Letters to the Editor

Published: February 26, 2009

Medicare-certified hospice needed

To the Editor:

I believe that a Medicare-certified hospice on the Vineyard is essential.

Last year, a man I loved had to leave Martha's Vineyard to obtain the care he needed under the hospice benefits provided by his insurance. Those benefits included durable medical equipment such as a hospital bed, commode, etc., daily home health aide services, medications without co-pays delivered to the house, daily nursing visits, physician home visits, companion and respite services in the home all covered by his insurance, but only through a Medicare-certified Hospice.

Before he left, Hospice of Martha's Vineyard was involved. They, and especially Ann Ledden, were wonderful, but limited in the volunteer services they could provide. The services he needed would only have been available to him on the Vineyard on a private pay basis, which was out of the question.

It is true that Medicare imposes some restrictions, but I wonder how many people actually know how many more benefits are covered by their insurance or Medicare under elected hospice status and provided by a Medicare certified hospice. For many of us, it is important to utilize those insurance benefits to the max.

Hannah Beecher
West Tisbury

Different levels of care

To the Editor:

I am not surprised to hear that the VNA is adding Medicare hospice services, even though they have been assuring the board and director of Hospice of Martha's Vineyard for several years that they are not. It is vital to recognize the difference in the level of care being offered by the VNA and Hospice of Martha's Vineyard It would be better for this community if these apples are not all in one big VNA basket.

Because Hospice of Martha's Vineyard is nonprofit, and their services are free of charge, they are unique among only a few others in the nation. The VNA is a nonprofit, private nursing agency that collects money from individuals and both private and government-sponsored insurance companies. Both agencies need money, but one survives on free will donations, and the other is a fee-for-service agency which supplements with donations. That means that you can use the services of Hospice of Martha's Vineyard for as long as you need to and never pay a dime. At the VNA, every time they see you there is a charge, to you or your insurance agency. Under Medicare hospice rules, the VNA will receive a lump sum for your care, and there will be limits to that care.

I worked as a registered nurse at Hospice of Martha's Vineyard both in its early years and again recently when asked to return to fill a temporary staffing need. During my more recent employment, the VNA was telling their patients that they could take care of them at home until they died, but they simply couldn't always cover it the way Hospice of Martha's Vineyard does. Some families turned to Hospice of Martha's Vineyard for additional support when they found this out. No Medicare-limited program can provide the level of attentiveness that patients and families receive from Hospice of Martha's Vineyard

Everyone who staffs the office is a trained volunteer, social worker, or nurse, or who serves on the board (and it truly is a working board) does so with the single focus of serving the needs of those who are nearing the end of life. The Hospice of Martha's Vineyard nurses and social worker can make unlimited house calls; they can stay for as long as necessary. They visit their patients during hospital admissions and help make the transition home smoother. The nurses are on call seven days and nights a week. Hospice of Martha's Vineyard rents two storage units for all sorts of medical equipment that has been donated to them to loan to others. After a death there is follow-up care and bereavement services.

Furthermore, you don't have to be certified by anyone to be a Hospice of Martha's Vineyard patient. If by some miracle you don't pass away as expected - and sometimes when patients' pain and other needs are relieved, they don't - they will still check on you. You can have a hospital bed too, covered by insurance with a doctor's order. The doctor, not the insurance company, decides whether, or when, to make house calls.

Of course the VNA would love to absorb Hospice of Martha's Vineyard - their trained volunteers and staff, their donor list, their endowment, and those all-important donations given "in memory of." Hospice of Martha's Vineyard has studied the possibility of becoming Medicare-certified and wisely decided to remain an independent, community-based organization. For the VNA to disguise a grab for Hospice of Martha's Vineyard as a "discussion" was a publicity stunt.

It is self-evident that our community needs and supports both the VNA and Hospice of Martha's Vineyard How they will work together, and support each other's work, remains to be seen.

Marie Laursen
Vineyard Haven