You are chairperson of the National Association of Home Care and Hospice and went to the White House in March for a health care briefing in the East Room. Why is home care critical to the national health equation?
“Home health care and hospice are part of the solution to the national health equation. It is clear that the cost of providing services in the community is far less expensive, promotes a sense of independence and is the primary choice for individuals requiring health care. The incidence of infection is less in the home as cross contamination from other patients is not an issue. While there is a place for every provider in the health care system, we see more and more that care is being moved outside of the hospital. Hospital care is being reserved for acute illness that cannot be managed elsewhere.
“The new trends in health care are focused on management of chronic illness. Seventy-five percent of the health care dollar is spent on 12 percent of the population. Those in this 12 percent are individuals who have one or more chronic diseases. Home care is more than prepared to manage chronic illness with frequent monitoring and patient education, often preventing ER and hospital admissions.”
The Visiting Nurse Association of Hudson Valley has been serving Westchester and Putnam counties for 112 years. In that time, your mission has expanded. What organizations serve under your umbrella and how many people do you serve? What is the spectrum of coverage?
“The VNA of Hudson Valley is a family of organizations comprised of The Visiting Nurse Association of Hudson Valley, Hospice Care in Westchester & Putnam, VNA Home Health Services and the VNA and Hospice Care Foundation of Hudson Valley. Annually, our family of organizations serves more than 6,000 patients averaging about 700 daily.
“The Visiting Nurse Association of Hudson Valley began in 1898 as the District Nursing Association of Northern Westchester County. The mission remains the same: to provide quality and compassionate homecare to anyone who needs it regardless of ability of pay.
“Our nurses provide medical care and monitoring, which is enhanced with specialized training and equipment. Palliative care, hospice, wound care, telehealth, mental health and maternal child health nurses offer specialized care for those patients with more specific needs. All of the nursing services are supported by a variety of disciplines including speech, physical and occupational therapies as well as assistance from home health aides, medical social workers and holistic therapies in the hospice program. The addition of telehealth ”“ patient video monitoring ”“ has complemented care by offering patients remote access to a nurse between visits or when necessary.”
Your organization ranks in the top quarter of Medicare-certified health care providers. What path do you follow that the 75 percent behind you could learn from?
“Our relationships with staff are critical. Staff receives feedback on not only what may be problematic, but on their strengths as well. Educational programs and frequent case contact keep staff connected so that everything we do reflects our mission, standards of excellence and commitment.”
We tend to think of health care as a numbers game. Is there a single anecdote that comes to mind that personalizes all you do?
“One particular client comes to mind. This client was initially referred approximately three years ago to the VNA of Hudson Valley, with a diagnosis of Amyotrophic Lateral Sclerosis or Lou Gehrig”™s disease and was somewhat functional. Skilled services were provided by a nurse, physical therapist, occupational therapist and home health aide to create a plan of care that would promote optimal function and support the family in providing this care. Once the client stabilized, a home health aide continued to provide care through our licensed home care agency, VNA Home Health Services.
“Currently, the client is active with VNA of Hudson Valley and receives mental health nursing along with physical therapy.”
What in your experience plays out as the single greatest threat to a healthy life for your clients? Could it be the loss of financial security?
“We often see that plans to manage care are often unrealistic for so many. The financial issues related to health care do not appear to be improving as our country”™s economic troubles have evolved. The cost of pharmaceuticals is skyrocketing and insurance coverage for care seems to be shrinking even though the promise of low out-of-pocket co-pays is touted. Patients are trying to balance the cost of care with the necessities of life: food, rent, clothing, etc. It”™s a hard choice to make and I believe one of the greatest challenges we face.”
