WARSAW — State changes to Certified Home Health Agency rules have sparked opposition among Wyoming County officials.
The amendments were adopted Dec. 8. They allow other entities to establish Certified Home Health Agencies in counties with fewer than two such organizations.
The Wyoming County Board of Supervisors has requested a waiver, saying the amendments would ultimately hurt health care within the county.
“Although public need is being met and patients are being served in Wyoming County by our CHHA, new agencies will be permitted to enter the market,” said Chairman Douglas Berwanger at Tuesday’s annual organizational meeting. “These will be agencies that seek to establish their own CHHAs — not with the basic goal of caring for residents of Wyoming County, but rather to improve their profit margins.”
Berwanger was reading a letter sent to state lawmakers and health officials. The Board of Supervisors has also approved a nearly-identical resolution.
State Department of Health Spokesman Jeffrey W. Hammond said Wednesday that no new CHHAs are being created.
The lifting of the state’s moratorium on CHHAs would help efforts to shift benificiaries from fee-for-service to Medicaid Managed Care by creating additional care options, he said.
“This a process to allow organizations to apply for new or expanded CHHAs if more are needed,” he said. ‘‘It will include a request for applications. Ultimately, the Public Health and Health Planning Council would vote on any CHHA proposal. This would include assessing community need.”
Wyoming County officials see the changes as “unnecessary and irrational.”
The county’s CHHA has provided care to about 1,000 patients annually and has been self-supporting — an unusual status statewide. The organization also received an IPRO Quality Award in 2006, recognizing its health care improvement efforts.
Officials have several concerns.
Berwanger said after Tuesday’s meeting that the CHHA’s existing staff is capable, dedicated and local. He cited a woman in Perry who received immediate care after arriving home from surgery.
Local officials are skeptical patients would get the same care.
“If something had gone wrong with that lady at 2 a.m., more than likely with the new providers, one would come from Rochester and one from Buffalo,” Berwanger said. “At 2 a.m. do you think a nurse will drive out here in a snowstorm from Buffalo or Rochester?
“Our nurses are on-call,” he continued. “We’ve got the system all in-place. That’s what makes us so effective.”
Wyoming County Public Health Commissioner Dr. Gregory Collins has similar concerns.
“The issue is private companies are coming in as for-profits,” he said. “The clients they’re looking to serve are the ones they’re going to make the most money from, which leaves the county taking those that are less-fortunate, and don’t have as good insurance and reimbursement. They’ll basically come in and take the best-paying clients and leave the rest for everybody else to serve.”
That would place a financial strain on the CHAA, while not necessarily guaranteeing the same levels of patient care.
Collins said he thinks it would be a major blow.
“We’re not in the business to make a profit,” he said. “We’re there to serve the community. The other issue is the nursing staff (outside agencies) employ would be coming from outside the county, whereas our nurses live here.
“They go the extra mile. Because they live here, they’ll work in off-hours, and stop off and see people if need be. You’re not going to see that kind of service from people that aren’t here in the county.”
The CHHA includes 12 nurses and 2.5 support staff, with a census running generally at 160 to 170 patients. The agency handled 1,005 referrals in 2010, including 8,653 skilled nursing visits, and 15,841 visits overall.
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