Benefits of Pediatric Private Duty Nursing (and How to Get Medicaid to Pay)

Benefits of Pediatric Private Duty Nursing (and How to Get Medicaid to Pay)

If your child is medically complex and requires pediatric private duty nursing, it’s important to know that you can receive this care in your home. The Katie Beckett waiver allows Medicaid to cover medical services for children in the home, regardless of parent income or resources. Only your child’s income and resources are a consideration.

Continuum Pediatric Nursing offers a high level of care to medically complex children and their families. We believe that informed families can make the best decisions for their children, which is why we also aim to educate families. 

Let’s learn more about Katie Beckett, how this waiver works and the benefits of pursuing pediatric home health care

Katie Beckett Program: What is it and How Does it Work? 

A Katie Beckett waiver is a Medicaid waiver that allows children 19 and under to be eligible for pediatric home care nursing. Prior to this waiver, it was more difficult for a child with significant medical needs to qualify for in-home care because their parents’ income and resources were a factor. 

At this time, the only way a child was eligible for Medicaid was if they were in the hospital for more than 30 days. As a result, some families had no choice but to hospitalize their children in costly settings. Thanks to the Katie Beckett program, this is no longer necessary. Families can stay intact and high-quality pediatric services can be delivered in the home. 

Who is Eligible for the Katie Beckett Waiver? 

Katie Beckett Medicaid waivers have been enacted in some form in 24 states and are available to children 19 and under with certain serious medical conditions. Rather than having to stay in an institution, these children can receive skilled nursing care in the comfort of home. 

When determining eligibility, only your child’s income and resources are a consideration – NOT yours (the parents). Once your child turns 19, they are eligible for Medicaid. They can also take out Social Security Income (SSI) at this time. 

To qualify for the Katie Beckett program, your child has to meet the following criteria: 

  • Under 19 years of age
  • US citizen or acceptable immigration status
  • Meet income and resource requirements 
  • Meet the Social Security Administration’s disability requirement 
  • Live at home
  • Require a level of care provided by a hospital 

What are the Benefits of Pediatric Private Duty Nursing? 

Once your child qualifies for Katie Beckett, they can start receiving medical services in the home. There is no waiting period. The benefits to in-home care are substantial and include the following: 

Optimize your child’s quality of life 

If your doctor has recommended pediatric private duty nursing, it’s probably because your child has a complex medical condition that requires prolonged care. Having a private duty nurse will allow your child to get the support they need to improve their quality of life – and yours too. 

In fact, many children are able to lead “normal” lives with in-home care because they have someone to manage their medications, equipment and personal care needs. Some attend school, enjoy time with friends and siblings and maintain a higher level of independence. 

sick child with mom

Keep your family intact 

It’s possible that your child’s medical condition can cut their years short. Keeping the family together is a prime concern for families in this position, but this is difficult to do when your child is constantly hospitalized or traveling back and forth to appointments. 

When you have a pediatric home health nurse, you can keep the family unit together. The time that would have been spent sitting in waiting rooms and driving to the hospital can be used to spend more time with your child, strengthen sibling bonds and create long-lasting memories. 

Reduce the need for hospitalizations 

Hospitalizations are a particular concern right now due to COVID-19, but as any family with a medically complex child knows, they always pose a risk. Hospitals are vital, but they can also increase a young child’s risk for infection or complications. 

Additionally, having your child in the hospital places a huge burden on everyone in the home. You have to travel back and forth (especially if you have other children), incur costs for food and lodging and take time off work. 

With the right pediatric private duty nursing, many of your child’s medical needs can be taken care of at home. Your nurse will communicate with your child’s doctors, monitor their vitals and notice symptoms early. If your child does need medical attention, you and the nurse can work together to come up with a plan of action. 

Receive personalized care and attention 

Your child is unique. Your family is unique. And over time, your child’s medical needs may change. Fortunately, private pediatric services are flexible and can be easily adjusted to meet your child’s needs. 

From the start, you will receive a plan of action that takes into account your child’s condition, personality, strengths and challenges. As things change, your private duty nurse can make recommendations that will help your child reach their health milestones. 

How the Katie Beckett Waiver Fits Into Pediatric Home Health Care 

As you can see, there are endless benefits to receiving pediatric care in the home. Before the Katie Beckett waiver, it was difficult to receive Medicaid for this type of care. As a result, children ended up in the hospital for long periods of time, away from their families. Today, medically complex children can receive Medicaid to pay for pediatric home care nursing, regardless of their parents’ income or resources. 

Continuum Pediatric Nursing provides caring, compassionate private duty nursing for medically complex children. We accept Medicaid and will walk you through your options for transitioning your child home safely and securely. Contact us today to learn more.