Wednesday, March 24, 2010
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Board of Health hears success of home health care services

State funding delay affects health dept.; recertification process under way

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[March 24, 2010]  When the Logan County Board of Health met this month, it was a mixed bag of news.

HardwareOn 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

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

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.


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