More On Saratoga County Government’s Dumping Of The Visiting Nurses

Stephen Williams writes yet another excellent article on Saratoga County.

The continued silence of Saratoga Springs two supervisors is a sad commentary on both Peter Martin and Matt Veitch.

Gazette Newspaper March 14

From The Front Page

SARATOGA COUNTY Home-care nursing services termination explained


In a previously unreleased report, a private consultant concluded last year that Saratoga County would not only continue losing money on providing home-care nursing services, but also couldn’t provide them as cheaply and efficiently as available private nursing services. “The decision to continue as a [certifi ed home health agency] service provider is a philosophical and fiscal decision that must be made by the county Board of Supervisors,” the consultant, health care accounting specialists McCarthy & Conlon of Glens Falls, wrote in its conclusion. However, any philosophical debate took place behind closed doors, and word of the county’s decision to end the home-visit nursing program didn’t emerge until a formal legal notice was sent out Feb. 20, announcing that the service would end March 20.

The consultant’s report was not made public, but was obtained by the Daily Gazette last week through a Freedom of Information Law request.

Board Chairman Arthur “Mo” Wright, RHadley, said county officials didn’t want to say anything until they knew whether the state Department of Health would approve the county’s application to discontinue the service, which the county filed last fall. That application was approved in February.

“It’s fully funded for this year,” Wright said. “We didn’t know what the Health Department was going to do.”

The elimination of the county Public Health Nursing Service’s home nursing program is resulting in the loss of 29 county jobs, though only 18 layoffs are anticipated: twelve nurses and six clerical personnel. The county recently held a job fair to help those employees find new jobs.

Wright said the elimination of the service was discussed last year by the county’s Public Health Committee, during meetings that were held in executive session because of the potential impact on personnel.

While county records show that the Public Health Committee held an executive session to discuss personnel issues Oct. 6, 2015, there is no indication in the minutes of any decision being made then.

“All actions on the part of county offi cials were carried out in secrecy with no notice to employees or residents,” said Kathy Garrison, regional president of the Civil Service Employees Association, which represents the county workers.

As with the decision in 2012 to sell the Maplewood Manor nursing home, the county’s decision to stop providing a health care service was based on money — though the nursing service was losing far less than the millions of dollars being sunk into the nursing home each year.

“Have you read the report?” Wright asked last Wednesday. “It’s a no-brainer. It’s something we should have done years ago.”

The McCarthy & Conlon report found the service lost as much as $3 million in recent years, though its loss in 2014 was only $316,000. It said the Medicaid reimbursement system doesn’t cover the actual cost of providing service to Medicaid patients, particularly since the high benefit costs for public employees and their seven-hour workday mean the county’s costs are higher than those of private home nursing providers.

The county has seen the number of patients being referred to it for home care drop. In part, the report said, that’s because private nursing services can market themselves more effectively, and develop more effective relationships with hospital discharge planners whose job can include recommending a nursing agency.

The report noted that six private companies provide home care nursing in the county, and that one state reimbursement program was ended because there were private services available in the county.

Medicaid, Medicare and private insurance companies all face pressure to reduce their costs, and there’s a likelihood the reimbursements for home nursing visits will decrease in the future, the report said.

It also noted that while the county service had high patient satisfaction ratings, its quality of care ratings generally fell below those of the competitors. Whether that’s accurate or not, the report said, it’s information that patients and families can readily find on the Internet.

“With six CHHAs licensed to operate in Saratoga County, it is likely that patients will still receive services even without the county CHHA,” the report concluded.

With the end of the service next week, the county supervisors will be voting Tuesday on changing the name of the department from the Saratoga County Public Health Nursing Service to the county Public Health Services. It will still provide public health education, immunization clinics, community health risk assessments and communicable disease prevention services.

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