California Neglects Private Nurses, Abandons Sick Children

By Jarrod DePriest, especially for CalMatters

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Leah Hernandez is a 9-month-old baby living with bronchopulmonary dysplasia, a chronic lung disease affecting newborns.

Born prematurely at 29 weeks, Leah depends on a gastrostomy tube for feeding, a tracheostomy to maintain her airway and a ventilator to help her breathe. She and her family live in Sacramento and rely on Private Nursing, a home health care service for medically vulnerable patients.

The lack of available nurses delayed Leah’s return home by several months due to Medi-Cal’s lack of investment in private practice nurses.

Instead of going home, Leah was discharged to a pediatric nursing home in the Bay Area — more than two hours away from her family — where she stayed for several months. She had to be readmitted to the hospital several times, costing Medi-Cal thousands of dollars in unnecessary costs.

Unfortunately, Leah’s story is all too common. Like home healthcare provider operating in California for over 30 years, we care for some of the state’s most medically vulnerable patients. Most of these patients are children who depend on ventilators, feeding tubes, seizure treatments and round-the-clock care to survive.

Pediatric private nursing for them is not mandatory, optional or enjoyable. It’s a legally required Medicaid service designed to keep vulnerable patients at home and out of expensive hospitals.

Yet while California has continued to invest in Medi-Calthe state has not raised reimbursement levels for private nursing care in nearly a decade. During that time, the cost of living has risen, salaries in other areas of nursing have increased, and our responsibilities have become more complex.

Many nurses have been forced out of the field entirely, not because they want to abandon the families who rely on them for nursing care, but because the state’s reimbursement structure makes it very difficult to provide nursing care at home.

Families like Leah’s wait months, sometimes years, for the medical care they are legally entitled to receive. Medically fragile children end up being repeatedly hospitalized for preventable complications simply because there aren’t enough nurses to keep them safe at home. Hospital readmissions are up to 1300 times more expensive rather than offering appropriately compensated care in a home environment.

Right now there are hundreds of sick children stuck in hospitals waiting to go home. Many of us cannot imagine the reality of being separated from our children, let alone when they are sick.

We need our legislators to act and honor their oath to protect and serve all of California’s children. Governor Gavin Newsom needs to do the right thing and allocate funds for private nursing in the state budget.

By investing in private nursing services, California is expected to saves more than $175 million dollars annuallyby reducing unnecessary hospital stays and promoting consistent home care for medically vulnerable patients.

California speaks proudly of its values ​​of justice, compassion and caring for the most vulnerable. But right now, our country’s politicians are failing precisely against the people who embody that description.

A decade of neglect is long enough. Now is the time to meet California’s commitments and invest in private nursing. Our patients’ lives depend on it.

This article was originally published on CalMatters and is republished under Creative Commons Attribution-NonCommercial-No Derivatives license.