Pepin County to phase out home care program by July 1

Due to restrictive budget dollars, Pepin County will be phasing out its home care program, which has been offered for 48 years.
"Every year at budget time the cost of programs are examined," said Director and Health Officer Heidi Stewart. "This happens county-wide, and department heads have to look for efficiencies, which the health department has done over time through staffing changes, streamlining our home-care nurse, and hiring casual positions."
In the past, Stewart said the health department's budget was mixed together, and a clear view of home care and public health money wasn't available.
"We wanted a clearer picture in general, prior to the previous finance director leaving, so there were no surprises in the process," she said. "We knew the cost to employ good quality staff was rising, but reimbursement rates were staying the same. There was an increasing gap between the cost to run the program and reimbursement."
Stewart said the struggle wasn't only with staff, but with other requirements of the program, as well, such as the cost of maintaining a license, purchasing specific software to submit claims, time tracking, and other things that created a large amount of overhead.
"The 2015 budget went to the Board of Health, and knowing the County was using a lot of surplus dollars, we needed to look at mandated and non-mandated programs, and decide what we could keep," she said. "The 2015 budget was passed as presented with a statement that beginning in 2015 we would seriously look at our programs."
Stewart said some board members questioned why the department would wait until 2015, and worried that some staff may be lost if they knew cuts were coming.
"Home care has been in question for years, and the Board has strongly supported it," Stewart said.
Outside providers were invited to a Board of Health meeting to see if other sources in the
County were providing the same services, causing a duplicate offering from the county.
"We came up with a list of about 15 providers that were offering the same services in the county as we are," Stewart said. "We've been providing very high quality care, but with limited funding and the services being available to those in need, the home care program needed to be seriously looked at and considered."
Stewart said Pepin County currently has 28 clients on its home care case load, and they were working to notify each individual of the changes by December 19.
"Effective immediately, we've stopped taking referrals for new clients," she said. "Certainly if no one else is picking up a client, we look at the case and help if needed."
Stewart said she's looking at models and working to create a program for outreach, education, and individual-type care until a person can connect with another provider.
"There are a lot of unknowns," Stewart said. "There's a program in the state that focuses on different groups, but we're looking at having a community health nurse to work with the whole community. We're special because of the size, population, and type of people we have here. This may allow us to reach even more people."
If the home care program had been left as is, the 2015 tax levy would have been $198,715. With the changes and proposal that was put forward, that number decreased to $60,375.34, most of which is the cost for a community nurse.
"One of our hopes is that in this transition, we can transition clients to programs that allow them to keep the same staff they've been working with," Stewart said. "Our staff is able to be hired, and we're working closely with clients to ensure they receive quality care."
Stewart said she hates to have things come down to money.
"When the County is spending so much on the program while other providers are offering the same services, it doesn't make sense for the County to provide it," she said.
Stewart said she doesn't believe the switch will cost clients any more money.
"There may even be a small savings for some programs," she said.
Home care nurse Jacque Traun said there are so many rules, regulations, and loopholes that they must go through.
"The program has gotten a lot more thorough and strict," she said. "Cutting this program is a lot harder than people might think. You develop a relationship, and these clients are precious—each and every one. This is not an easy thing, but it needs to be done."
Stewart said she feels bad that the cut is happening.
"I feel like a lot is hitting our local seniors all at once," she said. "We're hoping job loss is minimized."
The home care program employs seven workers.
A resolution passed at the December 17 County Board meeting states the Pepin County home care program will be phased out and closed by July 1, 2015. The resolution came forward on the recommendation of the Board of Health.
The resolution also states Pepin County has long recognized the value of assisting residents in obtaining health care services that enable them to remain in their own homes, and at the time the program was created, there were few, if any, alternatives to a publicly-funded home care program.
The Board recognized that other counties within the State and Region have made the determination that outside providers can adequately meet the need for such services, and have ended their publicly-funded home care programs.
The resolution also states it is possible to both assure current home care clients that their services in Pepin County will continue uninterrupted should Pepin County phase out this program, and the County will be able to monitor the future need for home care services and may intervene again in this market, should a role for the County be determined.
Nancy Hei, a 78-year-old Durand resident who has lived here just over two years, is a current home care client. She is legally blind, but lives alone in an apartment. She has had eye trouble since she was 62.
"I'm saddened by the fact they're not going to be doing this anymore," she said. "I felt bad because the girls I have come help me are very nice."
Hei receives a visit seven days a week in the morning for about half an hour, and 15 minutes in the evening, to get eye drops. She is occasionally helped into and out of the bathtub, as well.
"I'm not sure what I'm going to do to stay living independently," she said. "My main concern is getting my eye drops and medications set up."
Hei said she will have to get set up with a new program, but feels bad that the county cannot afford to help anymore. She said there's another gal in her building who also gets help from the home care program.
Prior to moving to Durand, Hei was also receiving home care services when she lived at home while her husband was living.
"I feel bad that people who receiving help will no longer get that help from the County," Hei said. "I'm able to get around and do a lot, but many aren't."
Hei makes coffee and gets out treats for a little group in her building every morning, except for Sunday. She also helps decorate the common area for the holidays.
"I like helping other people," she said. "I just wish I could do more."
Hei said the services she receives are very important. She's had eight cornea transplants, and needs her eyedrops.
"The girls sometimes help with some household chores, or getting my breakfast," she said. "They also make sure I get into and out of the tub OK, because I don't want to fall."
Hei said she likes living in her apartment very much, and likes all of the girls who help her.
"I'll miss them terribly," she said. "I think the program is very important because we're able to stay living independently. It keeps us out of the nursing homes."
Hei said she hopes in the future, the County can again offer the program.