Dan Haar: Patients Stuck In Hospital Beds Due To Medicaid Home-Care Cut

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The call from Connecticut Children’s Medical Center on Monday was supposed to be routine.

A case manager at the hospital in Hartford had a 14-year-old patient ready to go home. She needed to make sure the preferred home health agency, Pediatric Services of America, had nurses ready to visit the youth’s home.

Medicaid covers the cost of the home visits. But it’s been 10 years since agencies such as PSA have seen an increase in those basic rates — $37 an hour for a licensed practical nurse, $45 for a registered nurse.

A small add-on fee, less than $2 an hour, also covered by Medicaid, was tacked on a few years ago for some of the most severe cases. But, starting Aug. 11, with no state budget adopted, Gov. Dannel P. Malloy ended those add-on payments in an executive order — to save the state $1.9 million a year.

With that change, PSA could no longer make the numbers work. The Atlanta-based, for-profit company works with about 300 patients at a time, including some of the toughest home-care cases in Connecticut. The company decided it wouldn’t take on new patients as of this week.

That shocked the case manager at Connecticut Children’s.

“She was irate,” said Jeanne Silverwatch, the PSA vice president overseeing Connecticut and Massachusetts. “They wanted to discharge this child. … She’s angry, she’s upset and she said she was going to take it up the administrative ladder.”

She can take it all the way up to Malloy. She might find that this latest cut was too much to bear in a crisis that’s been brewing for more than 15 years as Medicaid payments to private health care providers have squeezed tighter and requirements have ballooned.


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