Several changes have been made concerning the home care program of the Lafayette County Health Department since July at the committee level of Lafayette County government, with the possibility of more to come.
Among those changes was the decision to not refill a recently vacated full-time position; reduce another full-time position to regular part-time and to outsource coding and possibly billing tasks in the future.
A decision was also made to increase the levy amount allocated to the home care program in the 2016 budget from $60,000 to $100,000, however $30,000 of that increase will be coming from the health department’s budget.
These changes are coming about as a result of the home care program being an estimated $100,000 over their budget at only half way through the year. Based on year to date financial results as of June 2015, compiled by finance and health department personnel, it is projected that home care will need a total of $240,000 (including the originally granted $60,000) by the end of the year.
“As it turns out, the $60,000 tax levy amount allocated to home care was an unrealistic goal to achieve for 2015,” said Sue Matye, director of Lafayette County Health Department.
During the budgeting process in 2014 the Lafayette County Health Department originally asked for a total levy of $200,617 to be allocated to the home care program. After a long process, during which a proposal was made by the Lafayette County Finance Committee to not fund home care at all, home care was eventually provided with a total of $60,000 in levy monies to operate for the year, with the understanding that they would eliminate a full-time position.
On July 8, Rebecca Steffes, the former home care director and assistant health department director, gave notice of her resignation with a last day of July 23.
At the joint meeting of the finance committee and health committee that was held on July 13 it was approved to increase the home care levy to a total of $100,000 with $30,000 of that coming from the public health department.
However, if the home care department continued to operate as it had, the budget would still be over the $100,000 levy.
In order to make the home care budget fit within the $100,000 levy amount, several decisions were made, including a motion to not refill the home care director/assistant health department director position, which according to Lafayette County finance director Nicola Maurer, would realize a cost savings of approximately $82,000 in wages and benefits.
At that meeting it was also decided that the home care department should be able to generate additional revenue of at least $18,000, as a result of the decision to outsource the department’s coding.
Another decision was made to reduce a full-time position to part-time, not specifying what position that would be, and utilize the savings from that to cover the cost of outsourcing the coding, which Maurer after research, determined would cost around $18,000.
At the July 28 health meeting, there was action specifying that the full-time position to be reduced would be a nurse position that would be reduced to regular part-time of four days per week while still retaining benefits. Maurer noted that this would result in a saving of approximately $13,000.
Matye noted that while the reduction in staffing helps with the budget, it does leave an enormous amount of work left behind for those who are still there and qualified to do it.
“I had to take on the role of home care supervisor, and our three home care nurses will take on other tasks that I need to delegate,” said Matye. “Since our nurses currently do the coding, [outsourcing] it should free up some time for these tasks but we will have to see how all that looks once it is implemented.”
During her research on outsourcing coding, Maurer found several national companies that specialize in home care coding, and discovered that the department’s billing could also be outsourced to those companies at a cost of around $15,000.
Currently, the billing specialist position for home care costs about $55,000, according to Maurer, and it is anticipated that outsourcing the billing along with the coding could eliminate the in-house billing specialist position and result in additional savings.
Discussion and potential action regarding that situation was on the agenda for the Tuesday, Aug. 11 board of health meeting, but was not finalized before the Republican Journal’s print deadline. Look for the story on that in next week’s paper.
According to Matye the future of the home care program hinges on many components.
“I am hopeful we will see a significant increase in revenue from the coding and billing changes, but that is an unknown at this point. It will also depend on whether the remaining home care staff will persevere and not seek employment elsewhere,” said Matye. “I have to give them a lot of credit for hanging in there. We will increase our marketing so people realize we are still in business. The care we give has never been disputed so hopefully we will continue to provide our services to the people of Lafayette County.