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The Visiting Nurse Service of New York is one of the oldest not-for-profit home health care agencies in the country. Since 1893, VNSNY has been a vital part of New York’s public health infrastructure. Our founder, Lillian Wald, was the first public health nurse in the United States.
Although VNSNY focuses on home health care, we still believe that healthy individuals do best in healthy communities. From our earliest days, VNSNY has combined the latest medical knowledge and nursing techniques with a commitment to social programs.
Lillian Wald’s very first home visit was to a young mother who was hemorrhaging after giving birth. At the time, the Lower East Side was the most densely populated area in the world, with more than 1,000 people crammed into each acre—most were immigrants who arrived in the United States with little more than their dreams. Disease was rampant because the connection between health and hygiene wasn’t fully understood. By 1895, demand for services had grown enough for Wald to move her operation to Henry Street.
Immigration through Ellis Island remained high. Recognizing that illness had a social and economic impact on families, the Henry Street Settlement provided financial assistance and established social programs. By 1903, the Settlement had opened branches throughout Manhattan and the Bronx, some serving specific ethnic and immigrant populations. In 1906, nurses began caring for the black community.
Throughout the decade, major outbreaks of polio, influenza and diphtheria struck New York City—the influenza epidemic of 1918 alone killed more than 12,500. Ward’s agency was instrumental in providing nursing care throughout these outbreaks, as well as for caring for victims crippled by polio. In addition to treating disease, nurses began to train families to prevent disease and preserve health. Nursing service was extended to the Bronx. Geographical areas were divided into districts, with separate staffs for contagious diseases and obstetrical cases.
Immigration limits established in 1921 change the demographics of New York City. European immigration decreased and native immigration increased, and by the late 1920s, 7 percent of New York City’s population was black (an increase from less than 2 percent in 1910). The nursing service established Healthmobiles to test for diseases like diphtheria and to administer immunizations; by the end of the decade 292,000 children had been inoculated.
When the city learned that 65 percent of new mothers’ deaths in 1930-32 were preventable, maternal and prenatal health became a priority. Lillian Wald retired in 1933; that year, her staff of 265 made 550,000 home visits to more than 100,000 patients.
Wartime emphasis on maternal and child health cut the infant mortality rate in half between 1941 and 1947. In 1944, the Visiting Nurse Service of New York was established as an agency separate from the Henry Street Settlement, devoted to home health care. Physical therapy became a nursing specialty when the Association for the Aid of Crippled Children transferred its home program to VNSNY.
At the beginning of the decade, approximately 20 percent of VNSNY patients were elderly people with chronic conditions. Thanks to extraordinary advances in medical science post-World War II, Americans began to live longer, and by the end of the decade about 50 percent of our patients were elderly. VNSNY began a program of volunteer-friendly visits to the elderly in the mid-1950s, and in 1957, VNSNY hired its first mental health nurse consultant, whose role was to address the emotional problems patients faced as a result of coping with illness.
In 1962, VNSNY received a grant for a Home Aide Program, which began as a pilot program to help the sick and chronically ill with routine health and housekeeping duties. Medicare and Medicaid were signed into law in 1965. With governments responsible for financing health care for the elderly and low-income people in need of medical care, VNSNY was able to reduce the gap between income and expenditures, and began to develop as a multi-service agency. As funding streams changed, VNSNY began to implement a team nursing approach. Home health aides became an integral part of the home health care teams, and speech therapists and social workers were added to the staff.
Home health care was officially recognized as a viable alternative to institutional care through two laws passed in New York State in 1973 and through the National Health Insurance Law of 1974, and VNSNY established its Long Term Home Health Care Program. In 1976, VNSNY began participating in a program with the Maternity Center Association’s Childbearing Center.
As early as 1981, VNSNY began to work with New York City officials to address the AIDS crisis—half of the known cases were in New York City. By 1985, VNSNY had launched an ambitious program of services, training and support for AIDS patients; in 1989, VNSNY nurses saw almost 600 adults and children with AIDS on a daily basis.
In 1983, Partners in Care, which provides private care nursing, home health aides and housekeepers, was created as a subsidiary. VNSNY also established its Hospice Program in 1983; within six years, the program had grown to serve more than 260 New Yorkers.
In response to patients’ concerns about the quality of home health care, the National League for Nursing created the Community Health Accreditation Program (CHAP) in 1987. Agencies accredited through CHAP must meet specific criteria. Since the program’s inception, VNSNY remains the only CHAP-accredited, certified home health care agency in New York State.
First Steps, coordinated with Harlem Hospital and VNSNY’s Maternal/Child Health and Pediatric Care Program, was established to address substance abuse problems of drug-dependent mothers and their newborns; it soon became the fastest growing service within VNSNY Home Care. VNSNY continued to add programs to assist those with HIV and AIDS; by 1993, VNSNY was the largest home health care provider for AIDS patients in the country. In 1993, VNSNY also teamed up with the New York City Department of Health to provide free flu shots to seniors—the program is still running today.
1993 also saw the launch of the Center for Home Care Policy and Research (CHCPR), the first and only research center of its kind. CHCPR conducts scientifically rigorous research to promote the delivery of high-quality, cost-effective care in the home and community, and to support informed decision making by policy makers, payers, managers, practitioners and consumers of home- and community-based services.
In 1998, the Visiting Nurse Service of New York developed VNSNY CHOICE Health Plans to help people remain safely and independently in their homes—and stay out of nursing homes—for as long as possible. VNSNY CHOICE Health Plans builds on VNSNY's rich reserves of knowledge and expertise to coordinate all the health and support services that elderly and frail New York residents need to live well at home.
VNSNY continued to expand geographically (service to Nassau County was added in 2001, Westchester County in 2003), culturally (with programs to address the unique needs of Chinese, Orthodox Jewish, Russian and Korean communities) and with social programs. In 2005, VNSNY launched its Nurse-Family Partnership in the South Bronx. Within two years, more than 700 families had enrolled, and in 2008, the program was expanded to the Lower East Side.
In 2006, VNSNY opened the first hospice residence in New York City, located on the Upper East Side.
VNSNY’s commitment to our patients and their caregivers continues. In 2010, we began Strong Foundations, which help seniors avoid debilitating falls, as well as programs for Behavioral Health and Family Caregiver Support. The Haven, a hospice specialty care unit at Bellevue Hospital, provides specialized care for end-of-life patients whose symptoms cannot be managed at home. VNSNY CHOICE health plans became available throughout New York State in 2012, and our Chinatown Community Center opened in 2013.
Although our focus is on home health care, we take seriously our Vision to be community-based, and when tragedy has hit New York, VNSNY has responded.
Throughout all crises, our staff provides more than just medical care. For many of our patients, our nurses and aides provide a link to the outside world. And although their patients are their priorities, VNSNY staff responds to the needs of all community members.
On September 11, 2001, VNSNY nurses rushed to triage centers and local hospitals, and many social workers and mental health counselors offered their services. At the time of the attacks, VNSNY had 1,600 patients, mostly frail elderly or chronically ill, living in Lower Manhattan.
And during and after the devastation of Superstorm Sandy, VNSNY’s Emergency Response team coordinated the efforts of thousands of staff and clinicians. More than 5,000 nurses, aides, social workers and other staff overcame power outages, flooding and lack of public transportation to see patients, making sure they were safe and had supplies.
A lot has changed since 1893, but one thing remains constant: VNSNY’s commitment to our patients, our city, our home. Now more than ever, we’re here for you.