Fragile care boost

Home health care for medically fragile children is dependent on an adequate supply of specially trained nurses to insure that timely care is available when necessary. To attract and retain skilled pediatric nurses reimbursement rates for medically fragile children must be fair and competitive. Currently, the rates paid by Medicaid are inadequate. The rates for pediatric shift nursing services are significantly lower than for other Department of Public Welfare (DPW) programs such as those in the Office of Long-Term Living (OLTL) and the Office of Developmental Programs (ODP) and lower than in more highly reimbursed hospital settings.

We need to increase the Medicaid shift nursing rate for pediatric home health care by $10 per hour, consistent with reimbursement levels for skilled nursing services in other DPW programs and competitive with other settings employing nursing.

Increasingly medically fragile children are able to be cared for in the home setting rather than in institutions. The transformation to the home setting has been facilitated by advanced technology, whereby the home setting can be transformed into “mini ICUs” to accommodate children with tracheotomies or dependent on ventilators.

This highly desirable change is not possible without the assistance of specially trained and skilled pediatric nurses to augment and supervise the complex and constant medical needs of the children while their parents work, care for other children, or sleep.

Highly skilled pediatric nurses are in short supply. An additional $10 per hour could increase the potential labor pool by 150 percent.

The reimbursement rate under Medicaid for shift nursing was last increased by $5, or 14 percent, in July 2008 to $40 per hour. This was the only increase in the program since 1993, a total of 21 years.

A new rate schedule in June 2012 increased nursing reimbursement rates.. ODP rates for skilled nursing services were also increased. Both reimbursement rate schedules are far in excess of the pediatric shift nursing reimbursement rate.

Because of the inadequate reimbursement rates for shift nursing services for medically fragile children, providers are unable to be competitive for qualified nurses with the more highly reimbursed programs and institutions leading to difficulty in hiring and retaining staff.

A constrained labor pool leads to open shifts, when a child in need cannot be matched with an appropriately skilled nurse. Open shifts more than double the risk of a child being re-hospitalized, at enormous cost to the child, to the family and to the Commonwealth.

The Medicaid reimbursement rate for shift nursing for medically fragile children must be raised to $50 per hour, a $10 increase over the current rate. The allocation necessary to increase the reimbursement rate is not included in the budget proposed by Governor Corbett. We are asking legislators in support of this issue to speak to their legislative leaders and to their appropriation committee chair to include this request in this year’s budget

Bill Winder

Lock Haven

Submitted by Virtual Newsroom