Why we're closing homecare agency

Each day, those who work for Catholic Charities witness and respond to the needs of the poor and vulnerable individuals in our communities who work diligently in a struggle to meet their basic needs. This is especially true for several hundred homecare clients served by Catholic Charities.

For more than 15 years, Catholic Charities has been committed to helping elderly and disabled individuals live independently in their own homes, through Inter County Home Care's (ICHC) provision of compassionate care. ICHC initiated operations in the mid-1980s because frail and elderly individuals living in rural areas in New York State lacked access to the home healthcare services that were available in more densely populated regions. The agency is staffed by committed individuals, many of whom have over a decade of service.

Recent healthcare financing trends have posed new challenges for homecare providers, including Catholic Charities. With hospitals favoring earlier discharge for most patients, the need for home care has risen steadily. At the same time, reimbursement for home care has been severely limited and fails to meet the growing cost of providing the service. For example, it costs Inter County Home Care over $15.40 to provide a single hour of care. But the reimbursement for care is as low as $12.39 in some regions.

As a result, Inter County has operated at a significant deficit for ten consecutive years. Even though we have significantly reduced administrative and indirect costs, in this decade alone, Catholic Charities has subsidized its homecare operations for a total of almost $2 million.

After careful study, we concluded that costs could not be further reduced at ICHC without sacrificing the quality of care or the wages and benefits offered to our employees.

Catholic Charities can no longer sustain the unreimbursed expense associated with running a homecare agency. The resulting deficits have diminished our ability to provide other critical services to people in need, such as pregnancy and parenting services; care for the developmentally disabled; daycare and job training for families transitioning from welfare to work; domestic violence services; emergency food and shelter; and many other services.

Reluctantly, Catholic Charities has decided that we must exit the home health field and close Inter County Home Care, effective Oct. 31. This determination was reached in consultation with our Board of Trustees only after thoroughly exploring every possible option.

Catholic Charities worked diligently throughout the past two and half years to identify ways to maintain care to needy individuals by seeking an organization to operate Inter County. Although the search was exhaustive, it was not successful. Other homecare agencies indicated that they would face insurmountable challenges if they were to provide service in such a vast, rural region. No other organization was able to assume responsibility for the service Catholic Charities began in the 1980s.

The agency closure will not leave homecare clients struggling to find alternate care. Catholic Charities has developed a plan that should allow sufficient time to arrange alternate care for clients. The overwhelming majority of clients have case managers, either through a county government agency or through a certified home healthcare agency. We are providing all of these agencies with ample notice so they have time to find another home health agency to serve them. And, we will work one-on-one with each of our private clients to find an alternate care provider.

We sincerely regret that the closure of the agency will result in job losses. ICHC's employees are dedicated individuals who have worked tirelessly traveling to people's homes to care for them compassionately. Catholic Charities believes their skills and commitment will be valuable to other employers. By providing almost 60 days notice before any positions are eliminated, it is our expectation that many employees will secure other jobs and experience no gap in employment.

Catholic Charities has also prepared a generous severance package for all affected employees. In addition to severance payments based upon longevity with the agency, all employees will have access to career counseling and job-finding activities we will organize with other homecare providers. Counseling will be available at no cost to employees who experience undue stress as a result of this action.

As we enter the 21st century, the healthcare industry will undoubtedly continue to face rapid change. And, as the number of older adults living in our communities grows, we will be challenged to find new ways to ensure that people with healthcare needs that can be managed in their homes are neither unnecessarily institutionalized nor left unserved and alone. It is necessary to critically evaluate the current policies and funding for home care. We must also work with health care organizations and community leaders to identify ways to provide appropriate care to people in need, especially in rural regions.

We look forward to participating in these discussions as we work together to develop sound approaches to ensure that our frail and elderly neighbors are not left behind.

(Editor's note: The author is executive director of Catholic Charities for the Diocese of Albany.)

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