The Vineyard Nursing Association (VNA) opened its spacious, up-to-date new headquarters to the community on Saturday morning, impressing visitors with what they found there. Clients and other interested Islanders toured the newly renovated building on Breakdown Lane in Vineyard Haven, then chatted with staff and board members in the large conference room.
Many took advantage of free blood pressure checks, flu shots, physical and occupational therapy demonstrations and consultations, and presentations about existing and new programs. Brochures on health and wellness issues as well as a high-tech pill box for keeping medication dosages on schedule also drew considerable interest, as did a table of healthful refreshments.
“We’re very pleased,” said CEO Robert Tonti who has held the job for seven years, beginning when the agency was still located at the Martha’s Vineyard Hospital.
Both Mr. Tonti and Clinical Director Sandie Corr-Dolby, RN, BC, stressed that the agency has been constantly growing and is sure to continue this trend as patient demand increases.
“The Island thinks of us as a small, little VNA,” Mr. Tonti said. “But we’re no longer a little VNA. We’re a medium-size VNA.”
Currently the average caseload here is approximately 380, with another 50 to 75 patients on Nantucket. The Vineyard agency operates Nantucket Visiting Nurses remotely, thanks to electronic communication, Ms. Corr-Dolby said. But she added that Nantucket’s services represent a very small percentage of the agency’s overall activity.
Since it was established in 1984, the Vineyard Nursing Association has always rented office space, first from the hospital until 2006, and then from private business property owners. After two locations in six years, the agency now has a permanent home of its very own. Formerly occupied by Julie Robinson Designs and the Carol Craven Gallery, the warehouse-like building has been transformed into two floors of well-designed and appointed office and meeting space.
The new building comprises nearly 7,500 square feet, nearly doubling the 4,000-square-foot office space at the agency’s former headquarters at Merchant’s Court in Vineyard Haven.
The VNA purchased the building in January 2012 and hired Stateside Construction Group of Westborough for the massive $2.1 million renovation project.
According to Mr. Tonti, some $900,000 of that amount has been raised through a capital campaign, separate from annual appeals and fundraising activities. Approximately $1.25 million is still needed. “Our goal is to raise the balance over the next three years,” he said.
New home, new possibilities
During an interview in her new office Monday afternoon, Ms. Corr-Dolby discussed the agency’s new home, its impact on services, and some challenges the agency is facing. She said the complex renovation entailed thoroughly gutting the space because the second floor was not safe, then completely rebuilding the interior. “It gave us the opportunity to customize it to the way we wanted it, and use the space to the best advantage of the staff,” she said.
Connecting to the town sewer system took considerable work, Ms. Corr-Dolby said, but it is a great benefit.
Work was completed in late summer. At the end of August, a generous summer resident, owner of U.S. Business Interiors Inc. and a supporter of VNA, made a remarkable gift. He had a truckload of furniture delivered to outfit the entire office. The big van nearly got stuck turning from the driveway onto narrow Holmes Hole Road. Staff began moving in from their Merchant’s Court quarters on September 18. The facility officially opened for business on September 20.
Ms. Corr-Dolby especially commended Beth Toomey, former West Tisbury Police Chief and now Special Projects Coordinator for the VNA for her assistance in facilitating the move. Ms. Toomey is also serving as interim coordinator of the Home Health Aide Department.
Ms. Corr-Dolby has seen many changes since beginning with the VNA as a home health aide in 1995. She cited features of the new building that will enhance training, communication, and patient care in various ways.
Topping the list is the large meeting room, a first for the agency, which is accustomed to tight quarters. With a seating capacity for 100-plus, the room will be used for staff meetings, training sessions, and other gatherings. In the past the agency turned to outside organizations to rent or borrow meeting space.
Ms. Corr-Dolby said the VNA holds frequent training sessions. The room is fully equipped with the latest technology for webinars, video conferencing, and electronic presentations. “To be able to do that here now is a wonderful, wonderful gift for us,” she said.
Other community groups, including several health-oriented organizations, will also meet here, she added. The M.V. Chamber of Commerce will hold its Business After Hours at the new facility on November 14, for example.
The upstairs offices, with space for nurses, physical and occupational therapists, and social workers, is another boon, Ms. Corr-Dolby said. “They can share patient information, collaborate, and really work as a team,” she said.
Another innovation is that the Home Health Aide Department now has its own designated offices, making interoffice communication smoother. The aides previously had to use part of an open room.
“I can train and communicate with and coordinate my staff so much better now,” said Ms. Corr-Dolby. “That’s going to provide a better quality of care to our patients in the end and that’s what it’s all about.”
