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NRCHS cuts home care program

WORTHINGTON -- Members of the Nobles-Rock Community Health Services (NRCHS) Board on Wednesday approved a plan to eliminate home health care from the agency's offerings by Jan. 1, 2008. Notice to the agency's nine part-time home health aides was to be delivered Wednesday afternoon.

During the next 15 months, NRCHS will work to reduce the number of home health staff by two full-time equivalent (FTE) positions. Board chairwoman Karen Pfeifer said home health care employees will be given the option to move from a .6 FTE position to a part-time intermittent position in which they will not be guaranteed a specific number of hours. If there are no volunteers, seniority will be used as the basis for non-voluntary movement in status.

Pfeifer assured that no clients will lose service as a result of the home care program's elimination. The agency will continue to serve clients through 2007 and, by November 2007, remaining home care clients will be transitioned to one of several home care agencies within Nobles and Rock counties.

The decision to cut home health care from the agency's offerings was not an easy one to make, Pfeifer said, but one that was necessitated in order to pare the agency's expenses. Eliminating home health care is anticipated to save NRCHS approximately $274,000, while income the agency anticipates losing as a result is expected to be $204,650.

One month ago, NRCHS board members faced a 2007 budget request of $415,812, an increase of $139,943 from 2006. After commissioners on the NRCHS board said they would have difficulty approving such a large increase, a subcommittee was developed to include administrators and commissioners from both Rock and Nobles counties, as well as NRCHS officials and the board chair.

"We took the task very seriously ... knowing also that we have limited resources and recruiting qualified staff is getting difficult," Pfeifer said, adding that cuts will have an impact on both clients and staff.

In the original budget request, salaries and benefits accounted for 75 percent of the total increase. On Wednesday, board members presented a revised budget of $346,462 -- a budget that will require the elimination of 2.75 FTE positions within NRCHS, including .5 FTE in skilled nursing, .25 FTE in clerical and 2 FTE in home health aid and homemaker programs.

Official action on Wednesday included the unanimous approval of the revised budget request; unanimous approval to reorganize the agency and eliminate the skilled nursing service program effective Jan. 1, 2008; and the unanimous approval not to replace two vacant positions within NRCHS -- a full-time nursing supervisor and a full-time skilled nurse. Eliminating those two positions alone saved the agency $116,000.

"By keeping the supervisor position vacant, it means we are endorsing the team model," Pfeifer reminded fellow board members. The team model was created following the departure of the agency's director nearly two years ago.

Regarding the agency's reorganization, Nobles County Administrator Mel Ruppert said it's not going to be an easy transition.

"It's really (taking) some hard steps, but I know it's necessary," added Nobles County Commissioner David Benson. He said state and federal funding reductions have forced counties to make choices, not only in health care, but in other areas as well.

"In no way is this a reflection on staff," added Rock County Administrator Kyle Oldre. "It's clearly an economic decision."

Following the agency's reorganization, staff will focus efforts on programs including family health, disease prevention and control, health promotion, long-term care case management and public health preparedness.

In other action, the board:

- Set the NRCHS' price for the flu shot vaccine at $23 per dose.

"This year there is plenty of vaccine," said NRCHS nurse Cindy Frederickson. "There is not a shortage that they are projecting."

- Received a recruitment update regarding the hiring of a new director for NRCHS. Pfeifer said second interviews will be conducted with two candidates, one from Des Moines, Iowa, and one from Fargo, N.D., in early to mid-October.

- Received an update on the work South Dakota State University nursing students are doing with NRCHS, particularly in the areas of outcome-based quality assurance.

- Approved advertising for a community health organizer. The full-time position will be based in Nobles County and is entirely funded by a grant from Blue Cross Blue Shield.

Julie Buntjer

Julie Buntjer joined the Globe newsroom in December 2003, after working more than nine years for weekly newspapers. A native of Worthington, she has a bachelor's degree in agriculture journalism. Find more of her stories of farm life, family and various other tidbits at

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