Public Health nurse outlines options after county-based homecare ends

Fillmore County Director of Nursing Jessica Erickson addresses the media last Thursday morning during a press briefing regarding the discontinuation of homecare services in Fillmore County. GRETCHEN MENSINK LOVEJOY/CHATFIELD NEWS
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Jessica Erickson, director of nursing for Fillmore County Public Health, discussed the discontinuation of homecare services in Fillmore County effective July 1 at a press briefing Thursday, April 26, as many local residents have expressed concern about the change.

The Fillmore County Board voted at its April 10 meeting to end providing county-based homecare — skilled nursing and home health aide services, or services that deal with wound care or other medical matters and the grooming and dressing of clients – along with homemaking services, or keeping house for clients.  The decision, while difficult, was made due to the availability of resources, reimbursement levels by the state and the trend shown by neighboring counties toward departure from providing homecare and homemaking services, said Erickson. 

“The decision was made by the board because a decrease in clients and because of (a shortage) of other resources we have.  Most of the money is reimbursed by the state…it’s all determined by the state, and that’s not the only issue, but it was a consideration,” she said.

Homecare services can be provided by different agencies and state-funded programs, Fillmore County Public Health noted.  State-funded programs include Elderly Waiver, Alternative Care Waiver, Brain Injury Waiver, Community Alternative Care Waiver, Community Alternatives for Disabled Individuals Waiver, and Developmental Disabilities Waiver.    

Of the 87 Minnesota counties, fewer than 12 public health departments provide homecare services, according to information provided to the media.  Only two other public health agencies in southeastern Minnesota provide homecare services and only one other public health agency provides homemaking services. 

As of April 2018 in Fillmore County, there were 16 clients receiving skilled nursing services, 13 clients receiving home health aide services and 50 clients receiving homemaking services. Those numbers may include individuals who receive all three forms of services, meaning that there are not as many individual clients to support a need for county-based homecare, explained Erickson. 

While home health care — dealing directly with the health of a client — has been the Public Health Department’s main mission, homemaking was provided as a courtesy because county nurses and home health aides were already in the clients’ homes and could lend an extra hand for clients’ comfort, stated Erickson. 

While she acknowledged that clients have expressed concern for their futures as the county transitions from providing services to discontinuing them, she noted that the Public Health Department has been planning ahead as the vote was brought before the board and has identified two other agencies in Fillmore County that provide homecare services.

Homemaking service options include: Consumer Directed Community Supports (CDCS), a state program through the Minnesota Department of Human Services; volunteer groups; family, friends and neighbors; private pay; and other organizations that provide these resources.  Erickson reassured clients that they won’t be forgotten during the transition from public to private providers. 

“We will meet with individual clients and continue to ensure that they have access and resources to meet their needs, and we will help them determine which agency will serve them best,” said Erickson.  “They’re a bit concerned, but we understand that they will feel more comfortable if they know what’s ahead and if their current homecare health aide can follow them to a new provider.” 

The director also spoke about what is to become of the skilled nursing staff and home health aides who have worked in homecare.  The skilled nursing staff has been in demand at the Public Health Department and therefore won’t be lacking duties to fill their time. Fillmore County often has advertisements in its official newspaper and on its website seeking nursing staff to help carry out daily work. 

The county has seven home health and homemaking staff and about six nurses who provide homecare. 

“We held a job fair for the home health aides so that they can find private providers to work for, and if a client wants to follow them to that new provider, they can go with them and have the same person,” said Erickson.              

“Our clients are our number one priority, and we’ll ensure that they get the care that they need.  We care about them,” Erickson concluded.

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