County ends home health care program

Craig Moorhead

The Caledonia Argus

Houston County commissioners voted to discontinue their home health care program during the regular board meeting held May 2. The ballot will result in layoffs for seven part-time home health aides by the time the service ends on July 31, 2017.

Since January, a home health care feasibility study group has been gathering information on the issue, Houston County public health/nursing director Mary Marchel reported. That panel  consisted of five county staffers plus two county commissioners.

“The conversations we had were sometimes hard, and sometimes agonizing as we were discussing all of the potential options for our home care program,” Marchel said. The Houston County home care program dates from January of 1976, she added.

“We’ve met with three private sector home care agencies interested in expanding their services in Houston County. We’ve researched what they call the home health compare star ratings for the agencies that we’ve met with, to assure that we would have options for quality and patient satisfaction. There is a widening disparity between reimbursements and the costs of providing services.”

In 2014, $53,745 of the $613,549 total cost of the county’s program (8%) had to come from levy dollars. In 2016, that grew to 10%. The need for county home health aides has decreased drastically since 2014, the director noted. Clients numbered 107 that year, 69 in 2015, and 59 in 2016.

“There is no requirement statutorily to provide this service,” Marchel reported. “There is not a mandate. Minnesota currently has 51 community health boards. We are one of those, combined with Fillmore (County). We are seeing a decline in community health boards providing home care since 2009. In 2009, there were 25 community health boards that were continuing to provide, through their public health agencies, home care services. By 2015 they were down to 13.”

Marcel also said that Houston County’s decision will not impact Fillmore County, which belongs to the same Joint Board of Health.

The seven Houston County home health care aides are now covering 4.6 FTE (full-time equivalent positions). Commissioner Teresa Walter said that there are “options” for affected employees. “We would work very closely (with private agencies) to get them settled,” she stated. A job fair with three to five employers is planned.

“Of the 53 current home care clients that we have, 33 will continue to have case management services through our agency,” Marchel said. “That means that our nursing staff will still be in their homes some. It varies, depending upon what their needs are.

“So in some respects, there will be two agencies operating, one from a skilled nursing perspective and one from a case management perspective, for well over half of these folks.

“It’s probably one of the more difficult things that we will do this year,” board chair Jack Miller noted. The vote to terminate the program on July 31 was unanimous.

Following the meeting, Marchel told the Argus that clients will be able to continue to use whatever means they have been utilizing to pay for home care, such as Medicare, private insurance, VA benefits, or other programs. “Our intention is not to abandon anybody, that’s just not going to happen,” she stated.

Conditional Use Permits approved

Shawn and Chelsey Senn were granted a CUP to build a dwelling on less than 40 acres in an agricultural district. The “standard condition” was that the couple comply with all federal, state and local regulations.   

Another CUP, for Jamin and Nicole Ramsay  to build a dwelling on less than 40 acres in an agricultural district was approved with four conditions. The first was the standard stipulation (as above), while the others require that an existing structure (a shed remodeled to serve as a living quarters) will be brought into compliance with the Houston County zoning ordinance, an unpermitted septic system also be brought into compliance prior to issuance of the zoning permit, and that the driveway for the new home meet the slope requirements of the land use ordinance.

A CUP application from Darin Meyer to expand a feedlot from 147.8 animal units (AU) to 553.2 AU in Spring Grove Township was tabled for a feedlot advisory committee visit on May 10.

Another CUP by the same petitioner, to expand a 550 AU operation to 774 AU  (in Wilmington Township) passed with two conditions. The first was the standard stipulation that all federal, state, and local regulations be followed, while the second was that Meyer obtain all permits required under Minnesota animal feedlot rules prior to commencing construction on a new free stall barn and manure storage pit.

Other votes:

• Commissioners accepted an offer from low-bidder Van Gundy Excavating to replace a bridge on Swede Bottom Road for $214,103. That work is expected to begin during the third week of June.

• A new two-year sentence to serve contract, effective from July 1, 2017, also passed. The total cost to the county is $131,595.

• A one year professional services agreement beginning May 3 with iSpace Environments (Minneapolis) was also approved. The company will maintain audio-visual equipment at the Justice Center. The contract cost was $3,307.

• Three employment offers were approved, conditioned upon the successful completion of a background check. The first was for Rachel Meyer to become a probationary jailer/dispatcher. The second went to Zachary Swedberg, who would become a probationary sheriff’s deputy. The last went to Jacob Reburn, who would become a probationary mechanic for the Houston County Highway Department.

• Commissioners also convened a full-board interview with interim county assessor Cindy Cresswell, who is seeking the county assessor’s position on a permanent basis. No immediate decision was made on that hiring.