County discloses NYS has approved closure of its Certified Home Care Agency

By RICK MILLER

Olean Star

Cattaraugus County announced Wednesday it has been given permission from the New York state Department of Health to close its certified home health agency.

No date has been announced for the county to end its home care program.

The announcement came a day after the Olean Star asked for an update on the home care program from Public Health Director Dr. Kevin D. Watkins.

Funding for the program, operated by the Cattaraugus County Health Department, was cut in the 2026 budget and health officials said it was being right-sized. 

Wages were slashed by half from the $2.6 million in the 2025 budget. Layoffs were largely avoided by transferring nurses to other county departments including the nursing homes.

The number of nurses in the program, which assists patients after they have been discharged from the hospital, has dropped from 17 last November to four in June.

For more than a month, no new patients have been accepted by the county home care program and no current patients were readmitted into the program if they went into the hospital.

More recently, patients have been called by county employees and asked to voluntarily transfer to the VNA home care program run by Kaleida Health.

A few years ago, it was not uncommon for the program to have an average census of around 300. Last November, there were 225 patients. That dropped to 193 in December and further to 135 in February.  In March there were 140 patients in home care, 128 in April, 104 in May and 88 in June.

On Tuesday, Public Health Director Dr. Kevin D. Watkins said there were 82 patients remaining in the home care program, 53 of whom are being followed by skilled nurses. The remainder are being followed by physical, occupational and speech therapists.

The Olean Star questions were spanked by a telephone call from a woman whose father is a daily patient in the program. She was concerned that patients were being encouraged to voluntarily transfer to VNA — including her father. She doesn’t feel VNA can meet his needs. Later on Tuesday, she said she was informed by VNA that his care had been transferred to their group. That was against her wishes.

Cattaraugus County Administrator Kelly J. Reed issued the press release Wednesday saying the county “has made the difficult decision to request closure of its Certified Home Health Agency. This decision was not made lightly. “Despite the County’s earnest efforts, the operational challenge of efficiently operating a Certified Home Care Agency remains unduly burdensome due to outdated and unchanged insurance reimbursement rates and heavy pressure from competition within the market.  

“Consistent with legal and regulatory requirements, the State has approved the Closure Plan. This plan ensures that all home care patients will continue to receive appropriate medical treatment and will receive a coordinated transition to another Certified Home Care Agency prior to closure of Cattaraugus County’s agency.  Cattaraugus County remains committed to its responsibility to taxpayers, employees, and residents who rely on County services. 

“The County is among a small number in New York State that continue to operate a home care agency; however, ongoing financial losses, driven by declining reimbursement rates and reduced patient volume, have made continued operations unsustainable. 

“The Cattaraugus County Health Department is working and will continue to work cooperatively with the State Department of Health to provide existing patients and families with necessary services and to seamlessly transition all patients to another certified home care agency. 

“The Health Department has been in close contact with the Visiting Nursing Association of Western New York (“VNA”), which provides high quality CHHA services in Cattaraugus County, and which is willing and able to accept qualified Cattaraugus County residents in need of CHHA services. The Cattaraugus County Health Department will continue to provide certified home care services to existing patients while it simultaneously works with the VNA and the New York State Department of Health to seamlessly transition all patients to a certified provider as required by the Closure Plan.  

“This decision impacts only the Certified Home Care Agency of the Cattaraugus County Health Department. Our Health Department will continue to provide a broad array of health services to County residents including family planning and health services, communicable disease control, environmental health, chronic disease prevention, public health emergency preparedness, community health assessments, immunizations, WIC nutrition services, health education, clinical services, and early intervention services. 

“While there will be an impact to staffing, as it has done historically, Cattaraugus County will make every effort to minimize any adverse impact upon its existing employees,” Reed concluded.

Dr. Watkins responded Wednesday to several questions raised by the Olean Star:

Q. Who knew the County had submitted a closure plan? 

A. Cattaraugus County was under strict confidentiality and non-disclosure requirements established by the New York State Department of Health throughout the review of the closure plan.  What happens to long-term patients? The Cattaraugus County Certified Home Health Agency (CHHA) discontinued its long-term home care program in February 2018. Patients who have remained on our census for an extended period (greater than one year) and continue to require Certified Home Health Agency services will be transitioned to the Visiting Nurse Association (VNA) or another appropriate Home Health Agency. Every patient’s clinical needs will be assessed, and transfers will be coordinated to ensure continuity of medically necessary services.

Q. What about patients who need a VNA nurse on a weekend? 

A. The VNA maintains an on-call clinical system to respond to patients who require assistance outside of normal business hours, including weekends and holidays. Patients transferred to the VNA will continue to have access to after-hours nursing support consistent with the services provided by a Certified Home Health Agency. 

Q. What if the VNA doesn’t take a patient’s insurance? 

A. Based on our discussions with the VNA, the agency currently participates with all but one of the insurance plans used by patients on our current census. The VNA is actively negotiating participation with that remaining insurer and expects to have a resolution in the coming weeks. For any patient affected, the Health Department will work closely with the patient, the insurer, and other Certified Home Health Agencies, if necessary, to ensure appropriate home care services continue. The Cattaraugus County Certified Home Health Agency will continue operating until every patient has been safely transitioned to another qualified provider or is no longer in need of home health services. The Department’s highest priority is ensuring that patients continue to receive medically necessary care without interruption throughout the transition process.