For sixteen years I was the executive director of the Saratoga County Economic Opportunity Council (President Johnson’s war on poverty). During that time I frequently worked with the Saratoga County Public Health Nursing Service. I cannot begin to tell you how much I admired these women (they were all women).
Their work with my agency was above and beyond their normal duties but these women, who visited homebound elderly and disabled, did whatever it took to help the people they were caring for.
I was appalled to read in today’s Gazette that Saratoga County is discontinuing this agency’s home nursing services. The county alleges that there has been a dropping demand for these services and that the program has been losing money.
Of course, in the spirit of the way the county is run, the nurses were notified on the same day that the county publicly announced that it would discontinue the service. According to the Gazette, as early as November, the county had applied to the New York State Health Department to end the service. Apparently, they have given thirty days notice to both the employees and the people being served that the service will end. I have no idea how difficult it will be for the existing clients to find another source. I feel just as confident that the county has done no planning for transitioning the clients since they have kept this entire business secret.
One might ask, why is it that private agencies can make this service work financially but our county cannot? People asked the same questions when the county closed our nursing home and sold it to a private for profit corporation. They never got an answer.
So what happened with transparency? Wouldn’t a decision like this involve some sort of public debate by the county supervisors and some sort of vote? I know it is rather quaint of me to ask that question.
So where are our Supervisors? In the past I would have emailed them about this but I have learned that both Peter Martin and Matt Veitch are incapable of action in these matters or of thoughtfully responding. I will save Supervisor Veitch the trouble of emailing me his response. He will simply repeat the position of the County Administrator that the service loses money and that other private agencies will fill the gap. If I ask him to offer any proof of these assertions he will simply tell me that the issue is closed. Peter Martin will email me back that he is forwarding my email to the County Administrator.
Neither of these two men will have any idea about the harm that this may do to some very vulnerable people. They simply do not care.
Here is the story:
Saratoga County to end home nursing visits
Layoffs of 12 nurses, six clerical staff also announced
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.