Even though the meeting took place at 7 a.m., several members of the public tuned into the Wright County Board of Health meeting via Zoom last Thursday. The big topic of interest was again the county’s decision to decertify skilled home care services that are reimbursed by Medicare, Medicaid, the VA and insurance beginning November 1 and the layoffs of staff that will result from this.
As was the case in this week and last week’s county supervisors meetings, no one was happy with the move that came after an August Board of Health decision. Several people implored the board to listen to the public’s input on the matter. Kelly Langfitt, who explained that she had to utilize Wright County home care in the past after a bad accident, also asked the board to listen to the will of the people, especially considering that the taxpayers help fund this department. Many people who spoke worried that once this decision is finalized, there is no going back and recertifying home care later. Others were concerned that this will force unprovided-for Wright County patients into nursing homes.
Kari Prescott with Webster County Public Health was also tuning into the meeting. She indicated that her department has contract obligations with Wright County. She was concerned that they had not been informed about how services will continue to be provided. She requested a staffing and management plan from Wright County for the assurance of continued services.
Both Steve Sebby and Alice Rector spoke before the board. Sebby and Rector have been two of the most fervent voices against decertification. Sebby, who has been receiving care from Wright County after a debilitating accident left him with C5 quadriplegia, voiced several concerns. He reminded the board, “You will determine the quality of nursing for a small group of people that aren’t visible.” He noted that he has met with the company who agreed to take him and other WC patients on. Sebby said this is the same company that had dropped him and other quadriplegics from their service a few years earlier. He wondered, “how long will they continue to support patients in Wright County. Will they cut services? Will they charge out of pocket for other services?”
Rector, a former nurse and public health administrator, said, “This just does not feel right. This decision should be made slowly with community input and transparency. We should have been told six months ago not sixty days before the service ends. That makes it almost an insurmountable task to fix this. No doubt changes need to be made. Ultimately, people should get to decide where their tax dollars go, and people might want this more than another bridge or courthouse renovation. Please reverse your original decision.”
In the end, the board gave no indication that they would reverse their decision. Mickey Cooper, Chairman of the Board of Health, was emotional as she apologized but said that the board made the best choice they could given the changes in healthcare. She reiterated the factors that weighed into the decision including poor reimbursements, plummeting referrals, and more privatization of home care. She also said that COVID hit the department hard. “It’s unfortunate that it came to this,” Cooper emphasized.
Mike Galloway who works with the county as a human resources attorney added to Cooper’s points. He said that he works with over two dozen other Iowa counties and many others are facing similar problems with providing home care. “Many counties are evaluating if they can maintain services,” he noted.
The board also voted on a staff reduction plan, employee package and reorganization plan. Ten Public Health employees will receive layoff notices due to the department’s changes, though there will be an opportunity for some of these people to be rehired in different positions. Cooper also said that the county will help laid off employees find jobs elsewhere.
