Madison County Board of Health and supervisors move to end county home‑health program; 27 clients affected

The Madison County Board of Health reported that the county's non‑certified home‑health (homemaker) program will be eliminated effective June 13, citing an impending loss of state LPHS funding and county budget reductions.

The board chair, speaking at the supervisors’ meeting, said the board of health unanimously agreed to the elimination after discussing the county’s fiscal outlook and statewide funding pressures. The presentation said the program serves 27 clients countywide — 18 in Winterset, 7 in Eldon (transcript variant), and 2 in Truro/Maxburg — and employs two full‑time homemaker aides. Staff said clients and employees were notified in November and that the board provided a list of alternative homemaker and in‑home care providers for each client.

Public commenters at the meeting expressed concern about the loss of local in‑home supports. Pam Palestad, who described recent personal experience with post‑hospital needs, said county residents rely on visiting‑nurse and homemaker services after hospital discharge and asked the county to explain why services are being discontinued. "I know there are a lot of people here that need help... I would really like to understand why we don't have a county health department," Palestad said.

Board of Health and county staff said the decision was not taken lightly and was prompted by both decreased state funding and local budget constraints; supervisors had discussed public‑health funding during recent budget work sessions. The board said it will continue to be a resource to help affected clients find alternative in‑home care options.