Press Release

September 18, 2017

OHCA Contacts: Jo Stainsby - (405) 522-7474

OHCA looks to increase private duty nursing rates

OKLAHOMA CITY – On July 25, 2016, Avery Anderson’s life changed drastically. The 17-year-old was in a car accident that resulted in her being flown to Oklahoma City for treatment and left her in a minimally conscious state with a traumatic brain injury. About a year later, Avery was finally able to go home to Ada, Okla., to continue healing due largely to private duty nursing (PDN) benefits provided by SoonerCare (Oklahoma Medicaid).

“Since Avery is on a ventilator, she can’t be left alone. We were approved for PDN benefits of 16 hours a day, 7 days a week,” said Tiffany Anderson, Avery’s mother, who left her job as a children’s pastor to care for Avery. “However, we’ve only been able to secure two nurses who each work 40 hours a week. That leaves us 32 hours short, which is the weekend, so for now I’m taking care of that.” 

The Oklahoma Health Care Authority (OHCA) which administers the SoonerCare program is trying to address the shortage of nurses working in the PDN field. The agency is proposing to increase the rates paid to PDN providers to $30.20 per hour from $25.20 per hour. It would be the first rate increase for the provider type since January 2007.

“Currently, there are not enough providers to fulfill the demand for these services,” said OHCA CEO Becky Pasternik-Ikard. “We believe the rate increase will enable providers to hire more nurses and thus have a positive impact on access to care.” 

The proposed rate change which would go into effect Oct. 1 is projected to be budget neutral for the agency. Currently, only three organizations provide PDN services to SoonerCare children. With current rates, those agencies are unable to recruit and retain nurses. Without nurses who are available to care for the patients, facilities are unable to discharge the patients to go home. 

“With no rate increase, we believe we will continue to see delayed discharges from long-term acute care children’s hospitals. We anticipate an increase in PDN utilization with an increased rate due to the addition of nursing staff, but there will be a corresponding decrease in acute care hospital days which could actually result in a net savings to the agency,” Pasternik-Ikard added.    

Not only is moving the patients home a potential savings for the state, but it’s also a positive move reuniting the patient and their family.     

“We’ve seen progress since Avery’s been home. She’s back with her family under one roof. The alarms don’t go off in the middle of the night, her vitals have improved and she’s more at ease,” Anderson added. “We are so encouraged with this new season of healing for Avery. She’s back to familiar sounds and faces, she’s HOME.”    

There is a Facebook group, Avery Anderson Updates, on which Anderson posts pictures and updates of her daughter’s progress.    

The OHCA board will vote on the PDN rate increase at their Sept. 27 board meeting. More information about the meeting and the SoonerCare program is available at www.okhca.org.

 

The Oklahoma Health Care Authority (OHCA) administers two health programs for the state. The first is SoonerCare, Oklahoma’s Medicaid program. SoonerCare works to improve the health of qualified Oklahomans by ensuring that medically necessary benefits and services are available. Qualifying Oklahomans include certain low-income children, seniors, the disabled, those being treated for breast or cervical cancer and those seeking family planning services. The second program OHCA operates is Insure Oklahoma, which assists qualifying adults and small business employees in obtaining health care coverage for themselves and their families. Currently, there are 827,962 Oklahomans enrolled in OHCA’s programs. The agency contracts with a network of 44,436 providers. For more information, visit www.okhca.org or www.insureoklahoma.org.