Andwell Health Urges HHS to Save Skilled Home Health Care for Kids

Lewiston, ME, January 16 – Andwell Health Partners is urging the Department of Health and Human Services to adopt a plan it says would ensure children who need skilled home health care get the services they need.

The nonprofit presented the DHHS with solutions it says would financially support home health visits not just for Andwell’s patients but for all kids on MaineCare across the state.

“Reimbursements for pediatric home health care services under Section 40 of MaineCare has not increased more than once in the last 20 years,” says Ken Albert, President and CEO of Andwell Health Partners. Since increasing MaineCare reimbursements would take time, Andwell’s plan suggests immediately shifting allocations from designated unused healthcare transportation funding to supplement the home health MaineCare rate. Additionally, Andwell has proposed an alternative payment structure for medically complex children using a model the Department has recently designed to reimburse for care delivery and case management of similarly situated MaineCare enrollees.

Andwell presented its plan to DHHS at a meeting in Augusta last month. The department has not yet responded nor provided a timeline to do so. The lack of response from DHHS is very concerning for Andwell and the parents of children it serves. Andwell was forced to discharge or transfer pediatric patients to outpatient care in early January after requests for DHHS to intervene failed.

“We are exhausted from navigating a very complex medical world to ensure that they receive everything that they need,” said Alyssa Breau, whose three-year-old son Darrius was born prematurely and has required several forms of therapy including nursing, physical, occupational and speech. “With the support of our Andwell therapists,” said Breau, “We gain the strength to keep advocating for our children because we see their true potential. Their progress is a testimony that is nothing short of a miracle.”

Andwell is reaching out to Republican and Democratic legislators in rural districts for support in the cause. “Accessible home health care for severely ill children or children with disabilities is a bipartisan issue,” said Albert, “We must find innovative strategies to fund home-based health care for Maine’s children. The costs to MaineCare for failing to do so far exceed the costs for providing pediatric skilled home health.”

Over the last decade, Andwell has absorbed millions of dollars in deficits due to inadequate MaineCare reimbursements, losses which are no longer sustainable. Andwell prides itself on paying its clinical teams market wages that consider inflationary factors such as cost of living adjustments year-to-year, and MaineCare reimbursements don’t come close to supporting salaries for the skilled professionals providing care for children enrolled in MaineCare.

“When 96% of our pediatric patients have MaineCare to cover the costs of their health care, and MaineCare home health rates haven’t had meaningful increases in twenty years, it is impossible to make the ends meet.”  Albert went on to say that “As a society, we pay for what we value, and I firmly believe that Maine people want to make sure that all children receive the care they need to get the best possible chance for their future – for our future.”

The nonprofit is continuously fundraising to meet the health care needs for well over 900 pediatric patients it serves on any given day. “Every day that passes,” said Albert, “leaves children with medically complex issues and the livelihoods of their caregivers more at risk.”