If you read the Gazette last week, you learned that the Vineyard Nursing Association is having financial difficulties. The simple truth is that without a reserve or an endowment, we have operated for most of our 30-year history on the narrowest of margins. We have carefully balanced our operations to minimize annual losses, raising funds from the community to fill the gap. Typically, five to eight per cent of our budget comes from donated funds.

What is different this time around is the magnitude of the problem. Losses in 2013 have mounted, as the combination of the Affordable Care Act/sequestration cuts, Medicare reimbursement cuts, and tighter Medicare regulations have created the perfect storm of reducing admissions by making it more difficult to meet eligibility requirements and, simultaneously, by paying less money for each of those admissions. We are not the small agency we once were, having grown to meet the rising demands of the Island populations. In our present configuration, systemic cutbacks of this nature are hard to absorb. Next year we face further reimbursement reductions for our Medicare work.

The good news is that two things are clear. First, we know that VNA home care is absolutely critical for the health of Islanders, and we are in no way reducing access to quality home care as we seek a solution to the financial challenges of operating an independent agency in the post-Affordable Care Act world. Second, we have found support and wisdom in reaching out to our colleagues at Martha’s Vineyard Hospital, Nantucket Cottage Hospital, Community Services, Elder Services, the Health Care Access program, and the Dukes County Health Council.

Securing the future for home care on the Islands will take collaboration. We hope, in fact, that our efforts will be a springboard for the community to move toward a more comprehensive and integrated health care solution.

But in the short term, realities dictate that we become a leaner and more efficient agency, and we will need to rely on community support to sustain our mission. For the past 30 years, we have been there for the Island community, and the community has been there for us. We are launching a 
fundraising campaign and hope to raise $250,000 by the year’s end. Our board of directors has personally pledged $100,000 to jumpstart the effort, and we hope that you will join us to enable the VNA to continue its history of service.

We thank you in advance for your support.

Michael A. Goldsmith

The writer is chairman of the board for VNA.