Claiming the city is struggling financially, city councilors refused this week to reconsider a decision to wipe out the city’s $70,000 contribution to the Greater Bristol Visiting Nurse Association.The move may mean that the nonprofit VNA will cease offering free or reduced price care to chronically ill poor people in Bristol.
“We’re really at a loss about what to say to the Bristol community,” said Maryellen Frele, the acting chief operating officer of the association.
Mayor Art Ward hailed the century-old group’s work but insisted that it could tap into its $1.5 million in reserves to make up for the virtual depletion of city aid this year – a move that VNA officials said would be fiscally irresponsible and could jeopardize their existence down the road.
Ward said that slashing the aid offered by the city to just $100 was “an economic action that had to be taken” as part of an effort to reduce spending and hold down property taxes.
“Our backs are up against the wall,” Ward said.
But Ruth Tubbs, a Bristol resident, said that people need access to visiting nurses.
Tubbs said she’s had a visiting nurse for three years.
“She’s always there and she’s always taking care of me,” Tubbs said. “I have had the best care that anyone could give me.”
“What are we going to do?” Tubbs asked.
City councilors and Ward said they want the VNA to shoulder the cost this year and then, with luck, the city can renew its commitment to help in 2009.
Ward said Wednesday that he’s scheduled a meeting next week between the city, the VNA and the office of U.S. Rep. John Larson, the East Hartford Democrat whose 1st District includes Bristol, to see if any additional funding may be available from other sources.
Anne Dolson, the association’s president, said the VNA is facing a shortfall already this year and can’t be expected to pick up the entire tab for nearly $300,000 worth of free and reduced cost care for the poor.
“Historically, the burden of providing for indigent care has rested with the city,” Frele said. “It is the city’s responsibility to provide for its indigent, not the VNA’s responsibility.”
“In this time when the average person is suffering from serious economic constraints, it is unconscionable for the city of Bristol to turn its back on its poor and deny them home health care,” Frele said.
Yet city leaders said they have no choice.
City Councilor Ken Cockayne said he spoke this week to an 85-year-old resident who’s facing a $1,200 property tax increase. He asked how he could tell that man to pay more in order to subsidize someone else’s health care.
“What are you going to say to seniors who need home health care?” Frele answered, adding that the VNA doesn’t have the resources to subsidize care the city has traditionally paid for.
City Councilor Frank Nicastro said the problems facing the VNA are “just the tip of the iceberg” as a sinking economy leaves government at all levels pinching pennies to try to cope with the downturn.
Nicastro said that nobody is happy about the cut to the VNA “but it had to be done.”
Comptroller Glenn Klocko, who initially recommended the cut, said that the nonprofit’s budget information showed it had a $200,000 surplus in the previous year. It also listed a contribution of $17,000 from the United Way in its books but never mentioned Bristol’s much larger donation, he said.
Klocko said the city can’t subsidize every worthwhile organization that asks for money.
Frele said that her association’s income goes up and down depending on reimbursement rates for its care, but that it’s looking at a $50,000 loss this year.
She said the available assets in its rainy day fund would only cover three months of operation, money it may need someday if there’s a changeover in the way the government handles visiting nurse care.
Frele said that if the VNA begins dipping into its reserves, the day may come “when we have to close our doors.”
Tom Morrow, the director of the Bristol Community Organization, said Wednesday he doesn’t know what will happen to the VNA’s patients if the group ceases serving the uninsured poor.
“I don’t know of any other resource that these folks could turn to,” Morrow said.
Who loses out?
Though the Greater Bristol Visiting Nurse Association can’t disclose specific information about its patients, officials described in general terms a recent case referred to the organization by Bristol Hospital.
A 53-year-old widow was left without income or insurance after her husband dropped dead in front of her eyes, Maryellen Frele, the acting chief operating officer of the association, said.
As a result, she couldn’t buy her diabetes medication, “which gradually put her into diabetic ketoacidosis, the first step toward a diabetic coma,” Frele said.
At Bristol Hospital, the woman got treatment and doctors switched her from oral medication to injectable insulin.
Before discharging the widow, the hospital asked the VNA if it would take her on since she lacked insurance, Frele said.
Because her diabetes posed a “high risk,” Frele said, the nonprofit agreed.
“The patient required home health for skilled nursing assessment and teaching so that the patient’s diabetes would stabilize and she would become independent in her diabetes management,” Frele said.
“This patient is typical of the kinds of Bristol community residents who are referred to the VNA because they have no insurance, but are in dire need of home health services,” Frele said.
It’s likely, though, the group is going to refuse similar cases in the weeks and months ahead because of the city’s decision to slice its aid.
There appears to be noplace else for people who need the help to turn.
Update on Thursday: Here's a PDF of the Bristol VNA's Form 990 for 2006, which lays out most of its finances at that point.
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