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Dare County commissioners are looking at how to provide home health and hospice services as efficiently as possible.

At the commissioners’ Dec. 21 meeting, the board authorized spending $37,500 to retain attorney Erin Roberts in the Roberts Law Office to explore the marketplace and outline options. Roberts represents public and private organizations in acquisition and sale of hospitals, hospice and home care agencies and physician practices, states a summary online of her practice.

Dare County is one of eight counties in North Carolina that offers a home health program and hospice services. Two of the eight are now under contract to be sold.

Dare County started Dare Home Health and Dare Hospice services because, at the time, a need existed and no private provider would serve the county. Dare County holds certificates of need, issued by the state to provide home care and hospice services within the entire county.

At the meeting, county manager Robert L. Outten told the commissioners that the county is having difficulty retaining nurses.

Normally, the home health and hospice program has seven field nurses, an intake nurse, a supervisor and a director. Currently, three nurses are providing services, with the supervisor and director taking visits as needed. With the staff shortage, the work-life balance is said to be out of whack.

The agency has two physical therapists but needs another, one occupational therapist and one speech therapist.

Services are provided 24 hours a day, seven days a week. With a larger staff, after-hours and weekend work would be spread out. The work-life balance is the main reason given in exit interviews when a nurse is leaving.

With the small staff, the number of cases the agency can handle is reduced. That in turn reduces revenues.

In looking at solutions, Outten made it clear that the county would take care of employees, which he said was the norm in the industry, and that any private provider must contract to provide services to the entirety of Dare County.

Outten pointed out several options: sell the certificates of need; change salaries upward; decide to subsidize the service; contract with a private provider to provide staff.

Outten expects the Roberts report to provide some clarity for budget season.

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