County Public Health staff ‘terrified’ after March 7 supervisors discussion

By Zach Jensen,

The Winneshiek County Board of Supervisors is looking for ways to cut costs, and Public Health Administrator Krista Vanden Brink reported during the March 25 supervisors meeting that her staff was “terrified” after the supervisors’ discussion of the issue earlier this month.

Monday’s meeting with the supervisors was the second time that Vanden Brink’s met with them this month. During the March 7 supervisors meeting, the supervisors began asking Vanden Brink what the county is getting for its money. Winneshiek County pays $740,000 per year for its public health services, while Allamakee, Clayton, Fayette and Howard counties, which all rely on hospitals for their public health services, each pay less than $170,000 annually.

Vanden Brink essentially told the supervisors that comparing Winneshiek County to Allamakee and Howard counties is comparing apples to oranges.

“Yes, they’re receiving less in county tax dollars from their supervisors, but again, like I said before, the hospitals are paying way more money,” she explained. “They’re paying the wages for all of those staff. They’re paying the health insurance, and that money isn’t enough to take care of the entire agency. They’re also doing a lot more home care.

“We have a workforce problem in the country,” Vanden Brink continued. “There’s not enough people to be working. Winneshiek County has the highest population over the age of 80 in the state of Iowa. It’s great that people want to come here to retire. But, because we have all these older people, they all need home care. They all need services. Just last week, I had four referrals, and I can’t take them, because I don’t have staff that can provide those services. It’s a workforce problem. There is not one entity around that can service everybody, because they all have different needs.”

Vanden Brink said the county’s public health department provides home care for all ages, from infants to the elderly, with services that include everything from bathing and home cleaning to medication planning and more. And, all those services have different payors, such as Medicare, Medicaid, Veterans Affairs and the Managed Care Organizations. 

“The only thing that we have any control over for payment … is our private-pay people,” she said. “Private pay is based on a sliding-fee scale, and we have to take a look at what their income is. There’s a lot of people with an income of less than a thousand dollars a month. That’s hard to live on.

“I don’t know what else you want,” Vanden Brink continued. “I do know that, when I shared with my staff that there are concerns, they got really scared. They were really scared.”

“How much duplication of services do we have?” asked Supervisor Steve Kelsay. 

“There isn’t duplication,” Vanden Brink replied.

Kelsay said that during the March 7 meeting, Vanden Brink had talked about STD testing provided by Public Health — testing that is also done by Luther College for its students.

Full discussion in the March 28 Public Opinion Newspaper. 

As the discussion was wrapping up, Vermace told Vanden Brink that she was sorry that Vanden Brink’s staff was frightened.

“They’re terrified,” Vanden Brink said. 

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