Texas families could lose at-home nursing under stricter Medicaid rule

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Disabilities,Health Care,Medicaid

Some children who receive private duty nursing, a more continuous type of medical care in their homes, could lose their ability to live at home if an HHSC rule change goes into effect.

JaReen Williams adjusts an iPad for her 16-year-old daughter, Lydia, so she can watch one of her comfort shows"Charlie Brown" in preparation for the treatment she undergoes three times a week by a nurse., The Texas Tribune’s daily newsletter that keeps readers up to speed on the most essential Texas news.As Komika Sales returns home from work, her son’s nurse completes his evening routine — giving him his last medications, connecting him to his ventilation machine.

“If I don't work, then there's no roof,” Sales said of being a single mom. “I don't have a backup plan or support system because I am the backup plan and the support system.” According to the agency, this is how they've always interpreted the policy. Because of this, HHSC “is not setting new or different expectations about how this policy is monitored or reported,” Ruffcorn said. But, advocates say, the formalized proposal could create confusion for nursing provider companies and affect families’ eligibility for their services.JaReen Williams’ 16-year-old daughter can’t use the bathroom on her own.

“I really don't want anyone hovering over me trying to watch what I'm doing. I know what I'm doing,” Ozoh said. “I went to school for it. It will make me feel like, ‘OK, don't you trust me?’” “It is unequivocally denying the reality of the level of care that that child needs,” Sage Cheng said.The rule draft has befuddled advocates, both because it’s not clear why the change is necessary, and because the concept has been introduced before and received public rancor, they said.

Since 2015, HHSC has interpreted the current rules to mean that parents cannot “regularly or routinely leave” a nurse at home alone with a child while at work because that would qualify as respite care, which isn’t covered, her statement said. But this draft was leaked to the public, as a result, HHSC received “around 130 emails from stakeholders ,” according to the documents.

 

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