Commissioners hear budget request from Bladen County Home Healthbladenonline 05/31/2016 0 COMMENTS
By: Erin Smith
The Bladen County Board of Commissioners met Tuesday morning for a budget workshop for the FY 2016-17 proposed budget and voted to give Bladen County Home Health six months to improve their financial situation. Commissioner Wayne Edge was unable to attend the meeting.
Bladen County Health and Human Services Director David Howard presented information to the board regarding Bladen County Home Health. He presented the board an overview of the history of the department, some recent trends as well as current data.
“Home Health is a business owned by the county,” said Howard. He explained that Bladen County Home Health is not integrated into Public Health but operates as if it were an independent agency.
Howard said that the Home Health agency has been operated by Bladen County since the 1970s and was financially self-supporting until 2008-10. He said that at that time, there were fewer private agencies offering home health services and there were fewer associated services as well.
Howard said that at that time there were also high reimbursement rates. Today, reimbursement rates are significantly lower and compounding that is a complex billing system. Howard said today, home health is being paid per episode not per patient.
Howard said the way the system works is the referring doctor will establish what type of the care and services the patient needs and the home health agency implements the plan of care. He said the patient is presented a list of the various home health providers for their area and the patient chooses which company he or she wants to provide their services.
Howard said that some of the trends in home health are lower reimbursement rates, higher competition from private home health companies, increased complexity in the billing system, and a shift in federal funding.
He said there are some positive advances being made. Howard said the caseload has increased to 115-130; the agency has achieved Joint Commission Accreditation; private insurance is being applied for; a greater caseload can be managed without adding more staff and revenue is increasing.
He said the staff is applying to private insurance carriers to be included as an in-network provider.
Howard told the Commissioners that currently the agency is generating about $62,300 per month in revenue. He said the agency would generate about $747,600 in 2016-17 revenue based on that average monthly figure. He said the agency would need from the county an additional $12,270 each month to “break-even.” His total budget request from the fund balance is for FY 2016-17 is $224,157.
He told the board there are three possible scenarios for the agency: Scenario 1 is to budget a figure for the coming year; Scenario 2 is to budget a figure and indicate an acceptable annual contribution for future years; or Scenario 3 is to sale Bladen County Home Health.
Howard said that if the county chooses Scenario 1 the Home Health agency will need to reach to private insurance more and track caseloads and revenues and make sure they are trending upward. He said they would also track expenses.
He said if the county chooses Scenario 2, then the Home Health agency would need to behave more like a private Home Health company and start implementing similar strategies to private companies.
“The Catch-22 is you have to behave more like a private company. That defeats the purpose of serving someone regardless of their ability to pay,” said Howard.
He said if the county chooses Scenario 3, they can put the agency up for sale and there are General Statutes that govern the sale of home health agencies. Howard also if the county chooses to sale the Home Health agency, it would be a one-time revenue generator. Howard also that if the county did not think the bids offered were high enough, they have the right to reject all of the bids they receive.
Howard also told the board that if they put the agency up for sale the county can have certain assurances such as what happens to employees, how residents will be served, etc. into the contract to purchase.
Commissioner Michael Cogdell asked Howard what the trend is in county operated home health and Howard said the trend is for counties to sell their home health agencies to private companies.
After further discussion, it was determined that the Home Health agency had been losing money since about 2008.
Commissioner Delilah Blanks said, “We need to convert this. We need to move from running a business to providing a service. We can’t keep taking people’s taxes and subsidizing this business we are engaged in.”
Commissioner Charles Ray Peterson pointed out that when this was first brought to the board’s attention last year, they did not take any action on it. “I think this board needs to give Home Health six months. We spent a lot of money there. We owe it to the employees. I think we need to give them six months to increase the patient load and increase the revenues. We need to hang on and see if we can turn it around,” said Peterson.
“I think what we need to do is look at this seriously. We’re wasting tax dollars,” said Commissioner Arthur Bullock.
The board voted in favor of giving Bladen County Home Health six months and to review the situation every month.Share: