Hertford County looks to join ARHS
By Jon Hawley
Monday, March 5, 2018
Hertford County is looking to join Albemarle Regional Health Services, in a move to cut costs while maintaining basic health services for the small county.
ARHS Director Battle Betts reported on the talks during last week's ARHS Board of Health meeting. If both sides agree to the merger, Hertford would become the eighth county to join ARHS. State law also provides the merger could only take effect with the start of a new fiscal year, meaning the target date now is July 1.
Betts said the Hertford County Public Health Authority is now the only single-county health authority in the state, and “it is becoming more and more difficult” for such departments to remain viable in rural areas. Health departments not only face pressure from tight and sometimes shrinking state and federal funding, but also face more administrative costs than other county departments because they have to run more independently.
The Hertford PHA's most recent fiscal year audit also shows the strain it's facing. Provided by PHA Director Ramona Bowser, it shows it saw an operating loss of about $332,000 for the fiscal year 2016-2017. Its liabilities also continue to exceed its assets, with its “net position” dropping by about $500,000 from the 2015-2016 budget year to a negative $1.97 million for 2016-2017.
The audit also shows that several of the Hertford PHA's key services are losing money. Its “governmental activities,” a category including home health, personal health, environmental health and community health services, cost $3.68 million to run, but only generated about $2.66 million in revenues.
The document also notes that facility damage in late 2016 due to Hurricane Matthew caused the Hertford PHA to offer limited services through a mobile medical unit. Many patients stopped coming due to lack of space and privacy, further hurting revenues, the audit explains.
In a major step to cut its losses, the Hertford PHA is also looking to sell off its home health services; a public notice on the Hertford PHA website states it is looking to sell the Hertford-Gates Home Health Agency. ARHS sold off its own home health and hospice agencies in 2015 and 2016, following then-Director Jerry Parks reporting that changes and cuts in federal reimbursements meant the agencies would only lose more money in years to come.
The audit also notes the Hertford PHA has even laid off staff to curb costs. Bowser reported last week the authority has 25 full-time and 2 part-time staffers.
In reporting to the ARHS board, Betts said the benefits of the merger should include the greater efficiencies that come with a larger organization and to expand services in Hertford. He also praised the Hertford PHA for having a “robust” Women, Infants and Children program and “one of the best HIV programs in the state,” referring to services to prevent and treat the human immunodeficiency virus.
In a followup interview, Betts explained that ARHS and Hertford are still going through “due diligence” to study the costs, benefits and implementation of the potential merger. ARHS will not ask its member counties to pay more to make the merger work, he said.
Mergers often find savings by eliminating personnel who are redundant and, often, administrative. Betts did not rule out eliminating some positions, but reiterated ARHS’s plan is to expand services in Hertford, not reduce them. He also said ARHS's goal will be for Hertford's health services to retain their own identity, as it does for all its member counties.
ARHS currently includes Bertie, Camden, Chowan, Currituck, Gates, Pasquotank and Perquimans counties. Notably, Gates and Hertford ran a joint health department until Gates joined ARHS in 2004.