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County not funding Home Health Care

Douglas County's Home Health Care program may be in its death throes. Employees have known about the program's possible demise since early September.

Douglas County's Home Health Care program may be in its death throes. Employees have known about the program's possible demise since early September.

"They announced to staff they were going to shut it down," said Bob Shutes, a self-employed physical therapist with Northland Therapy Association who has worked for the program since 1985.

During county budget talks Tuesday, no money had been earmarked for Home Health Care next year.

"It's highly probable it will be closing," said Deb Clasen, Douglas County health and human services deputy director of health.

When discussions resumed today, the administration committee took no action to put home health care back into the budget. Without county funding, the program will close its doors Dec. 31.

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The county stepped in to provide home health care in 1979 when funding was unavailable elsewhere.

"It's been a real treasure for the county," Shutes said.

The agency turned a profit every year until 1998, when a cut in Medicare reimbursement left the program with a $543,000 loss. It continued to hemorrhage in 1999, losing $225,000. Board members tackled the issue of cuts in 2000, when delegating space for the new Government Center. Residents objected, and the board opted to keep the program, which then had about 400 clients.

It provides Medicare and Medicaid skilled nursing care for patients at home. Clients receive an average of 59 days of care.

Former County Finance Director Larry Kroll said he always supported Home Health Care.

"I felt it provided good service to patients," he said.

Brad Beckman, director of the Aging Resource Center for Douglas County, agreed.

"They've done a tremendous service for our community," he said.

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The program's numbers have declined sharply since 2002, when there were 307 admissions. It currently has 22 patients. Of those, six live in rural Douglas County. With so few participants, Clasen estimated the program would rack up a deficit of more than $100,000 in 2008.

Numbers have dropped for many reasons, she said, including the opening of St. Mary's Hospital of Superior's Step Down Unit and an increase in the number of beds available at regional assisted living facilities.

In 2004, the county participated in a pilot program to develop best practices criteria for skilled nursing care at home. The program became more realistic about who could and could not receive services, Clasen said. Last year, 35 percent of applicants were rejected.

Home Health Care is not a mandated service. Other providers are willing to take up the caseload, Clasen said.

"As a county, we really should not be in competition with private businesses," she said.

There are a number of skilled nursing care providers in the community, Beckman said, including The Dove, Inc., St. Mary's and St. Luke's. But with the closing of the county program, he said, "the consumers have lost one choice."

Douglas County's Home Health Care program has made a difference in the quality of life for residents, Shutes said, especially those in rural areas.

He called the decision "distressing."

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"A significant number of people are going to be without home health care," he said, explaining it's not cost effective for private businesses to provide services in the rural areas.

Greg Leiviska, administrator of The Dove, Inc., a home health care facility affiliated with Catholic Charities, disagreed.

"We do provide services outside the city limits," he said. "We're hoping we'll be able to meet the needs of everyone."

Clasen said only eight of the county's current patients will need to be transferred to a different caregiver.

"They will not be without skilled home health care services," she said.

The cut does not affect public health nurses or the Community Options Program, which provides custodial services such as running errands, washing clothes and providing help with bathing.

Closing home health care will eliminate four nursing positions. Of them, one employee will be retiring in December and another is considering training to become a public health nurse, Clasen said. She said other home health care providers in the community are seeking more nurses.

For information on home health care providers for Douglas County residents, call 394-3611.

Maria Lockwood covers news in Douglas County, Wisconsin, for the Superior Telegram.
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