San Diego (KGTV) - A local family says their two-year-old needs round the clock nursing help, but they can’t find anyone to take the hours.
Doctors believe Reilly Phipps suffered a spinal stroke, paralyzing him from the shoulders down.
“For the long term, we’re looking at complete quadriplegia, below the shoulders and he’ll be vent dependent,” said Reilly’s father Kyle.
It’s a devastating diagnosis no parents want for their child.
“The hardest part is that we can't help him and fix it,” Kyle said. “Some days are better than others some days are worse than others.”
After spending five months at Rady Children’s Hospital, the Phipps family is ready to go home.
Kyle tells 10News they have Medi-Cal and have been told to expect at least 16 hours of approved at-home nursing care a day.
There’s just one problem, there are no nurses to fill those hours.
"We can’t get any hours because there's no nurses available to fill those hours we're approved for,” Kyle said.
Health advocates tell 10News there's a shortage of licensed vocational nurses. They say the shortage is because of out of date Medi-Cal reimbursement rates. It makes it difficult to recruit nurses with the right skills willing to work for less.
"Medi-Cal will only pay them a certain dollar amount per hour and that's non-negotiable," Phipps said. "These nurses are looking at taking, in some cases, more than a 50 percent pay cut if they were to work at a hospital like Rady's versus coming home and taking care of our son with us."
In February 10News met the Beaubien family and their four-year-old son Julian.
Julian can't walk or sit up. He's fed through a gastronomy tube and breathes with the help a ventilator. He needs round the clock help.
Alisa Beaubien and her husband have health insurance through the military. She said they are also Medi-Cal approved for home health nursing 22 hours a day, seven days a week.
"Right now we get about eight of that," she said.
Team 10 discovered the rate for one of Julian's Medi-Cal reimbursement codes is $29.41. According to the California Department of Health Care Services, the rate has been the same since Aug. 1, 2000.
Kyle says the hospital has been great, but he just wants to be able to take his son home.
“We cant use our hours because they aren’t paying enough,” he said. “That’s the last hurdle we have. It’s a roadblock we cant get around at this point.”
State Assemblyman Brian Maienschien proposed a bill that would in part increase Medi-Cal reimbursement rates.
In February he told Team 10 investigator Adam Racusin the state needs to do more to help families.
As a result of increasing the reimbursement rates, it takes these kids out of a much more costly system, into a system in terms of the overall result will be less costly," he said. "Gives them better care and gives a better quality of life as well."
The bill didn’t make it out of the appropriations committee.
However, the budget subcommittee approved $10 million for pediatric in-home health care.
Team 10 reached out to both of the family’s state representatives.
In a statement, State Senator Joel Anderson wrote:
“Budgets are about priorities. Sadly, despite passing budgets with record-high spending, the supermajority who controls the entire budget process has not made funding for needy children’s healthcare a priority.
I’ve long believed increasing these rates should be a top priority, and I stand ready to work with the supermajority when they decide this issue is important to them, too.”
Team 10 did not get a comment from Assemblyman Randy Voepel.
The following links are available if you’d like to help Reilly and his family:
