It’s troubling to hear County Commissioner Bob Johnson refer to the financial situation at Douglas County Visiting Nurses Assn. as a “train wreck.”

The comment came in response to a VNA request for additional funding from the county to offset a $240,000 shortfall that agency officials say is the result of reduced Medicaid reimbursements and other factors. Because they weren’t satisfied that VNA officials had an adequate plan to avoid a continuing deficit, county commissioners have declined to increase funding to VNA and, in fact, tentatively reduced its allocation from last year’s total by $50,000.

We elect county commissioners to make tough decisions and this surely was one. They know that Douglas County VNA made 41,000 in-home visits to serve 950 county residents last year. For many of these people, the care they received at home probably was necessary to keep them out of a nursing home, rehabilitation center or other, more expensive, care situation. The agency has been providing this service, regardless of a person’s ability to pay, for 35 years. But it’s also the commission’s responsibility to see that the tax money they distribute isn’t used to help an organization avoid making spending and management changes that are needed to make itself financially viable.

It’s unclear whether VNA needs such changes. It’s certainly true that various government decisions have reduced the aid that many people used to pay for home health services. Why government decision-makers can’t recognize the wisdom of funding in-home care but are willing to pay far more for nursing home care remains a mystery.

That being said, however, the local VNA may have to make some difficult decisions of its own. Some such actions, including reduced salaries and services, already have been taken. It’s not the first time the agency has had to cut back on some services to help balance its budget. The cuts are painful, but the agency can’t compromise its overall financial stability and, therefore, its ability to provide other services on which the community depends.

Over time, almost every Douglas County family will have a need for home health care, often at a stressful time in their lives. VNA has been a reliable and compassionate provider of in-home care for many years and, with or without additional county funding, it deserves the community’s support and understanding as it deals with its current financial challenges.