With commissioners beginning the budget process and serving as the Board of Equalization and Review, the last thing they need is bad news.
Harrelson laid out the prospects for either additional local funding for the Home Health Care program or getting out of the business.
He told commissioners that the program had been a successful program over the years, in fact they had been able to make money and save some for a hard times. About two or three years ago, the agency began to dip into the fund balance from previous years to fund the current operation.
The agency needs about 200 clients per year to break even. The past year they served 98. Harrelson said there were three reasons for the short fall.
1) Competition in the market. Over the years, Bladen County Hospital has provided most of their referrals. Today, hospitals in the area are providing more of the services, expanding their ‘foot print’ in the market place, and every year it gets more difficult for the Health Department to compete.
2) Shrinking reimbursement rates.
3) Increasing program standards make it more difficult.
Harrelson said area providers are mostly for-profit agencies that operate in a wider area and save by combining some services that are not available to the local agency, example billing and collections. One way to overcome that is to expand the service area and that will be difficult to do, he added.
The agency has spent from $100,000 to $200,000 more than they have billed over the past 2 or 3 years, and according to Harrelson, that is unsustainable unless the county decides to subsidize the program.
He added only 23 local health departments have Home Health programs at this time and 2 of the 23 are in the process of being sold. Others are currently considering selling.
The alternative is to “get out of the business.” It is not a required service and Harrelson questioned if county tax payers would be willing to subsidize a program that was readily available in the area, offered by for-profit agencies.
Commissioners ask questions related to availability for local residents, quality of care and what did they have to sell.
Harrelson said the health department provided a good service, he could not speak for others but was sure they were good as well. The department has a medicare number that could be sold, and it would eliminate the cost of operating the program by the county.
He was told to move forward on gathering information on selling and report back to the board.
Currently, there are 12 employees involved in the program. Harrelson expressed concern for them. He said some may find employment in other departments. The commissioners asked if there were any employees at retirement age. Harrelson reported there is one employee at retirement age.Share: