According to Mickey Cooper, Chairman of the Wright County Board of Health, a decision was made at their August meeting to decertify the in-home nursing side of Public Health.
“We have seen a steady downswing of admissions and we can see this trend is going to continue,” explained Cooper. “This was a tough decision and it was not made lightly.”
Cooper said they pursued and considered several different avenues to try and keep the service active in Wright County, but in the end it was just not fiscally responsible. One of the main reasons for the decertification she stated was how Medicare reimbursement has changed. Say for example an individual has surgery – Medicare will pay a lump some of money and if the patient doesn’t recover in the “expected” amount of time, the hospital loses money, so many hospitals have their own nursing services that go into homes to help these patients instead of referring them to the nursing services of Public Health. Cooper sited that since 2016, they have seen about a 50% reduction in services needed from Wright County Public Health home-care nursing needs. Cooper said she believes this will only get worse as more Medicare rules and regulation changes are coming. This, in conjunction with Iowa Medicaid changing to MCO (which does not pay well), and changes in home-health care documentation requirements, all lead to the difficult decision being made to discontinue the service.
While many in the public, especially those who utilize home-health care and those who work for the system, are wondering why this decision wasn’t brought to the public for input, Cooper said it was a matter of the rules that are changing.
“It had to be (the boards) call. I’ve been on the board for 35 years…we have gone through four different nursing administrators in the last five years…rules have changed. Documentation has changed. Software has changes, and there’s a lot of cost associated with running the program,” she said.
Although the service will no longer be available through Public Health, those patients in need of in-home health care will still be taken care of, just through different agencies.
“We are currently working on placing our clients with new agencies. We want the transition to go smoothly,” said Cooper.
She added that care will continue to be provided, only it will now be through the Public Health aspect. You call for assistance that you need, and they will help connect you to the services you are looking for. Cooper did note that Public Health will, however, continue to do home well-checks when requested by a physician.
“Our goal is to decertify by November 1, then we will start ramping up the Public Health side of things,” said Cooper.
“We want to be clear that Public Health is not going away,” said Sandy McGrath, Wright County epidemiologist and Public Health representative. “It’s just that we can’t compete with the private sector of home health-care…a lot of public health facilities are going this way.”
Cooper further explained saying that the nursing side of Public Health is about the care for an individual patient, whereas the Public Health sector is about taking care of the whole county.
“Public Health’s presence couldn’t be more obvious with the COVID-19 pandemic,” said Cooper, stating that there had been no major outbreaks or closures of any Wright County businesses or nursing homes. “I think we/they did a great job in that department.”
Another way Public Health is serving the entire county is by working together with all providers throughout the county (2 pharmacies and each of the hospitals/clinics) who provide vaccinations to reach out for vaccinations to every industry that wants them as well as to the school students, teachers, and staff.
“We want to get as high of vaccination rates as possible for the flu, especially this year,” said Cooper in reference how the flu could mask COVID-19 identifications. “You should get the shot. It will NOT cause the flu.”
Cooper said they recommend everyone get their flu shot after October 1 because it is at its best for six months, which puts you through until the end of March.
Cooper said Public Health is also already making plans for distribution once the COVID-19 vaccination is approved. She does not, however, anticipate that being until after the first of the year. But when it is, Cooper said the first vaccines will likely be given to those in nursing homes.
For those wondering how Public Health can continued to be funded, Cooper explained that that money comes from grants as well as some support from the Board of Supervisors. Money for home-health comes from Medicare and Medicaid reimbursements and the difference is made up by county dollars.
“We did not make this decision quickly,” reiterated Cooper about the decision to decertify the nursing side of Public Health. But she, and the entire board, feel it was a necessary move that will allow Public Health to move forward in other ways to best serve the entire community.
As for those employed on the nursing side, Cooper said seven will stay on as part of Public Health while the others may have opportunities to get involved with the other agencies that will be taking over the Wright County home-health patients.
