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When the County Legislature considers the future of the County’s Home Health Agency, that discussion will be based on a recommendation from its Health and Human Services Committee to proceed toward divesting of the agency and seeking another qualified provider to purchase the Agency license.  The Committee’s recommendation today came in a split 3-2 vote, with Legislators Jim Dennis, Nathan Shinagawa, and Will Burbank voting in favor, and Legislator Kathy Luz Herrera and Chair Frank Proto opposed.

Over the past two months, the committee has led a painstaking review of whether the County should continue to operate the Certified Home Health Agency (CHHA) through the Health Department, now that New York State has eliminated its financial support, 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.

In remarks to the committee, County Administrator Joe Mareane noted that the Legislature’s mission statement contained in the County Charter states that “County government may perform those functions not provided as well by individuals, the private sector, other levels of government, or the not-for-profit sector.”  Study of the CHHA’s future over the past two months, he maintained, shows that other entities can provide the service; that they can provide it as well as the County; that, even with improvements proposed, the County cannot provide the service without a significant property tax subsidy; and that there is no evidence that divestiture will result in the loss or service or reduction of quality.

Even those Legislators who supported divestiture spoke of the difficulty of the decision.  Legislator Nathan Shinagawa said he must approach the issue considering County programs overall, and the need to reduce spending by $3 million or more to meet the Legislature’s tax levy goal for 2012.  Expressing “immense regard” for home health staff, Shinagawa said he must still support divestment, since it will reduce spending by about $400.000, while preserving the service for residents.  Legislator Burbank said, in view of tough budget realities, he “reluctantly and painfully” came to the decision to support divestment.  Legislator Dennis noted that, even with investments proposed by the Health Department, he believes the program would still need annual deficit funding of at least $100,000.  He predicted no department will be exempt from the difficult cuts the County will need to make for 2012, and observed this situation is better than most, since it would assure that home health service will be preserved through a private provider.

Legislator Luz Herrera said she cannot support divestiture, that it runs counter to her core values regarding how a community treats its most vulnerable, and she urged the County to show its ingenuity and creativity to preserve program.  Chair Proto said that the full Legislature must review the matter in context of County services overall, praised the Agency’s staff and service, and expressed concern that divestment of the Agency would produce hidden effects on the Health Department overall.

Both Health Department Medical Director Dr. William Klepak and Director of Patient Services Sigrid Connors cautioned that losing CHHA will significantly reduce the department’s depth of resources, affecting staffing and programs throughout the department.  Connors asked that the Committee recognize the full value of the Agency’s services and invest in the department’s commitment to initiate financial improvements.  Public Health Director Frank Kruppa expressed his great regard for the passion and true patient care demonstrated by home health staff, saying he would welcome the opportunity to work with staff to achieve a potential quarter-million dollars in savings; however, he added he could not determine what is best for the entire community.

Among other options before the committee—which could still be taken up by the full Legislature—were whether to retain and possibly add funding to help sustain the CHHA; to retain it but begin to seek proposals for alternate operation; or to continue to operate the Agency on the condition that the department reduce next year’s tax subsidy by a little more than $100,000 in the first five months of 2012.

Addressing the committee, Legislature Chair Martha Robertson called the CHHA situation “the first casualty of the tax cap without mandate relief,” noting it makes a big difference between whether the State or counties pay for a program, and said the State in this case has failed to live up to its responsibility.  Even with divestment, she said, much work would remain, and conditions to reflect the County’s values must be included in any transfer agreement. One idea, suggested by County Health Planning Council Director Betty Falcao, would be to initiate a formal ombudsman or advocate process, to monitor access and quality of care is issues.

The full Legislature is scheduled to consider the CHHA’s future at its next meeting, June 21.

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