After rapid growth, a deficit and then cutbacks, a county-supported home health agency plans for modest growth.
After more than a year of cutbacks to overcome a $72,000 deficit, the Douglas County Visiting Nurses Assn. is anticipating modest growth this year.
And with its 1994 deficit taken care of, the private, nonprofit home health agency is lowering some fees for low-income clients. It also plans to provide more indigent care.
"We have the financial stability now to absorb the loss that comes with lowering fees," said Marceil Lauppe, VNA's director.
VNA has 130 employees, including full- and part-time nurses, speech, physical and occupational therapists, home health aides and administrative staff.
Nationally, as patients spend less time in hospitals and more time recovering from illnesses and surgery at home, demand for home health care services has been on the rise.
VNA experienced growth of more than 20 percent a year in the early '90s. Its 1994 deficit was attributed to increases in the number of clients who couldn't afford to pay their bills and lower fees paid by managed-care insurers.
To stem the flow of red ink, VNA temporarily halted the admission of new indigent care patients, increased rates and instituted new minimum fees charged to low-income clients. It also eliminated a program that provided cleaning, cooking and laundry services to people just beginning to need assistance at home.
Last year, the agency's indigent care visits were down 46 percent, from 18,727 in 1994 to 10,206 in 1995. In all, the agency made 60,593 visits in 1995 throughout the county.
This year, Lauppe expects overall growth of about 4 percent, and on Wednesday, VNA's board approved a 7.6 percent budget increase for 1997, to $3.5 million. That included a 3 percent increase for inflation.
About 75 percent of the budget comes from federal health care programs, such as Medicare for the elderly and Medicaid for the poor. VNA also gets about 3 percent of its budget from Douglas County -- $112,875 in 1996 -- and 2 percent from United Way. Patient fees and insurance payments make up about 15 percent of the budget.
Last year, VNA provided home health services to 1,081 people, down 14 percent from 1,250 in 1994.