LCHD board fights back against hospice closure

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In the last two fiscal years, we did operate in the red,” Ross said. “When we were in the middle of the pandemic, I will be the first to admit, I wasn’t on it. We have a very large operating budget and when one thing’s occurring here, we get focused and with the pandemic we were largely focused on that. I’ll take responsibility, but we want to turn it around.”

Michele Ross, LCHD Administrator

LEE COUNTY -  A move by a Lee County Supervisor that threatened the continuance of the Lee County Health Department’s Hospice program was met with a visceral reaction Thursday morning.
The Lee County Health Department Board of Directors met in their regular meeting at the John Bennett Center on the former Iowa State Prison grounds Thursday and were met with a statement from Lee County Supervisor Chuck Holmes regarding the LCHD Hospice program.
Holmes told the health board that he was going to ask Lee County Supervisor Chair Garry Seyb to add an agenda item to an upcoming board meeting that could’ve pulled tax support from the county’s hospice program if approved.
The hospice program has run in the red for the past two years, according to LCHD Administrator Michele Ross.  Ross fell on the sword saying dealing with the pandemic over the past two years changed the department’s focus.
“In the last two fiscal years, we did operate in the red,” Ross said. “When we were in the middle of the pandemic, I will be the first to admit, I wasn’t on it. We have a very large operating budget and when one thing’s occurring here, we get focused and, with the pandemic, we were largely focused on that. I’ll take responsibility, but we want to turn it around.”
Ross said they’ve been asking supervisors for time to show that the program can be self-sufficient.
LCHD finance operations manager Tammy Wilson said currently the program is running only about $8,000 behind after moving some salaries and benefits into other grant programs.
The health department is also awaiting some reimbursements for room and board, and VA contracts that will make the picture even better.
The health department pays up front for hospice clients that live in long-term care facilities, and then gets reimbursed through Medicare. About $105,000 of those payments are behind, according to Wilson.
The health board said the service was critical to the people of Lee County and the private sector is volatile, which could leave residents without hospice services.
“I think that’ll be a regrettable event for all the citizens of Lee County to what this organization is dedicated to. These are the people that have the most serious problems. You know that and you know how difficult that is,” health board member Dr. Philip Caropreso said to Holmes.
Caropreso said it appears that LCHD is being targeted by the supervisors.
“The whole process seems to have been decided beforehand and we’re being confronted by this decision. People have already made up their mind with very little input, and no input from the experts in the department,” Caropreso said.
Supervisor Matt Pflug, who is the Board of Supervisors' liaison to the LCHD board, said the health department is being targeted. Pflug said  he agreed supervisors should give the health department time to show their budget for the next fiscal year before making any decisions.
“They’re targeting the health department. I’m just gonna come right out and say it,” Pflug said.
“What if these private service providers are gone tomorrow? It happened with the Keokuk hospital."
Holmes said he’s spoken with Southeast Iowa Regional Medical Center and was told they could handle the transition of hospice patients to their hospice program. He said there are three other hospice programs functioning in Lee County.
LCHD’s Emily Biddenstadt said county residents need to have a choice for hospice care.
“We can’t just transfer a patient to a different hospice provider,” Biddenstadt said.
Seyb had said during a prior Board of Supervisors meeting that the county shouldn’t be involved in providing public services on taxpayers' dimes, when private companies are providing the same service.
Holmes read a statement he had prepared for Thursday’s board meeting.
Holmes’, in reading from his statement, said the program should be discontinued.
“BOS chairman Garry Seyb and other supervisors support the premise that programs and services not required by code, and that have these programs and services provided by the private sector, and where the private sector is able to provide these programs and services to all Lee County residents who apply for it – should be discontinued,” Holmes said.
He said he was going to ask an item be added to an upcoming agenda for the Board of Supervisors to decertify the Hospice Program and to terminate the operation of the program by the end of this fiscal year, which would be June 30, 2024.
Holmes said if that motion carried, there would be no budget appropriation for hospice services in the upcoming fiscal year.
LCHD board member Heather McCormick asked if Supervisors had the authority to terminate the Hospice program. Holmes said he didn’t think the board could terminate the program, but could end property tax support in the budget process. McCormick has 30 years experience in health care finance and said supervisors shouldn’t be “stirring the pot”, if they don’t have authority to shutter the program.
Lee County Health Department has been offering hospice care for 31 years and Ross said it’s a service known for quality and compassion.
She said the staff is working diligently to show that the hospice program can function without taxpayer support and supervisors should wait to make any decisions until they see the department's project budget.
Holmes said he would take the board's reaction to his statement to Supervisors at their next meeeting, but would leave it up to Seyb to add the item to the agenda. Pflug said he would reach out to Seyb to discourage that action.
Budget workshops usually take place immediately following the holidays in January.