OLR Research Report


December 21, 2004

 

2004-R-0980

MEDICAID AND PRIVATE DUTY NURSING

By: Helga Niesz, Principal Analyst

You asked whether the Medicaid program in Connecticut covers private duty nursing.

The Connecticut Medicaid program does not cover private duty nursing. It is an optional Medicaid service that the federal government allows, but does not require, states to offer people who qualify for Medicaid.

Private duty nursing means extensive and sometimes round-the-clock attendance by a registered or licensed practical nurse at an individual’s home or in a hospital or nursing home. While Connecticut’s Medicaid program does not offer this service, it does offer shorter visits by nurses for specific purposes and it provides care from home health aides and home care aides.

Twenty-one states (Arizona, Arkansas, Colorado, Delaware, Indiana, Maine, Massachusetts, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New York, North Carolina, North Dakota, Ohio, Oregon, Utah, Vermont, Washington, and Wisconsin) cover private duty nursing as of January 2003, according to the Kaiser Commission on Medicaid and the Uninsured website at http: //www. kff. org/medicaidbenefits /privateduty. cfm. Most states limit the service in some way, either to people who are ventilator- or technology dependent or to situations where regular home health care is unavailable. Some limit the number of hours or days the state will pay for the service.

HN: ro