Policy would bring medically fragile children out of the hospital and back home

The California State Senate Health Committee unanimously passed SB1492 to make Medi-Cal reimbursement rates for private duty nursing (PDN) eligible for Managed Care Organization (MCO) provider tax distribution. The legislation, authored by Senator Caroline Menjivar (D- San Fernando Valley), would provide a funding pathway for continuous skilled nursing care in the home for medically complex and vulnerable pediatric and adult patients under Medi-Cal. Many of these patients require assistive technologies such as ventilators and tracheostomies to sustain their lives, and PDN provides long-term, comprehensive, and cost-effective care for these patients at home.

“Patients across California are facing a crisis,” said Dean Chalios, President & CEO of the California Association for Health Services at Home (CAHSAH). “Currently, there are more than 1,000 families looking for in-home comprehensive care for their children’s complex medical needs. These families are unable to take their children home from the hospital due to a lack of available PDN nurses.”

Improving Medi-Cal rates for PDN will help contain costs and promote a better quality of life for California’s medically-complex patients and their families. This legislation makes that possible, through inclusion of PDN in the MCO provider tax.

“We urge Governor Newsom and the California legislature to bring these patients home,” said Chalios. “As it stands now, families are unable to get the care they need at home, which means patients are staying in the hospital unnecessarily and occupying much-needed hospital beds. Not only does this significantly impact the state financially, but it is also not in the best interest of our medically fragile patient population.”

According to a recent study conducted by David Maxwell-Jolly and California Health Policy Strategies, this investment will save the state of California $175 million annually through reduced hospitalizations. SB1492 will be heard next in Senate Appropriations Committee on Monday, May 6.

The California Association for Health Services at Home (CAHSAH) is a nonprofit association representing California's licensed home health, home care, and hospice providers across the state. Established in 1966, CAHSAH is one of the oldest and largest state home care associations in the nation with a long tradition of service dedicated to promoting quality home care and enhancing the effectiveness of the home care industry.

CAHSAH represents hundreds of provider locations including Medicare Certified and licensed home health agencies, hospices, providers of non-medical personal care service in the home, home infusion pharmacies, and over 100 affiliate members including suppliers of products, computer companies, consulting firms, and insurance providers.

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