Governor proposes allowing home care workers to administer medication

The state is considering Gov. Dannel Malloy’s proposal to allow nurses to delegate the administration of medication to home care workers. Currently, workers caring for someone in the home can’t administer medication if the patient is somehow unable to do it himself or herself. Instead, the responsibility has to be taken by a family caregiver or a licensed nurse, which can be expensive. An informational hearing on the proposal is taking place today in Hartford. Here’s AARP’s press release on the proposal:

Policy experts today presented at an informational hearing before the state’s Aging Committee in support of Governor Malloy’s proposal to allow licensed nurses to delegate medication administration duties to home care workers.  The proposal to allow nurse delegation of medication administration — which has been successfully implemented in a number of states, including Washington and Oregon — would save Connecticut millions of dollars in Medicaid spending each year and allow more individuals to receive care at home, instead of in an institution.

According to Susan Reinhard, AARP’s Vice President of Public Policy, who spoke at today’s forum, “Nurse delegation is an important tool to help ease the burden on family caregivers, who must otherwise be available during the day to administer medication to their loved ones, or hire a licensed nurse to do it, which can be very costly.  Allowing nurses to delegate this task to a professional home care worker – who may already be providing services in the home – saves money, provides a needed break for family members, and supports an individual’s choice to remain in their home as they age.”

According to the Governor’s office, the state spent more than $113 million on medication administration for approximately 8,650 Medicaid clients in 2011 – or roughly $56 per visit.  Anne Foley, Under Secretary of the Office of Policy and Management, testified that the cost of medication administration is one of the primary cost drivers and one of the primary barriers to moving individuals from institutional settings into the community because of cost caps under the federal Money Follows the Person program.  The Governor’s proposal is estimated to save about $28 million a year when fully annualized.

Connecticut is one of 44 states currently participating in Money Follows the Person.  Over a recent six-month period, the state represented a third of the cases nationwide where the anticipated cost of caring for the individual at home prevented them from moving from an institutional setting back into the community.

Susan McDermott, R.N. directed a pilot study of nurse delegation in the state of New Jersey that found the practice to be effective at assisting clients to stay in their homes and communities and improving quality of care.  “We’ve known for some time in the health care industry that our nation is experiencing a shortage of skilled nurses,” McDermott said.  “With people living longer and the aging population expected to nearly double over the next two decades, we must find ways to be economically efficient, as well as ensure that care is delivered safely and effectively.  One way to achieve this is to allow nurses to delegate and train home health aides to administer medication to clients in their homes.”

Amanda Cuda