Paying family members for at-home medical care of their children found
to be a viable answer to healthcare worker shortage

Date:
February 21, 2023
Source:
Ann & Robert H. Lurie Children's Hospital of Chicago
Summary:
A recent study found that a Medicaid program in Colorado can help
address the shortage of home healthcare workers for children with
complex medical needs by offering family members certified nursing
assistant (CNA) training and paying them for at-home medical care
their child requires.

Results show that children who received family-CNA care were
not more likely to be hospitalized than children cared for by a
non-family CNA.

Children with family-CNA caregivers also experienced greater care
continuity since turnover was not an issue as it tends to be with
traditional home healthcare workers.


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FULL STORY ==========================================================================
A recent study found that a Medicaid program in Colorado can help address
the shortage of home healthcare workers for children with complex
medical needs by offering family members certified nursing assistant
(CNA) training and paying them for at-home medical care their child
requires. Results show that children who received family-CNA care
were not more likely to be hospitalized than children cared for by a
non-family CNA. Children with family-CNA caregivers also experienced
greater care continuity since turnover was not an issue as it tends to
be with traditional home healthcare workers. Findings were published in
the Journal of Pediatrics.


========================================================================== There is a general shortage of healthcare workers nationally across
the board, which worsened with the COVID pandemic. The shortage of home healthcare workers has been an even longer standing concern and often
drives families to leave a job or reduce work hours to care for their
child with complex medical needs. In addition to the financial burden
on families, the lack of professional home healthcare services can lead
to unnecessarily prolonged hospitalizations and institutionalization.

Some states allow non-parent family members, such as grandparents, to
be paid to provide care. But most states do not allow parent guardians
to be paid to provide medical care to their children, except for some
select programs that make exceptions for parents who are registered
nurses (RNs) or licensed practical nurses (LPNs). Illinois Medicaid has committed to finding alternative ways for parents to be paid caregivers
and is exploring ways for that to be implemented.

"Our study provides evidence that paid family caregiving as a concept
is feasible and can be successfully applied to meet the home care needs
of children with medical complexity," said lead author Carolyn Foster,
MD, MS, from Ann & Robert H. Lurie Children's Hospital of Chicago and
Assistant Professor of Pediatrics at Northwestern University Feinberg
School of Medicine.

"States should consider adopting policies that promote avenues to allow
for parents to obtain CNA or other relevant credentials and to be paid
for their child's at-home medical care. Such policies would enable state programs to meet their legal obligation to provide medical services
for enrolled children while also reducing family financial strain and
providing care continuity for these children." Dr. Foster and colleagues stress that according to previous research, care continuity results in
higher quality care. Broader literature also demonstrates cost savings
to the health system with reduced employee turnover. The lack of costs
for re-training and onboarding employees may be a source of savings in
family CNA programs.

The study compared the characteristics and healthcare utilization of
children with medical complexity who received paid CNA care by a family
member and by a traditional non-family CNA from 2017 to 2019, as part
of the Medicaid program in Colorado. Researchers analyzed de-identified
billing claims data for 861 children, including information such as hospitalization frequency and hospital lengths of stay.

"Colorado's family-centered model addresses the significant shortage of healthcare workforce while providing additional income to parents who
are compelled to leave work to care for their children. This program
may not be a fit for all situations but is a meaningful option for many children going without enough services," said Dr. Foster.

Research at Ann & Robert H. Lurie Children's Hospital of Chicago is
conducted through Stanley Manne Children's Research Institute. The Manne Research Institute is focused on improving child health, transforming
pediatric medicine and ensuring healthier futures through the relentless pursuit of knowledge.

Lurie Children's is ranked as one of the nation's top children's hospitals
by U.S. News & World Report.It is the pediatric training ground for Northwestern University Feinberg School of Medicine.

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========================================================================== Story Source: Materials provided by Ann_&_Robert_H._Lurie_Children's_Hospital_of_Chicago.

Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Carolyn Foster, Soyang Kwon, Christy Blakely, Kristin Carter,
Sarah A.

Sobotka, Denise M. Goodman, Rishi Agrawal, Mark Brittan. Paying
Family Medical Caregivers for Children's Home Healthcare in
Colorado: A Working Medicaid Model. The Journal of Pediatrics,
2023; DOI: 10.1016/ j.jpeds.2022.12.043 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2023/02/230221180107.htm

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