Legislators fret over in-home health care going private

Some lawmakers said Thursday that they are worried about the consequences of the state Department of Health's plan to sell the department's in-home health care services program to a private company.

They said they fear rural areas will lose service once a company purchases the program, and they're concerned about the fate of its state employees.

In August, the department alerted about 500 state employees and 1,800 contract workers that the program will be sold sometime this year. At that time, department Director Nathaniel Smith said he decided the program is no longer sustainable because of financial constraints and competition from the private sector. Today is the deadline for companies to submit proposals to buy the program.

The program, started in 1981, offers hospice, home health care, personal care and other services to about 9,100 patients, according to the department. Most patients pay for the services through Medicare or Medicaid with some patients using private insurance.

The Joint Budget Committee co-chairman, Sen. Larry Teague, D-Nashville, said there are parts of his district where the department is "the only home heath unit, so I am really teed off that you are quitting." Teague's district is in southwest and western Arkansas.

"I'll live with it, but I don't know you are serving my people very well with this action," he told Smith on the third day of the committee's prefiscal session budget hearings. The legislative fiscal session begins April 13.

Smith told lawmakers there are more than 100 in-home health care providers in the state, and he made the decision to sell the program after reviewing several years of information.

Some of the staff told him that the department's in-home services program was having trouble competing with private providers, and some of the private providers questioned the state competing with them, he said.

"It made more sense to make this transition at a time when we still have something left to transfer and could negotiate the very best terms, not just for the people we serve, but also for our staff," he said.

Smith said the department is seeking proposals from private companies through a "request for acquisition."

"Once we get those applications, we'll review them and our plan is to transition our in-home services to a qualified private provider," he said. He said he hopes to make the transition to a private provider this summer.

House Majority Leader Ken Bragg, R-Sheridan, said he wants to know how much the state will save from the sale of the program.

"The big unknown is going to be basically the sale price," Smith said. "In terms of what the savings will be to the state, at the end, will really depend on the sale price."

Rep. Charlotte Douglas, R-Alma, questioned whether there are any counties that aren't covered by the in-home health services program during this transitional period.

"There are counties in which the patients have gone to other private providers there and we've scaled back our services," Smith replied. "But I am not aware of any part of the state where there are people who don't have access to services. If there were, we would move folks in there."

Ann Purvis, deputy director of administration for the department, said about 200 of the 500 full-time state employees left the program since the August announcement. About 1,500 of the contracted workers are still operating around the state, she said.

But Douglas said she has been hearing about "chaos" in the Health Department resulting from state employees who were in the in-home health care program being hired into vacant positions for which they were not qualified and "pushing someone who is qualified out of a job."

Purvis said employees must meet the minimum qualifications to be placed in any vacancy and they get "the first pass for those open positions.

"I know that maybe that has created some concerns out in the state, but those people that are placed in positions do meet the minimum qualifications," she said. "They are normally long-term employees of the department as well."

Rep. Josh Miller, R-Heber Springs, asked "what kind of guarantees [for the state employees] are going to be in place in this contract with whoever the new company is?"

Smith said there will be "a retention bonus for those who stay with the program until the time of the transition.

"But the reality is that someone who has 20 years with the state and a vacancy comes up and they are qualified for that position and it is something that they would like to do ... they are likely to jump ship at at that point."

Purvis said the retention bonus will be based on the proceeds of the sale of the program to a private company.

She said it will be "a minimum requirement" for the company that purchases the program to retain the state employees in the program for a year.

Metro on 03/11/2016

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