Dr. Nate Smith, Director of the Arkansas Department of Health, recently announced that the Department’s In-Home Services Office will be transitioned to a private sector provider. This process is expected to take at least six months and comes in the wake of financial constraints and competition from the private sector over the last five years. The Department does not intend to wind down the business and cease operating, but instead will market the program to private providers with the capacity to manage the size and scope of our operations, including our employees and patients.
In-Home Services has suffered a 28 percent decline in patients, an 18 percent decline in revenues and a 19 percent decline in the number of employees over the last five years. Had this decision not been made now, an immediate reduction of employees would have been necessary.
Throughout this process, patients will remain a priority. ADH will strive to assist patients and to ensure continuity of care. The In-Home Services Office currently serves more than 13,000 patients in their homes by providing a number of healthcare programs. These programs include Personal Care and ElderChoices, Home Health and Hospice.
“The Department provides high quality healthcare services to our patients, and this decision was not taken lightly,” said Dr. Smith. “However, the Department must act responsibly in addressing the sustainability of continuing to operate the program with the challenges that we currently face. As we move forward in this process, a top priority will be to maintain healthcare services in the rural areas of the state.”
Governor Asa Hutchinson voiced his support for this decision.
“I want to thank Dr. Smith and his staff for the compassionate and thorough way that they are dealing with this issue. I know a lot of thought and research has gone into this decision. It’s the right one,” said Governor Hutchinson. “This is an example of a government program that is no longer sustainable and can be ended because the private sector has stepped in to meet demand. In the long run, this transition will preserve jobs, save taxpayer dollars and result in a more efficient, viable and sustainable in-home care program for Arkansans. It makes sense.
He went on to add, “Government should not be in the business of competing with the private sector, especially when the private sector can provide the same level of quality care. As a state, we will continue to work with all in-home service agencies to provide healthcare throughout Arkansas. I know the Health Department will assist employees through this process and that patients will be taken care of.”
General Questions about the Transition
What is happening to In-Home Services?
The ADH is beginning the process of transitioning the In-Home Services program to a private provider. We are at the very beginning of the process and it will take six months to a year for this transition to occur. In the meantime, we will continue to provide quality care for our patients.
Will this transition affect all areas of In-Home Services?
This transition will affect Personal Care, Hospice, and Home Health. The Maternal and Infant Home Visiting Program (MIP) will not be transitioned to the private sector. The MIP Program is a short-stay maternity program that combines a brief hospital stay with skilled home nursing visits. The Nurse Family Partnership is a grant-funded program and will continue.
Why was this decision made now?
In-Home Services has suffered a 28 percent decline in patients, an 18 percent decline in revenues and a 19 percent decline in the number of employees over the last five years. An independent analysis has shown that, in short, revenue has continued to decline while health care costs have increased. The In-Home Services program staff has done an exemplary job of providing services, despite the challenges presented. Had this difficult decision not been made now, an immediate reduction of employees would have been necessary.
Has a new provider been identified?
Not at this time. We are at the beginning of the process to identify a provider or multiple providers.
Does this transition have to do with the Affordable Care Act?
The ACA has helped reduce the amount of uncompensated care that In-Home Services provided to patients. This transition is occurring because revenue, patients and staff have declined in In-Home Services. Long-term, the program cannot be sustained, and so the decision has been made to transition In-Home Services to a private provider(s).
Patient Specific Questions
Will services stop for patients?
Services are not being discontinued for patients. We will continue to provide care as we work through this transition. Throughout this process, patients will remain a priority. ADH will strive to assist patients and to ensure continuity of care through the transition. The In-Home Services programs currently serve more than 13,000 patients in their homes by providing a number of healthcare programs.
If patients are transitioned to a private provider what happens to patients that are no pay?
ADH is committed, and will remain committed, to ensuring that all Arkansans receive the care they need. We will work with the private provider to ensure that those needs are addressed
Employee Specific Questions
Am I going to lose my job?
It is our intention to be as transparent as possible throughout this process. It is our hope that the new provider will employ many of the staff that currently serve in our In-Home Service programs. We expect this transition to take six months to a year. During this process, we are committed to assisting employees as they seek employment with the new provider or pursue other opportunities with the State or outside the State organization. Employees will be receiving a letter with additional information about resources to assist them.
Will ADH assist employees with finding a job within the agency?
As we transition home health services from the Department of Health, we are committed to assisting our employees as they seek new employment, in either the public or private sectors. As we transition our services to private providers, we anticipate opportunities with those providers. Though we cannot guarantee employment, we will work to connect our employees with all available opportunities.
We are working with the Office of Personnel Management and all state agencies to make sure that you are aware of any opportunities within state government. Our current In-Home Services employees will have access to a list of available positions within ADH before they are posted to the public state jobs website. We are currently working on creating that list and determining the most effective way to share it will all of you. We plan to have this finalized within two weeks, and we will provide more information soon.
What will happen to my retirement benefits?
Arkansas Public Employees Retirement System (APERS) is currently working on an information packet for employees. That information will be posted on this website as soon as it is available. Also, there are a series of retirement seminars around the state that would provide information regarding retirement benefits. Please check www.apers.org for the seminar schedules.
If you have a retirement plan through the Arkansas Diamond Deferred Plan, you will be able to roll those contributions to a new employer plan or to withdraw the contributions without a penalty. However, if you choose to withdraw your contributions, the account will be subject to any applicable state and federal taxes.
What will happen with my insurance benefits?
Employees who currently have insurance benefits through the state will be eligible to enroll in COBRA for your benefits upon termination of employment. If you would like to speak with someone about options that are available to you, please contact the Employee Benefits Division of the Department of Finance and Administration at (501) 682-9656.
What will happen to my vacation and sick hours? Will they be paid out to me if I leave the Department of Health?
At the end of your employment with the state, you will receive a lump sum payment for your accrued annual leave. This lump sum must not exceed 30 days of annual leave inclusive of holidays.
You will not receive payment for your accrued sick leave, unless you retire and have at least 50-80 days of accumulated sick leave. For retirees, a percentage of the unused sick leave above 50-80 days is payable as a lump sum not to exceed $7,500.
If you continue working for the state of Arkansas, either with ADH or another State Agency, your leave time will transfer to the new State Agency. Also, if an employee is terminated due to a Reduction in Force, the employee will have all accrued sick leave restored if the employee returns to state employment within six (6) months of termination.
How can I get more information?
A phone number has been established for questions, concerns or comments at 1-800-554-5738, or by email at ADHQuestions@arkansas.gov. Because of the volume of calls, we aren’t able to provide an immediate call-back to every employee at this time, but we will post the responses to the most common questions we receive on our website. We will continue to update this webpage as it becomes available.