WILLMAR — The decision wasn't easy and the Kandiyohi County Board of Commissioners worried about how the decision would impact some of the county's seniors, but the vote to terminate the care coordination contract between the county and Blue Cross Blue Shield of Minnesota was unanimous.

It brings to an end a partnership that has been in place for over 20 years.

"It has always been the assumption the county would continue this work as long as it was viable and it didn't require any county levy dollars to support this contract," said Jennie Lippert, county Health and Human Services director at Tuesday's board meeting.

The main reasons the county decided to terminate the contract now were staffing concerns and upcoming training because of a major revision to a software program that will be used by the county Health and Human Services Home and Community Based Services division, which care coordination is a part of.

"We've been watching this for a number of years," Lippert said.

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Care coordination is a service provided to subscribers to BCBS's Blue Plus program, for seniors on state medical programs. The work is currently done by a team of social workers and a nurse from Kandiyohi County on behalf of BCBS.

"That individual helps them (subscribers) with medical appointments, if they have medical questions, if they need help getting resources," Lippert said.

The contract requires 130 days notice prior to termination, so for the next three to four months the county will continue to provide the program to the clients. BCBS will be responsible to find another entity to replace the county.

"Clients shouldn't see any downfall from this," Lippert said. "It should hopefully be a seamless transition."

With the termination of the care coordination contract, those staff from the program can be reassigned to other areas, helping to alleviate the staffing crunch in the county's HCBS. There is still the possibility that additional employees will be needed, as the caseloads for these programs increase as more people become eligible for them.

While the commissioners don't love having to increase staff and continue to grow the size and cost of government, they also understand that there really is no choice if the state mandates services and the population that uses those services continues to grow. As more of the baby boomer generation reaches the age of 65 and go on state medical programs and services, the county will have to be able to serve them.

"The numbers just speak for themselves, you can't change that," said Commissioner Roger Imdieke. "Increase services, increased costs are a fact of life."