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Be the reason your community stays informed—give to local journalism now! DECORAH – At the latest Winneshiek County Supervisors meeting on Monday, Public Health Director Krista VandenBrink addressed concerns over home care services funding. She detailed a five-year state plan that is phasing out the use of local public health service contract funds for home care. "In state fiscal year '21, of the approximately $7 million that was allocated just to local public health agencies, $3.2 million was used to provide home care services for just over 4,021 people here in the state. Those community health consultants didn't feel that that was an appropriate use of funds. They said that there were actually other places that could provide home care." As a result, local public health agencies are seeing a steady reduction in their ability to fund home care services, with the final phase-out scheduled for fiscal year 2027. "In fiscal year '26, coming up here in July, we can't use more than 25% of the funds," VandenBrink explained. "[Our staff is] looking at how [we] can make sure that we're not even using that 25% because we know in '27 we kind of fall off." The cost of services remains a concern, with private pay clients facing high out-of-pocket expenses. "For a home care aide, it's $50 an hour. For homemaking, it is $35 an hour," VandenBrink outlined, emphasizing that some individuals are on a sliding fee scale—while most are paying in full. The shift in funding has forced the county's public health department to make adjustments, including modifications to its sliding fee scale. "We know we're going to have to do another adjustment," VandenBrink said. "We've talked about this just briefly at our board meeting, saying, 'We have to do this.'" Staffing limitations also present challenges. "We don't have capacity to do [more home visits] at this point in time. We've got capacity to do about one hour once a week for people. That's not enough," she noted. The supervisors debated the broader implications of funding gaps for home health services. "It sounds like there needs to be a state law change other than the county's taxpayer responsibility to put in the gap for that," Supervisor Steve Kelsay commented, questioning the financial burden on local taxpayers. He pressed VandenBrink on the financial sustainability of the program, "The justification has to come for the county taxpayer [who] next month takes out that checkbook and writes a check to pay their property tax," Kelsay stated. "They always ask us, why is our property tax so high? Give me an answer." VandenBrink emphasized the critical nature of these services. "Public health is the gap filler for all of these services," she said. "It's going to cost us way more money in the long run if they're not being seen, then they get hospitalized, and then they end up in a long-term care facility. It will cost much more money." Supervisor Shirley Vermace, however, pushed back, defending the necessity of the public health program. "These are people. These are some of the most vulnerable people in our community," Vermace asserted. "Who are we [as a county]? Who do we want to be? What quality of life do we want in this corner of the state?" She emphasized the county's responsibility to support those in need, even in the face of budgetary challenges. The discussion concluded with a consensus that further fact-finding is necessary to determine the extent of comparable services in neighboring counties and potential solutions to mitigate financial strain on the county's public health department. Don't miss out on important updates! Subscribe to the newsletter for free and stay informed about local topics that matter most to you.

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Funding Cuts Threaten Home Health Services