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County Records: Sale of CHHA Remains Mystery, Led to Current Issues

Written By Editor on 11/8/13 | 11/8/13

The transfer of the County Home Health services was one of the key moments in multiple threads leading to the Fitzmaurice Report. First, the sale was controversial and considered both unnecessary and puzzling to Supervisors such as Phil Skowfoe and Earl vanWormer. Second, the transfer of the agency to a private firm was handed over to Cassandra Ethington, directly leading to her placement as interim Health Director.

The process started at the April 21, 2006 meeting of the Board of Supervisors. Former Supervisor Dennis Richards of Middleburgh asked for a review of the efficiency of CHHA at no cost to the County. It would take three years and was seconded by former Schoharie Supervisor Martin Shrederis. The motion was approved without controversy.

The findings of the report were discussed in a July 21, 2009 special meeting. There were questions over why such a transfer should take place. CHHA was described as professional and an overall source of positive cash flow for the County.

On October 16, 2009 another discussion was held over whether a transfer of CHHA to a private company was necessary. There were similar questions regarding the arrangement, with Supervisor Skowfoe stating that if the agency broke even or made money it should be kept. Board of Health President Betsy Bernocco said, "You have invested money in the CHHA over the last several years that we believe will start to pay off on the collection of the services." Supervisor Mann of Blenheim made a motion, seconded by Supervisor Vroman of Summit to put out a request for proposals on the sale of the agency. Only Supervisors Skowfoe and Larry Phillips of Seward voted no.

At the November 10, 2009 meeting, similar concerns again arose. Top on the agenda was the CHHA, and documentation supporting the existing structure were presented. One was a positive letter from Bernocco followed by one of Dr. Thomas Greenlees, a member of the County Board of Health. He wrote in part: 


"Current Health Department revenue figures show that the Nursing Department has turned around the CHHA deficit and is coming very close to paying for itself.  I well realize the financial crisis that the county is enduring but I also realize that should we lose our Home Health Agency it may very well lead to the eventual demise of our organized county health department."


At the January 15, 2010 meeting, it was revealed that the County Board of Health carried a motion opposing the transfer of the CHHA. Former Supervisor Goblet motioned, seconded by Skowfoe, to support this position. The Board approved, with the exception of Mann. After this Supervisor Barbic of Seward even asked, "are we seriously looking at this?"


There were sporadic mentions of CHHA throughout the first portion of 2010, with concerns about keeping services open and about potential costs. The next in depth discussion happened during executive session on June 2 during a special meeting. There were no minutes taken of the discussion as it took place during executive session.


There was even further concern at the June 30th meeting. County Attorney West explained that other counties privatized their CHHAs because they often had more than one. Supervisor Murray of Cobleskill stated that he was "shocked" that HCR, the firm that was eventually chosen, "does not have to take calls." Seperately, there were questions on why HCR would be the firm to privatize, when a local company like Bassett Health Care was already involved within Schoharie County. There was then a motion to begin negotiations with HCR with the intent of having them take over the CHHA. This was made by Mr. Singletary.

The conversation seemed to become fatalist, almost as though the decision had already been made behind closed doors. Former Supervisor of Richmondville Barlow even said, "everybody is assuming this is a done deal and they should not assume until it is a done deal.  We are still in discussion." Dr. Greenlees told the Board:



"We were in a hole with mismanagement the CHHA did lose money.  When Jack Vanesky report revealed problems the Board of Supervisors said they would give us 18 months to turn thing around and we have done that.  In the 1st quarter of 2010 we brought in $342,000.  Vanesky’s projections for 2010 are $1,263,000.  We are headed in the right direction." 

The question was then brought to a vote with multiple Supervisors voting yes, including Shrederis, Murray, Richards, and Singletary. Against were
 Mr. Barlow, Mr. Bradt, Mr. Brandow, Mrs. Campbell, Mrs. Manko, Mr. Skowfoe, Mr. VanGlad and Mr. VanWormer.

At the next meeting of July 16th, more details of the potential sale were discussed, with Skowfoe saying, "I am disappointed in the Board of Supervisors.  You are moving forward with little communication with the Board of Health and the Board of Health is against this." On August 20, Bernocco relayed to the Board that the Board of Health held a meeting and that the agency did not lose money. County Treasurer Cherry said that "we are about breaking even and providing a critical service to residents."

On November 19, 2010 the major work was done. Supervisor Richards announced that the State had approved the sale of the CHHA to HCR. The same meeting Supervisor Goblet made the motion to allow Cassandra Ethington to run the transfer of the CHHA.

A year later at the December 9th, 2011 meeting after there was severe concern that severe layoffs would hit the County, an old issue resurfaced. HCR was defaulting on payments to other counties that this could be a concern for the County's budget. An email from Bill Cherry was read, stating: "It is my understanding that counties will not be receiving the payments that they expected from HCR from the sales, and some counties are now withholding all fees that they are being billed for by HCR."

In April 2013, payments again were an issue as County Attorney West explained that HCR was behind on payments.

How the transfer of a major agency out of the hands of the County while opposed by the Board of Health is still a mystery. There have been bits and pieces of how the process convinced Supervisors to vote for the action but the initial impulse and the discussions behind the scenes are still murky. This transfer caused many of the issues that the County is dealing with today and remains controversial to many Supervisors and employees involved in health care in the County.

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2 comments:

Shawn Bevins said...

My father had a visit from an HCR "nurse" after his surgery. The visit was less than satisfactory. The nurse was supposed to show up the following day since there were issues. The next day came and went with no HCR nurse. My mother called the Dr's office to check on what needed to be done and the HCR nurse had reported that she had seen my father on a day she was never there. This is documented. Privatization of a service like this isn't a good thing.

HCR Home Care said...

HCR Home Care's state-of-the-art compliance and quality management operation features GPS-based tracking -- and we require a patient's signature for every appointment -- so we know when a nurse visits a home.

Because patient satisfaction is critically important to us, we always want to hear about any individual concerns. To share a concern or provide feedback, anyone can contact our toll-free, confidential, third-party compliance hotline at 866-875-2974 or through our website (at http://www.hcrhealth.com/about/privacy).

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