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County officials today continued their process of gathering information on potential options, as they consider whether the County should continue to operate its Certified Home Health Agency (CHHA), now that New York State has eliminated its financial support for such agencies.    The County must decide whether the local property tax subsidy needed to operate the agency can be reduced or eliminated, or if the Agency should be sold or transferred to another home health provider.

The Legislature’s Health and Human Services Committee heard the perspective on CHHA operations from representatives of a non-governmental home health agency, Home Care of Rochester (HCR).  HCR president Mark Maxim and Elizabeth Zicari, HCR’s Vice President of Clinical Services, were unable to attend a panel discussion on program options sponsored by the committee last month, and the committee scheduled the session to provide an opportunity for the committee to ask questions.  HCR, a private, for-profit, employee-owned company, has acquired several county CHHAs, and answered some questions related to their experience with such transitions.

Among questions raised was how quality of care can be assured in a private organization.  Zicari responded that all such agencies, public or private, are regulated by the New York State Department of Health and are held to the same standards, and said if an agency simply focused on the bottom-line, it would not survive in that regulatory environment.  Maxim added that private organizations have the economies of scale to spread overhead cost over many more patients than a county can do, to support cost of keeping up with changing regulations and new technology.  On the issue of whether private agencies “cherry-pick” (denying cases because of financial considerations or complexity), the representatives responded that does not happen in their organization—that financial aspects are not considered and that they have not experienced people who need care being “left behind.”  Zicari did note, however, that there are some patients who require too high a level of care to be cared for at home.

Zicari reported said that in counties where HCR acquired a county CHHA, her company met with affected staff, most applied for positions, and the agency hired all.  Wages and benefits overall, she said, were comparable, though the company could not duplicate the public pension plan.

The Health and Human Services Committee will begin to work toward a recommendation to the Legislature on the CHHA’s future at a special session June 14.  The committee currently has before it three potential options:  retaining and possibly adding funding to help sustain the Agency; retaining it but beginning to consider proposal for alternate operation; or divesting altogether to a State-regulated agency selected by the County.  A consultant’s financial analysis received by the County projects deficit funding of about a half-million dollars a year would be needed to continue to operate the CHHA as a County agency, but also indicated that initiatives to increase productivity and patient caseload could reduce such a shortfall.

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