The VISITING NURSE ASSN. OF CLEVELAND (VNA) is a nonprofit, voluntary health organization dedicated to assisting homebound, mainly indigent patients. Officially organized in 1901, it is one of the oldest organizations of its type in the U.S. The Cleveland VNA developed from a volunteer group of young women, mainly from wealthy backgrounds, who called themselves "the Baker's Dozen." Medically untrained, they visited and comforted needy families where there was an illness. The association became official when a graduate nurse, Alice Page, was hired as superintendent to recruit other nurses. The initial purpose was "to provide graduate nurses to visit those otherwise unable to secure skilled assistance in time of illness, to teach cleanliness and the proper care of the sick, and to prevent the spread of disease." The VNA was modeled after a similar organization in Chicago. Nurses were initially placed in 3 settlement houses--Goodrich House (see GOODRICH-GANNETT NEIGHBORHOOD CTR.), ALTA HOUSE, and HIRAM HOUSE. Although a donation of $.25 was accepted from patients, there was no required charge.
A scholarly journal, Visiting Nurse Quarterly of Cleveland, developed by local VNA nurses in 1909, soon became the official publication of a national public-health nursing organization. In 1917 the VNA, the Cleveland Health Department (see CLEVELAND BOARD OF HEALTH), Western Reserve Univ. (see CASE WESTERN RESERVE UNIV.), and other agencies collaborated to establish the Univ. Public Health Nursing District. Its purpose was to prepare well-qualified nurses for public-health service, provide nursing services in one city district, and set standards for public-health nursing. This district became a national and international model for public-health nursing programs.
By 1939 the Cleveland Community Fund provided most of the financial support for the VNA. Seven stations had been established throughout the city, with headquarters on Fulton Rd., and the nursing staff numbered 74. Care shifted to infants and tubercular patients. The nurses continued to offer basic medical care and to evaluate the need for expert services. A standard charge was introduced, generally scaled to the patient's ability to pay. Often, there was no charge. The VNA inspired the establishment of preschool centers and child dispensaries, and was largely responsible for having nurses placed in schools. Between 1940-80 care shifted from acute illness, such as bronchitis, pneumonia, and communicable diseases, to heart disease, strokes, cancer, and diabetes. Programs for the elderly and former mental patients were added in the 1970s. Other developments included the total-care concept, coordinating services with social- and mental-health consultants, nutritionists, and home health aides. Since the 1960s, Medicare and Medicaid have made 33% of the payments; other money has come from fees, United Appeal (see UNITED WAY SERVICES), and various government programs. Because of rising health costs, the VNA reduced its staff and number of visits in the 1980s. On 12 Dec. 1951, the cornerstone was laid for its present building at 3300 Chester Ave.
See also MEDICINE; PUBLIC HEALTH.