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By Jim Hoffman
Chairman, Wayne County Board of Supervisors

   LYONS (Oct 28 10) -- One of the important issues the Board of Supervisors is currently reviewing is the future of the Certified Home Health Agency (CHHA).  
     The CHHA was created in the mid-1960’s to provide home health aide services to Wayne County residents. It operates under a license issued by the New York State Department of Health.  A staff of approximately 23 provided both nursing and home health aide services until 2005 when home health aides were eliminated and that portion of the services contracted.   The CHHA now provides only nursing services and is staffed by seven full-time employees: a Supervisor, five Registered Nurses and a Public Health Nurse and three part-time employees: a Home Health Aide and two Public Health Nurses.
    The workload for the CHHA has declined in the past ten years. Two private nursing services provide approximately 85% of the market share of home health services, with Wayne County’s CHHA having 15 per cent of the market.  Billable visits have declined from 17,215 in 2000 to 8,824 in 2009.
   The proposed budget for the CHHA in 2011 is $1,414,817. In recent budget years the CHHA did not require a tax subsidy.  However, in budget year 2011 the CHHA will require a subsidy of $37,317 for its direct expenses.  The amount of the subsidy required to maintain the CHHA will very likely increase in the next few years as costs go up and Medicaid reimbursements from the state decrease.
   Medicaid, for those meeting certain income requirements, is funded in large part through property taxes and is relied on to fund CHHA services for Medicaid eligibles.  Using an additional tax subsidy to maintain the CHHA as an agency in 2011 is an additional burden on property taxes.  For individuals with private health insurance, home health services are typically provided as a benefit and included in the cost of your insurance premium.
   Recognizing that cost is not the only consideration in determining the future of the CHHA, the Board of Supervisors conducted an optional public hearing to solicit public input on September 23rd.  Twenty-six people spoke in favor of continuing the CHHA.
   If the Board decided to discontinue funding the CHHA, the license could be sold pursuant to a bidding process.  Non-monetary issues of concern can be included in the terms of sale. Several other counties have recently gone through the process of discontinuing funding to a county operated agency in favor of the private sector providing home health services whether through Medicaid, Medicare or private insurance.


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