10 Feb Guest editorial: The need for home health and hospice
This guest editorial was originally published in the Feb. 5, 2020, edition of the Burns Times-Herald.
In last week’s Burns Times-Herald, Patty Leahy wrote a masterful editorial about the importance of home health and hospice in our county. She was very articulate and painted a clear picture for the need to keep home health and hospice services in our communities. In the spirit of transparency, I would like to share the discussions we have had with the county on this topic during the past few months.
On Tuesday, Oct. 8, 2019, Judge Pete Runnels and Jodi McLean, RN, met with us to discuss home health and hospice. Beginning Jan. 1, 2020, the software they were using for billing would no longer serve their needs, and they were not able to invest in a new software program. They reported that a hospice agency in Idaho was interested in taking over hospice, but the Harney County Court wanted both services to be locally owned and asked whether Harney County Health District would be willing to take over these two services.
We believe that home health and hospice are vital to our community, and it’s imperative that these services continue to be available locally. However, without a good understanding of their volumes, expenses, income streams, etc., we could only commit to evaluate their current operations and conduct due diligence to know what we would be getting into. Judge Runnels and Jodi were very cooperative in providing us the information that we requested.
As part of our due diligence, we contacted Wallowa County Health District who had formerly operated a home health agency in Wallowa County. We discovered that it was a financial drain on their organization, just as it is currently for our county. They made the decision to close the agency and petition Medicare for a Home Health Shortage designation, which would provide a higher rate of reimbursement and more flexibility in meeting the needs of home care patients. Their petition was granted, and they hired nurses to do home care visits from their Rural Health Clinic. This action resulted in significantly better care for patients and became a financially sustainable model for them going forward. Since visiting nurses from a Rural Health Clinic are not tied to the rules of Home Health Agencies, they can see patients who are not entirely home bound, there is greater integration and flow of information with the doctors, documentation requirements are less stringent, and they are able to document in their clinic record, rather than having to use expensive home-health software.
As a result of our assessment and many hours of internal discussion with our board, we met with Judge Runnels late October and informed him that we would be interested in home health if the county supported a Home Health Shortage designation, with us operating it through the Rural Health Clinic model. We also let him know that our administration and board felt that our hospice community would be better served by the hospice agency from Idaho, instead of our health district. They have experience, expertise, and the software to provide a smooth transition.
During the past several months, we touched base with the county periodically and reiterated our interest in home health, while encouraging them to pursue the outside hospice agency. The county signed an agreement with a software vendor in November to provide them more time to make the decision and any transitions. At the county court meeting last week, it was recommended that a group be brought together to work toward finding a solution. As a health district, we look forward to being part of that and stand ready to move forward as soon as a final decision is made.
Without question, home health and hospice are vital to our communities, and it’s imperative that these services continue without interruption. We appreciate the opportunity to collaborate with the county. We are confident that the Rural Health Clinic model will provide better care to home care patients, and that a strong, experienced, and established hospice agency will better meet the needs of our hospice patients.
CEO, Harney County Health District