On an upside, assistant administrator Margie Harris reported, "Home
health care remains strong." Harris spoke in depth and
enthusiastically about how well the home health care service that
the department offers is doing.
Home Care of Central Illinois includes Medicare-covered services
and offers nursing care, physical therapy, occupational therapy,
speech pathology and home health aide services.
Harris explained that agencies that participate in Medicare must
participate in performance measures, which are released every six
months. She has been tracking the reports produced by the state's
Central Management Services since they first went public three years
ago. At that time there were six home health care agencies providing
service in Logan County. Now there are at least 20 providers, she
said, "so, home health care has become more competitive."
Nurses chart and submit patient care and results consistently.
Information gleaned from that documentation is then put into the
comparative reports. Harris provided copies of the latest report
that was just released. She was excited by the positive results the
agency has attained.
Harris provided printouts of two comparatives that were in the
report. One compilation provided the most recent data in 12 quality
measures comparing Home Care of Central Illinois with state and
national averages.
"We still ranked higher than other agencies coming to Logan
County. We're meeting (or exceeding) eight to nine performance
measures out of 12," Harris said.
In the nine categories that assessed patient improvement while at
home, patients' improvements were either the same, slightly or
substantially better than state and national averages.
The agency has room for improvement in the remaining three
categories, which deal with unplanned doctor's visits or readmission
to the hospital, Harris said, and measures have been taken to work
on those. This included staggering physical therapy, nurse and aide
visits so the patient is seen with more frequency, as many as six
days in a week.
The department has also joined the national campaign for quality
improvements with goals to reduce admissions to the hospital and to
increase patient ability to self-manage oral medications. This
involves monthly training.
In another document, three-year comparatives between Home Care of
Central Illinois, state and national averages, HCCI consistently
improved and was higher in nearly all measures. The reports can be
found online at
http://www.medicare.gov/HHCompare/Home.
Financial matters
Sally Gosda, director of finance for the Logan County Department
of Public Health, gave the financial report. The department relies
mainly on grant funds for its services and programs. As expected,
revenue from state-funded grants remains behind. The state of
Illinois currently owes the department $167,381.92.
The state awarded Logan County 22 grants that totaled
$1,159,800.80 for the fiscal year beginning July 1, 2009. To date,
$499,723.78 has been paid.
Other sources of grant funding commitments amounted to $25,025
for this year.
Administrator Mark Hilliard continues to monitor the state's
past-due bills and the effect on the health department. Several cuts
were made in December in conjunction with the delayed funding. With
some shifting of employees and one nurse out on leave, no additional
cuts have been necessary.
Gosda told the board that the county is looking at a significant
rate increase in employee health insurance this year. The health
department did build into its budget for some increase, though it is
not as much as what is now being talked about, she said.
Another expense will come in the disposal of unused portions of
expired H1N1 vaccine. To expedite inoculation, a number of area
health care providers were encouraged to purchase H1N1 vaccine for
distribution. The health department is now collecting the expired
leftovers, including from local providers, as it is hazardous waste
that requires special disposal. Harris said "luckily" there is still
some funding remaining from the H1N1 grant to help with that cost.
Harris added that there are still some H1N1 vaccines being given
each week. Some have been given to children who have been brought
in, just having reached 6 months of age, when they could get the
vaccine. The health department will also keep some vaccine on hand
for anyone who would still like to get vaccinated.
Community needs assessment and department recertification
processes under way
A Logan County native, Kristy Melton, is assisting the health
department with its recertification process as part of her
internship. Melton is working on a master's degree in public health
at UIS and works in the lab at Memorial in Springfield.
Hilliard said, "In the process she has gotten a complete overview
of the health department."
The certification is due in October.
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Harris explained that the health department must be certified by the
state health department every five years in order to receive any
state or federal funding. To become certified, the department needs
to go through a community needs assessment, as well as an
organizational assessment of strengths and weaknesses, she said.
Melton has facilitated two community health assessment meetings,
with one more scheduled.
Board members were also given organizational capacity survey
questions and asked to complete them in two weeks.
In conjunction with that, the health department will be seeking
to improve its health ranking scores based on statistical findings
in areas of weaknesses. These county scores can be found at
http://www.countyhealthrankings.org/illinois/logan.
The board asked questions about the community health needs
assessment process.
Lincoln Daily News is following this process. The process starts
with assessment of needs and resources, moves to prioritizing needs,
next finds programs and policies that work, seeks to implement
strategies, and finally evaluates efforts. The entire process
combines the efforts of employers and businesses, health care
professionals, community leaders, government officials, and public
health professionals.
Friday, at the second assessment meeting, the group was composed
mostly of health care providers and several individuals from the
community, including a high school Reality Team teen, local
Salvation Army director Rebecca Van Nydeggen and Lincoln Mayor Keith
Snyder. Melton reviewed what took place at the first meeting, when
data reports were presented and a list of needs was started. That
compiled list was reviewed at the start of the second meeting and
added to. Then small groups were formed to refine this list and
prioritize the needs in three different measures.
Melton will present the meshed priorities at the third and final
planning meeting, scheduled for April 9, and lead the final process
of refinement that will lead to the health priorities focus for the
next five-year plan.
During the last five-year health assessment, oral health care was
identified as the most critical health care need in Logan County.
The HOPE Mobile has been helping meet that need for children in the
last few years.
Other plans are to create a three-chair dental clinic in the
health department. Hilliard was disappointed that grants did not
come through last year but has hopes for this year.
A new grant request of $150,000 has been submitted to the Kresge
Foundation for the purposes of a dental clinic. A request will also
be made to the Illinois Children's Foundation when proposals come
out in April for a construction grant.
Additional public health services
Another effort in the works is for the health department to
provide school-age children with pertussis and tetanus boosters. The
grant to do this will probably be for this year only, Harris said.
The Illinois Breast and Cervical Cancer program in Logan County
ran into a glitch. The local program would probably never be able to
meet the case load of 900 patients. However, when the health
department offered to give back some of the grant money, the state
rejected that offer, saying they would prefer to work together to
increase the number of women served by the program.
Under crisis and emergency public health, the emergency response
coordinator, Shana Bean, has been able to attend three national
conferences in her area of expertise. In early February she went to
New Orleans to practice emergency communications; in mid-February
she also attended the National Public Health Preparedness Summit in
Atlanta, Ga.; and she will attend the Medical Reserve Corps National
Conference in Memphis, Tenn. Bean received scholarships to attend
each of these trainings.
The department is getting ready for the annual Community Health
Fair. In the offerings this year will be a collection of unused
pharmaceuticals and testing well water for nitrates.
Harris and Hilliard have been designated as the public
information officers for the agency. They have received training to
act for the health department in compliance with the Freedom of
Information Act. Their contact information is on the Logan County
Department of Public Health Web site.
It was announced that health board meeting agendas, notes and
minutes will be soon be posted on the Web site. Part of this was
being done already, but it will become more timely and meeting
minutes will be added.
[By
JAN YOUNGQUIST] |