After almost a half century of offering health services to homebound residents, the Marion County Home Health Agency will officially cease operations on Saturday, Oct. 31. The Marion County Health Department will continue its public health functions.

After almost a half century of offering health services to homebound residents, the Marion County Home Health Agency will officially cease operations on Saturday, Oct. 31. The Marion County Health Department will continue its public health functions.

“It's a hard thing to do to part with something that's been a part of the agency for so long, but it is a window of opportunity to give us a chance to go forward and just concentrate on public health,” said Jean McBride, administrator of the Marion County Health Department & Home Health Agency since March 2009. “It's something we've always taken very seriously and love to do, but there comes a time when you have to look at the facts and the board made a decision that we needed to close it.”

McBride cites federal guidelines as one reason behind the decision, made roughly two months ago, to close the agency.

“With the new regs changing and the restrictions, it just gets worse and worse,” she said. “When you have an episode with a client and they (Medicare) pay you for that episode, two years down the line they can decide some documentation the doctor did was not accurate and they'll take all that (reimbursement) money away from you. They call it an overpayment and you've got to pay it back with interest,” McBride explained. “It was different when it first started out. Medicare paid 100 percent and there wasn't all the requirements or restrictions. Somewhere along the line agencies abused it so we all got caught under the punitive side of the regulations being more stringent. We followed the rules, but sometimes you can't make it following the rules.”

The number of referrals receiving the agency's help have been in decline in recent years, according to McBride.

“It used to be we had a core group that you could keep on and you would 're-cert' them and keep them on. It would help keep them out of the nursing home and hospital,” she said. “Then with the rule changes it became a revolving door. If we got a referral they would only be on for a couple of weeks and there was tons of paperwork, and then they'd be discharged out. If you had a knee surgery, we only kept them on for a couple of weeks until they got on their feet for out-patient therapy. They had to be homebound, which has always been the case for Medicare. We've also got a younger generation that doesn't want to stay home. And if they weren't homebound they didn't qualify.”

The agency's number of home-health care clients had dwindled to a dozen. As Oct. 31 drew near the remaining clients were assisted in finding assistance elsewhere.

“They made a selection of where they wanted to go. We helped them with that,” said McBride.

Elimination of the home health agency will not result in lost jobs, according to McBride, noting that slots in the health department were found for those wishing to remain.

“My staff all had the opportunity to move on to other things (at the health department). Those that did we retained and re-trained,” she said.

Health department personnel will have plenty to keep them busy.

“We're going to focus on what public health does. There's all sorts of things that we oversee that people never know we look at to protect the health of the community,” said McBride. “I have a great public health staff that's knowledgable and willing to help the public. We're excited about that. We're going to come up with new programs. We're going to be creative.”

While excited about the opportunities which lay ahead for the health department, closing the home health agency, whose history in Marion County dates back to the late '60s, isn't easy for McBride.

“The agency has been great to serve the community as long as it did. It's been out there for everybody,” she said. “We do regret closing the home health agency, but I think we can help more people public health-wise this way.”

McBride predicts that more home-health providers will be following Marion County's lead.

“We're not the only health department in this situation. We just happen to be one of the first to do something,” she said. “When I called to ask about closing, they said this is happening more and more every day. It wasn't just us. It's unfortunate because it is a great service.”

Reach reporter Danny Henley at danny.henley@courierpost.com .