Growing Number Of Medically Fragile Children In New York's Medicaid Program Are Unable To Find Home Nursing Services Study Concludes That The Source Of The Crisis Lies In Medicaid Reimbursement Policies

NEW YORK, March 9, 2005 - Faced with inadequate reimbursement rates for nurses, a growing number of children enrolled in Medicaid in New York State are unable to find nurses to care for them in their homes, according to a report released today by The Coalition For Medically Fragile Children, an alliance of families, children's advocates, hospitals, and home care agencies dedicated to improving the health and well-being of seriously ill and severely disabled children. The shortage is making it difficult for families to care for children at home, which research shows is both better for children and less expensive than institutional care.

"I am committed to doing whatever it takes to keep my child out of an institution," said Angela Geising, mother of 6-year-old Nicholas, who suffers from a variety of conditions that leave him dependent on a ventilator to breathe. "But it's a constant struggle." Ms. Geising has had to give up her job and sleeps on the floor next to her son's bed at night to monitor his ventilator because the family is unable to find nurses to provide the care that Medicaid has authorized.

"As medical technology has changed, an increasing number of children can be safely cared for outside of institutional settings," said Carol Raphael, President and CEO of the Visiting Nurse Service of New York. "It is obvious that it's better emotionally and developmentally for a child to be at home with his or her family. Research also has shown that children cared for at home are less susceptible to infection. But often this is only possible if nurses are available to support their care."

The report notes that Medicaid reimbursement rates have increased only once in New York in the past 12 years and are currently lower than commercial rates, Medicaid rates in other states and even rates for some other Medicaid populations in New York. To solve the crisis, the report recommends the following measures:

Increase reimbursement rates for home nursing services to equal those provided to other high-needs Medicaid patients;

Provide case management services for medically fragile children as a covered benefit under the Medicaid program; Create a demonstration program that provides comprehensive care management and support services to medically fragile children; and

Invest $2 million in workforce retraining programs to bring new nurses into the underserved field of skilled, home-based nursing services for pediatric patients.

The study concludes that the proposals would be at least cost neutral and could even result in cost savings to the New York State Medicaid program.

"These changes will help ensure that children who can be cared for safely in their home have that option," said Carol Odnoha, a registered nurse and expert in the care of medically fragile children at home. "New York should be spending its scarce Medicaid resources on the most humane and appropriate care."

The Coalition will be meeting with members of the legislature and representatives of the Governor's office throughout the day to educate them about the rising crisis and ask for their help in passing the legislative solutions proposed.

The members of The Coalition For Medically Fragile Children are Blythedale Children's Hospital, Center for Independence of the Disabled; Children's Defense Fund - New York; Children's Health Fund; Continuing Care Leadership Coalition; Metropolitan Jewish Health System; Morgan Stanley Children's Hospital of New York-Presbyterian; New Alternatives for Children; New York Academy of Medicine and New York Forum for Child Health; Schuyler Center for Analysis and Advocacy; SKIP of NY; St. Mary's Healthcare System for Children; The Jewish Guild for the Blind; Visiting Nurse Service of New York; and Wartburg Lutheran Services, Inc.

The report was compiled by Manatt, Phelps & Phillips, LLP, a national law and consulting firm. To receive a copy of the full report, please contact Melinda Dutton, Healthcare Industry Counsel, at (212) 790-4522 or  mdutton@manatt.com .

About Manatt
Currently celebrating its 40 th anniversary, Manatt, Phelps & Phillips, LLP provides legal and consulting services to domestic and international clients from offices in Los Angeles, Orange County, Palo Alto and Sacramento, Calif.; New York and Albany, N.Y, and Washington D.C.. Its wholly owned subsidiary, Manatt Jones Global Strategies, LLC, develops and implements strategies to expand clients' businesses and facilitate their effective competition in global markets. For more information, visit www.manatt.com and www.manattjones.com .