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As hospital fill, some families are caring for their children at home. That's creating a new challenge.

Posted at 5:43 PM, Feb 02, 2023

RICHMOND, Va. -- More than 2,000 Virginia children rely on pediatric medical equipment to survive while receiving medical care from home.

Laura McGrath's 13-year-old son is one of those children.

"When he was born, he suffered a severe brain injury," McGrath said. "That brain injury caused him to be very medically complex. He has a feeding tube, he has a breathing tube, called a tracheostomy, and he requires a lot of nursing care, a lot of medical supplies, medical food, and a lot of support."

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McGrath said recently, it took three months for his medical-grade food to arrive at their front door.

"Medical supply companies are just having to say to families like ours, 'We can't afford to give you your medical food, because what we're being reimbursed is only 20-30% of the cost of that food," she said.

Pediatric medical equipment companies like Thrive, the Commonwealth's only pediatric medical supply company, which buys and rents equipment, rely on reimbursements from Virginia's Medicaid Waiver Program to do so.

Thrive, which serves over 2,000 families, particularly those in rural parts of Virginia, cannot keep up with growing costs.

"Between inflation, costs of gasoline, staff costs, and then freight costs, all have really kind of converged on us at the same time," Marc Castelo, a pediatric physical therapist now working with Thrive, said. "With the reimbursements staying the same, we're really having a hard time providing our purpose to our families, which is to provide high-quality clinical home care to medically fragile children so they can grow to their full potential."

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The issue has caused families to fight to keep their kids home.

"This is where healthcare is going," Castelo said. "It's going out of the hospital. Hospital beds are very precious right now in our NICUs and PICUs. We're seeing it every day, hospitals are at full capacity. So we need to keep our kids well at home."

Virginia Delegate Emily Brewer (R - Suffolk) is a patron of a proposed budget amendment to add $9 million from the general fund and almost $12 million from non-general funds to set the reimbursement rate to 100 percent of Medicare rural rates for durable medical equipment, including enteral products and supplies.

Virginia Senator Siobhan Dunnavant (R - Henrico) is also a patron.

“Families have not been able to get coverage of items that are necessary to care for their children in the home," Dunnavant said in a statement. "Virginia has made a commitment that the home is the best, most enriching place for children with these extraordinary needs and now we need to be sure they can get the tools they need for care so they can stay at home.”

A state budget is set to be released Sunday.

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