Underpaid nurses costing families MassHealth home care

BOSTON — At home or in the hospital. Those are the choices for hundreds of children in the Commonwealth who need care so specialized that any compromise will land them in the intensive care unit.

For these kids, there is state help. MassHealth pays for in-home nurses, but according to their parents, they don’t pay enough.

Joe and Sue McCarthy are the parents of two boys and a girl, named Caitlin.

"She is definitely a very special part of our family,” Sue McCarthy said.

Caitlin, who is 14, loves Disney movies and her black and purple bedroom.

“Most of all, she just likes being around family,” Sue said.

At just a year-old, Caitlin was diagnosed with mitochondrial disease. It impacts every cell, every organ of her body.

"As a parent, when you have a child, of course this isn't the path that you think you're going to go down, but it is the path that is chosen for us,” Sue explained.

It hasn't been easy.

In the beginning, Sue told her mom she didn't know how they'd make it.

“I used to say, why did God do this to us? And she used to say, 'He chose you because he knew that you would be the best possible parents for Caitlin and, I mean, we're trying,” Sue said.

Joe and Sue have arranged a small army of nurses and supplies for Caitlin's round-the-clock care.

But there are holes in their plans and they're not alone. There are 916 children who require in-home continuous skilled nursing, covered by state insurer MassHealth.

But according to Home Care Alliance of Massachusetts, 24 percent of the needed service hours go uncovered.

In fact, they say 46 percent of patients receive less than full coverage.

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That's because home care agencies can't staff enough nurses to do the job. The reason is the pay.

“For these home care agencies, they're looking at competing with a hospital paying benefits, paying a higher rate,” Joe said.

A continuous skill nurse makes about half of what nurses are paid at many hospitals.

• Continuous Skilled Nursing Program RN                   $30.58
• Boston Medical Center RN                                         $63.62

After 10 years at that rate, the McCarthys are among several families and agencies petitioning the state to raise the pay for nurses.

They say it’s crucial to Massachusetts families in desperate need of care.

“So that these children can stay at home where they belong,” said Sue.

Yesterday, a Beacon Hill hearing allowed for public comment, where Sue McCarthy shared her story.

It will be some time before we know the result of that hearing.

Mass Health issued the following statement to Boston 25 News:

Continuous skilled nursing (CSN) services is an important service for MassHealth members with  complex medical needs  to remain at home.  Prior to this administration, the last time a rate increase was approved for this service was in 2007.  MassHealth has made two rate adjustments – one in January, 2017 and another for July 2017 for a total of $4.6 million.  Regulatory rate hearings provide an opportunity for important input.  We value the public's input and will take this information and feedback into our review of rates and the program.

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