The Looniest Department: Putting Infants in Nursing Homes?

Carter Wrenn posted on November 10, 2009 10:44

They’re a lot of things going on at DHHS that are just plain odd, even for a state agency. For instance, Governor Perdue put a health care lobbyist in charge of DHHS’ budget – which includes granting billions in health care contracts.

Then the lobbyist – Secretary Lanier Cansler - put a gynecologist in charge of running the state’s Medicaid program. Then the gynecologist (who in fairness is also a lawyer) turned out to be an apparatchik capable of sitting in an office all day pouring over reams of statistics and reports then flicking a pen and issuing missives that send ripples through the lives of North Carolina’s 1.5 million Medicaid patients.

For instance, Medicaid Director Craigan Gray recently flicked his pen and cut medical care to low income pregnant women and troubled children 40% – that created such a rhubarb even North Carolina’s own version of a health care Czar had to beat a retreat.

But not for long. A few days later Director Gray flicked his pen again and this time it looks like he’s created an even bigger rhubarb: Because he’s cutting care for patients in Medicaid PDN (Private Duty Nurses). What’s Medicaid PDN? It’s a tiny program that only cares for 350 patients but they are among the sickest people in North Carolina – they suffer from MS, Cerebral Palsy, Lou Gehrig’s disease and other less known malady’s like Apert’s Syndrome and Pierre Robbins Syndrome – they’re paralyzed, have tracheotomies, use ventilators and are fed through tubes and many are infants and young children.

Here’s one example: Nathan is an eleven month old infant born with a chronic brain disorder. He can’t eat or breathe on his own and has up to 25 seizures a day.

The only reason he can stay at home – instead of spending the rest of his life in a Nursing Home – is because Medicaid provides a home care nurse to help his mother look after him.

As soon as Tim Rogers, head of the Home and Hospice Care Association, heard Director Gray was cutting care to these patients he went to see Secretary Lanier Cansler and asked him to reconsider. And, in response, Secretary Cansler said he was shocked and he’d sure look into it.

Then a couple of days later Rogers received an email from Dr. Gray who told him bluntly in no uncertain terms that providing home care nurses was costing the state $900 a day while putting patients – like Nathan – in an institution only costs $450 a day.

Now Director Gray’s math’s shaky. No Nursing Home can provide 24 hour a day nursing care to an eleven month old infant with chronic brain damage for $20 an hour. In fact, if Director Gray takes away his home care nurses Nathan is going to end up in a hospital intensive care ward and Director Gray is really going to learn the meaning of soaring medical cost.

But that’s not the point: The point is staring at his rows of statistics Craigan L. Gray missed something no number can define: He sees nothing wrong with taking patients – like Nathan – out of their homes where their mothers can help care for them (at least for part of the day when they’re not working) and putting them in institutions.

I’m all for cutting government waste but sometimes doing it takes a little more thought than staring at rows of statistics and adding up numbers and flicking a pen.

For example, right now, North Carolina is one of just six states without a Medicaid ‘Preferred Drug List. What’s a ‘Preferred Drug List’? It’s simple: It encourages the use of generic instead of name brand drugs. Director Craigan L. Gray’s North Carolina Medicaid program spends a billion dollars a year on drugs – and using generics would save $89 million.

Of course, the Pharmaceutical Companies don’t want a ‘Preferred Drug List’ and they’ve fought it tooth and toenail. In fact, Pharma, the Pharmaceutical Industry’s political arm has hired Gray’s bosses – Secretary Lanier Cansler’s – wife’s law firm to lobby for their interests in state government.

So, here’s a pretty clear example of the looniness in DHHS: Using generics would save $243,835 a day. But Craigan L. Gray’s bent on putting patients with MS and Lou Gehrig’s disease in Nursing Homes to save $450 each.

Posted in: General, North Carolina - Democrats , Issues

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The Looniest Department: Putting Infants in Nursing Homes?

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