Home Health Aides Next to Fear Privatization

CREST HAVEN — Privatize is likely the most feared and/or hated word uttered by Cape May County employees.
It is a figurative knife that cuts both ways: Taxpayers love the idea of saving tax dollars. Employees are loathe to lose jobs or, nearly as bad, accept lower-paying ones for new, private-sector employers with fewer or no benefits.
County Youth Shelter employees are among the most recent to feel the sting of privatization.
Freeholders, on Nov. 24, awarded a two-year contract to a Center for Family Services, Inc. of Camden, to operate the shelter for two years.
Next, may be the home health aides who tend the sick in their homes, and operate from Crest Haven Nursing and Rehabilitation Center.
Registered Nurse Nancy Alessandrini, case manager at the County Home Health Division, stood before freeholders Nov. 24 and said she and co-workers felt “targeted.”
A 16-year veteran who has cared for many recently-discharged hospital patients, who has drawn blood and provided skilled service to them, told the board the staff is “unique and dynamic,” as well as being cross trained to assist in mass vaccinations.
They are also members of the county Medical Reserve team, ready to spring to action should the need arise.
She also noted that the division has brought $1.5 million in revenue to the county coffers.
“The agency, in fact, is one of the few county facilities that have a positive cash flow,” said Alessandrini.
She added her belief that health and human services departments, headed by Freeholder Gerald Thornton, were being made to “unfairly shoulder the budget burden, and that at the expense of “women, children and the elderly, the most vulnerable, placing their health and welfare at risk.”
Maryann Heckler of the Nursing Department said the agency went through a state survey, and deficiencies were cited.
Among those deficiencies is the lack of an administrator. The agency is operating under a state-issued certificate of need, and certain criteria must be followed to comply.
Heckler said the group did its best, “given the limited support we have gotten from freeholders.”
Her statement drew a round of applause.
Registered Nurse Susan Seabrook, in the profession for 30 years, 27 of them with the county’s Home Care Division, has served in full and part-time roles.
She had “taken great pride in professional service to the elderly,” she said. “At the present, I’m extremely distressed and saddened. You allowed a personal political agenda to demoralize the professionals who serve you,” Seabrook added.
The group, she said, has been “lauded for its care” of patients, “without evidence of a stable administration and limited resources.”
Their administrator and three home health aides left and none was replaced, she said.
She added it was “Unsatisfactory to them to share an administrator with the nursing home.” She noted their director works. “10-14 hours in the absence of staff.”
Seabrook said the board had “ignored requests” made by Freeholder Gerald Thornton, and added that “the small health care agency could be profitable,” since health care services are becoming more in demand as Medicare and Medicaid seek ways to trim costs.
“With adequate staff and marketing, home care can be a very lucrative business, even in a recession.”
“Many things they brought to the board’s attention are reasonable and accurate,” responded Thornton.
“I’ve been saying for months how important it was to support home health agency staff,” he said, adding that the staff had been “left a lack of support for a period of two years or more.”
The staff, Thornton said, “has stepped up to the plate when asked.”
He also stressed the importance of the certificate of need, which is the license under which the agency operates.
He said the trend in health care means the demand for such services will be significantly larger in a short time.”
With Cape May County’s “rapidly aging population, demand is going to get higher,” Thornton told his peers.
With that need come more Medicaid patients and “the amount of charity care forced here?”
During a meeting earlier that day, Thornton said, “we are just trying to address this issue.”
Among deficiencies cited in the state inspection of the agency was “not having a director and administrator.” He noted it the board’s policy “not to replace” the vacancies, and added, “That may have been a mistake on our part.”
Thornton said he had not discussed the matter with the board, and added, “We haven’t made any decisions on privatizing.”
“I don’t want to be placing all the blame on my colleagues, there are a number of things they may not be aware of. Again, there is no final decision here<“said Thornton. He said the county wanted to “protect the license,” and added, “We are at a crisis where we are at this moment.” County Administrator Stephen O’Connor said the county had a cost study done, which revealed the Crest Haven Nursing and Rehabilitation Center had a $3.4-million deficit. He said an independent consultant would “come in and do cost studies” on the agency. The study will reveal deficiencies that require “an investment of personnel and other expenses,” O’Connor said. “I have been directed by freeholders not to put any more investments like that into the home health agency. This isn’t the time to invest in aspects of county government that cost money,” he added. “One direction freeholders have given me is to look to an outside provider who can offer the services and cost significantly less and provide the same service,” said O’Connor. He said he had been “instructed by the majority of the freeholders to move forward with the home health agency,” He said a task force would be assigned to the agency, “the same as mechanics and youth shelter.” O’Connor said the only certificates of need in the county to provide home health aide service were held by the county and Holy Redeemer Health Care Agency. No one can provide those services unless they possess such a certificate, O’Connor said. “Outside agencies would like to have the license,” O’Connor said. Of the deficiencies noted by the state, O’Connor said the county has 45 days in which to correct them. He said County Counsel John Porto was working on an emergency contract “to see if we can get someone in there to manage the agency right now.” “At the same time, we will be doing exploring for requests for proposals, the same as at the youth shelter,” he said. O’Connor said it is possible that the county could subcontract and retain the license, or sell the license to the highest bidder. He cited Atlantic County, which sold its license to Shore Memorial Hospital to provided home health service. Contact Campbell at (609) 886-8600 Ext 28 or at: al.c@cmcherald.com