WESTON -- John Frederick believes the closing of the Lewis County Health Department's homebound services is part of a trend induced by the 1997 federal Balanced Budget Act.
"Clay County closed theirs. Putnam County closed theirs. Cabell County's closed. Boone's closed. Harrison and Marion have had layoffs," said Frederick, department administrator, ticking off a growing list of programs that have collapsed or reduced in the past two years.
The Lewis department announced last week its 33-year-old home health-service program will end Sept. 30. Two nurses and one aide will lose their jobs. About 30 area residents, mostly from Lewis and Gilmer counties, will need to seek homebound medical services elsewhere, Frederick said.
That's just the tip of the iceberg, he added.
Prior to 1997, the Lewis County program served 240 patients in six counties and employed more than 40. They were lost through four other employee reductions prior to the closure -- all of which he directly attributes to the Balanced Budget Act.
The Balanced Budget Amendment has generally limited Medicare/Medicaid payments to amounts healthcare officials say are below their costs.
Frederick said the Lewis erosion was specifically brought about by two 15 percent cuts in Medicaid and Medicare payments for such services. Another funding change that Frederick said would have cut the budget 10 percent is scheduled for Oct. 1, prompting the September closure.
"It's become very hard to make ends meet doing this service anymore," Frederick said.
He said it is likely Stonewall Jackson Hospital in Weston, St. Joseph's Hospital in Buckhannon and United Hospital Center in Clarksburg will pick up some patients, while others may seek more expensive care in nursing homes. Government-funded home health services are limited to those who, among several criteria, are homebound and need medical care.
"The hospitals are staying in it (home health services), but they are not making money," Frederick said, adding 25 percent of all kinds of home health services have closed in the last three years nationwide.
"Everybody feels that there will be a turn around ... It's the ones with the deeper pockets that are holding out."
Jane Eisenbeis, Stonewall Jackson director of home health services, said that hospital's client base is about 40 patients. She expects to see a slight, short-term increase with the closing of the health department program.
She agreed with Frederick that the closing is part of a larger trend. She added that it may also include a change in how services are offered by those who remain in the business.
"We'll see that patients and caregivers are going to have to assume a lot of their care ... like wound care," Eisenbeis said of how systems may cut costs. "Then the nurse will go in and do observation."
Eisenbeis said former health department patients may contact Stonewall Jackson for more information if they are unsure about for which, if any, Medicare/Medicaid services they qualify.
While home health services will close, Frederick said the Health Department will continue to offer other services such as vaccinations, family planning and blood pressure/diabetes screening through its state funding. There are six remaining employees to handle those services and the department is considering sharing some services with Upshur County to cut expenses.
Regional editor Nora Edinger can be reached at 626-1403.