We would like to assure the community of the financial soundness of the Douglas County Visiting Nurses Assn. and our commitment and ability to continue to provide home care services to the residents of Douglas County.

Douglas County VNA is not in debt and never has been in debt in the 36-year history of the organization. Cash flow is sufficient to meet payroll and ongoing expenses. Adequate reserves are in place to permit a reasonable period of operation.

Douglas County VNA is a nonprofit home health agency certified by Medicare (federal funds) and Medicaid (state and federal matching funds). In 2002 and 2003, Medicare electronic billing procedures required VNA to purchase new computer equipment and train staff on the use of this equipment. This equipment was paid in full out of a combination of operating and endowment funds.

In 2003, all home health agencies across the nation experienced cuts in reimbursement from Medicare and Medicaid. In addition, the Kansas Medicaid program denied payment for medications and medical supplies that were previously paid for and raised the eligibility requirements for qualifying for the Medicaid program. This caused VNA to experience a dramatic increase in the number of people who needed home health care but had no or reduced insurance coverage. These Medicare and Medicaid cuts and the increased provision of uncompensated care adversely affected the agency’s bottom line by the end of 2003.

The need for internal adjustments was apparent and in October 2003, the following measures were implemented: (1) Restructuring the billing department; (2) Upper and middle management wage reductions; (3) No agency contributions to the employee pension plan; (4) Overtime reduction; (5) No employee wage increases in 2004; (6) Elimination of some positions; (7) No new admissions to the uncompensated care program (Home Care Support Services).

The full effect of these measures has resulted in steady improvement in the VNA bottom line. In the month of April 2004, monthly revenues exceeded expenses.

The supplemental request made to the County Commission for $79,957 was not a “bailout.” Rather, it was the amount of funds needed to enable VNA to continue serving Douglas County residents who we will no longer be able to serve as a result of cuts in Medicare and Medicaid funding. If our goal to have expenses and revenues balance by the end of 2004 is met, then supplemental funds would not be needed.

Individuals needing VNA home health care services that have coverage by Medicare, Medicaid or private insurance, will continue to be accepted. Individuals needing services that are uncompensated will be accepted, as funds are available.

Jan Jenkins is the executive director of Douglas County VNA. Patrick Donahue is president of the VNA Board of Directors, and Patricia Webb chairs the board’s finance committee.