Caring for the City’s Elderly

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The New York Sun

Planning for emergencies is an integral part of Jane Gould’s job, and that planning paid off yesterday.


“I’m proud that our nurses saw every home-bound patient that needed to be seen,” the president and CEO of the Visiting Nurse Regional Health Care System said. “Transit strike or not, our patients cannot be abandoned.”


The mostly elderly patients were treated in all five boroughs of the city. Ms. Gould’s staff of 400 full-time and part-time nurses was deployed by ZIP code and assigned to patients living closest to them, so that the care-givers could walk or drive to patients’ homes.


In Manhattan, Ms. Gould arranged for a car service and hotel rooms for nurses who had particularly acute transportation problems. Anticipating that the Transit Workers Union would go on strike, she had booked cars and hotel rooms for a two-week period. She also bought pre-paid cell phones for her nurses.


That Ms. Gould was able to get her organization – the oldest certified home health agency in New York City, and the fourth oldest in America – to respond smoothly to the emergency is a testament to her fluency with the requirements of public service.


“Public service requires an organization to have a really dedicated and persevering staff,” Ms. Gould said, referring not only to the nurses but the support personnel at the parent organization, which is the umbrella group for the Visiting Nurse Association of Brooklyn and Empire State Home Care Services.


That may seem obvious, but managing a multiethnic, multidisciplinary staff in a city like New York demands fortitude and creativity on the part of an administrator.


Ms. Gould, a graduate of Boston University in government, developed those qualities in a long public-service career that has included being director of the New York State Office for the Aging. There she was responsible for drafting legislation, seeking legislative approval, and implementing and overseeing the state’s Expanded In-Home Services for the Elderly Program. She has also co-chaired the board of the statefunded pharmaceutical program for the elderly.


When Ms. Gould was invited to head the Visiting Nurse Regional Health Care System in 1998, there was no such body. Technically, she was to lead the Visiting Nurse Association of Brooklyn, which was founded in 1888 and whose finances and operations were fragile. The Brooklyn-born and Bronx-raised Ms. Gould streamlined operations, acquired other nonprofits, and created the Visiting Nurse Regional Health Care System.


“I was brought in to protect the agency and ensure that it remained viable in a very complex industry,” Ms. Gould said.


Today the Visiting Nurse Regional Health Care System is among the largest providers of home care in the state, which has some 200 certified home health agencies. The organization serves more than 14,000 patients annually, with a budget of $82 million.


Much of that money comes from Medicare, which covers people older than 65, and from Medicaid, which assists the poor. Ms. Gould’s organization is one of the few such agencies handling behavioral health. Her nurses attend to orthopedic problems. Her nurses also treat wounds, congestive heart failure, and pediatric and adultonset diabetes.


Not all of the organization’s expenses are reimbursed, however.


“We also have charity care,” Ms. Gould said. “I’m always mindful of the fact that 32 million Americans have no health care coverage whatsoever.”


She’s also attentive to rising health care costs.


The health care services market in America is the world’s largest at $1.8 trillion. The 25 countries of the European Union have the next largest market, at $700 billion.


“There’s also the rising demand for services – people are living longer and need more care,” Ms. Gould said. She noted that cutbacks prescribed in the 1997 Balanced Budget Act meant that, beginning in 1998, health care providers were reimbursed based on per-day cost caps, not on the total cost of care.


And does Ms. Gould expect to continue advocating on behalf of the vulnerable? “Of course,” she said. “My paternal grandfather, Louis Golembe, who once ran a paint store near Mount Sinai Medical Center, always used to tell me how important it was to be tolerant and look after people who had problems. My parents, Robert and Shirley Golembe, reinforced those values in me, their only child. I like to think that I’ve passed on my heritage to my children.”


Her son, Andrew, is also in public service, as deputy commissioner of the New York City Sports Commission. And Ms. Gould’s daughter, Leslie, is a social worker.


New generation, same tradition.


The New York Sun

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