Key RI Home Visits Show Legislators and Medicaid Officials the Importance of Home Care

Home Visit 1: Rhode Island’s Deputy Medicaid Director and Medicaid Chief of Staff Meet with BAYADA RIS Client Kevin and his long-time nurse Larry

Recently, Deputy Medicaid Program Director Marlanea Peabody and Chief of Staff John Bonin visited Rhode Island Skilled (RIS) client Kevin to learn about the high acuity nursing services that Kevin receives from his long-time BAYADA nurse, Larry, and about the struggles that he and his family have recently faced due to issues within the state.

This year, Kevin’s home care nursing coverage switched from Neighborhood Health Plan of RI’s Managed Medicaid Plan to Medicaid Fee-for-Service, which caused the nursing reimbursement rates to drop more than $10.00 per hour. Kevin’s parents explained to Marlanea and John the challenges of navigating the medical coverage options for their son, as well as the added stresses of worrying about the effect the lower rate will have on Kevin’s nurse, Larry. Mom elaborated further about the unfortunate nature of their situation – that all of this is weighing on them while also dealing with the emotions surrounding the inevitability of Kevin’s diagnosis of Duchene’s Muscular Dystrophy.

Larry has been Kevin’s nurse for more than eight years. Seeing them together is like watching two best friends hang out – there’s always laughter and joking! They go bowling every Thursday, watch football, go to races and you can clearly see they enjoy each other’s company. With the transition of Kevin’s medical plan going from Managed Medicaid to Fee-for-Service, there is a possibility that with the drastic reduction in reimbursement rates that Larry’s pay may be reduced. If Larry decided to leave Kevin because of reduced rates to make more money elsewhere, not only would the family lose the ability to work, support their household and maintain some type normalcy, but Kevin would be devastated!

The home visit focused on educating our regulatory officials about what high-tech nursing involves, what home care nurses are responsible for, the value of continuity of care with consistent nursing and the quality of life Kevin has because of his long time nurse, Larry.

Both Marlanea and John asked great questions, engaged on high level discussion with mom and dad about the program transition and left the visit saying how grateful they were for the opportunity. They had the chance to not only witness Kevin’s high-tech care but also his strong bond with his nurse Larry.

Thank you to our regulators for attending this home visit and for being so receptive and responsive to Kevin and his family’s needs. Thank you to RIS Clinical Manager Bob Cardin and RIS Director Rick Boschwitz for coordinating this important visit with Kevin, his family, and Larry!

Home Visit 2: House Speaker Nicholas Mattiello Visits Corinna Calise, Who Relies on Home Care to Live with Her Family

Corinna’s parents, Michelle and Michael, first learned their daughter had Spinal Muscular Atrophy (SMA) when she was just 11 months old. “We were told to take our daughter home and enjoy whatever time we can with her because she’s not going to live to see her second birthday,” Michelle said. Now, thanks to the in-home care she receives, Corinna is thriving nearly 20 years later. Due to her condition, her nurses must have specialized training in life-sustaining equipment for tracheostomy care and ventilator maintenance, which allows Corinna to stay in her home with her family, instead of living in a facility. “People who don’t know us and see Corinna’s condition, say ‘how do you do it?’” Michelle said. “I will admit it can be difficult, but we feel blessed. Corinna is so much fun; she interacts as a typical young adult mentally and emotionally.”

Corinna and her family welcomed their Representative and Speaker of the House Nicholas Mattiello (D-Cranston) into their home for a visit to learn more about home care and the nurses providing Corinna’s care. Corinna is in college now, and she loves advocacy and policy and is considering going into Political Science. When the Speaker heard of Corinna’s interest in politics, he offered his help by inviting her up to sit in on session and get a behind the scenes tour of his office and House Chambers.

Corinna, her nurse, and her mom offered insight into some of the challenges with her home care nursing. Specifically, they discussed the low reimbursement rates for Medicaid which are not able to provide fair wages to highly trained nurses, like Corinna’s who must be able to provide tracheostomy care and ventilator maintenance. It’s imperative that they be ready at a moment’s notice if there should be an emergency, while also knowing the faint signs Corinna displays where there is an underlying issue developing. The Speaker was asking great questions to probe further discussion about how vital her nurses are to her wellbeing.  When Corinna was asked, “If you had a blank check, how much would you pay your nurses?” she replied by said “A LOT!”

During his visit, Speaker Mattiello was presented with a Legislative Champion Award by the Rhode Island Partnership for Home Care for his advocacy on behalf of home care and hospice providers, their direct care staff, their patients and clients and their families.

We are beyond grateful to have Speaker Nicholas Mattiello as a champion for home care! Thank you to everyone involved with this impactful visit!

It is important that we advocate for our staff and clients and show our legislators and regulators how Medicaid rates and other state and federal policies impact home care. For information on ways you can get involved in advocacy, contact me today.

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