Nursing Shortage Puts Medically Fragile Children at Risk, Spurs Calls for Change (calhealthreport.org)

Image: Mila Brokloff, 2, has a tracheotomy – a surgical opening in the throat to help her breath. She needs around-the-clock care. Photo courtesy of Analicia Brokloff.

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Finding nurses to care for medically fragile children at home has historically been difficult. But since the start of the COVID-19 pandemic, the problem has worsened dramatically, according to parents of children with disabilities and home health agencies. The pandemic set off a surge in demand for nurses at hospitals, clinics and other health care facilities, and widened the compensation gap between these and lower-paid home nursing jobs. This pulled nurses away from home care. At the same time, large numbers of nurses left the profession – many due to health concerns, retirement and burnout – shrinking the overall workforce. As a result, fulfilling requests for home nurses has become close to impossible, those in the field said. That’s especially true for the more than 1 in 4 California children with special health care needs who, like Mila, are insured through the state’s public health insurance program, Medi-Cal, which typically pays nurses less than private insurance.

“It’s worse than ever, it really is,” said Dean Chalios, president and chief executive officer of the California Association for Health Services at Home.

To solve the issue, the association is calling on California’s governor and legislature to increase Medi-Cal reimbursement rates for home nurses by 40 percent in next fiscal year’s budget. Chalios said a rate increase would make pay for home nursing more competitive and attract people back to the field. It would also save the government money, he said, by keeping medically fragile children out of hospitals and nursing facilities. Both are more expensive than caring for children at home.

“Even with the economic downturn, now’s really the time to do it because it’s going to save Medi-Cal money in the long run,” he said. “This needs to be done … these children need this help, these families need this help.”