By Joanne Handy

President, Visiting Nurse Association of Boston

It shouldn't be hard to do the math. The failure of the state to adequately reimburse the Visiting Nurse Association of Boston (VNAB) is a penny-wise and pound-foolish strategy that will end up costing the state far more than it might save.

For example, every patient who remains in a hospital costs Medicaid an average of $2,100 a day, versus the $23 a day for a visiting nurse. Patients forced into nursing homes cost an average cost of $3,200 a month, versus $675 a month through the VNA.

The advantages of keeping people at home rather than in more costly nursing homes or hospitals are well known. Governor Mitt Romney, who spent a campaign "work day" with the VNAB, has talked about the benefits of home care. "It is much lower cost than hospital or nursing home care and allows the patient to be in familiar surroundings," he said.

In addition to cost savings, we should not forget that there are real people whose survival and quality of life depends on the VNAB. Andrew Swanson is just one of the many patients who rely on the VNAB. While most 50-year-olds are still out working and enjoying life, Swanson is confined to his home. A few months ago, he suffered a massive stroke that left him paralyzed on his left side. But, even in adversity, he is grateful.

Swanson is happy that he is able to stay home, rather than in the hospital. He is appreciative of his nurse, Annette, who comes three times a week and the physical therapist and occupational therapists who are gradually helping him gain back some of the use of his left side. Swanson is grateful that his visiting nurse was able to detect his congestive heart failure and help him get life-saving treatment. The Visiting Nurse Association of Boston (VNAB) makes his care possible and he knows that without this help, Swanson knows he "would be in a lot of trouble."

Like one of its many patients, the VNAB is in trouble too. The VNAB is responsible for the lives of more than 16,000 elderly, children and new moms as the largest home health care provider in the state. After years of being under-paid by Medicaid for the care they provide, they need the state to step in and help. If you didn't know whether you could keep visiting patients like Andrew Swanson, wouldn't you ask for help?

The State Senate can ensure that the Visiting Nurses Association of Boston (VNAB), the oldest visiting nurse association in the country, can keep helping Massachusetts families care for their grandparents, ill adults and children in the comfort of their own homes. The VNAB needs that help now.

The Senate should act now because the VNAB is the only organization providing the full range of home health services to every Boston neighborhood, 24/7. In addition, the organization provides nearly 60 percent of all Medicaid home health services in Suffolk County. Fully one-third of the patients served by the VNAB live in Dorchester, Mattapan, and Roxbury. VNAB is the major safety net provider for Greater Boston's Medicaid and underserved populations.

After 117 years of continuous service - nursing care for the elderly, care for patients living with cancer, helping mothers care for her babies at home, or administering medications to someone suffering from HIV/AIDS - the future is uncertain.

Even with serious belt-tightening over the last three years - cutting $9 million from the budget, renegotiating HMO contracts, reducing service areas outside of Boston, and finding innovative ways to offer corporate wellness programs, there will not be enough money to continue providing services to the people who need them the most.

The story of the VNAB - the human story of the people it serves and the impact the nurses have on these peoples' lives and the precarious situation the VNAB is in is a story that should be told now before it is too late. The Senate is scheduled to vote on its budget next week…the clock is ticking.

We hope you agree. Please contact your state Senator if you want to help preserve these services that provide comfort and dignity for the most vulnerable in our population while still saving the state money.

Joanne Handy is President of the Visiting Nurse Association of Boston.