Jasper County Home Care program eliminated, again

After several sometimes heated meetings, the Jasper County Board of Health has once again voted to eliminate the Home Care Program during the special meeting Sept. 17. Out of four options laid before the board, the second proposal to eliminate home care direct service and establish a fund was selected at a 3-0, with board chair Margot Voshell abstaining.

“The task is to determine the future of the program based on the realities of the program, based on the intent of the program which, from what I understand in years in the making, that we are to be the agency that fills in the gaps of service in Jasper County for home care aide services,” Voshell said.

The board reviewed each proposal, which ranged from eliminating the program, establishing a $50,000 assistance fund and hiring a registered nurse in the first option, eliminating the program and establishing a fund without an RN in the second option, keeping the home care aide program but downsize with one aide while adding a department assistant and RN but no fund in the third option or keeping the program with no aides but the assistant and RN in the fourth option. The costs to run the program ranged from $84,000 for the second option to $175,000 for the third option.

Voshell also said in a statement, when reviewing the program’s original intentions “should not be used to replace other agencies, support systems such as family members, friends or providers for home care services” and currently consist of “homemaker services such as light housekeeping, laundry, some essential shopping and a few baths.”

“If people were eligible for other services, such as hospice, they would not be eligible for our services. I don’t think that many people realize when we are talking about Jasper County Home Care aides, they are talking about a homemaker program,” Voshell said. “Homemaker … is a needed service to the elderly or disabled in Jasper County. The department does not provide any skilled services. If an income is over poverty level and has access, you more than likely cannot utilize our homemaker services without paying significantly, which has a full fee of $60 per hour for housekeeping services.”

The second option selected stated: Eliminate home care aide program, contract with other agencies. Budget $50,000 to a public health line item to reimbursement to other agencies. Keep health department assistance at 21 hours a week. This position will serve as the secretary to the board of health, billing and office duties and was created as a result of the Jasper County Board of Supervisors moving the current office coordinator to the community development department. Utilize the previous process for the reimbursement of services at $30 per direct contact hour.

The approximate cost for the second option is $84,000 including the replacement of the office coordinator to be split between public health and home care aide. The board will also reevaluate the decision in 90 days.

“I was kind of divided initially between one and two versus three and four,” board medical director Dr. Andrew Cope said. “Our cost per employee is quite high as compared to most other people in the homemaking profession. I don’t know that we’re getting as good of bang for our buck on that because our carriage benefits are so high. That bothers me. Not only because pay is higher but then we have to have the office staff, computer systems … To me it makes more sense to use another company that volume-wise can absorb those costs much easier because they are a much bigger system and already have those technologies in place, to me that is a distinction.”

He also noted the RN position proposed in three of the options, questioning if the high skills of an RN would be utilized in the program.

“RNs are skilled, they are talented, they can do all kinds of things. I work with them every day,” Cope said. “None of what we are talking about here utilizes those skills and so to pay an RN salary, which is a good salary to do light housekeeping, doesn’t seem in line with our desire.”

Also addressed were severance packages for the employees eliminated in the decision. Jasper County Human Resource Director Dennis Simon explained the process typically used in this situation and the board gave him approval to move forward with discussions based on current trends and previously used practices.

Contact Jamee A. Pierson at 641-792-3121 ext. 6534 or jpierson@newtondailynews.com