The Saratoga County Public Health Nursing Service is going out of the home nursing business next month, with the anticipated layoff of 18 county employees.
County officials said the county will stop doing home visit nursing on March 22, with an anticipated layoff of a dozen nurses and a half-dozen clerical staff.
County officials said the change is driven by dropping demand for the service and its financial losses, but the county employees’ union, the Civil Service Employees’ Association, is expressing outrage.
The union said the information only reached it on Thursday — the same day the county announced the service elimination to the public, though without revealing the pending job cuts.
“CSEA has learned that the county laid out plans over a several-month period beginning in October continuing straight through to discussions with the state Department of Health,” said CSEA Regional President Kathy Garrison. “All actions on the part of county officials were carried out in secrecy with no notice to employees or residents. CSEA received notice yesterday.”
According to the county’s statement released late Thursday, last summer the Board of Supervisors hired an outside consultant to complete an analysis of the county’s certified home health agency, which recommended the county exit the business, in part because the service is also available privately. There is no record, however, of that report having been made public.
The request to close the program was submitted to the state Department of Health last November, county officials said, and was recently approved by DOH.
Giving 30 days notice that the services will end, the county can also stop taking any new referrals, effective immediately.
County Administrator Spencer Hellwig noted that the changing health care landscape and financial losses of home nursing services mean many other counties have also dropped the service in recent years.
“In 2012, there was 36 counties with certified home health programs, and now there are 12,” he said on Friday.
None of the other counties in the Capital Region provide county-funded home nursing, according to a Health Department data base.
The number of referrals for home care from hospitals or doctors has been dropping, and the county has been losing money providing the service, officials said, despite Medicare, Medicaid and private insurance reimbursements.
Hellwig said the county lost $316,000 providing the service in 2014, and will have lost around $350,000 in 2015, once figures are finalized.
The same kind of services are available from six non-government nursing services that provide “excellent” care, county officials said.
The nursing service has 86 employees, 29 of whom work in the home health care program. Hellwig said 11 will be moving into other jobs, while the details of the layoffs still need to be negotiated with CSEA officials.
Saratoga Springs Mayor Joanne Yepsen, a former county supervisor, said she was concerned about both the loss of services and the loss of jobs.
“As mayor I can say I’m very concerned and I can only imagine what the residents feel when they get the letter saying the service will no longer be provided,” she said.
The public health nursing department, based in the county’s Saratoga Springs office building, has been slowly transitioning into a more broad-based public health agency for at least a decade.
The nursing service is putting more attention on addressing public health issues like reducing smoking, providing immunizations, screening for lead exposure, evaluating community health risks, and addressing concerns about communicable diseases.
The state Health Department has pressured the county to create a more full-service public health department, getting away from the in-home nursing mission.
According to the county announcement, the nursing service will stop taking Medicare, Medicaid and private insurance payments for providing home health care at the end of the business day on March 21.
Reach Gazette reporter Stephen Williams at 395-3086, firstname.lastname@example.org or @gazettesteve on Twitter.