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Our Opinion: Can home health remain public and become profitable?

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When you’re flying blind, the smartest thing you can do is ease off the throttle.

Wilson County commissioners put the brakes on a vote to sell the county-owned home health agency to one of two private bidders last week as they navigate their way through a fog of fuzzy math.

Wilson County Home Health is operating in the red, but figures provided to the county board show the agency lost $900,000 last year and is projected to lose about $271,000 this year. The wide gulf between those two figures threw Commissioner Roger Lucas for a loop.

“If we had known the situation of some of the details I have gotten since this process started, I think home health would have been a different entity that what it looks like today,” Lucas said during Friday’s meeting.

Losing more than a quarter-million dollars is a hard pill to swallow, but that’s $629,000 better than a year before. With negative cash flow that volatile, it’s worth digging into the numbers to account for the difference and see if similar gains could be made in future years under county ownership.

Startled by the bid process’ rapid pace and stung by a public outcry over the nearly 50-year-old agency’s possible private sale, commissioners grabbed the controls from county health department officials and vowed to study the issue carefully. The board opted to delay a vote on selling home health for up to 30 days.

“We need to get this right,” newly appointed Commissioner JoAnne Daniels said. “I think that’s the most important thing.”

Wilson County Home Health has a stellar reputation for patient care. It’s also bleeding money, and rather than ask taxpayers to subsidize it, the health department and county Board of Health recommended selling the agency to a private provider. That sounded reasonable at the time, and it mirrors a trend of North Carolina counties getting out of the home health care business.

Many of the agency’s 350 patients and their families, along with its 30-plus employees, sounded the alarm. They fear a for-profit company will reduce charity care and diminish the quality of service home health provides in order to save money.

It doesn’t help that only one of the two bidders — In-Home Partnership, which has ties to Duke LifePoint — has a history of operating home health firms. The other suitor is a privately held Rocky Mount-based company whose ownership, vision and track record aren’t clear. Commissioners don’t have the benefit of weighing competing proposals from two known quantities. Charlotte Hicks, a county health board member, said the bid was “not even comparing apples to oranges — it’s apples to squash.”

Both firms offered $2 million to take home health off the county’s hands. A one-time infusion of cash and a merciful end to the flood of red ink is tempting, but some stakeholders say cutting and running would be shortsighted.

“Why can’t we figure this out ourselves and be the success story and leader, rather than follow suit and do like all the other health departments in our state?” physical therapist Marla Parker asked commissioners. “Can’t we be the innovative trendsetter and not a follower?”

Lucas said there may yet be a chance to solve the agency’s cash flow problems. We hope he’s right.

Best-case scenario for patients, employees and taxpayers alike is that Wilson County Home Health can not only stop losing money, but break even or turn a modest profit. If that’s possible, keeping the agency public will be a good investment.

It cannot, however, remain indefinitely as an albatross around the county’s neck that places a higher strain on the taxpayer each year. Commissioners have a keen understanding of that harsh reality.

For now, board members are trying to wrap their heads around the facts and figures in order to see if there’s a solution that benefits everyone. Wilson County Home Health in its current financial state is a liability, but a solvent public health care agency would be a valuable asset, a feather in Wilson County’s cap.

We always root for the win-win. If there’s a path to profitability under public ownership, we wish commissioners Godspeed as they work diligently to find it.

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