The nursing I am talking about is in addition to any respite hours you get such as from DSPD or MCCW. You can have both respite and nursing. They do not affect one another. If you get approved for night nursing it WILL NOT lower your repsite.
If you have Medicaid, here are the steps I would take to see if you qualify...(I live in Utah, so I don't know how it works other places, but please comment below and let us know).
#1) Call Medicaid (which ever you have...such as Healthy U, etc). Tell them you would like to look into getting night homehealth nurses. Ask them which Nursing Agencies are on their approved list.
#2) Call one of the Nursing Agencies and ask them to come do an "Acquity Grid" for you because you would like to try and get approved for night nursing.
#3) Make a list before they come out of all of the medical tasks that need to be done and how often they need to be done. Make it sound as bad as possible. Tell the truth, but lean towards when your child is really sick and not doing well at home. When making the list make as many tasks be during getting ready for bed and during the night-time hours as possible. So if you normally bathe them after school...list it as getting ready for bed. This is a task that the nurses can do for you. Same with meds and braces and range of motion etc. Write them down as getting ready for bed and night-time tasks.
#4) The Nursing Company will come out and do the Acquity Grid and submit it to Medicaid.
#5) Several things they will want when they come out (other than your list of night-time tasks)...list of diagnosis, list of Dr.'s (names and type of specialist is fine), medications (name, dosage, reason for taking, times given). And what hours you would want (I will talk about this below).
#5) If you do not hear back from Medicaid and/or the nursing company within a reasonable amount of time, follow up with them. It took me 2 tries to be approved. Somehow the ball was dropped the first time.
As soon as the acquity grid is filled out the nursing agency should be able to tell you immediately how many hours you should be approved for. They will then want to know which hours you would want. So with our acquity grid score we came out to 8 hours per night. The nursing agency wanted to know right then what 8 hours I wanted. They have to report this to Medicaid. For some reason this is a really big deal to them. I chose 8 PM-4 AM so that I could count all of her getting ready for bed things on her acquity grid. If I had them come from 10 PM-6 AM then she would already be in bed and most of her medical things would already be done.
They will only do straight shifts and they must be during the night. So even though I would rather have (2) 4 hours shifts, I have to have (1) 8 hour shift.
Once your nurses start working make sure they are doing and reporting the tasks that you get points on the acquity grid. These reports are sent to Medicaid. If those specific tasks aren't getting done, then you could lose services.
Here are some of the things I get points for on the acquity grid...Breathing treatments (vest and nebulized meds), suctioning, seizure monitoring, wearing braces, range of motion, giving g-tube meds and feeds, bath, monitoring vitals and oxygen, using oxygen when needed, cathing, bipap at night.
I am not sure if you can get a high enough score without bipap/cpap or trach. But it can't hurt to try. Let us know how it goes for you.
Here is a sample acquity grid that I found when I googled...I do not know if it is the most up to date. But it will give you an idea of things that earn you points.
https://medicaid.utah.gov/Documents/pdfs/Forms/PDN-Grid(printable)4-13.pdf
Just as an FYI there is a nursing shortage so even if you get approved you may not actually get nurses. I have been approved for over 6 months for 8 hours each night. On my schedule next month I have 17 covered nights. My friend that is with the same company has 7 covered shifts next month.
Please comment with questions or experiences below.
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