Along with the potential for preparing food for trainings and meetings, and as a possible site for nutrition classes or small group meetings, the sizeable kitchen fills an important need for staff, Ms. Corr-Dolby said.
“When you’re taking care of people that are sick that you bond with, it’s important to have that time out,” Ms. Corr-Dolby explained The kitchen is a comfortable place for a break from the often intense and tiring work where the staff can relax, eat, and talk together.
The building also offers a small conference room, an efficiently laid-out development office, intake and business offices, and a welcoming reception area.
Caring for the community
The good-sized agency now has 110 staff members, both full- and part-time. This number includes 23 nurses, 7 physical therapists, 1 occupational therapist, and 42 home health aides — as well as administrative and support personnel.
“I think we are the second largest health care organization on the Island next to the hospital,” Mr. Tonti said.
The staff provides an array of in-home services for a large variety of needs. The great majority, or about 60 percent, of services are medical, including post-surgery follow-up, care for chronic conditions or trauma, medication assistance, IV therapy, and more.
Elder care services account for another 25 percent. Ms. Corr-Dolby said the type of assistance offered to older Islanders is wide-ranging, including homemaking help, personal care, and more. Services are tailored directly to the client’s specific needs and these programs often are what make it possible for elders to continue to live safely at home, she said.
Private duty care is another facet, comprising about 10 percent of VNA services. Patients or their families pay directly for these services, which vary, depending on need.
A small amount of the VNA activity is dedicated to community clinics offered through contracts with five Island towns, not including Aquinnah. Services include blood pressure checks, flu shots, and health and medical education. Frequently these entail individual consultation with a nurse about health concerns.
The VNA’s $4.5 million annual operating budget comes largely from Medicare and other certified insurance reimbursements, which comprise 70 percent of the total. The Executive Office of Elder Affairs covers 10 percent. Another 15 percent comes from private “for hire” services and outside contracts including end-of-life care through Hope Hospice. Fundraising efforts bring in about 5 percent of revenue.
Challenges and innovations
The reality of a constantly expanding patient load as Vineyarders grow older, along with financial and staffing concerns, weigh heavy on the agency which must work to balance these impacts. “All our programs are growing like wildfire,” Ms. Corr-Dolby said.
More patients create need for more staff, and finding enough patient care personnel is a constant challenge, according to Mr. Tonti and Ms. Corr-Dolby. Mr. Tonti commented that although salaries for full-time professional staff may be sufficient to recruit candidates from off Island, compensation levels for other posts such as home health aides and per diem workers would probably not be.
Ms. Corr-Dolby said the agency would be hiring four new Home Health Aides in January. She said she was delighted to be able to offer to the community the positions that are full-time and include benefits.
With so much of its revenue coming from Medicare, the agency must face the fact that those reimbursements will be reduced as a result of the Affordable Care Act. “We’re going to have to increase fundraising and find other income sources to meet our financial needs,” she said.
While challenges must be met, a number of new initiatives promise a bright future. Ms. Corr-Dolby envisions the new facility being used for community wellness activities, such as exercise or education sessions, with the goal of preventing health problems before they occur.
“We want to increase outreach into the community and bring people more varied programs,” she said. “It’s time to get into prevention. We hope this building will allow us to do programs that will help people avoid getting into problems.”
Staff wellness activities will be offered soon too, so employees can better serve their clients.
Two major new projects promise to help the agency address its staffing needs while allowing local residents to obtain health-care training and credentials.
Thanks to the new Health Care Education Collaborative, the VNA is partnering with Cape Cod Community College and other medical providers to offer training programs here. “We’re going to be able to provide college level courses on Martha’s Vineyard,” Ms. Corr-Dolby said.
Beginning in 2013, an “LPN to RN” program will offer education for Licensed Practical Nurses to upgrade their degree to Registered Nurse. An informational meeting is scheduled for next Tuesday, Nov. 13, at 5:15 pm at the regional high school for those interested in participating.
“Our ultimate goal is to provide a full-fledged RN program right here on the Island,” Ms. Corr-Dolby said. Such a program would make it possible for Vineyarders to obtain nursing degrees without having to travel or move off-Island to attend nursing school. They could also begin taking basic courses here part-time, and complete their degrees here or off Island.
The VNA is also collaborating with the Medical Reserve Corps for such things as providing shelters and other emergency preparedness needs for the county.
Mr. Tonti said the VNA is working on a grant proposal that would enable the agency to offer a Certified Nursing Assistant (CNA) program to its employees and the community so home health aides can obtain necessary training. He said all these educational initiatives have the potential to ease staffing needs.
“This is a creative way of growing our own,” said Mr. Tonti. “Getting people education on the Island and giving them the opportunity to stay here.”