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.