Board hears public-health director27s proposal to end county home health to cut property-tax support; director says plan could save about $532,000

Iowa County27s public-health department budget, including proposed raises and a possible exit from county-run home health services, was a focal point of the meeting as supervisors and the health director discussed options to reduce the county’s property-tax ask.

The public-health director told supervisors the county currently subsidizes home health with property-tax dollars and presented preliminary numbers showing that discontinuing the department27s home health program could save the county about $532,000 in property-tax support. “I did some preliminary numbers of how much it would save us and it was to the tune of $532,000 is what it would save us in property taxes if we got out of the home health department,” the director said. The director stressed the figure was preliminary and that more detailed planning and legal review would be necessary before any change.

The board of health had approved a budget that included 7% wage increases and a targeted CNA starting-wage increase; the health director reported the health-board discussion included a proposal from the director to raise CNAs by $5 an hour (bringing starting wages closer to $22/hour), but the board of health recommended a smaller $3/hour raise to bring a starting wage to about $17/hour. The approved health department budget presented to supervisors for the county27s consideration included the 7% across-the-board increases plus the CNA adjustment, increasing the department total by approximately $35,000 to $1,111,232 in the current worksheets.

Supervisors raised implementation and coverage questions if the county discontinued home health. The director said private providers in the region had indicated willingness to take over geographic coverage in the county, but the county would need to develop an exit strategy to avoid leaving clients without services. The director also proposed establishing a small grant pool or sliding-scale fund to assist low-income residents who currently receive subsidized services. "I don't want people to not be able to have services," the director said; supervisors asked staff to examine the legal, staffing and fiscal implications before any decision.

No formal action to terminate home health services was taken. Supervisor discussion emphasized the need for a thorough exit plan if the board ultimately chooses to discontinue the service and noted the budget review schedule under which any recommended changes would be considered.

The matter will be further considered as county staff model FY scenarios and as the department provides more detailed data on client counts, payer mix and transition options.