see.
“We can re-examine and see if there is a small gap that we can fill and continue forward with that,” Wachter added. “It’s coming down to being selective with the services we provide.”
Adams said there are not funds in the current levy for any home health or hospice services, but existing health department staff could likely be utilized if any of the services are returned and so they would not need to seek additional funding.