Four home health-care agencies are seeking state approval to provide their services in Howard County.
The agencies -- Bay Area Health Care, HMSS Inc., Children's Home Health Care Services and Aaron Nursing and Childcare Services -- offer home care for patients recently released from hospitals.
Services include administration of intravenous medication, care for trauma and pediatric patients, and home health aides.
State health officials only began again to approve home health-care agencies in the summer of 1989, after four years of denying applications.
After 1985, no home health agencies were permitted to open because a state health plan --which serves as a guide for decisions of the Maryland Health Resources Planning Commission --said additional home' health-care services weren't needed.
When the plan expired in 1989, "it opened the gates for other agencies to apply, hoping to get approved," said Stacey VanHouten, a health planner wlth the Maryland Health Resources Planning Commission.
In order to bring their services to the county, the agencies must obtain a state-issued "certificate of need" by demonstrating to state health planners that a need exists for more home health-care service in Howard County.
"It's up to them to prove that what it is they are doing is needed by the citizens of Howard County, is in line cost- and charge-wise with other providers, and that it wiN not have a negative impact on existing providers,' VanHouten said.
"If they're going to come in and take patients from existing providers then there is in essence no need to enter," VanHouten said.
There are 22 licensed home-health agencies offering services in the county. For the most part, these agencies serve an elderly population, Van Houten said.
The four home-care applicants say there is a need for their specialized services to trauma and pediatric patients.
"There are trauma patients that would benefit from a trauma-specific program where there are actually trauma practitioners doing the visits," said David McDaniel, director of Bay Area Health .Care, which specializes in providing home health services developed by the University of Maryland Medical System (UMMS) to discharged trauma patients.
Patients discharged from UMMS who live in Howard County don't have access to these programs because Bay Area has state approval to serve Baltimore and Anne Arundel counties and Baltimore City.
"The result is that Howard County patients may not have access to trauma home-care specialists and may receive fragmented, or in the case of psychiatric patients, no care when discharged from the University of Maryland Medical System," Bay Area's application states.
HMSS Inc. supplies intravenous medication, including chemotherapy, to patients in their home.
"We feel it's a specialty service, so you need qualified IV nurses to be able to oversee and teach patients in their home," said Darlene Miller, HMSS branch manager.
Although other home-health agencies in the county administer intravenous medication, Mlller says those services are "more generalized."
HMSS recently received state approval for their services in Montgomery, Prince George's, Calvert and Charles counties, Miller said.
The trend toward early discharge from hospitals would indicate that there is a growing need for more home health-care services. But state health officials take other factors into account when deciding whether to grant approval to a home health agency.
The commission doesn't have any proof that the agencies that are out there could not continue to hire staff to handle the increased patient load," VanHouten said.
"There are 22 agencies that could provide services in Howard County. That's a lot of agencies," VanHouten said. "That sheer number would lead you to belleve there's no need."