Dr. Marti Trudeau met with legislators in April over the home healthcare topics.

Dr. Marti Trudeau, in conjunction with the PA Homecare Association, visited legislators to discuss homecare-related issues. Two of the priority issues raised with legislators are directly related to her role as Director of the Practical Nursing program which is currently in the approval process with the State Board of Nursing.

Medicaid is a major payer of homecare services and the state-determined reimbursement rates for Direct Care Workers and Nurses (RNs and LPNS) have a big impact on the ability to hire staff into this field. Additionally, Pennsylvania is part of the Nursing Licensure Compact which allows license reciprocity between Pennsylvania, Delaware, New Jersey, Maryland and Ohio. This means that a Pennsylvania-licensed nurse can cross borders to the other states. Unfortunately, Pennsylvania provides the lowest pay of all those states for homecare so nurses can easily work in higher paying states, thus exacerbating the nurse staffing problems in Pennsylvania. One remedy for this problem is to raise the reimbursement rates in PA to help keep nurses working here, Dr. Trudeau said.

Reimbursement rates have not kept pace with inflation and increased cost of care. Failing to adequately support in-home care will result in more costly Medicaid-funded institutional care, decreased client satisfaction, and decreased staff satisfaction and availability.

Another relevant issue related to LPNs is being legally prohibited from making death pronouncements for hospice patients. This is due to an outdated law from 1953 that limits this duty to doctors, RNs, physician assistants, and coroners. The bodies of deceased people cannot be moved without a pronouncement of death.  Even though LPNs may have been providing care in the homes, they are not permitted to pronounce the deaths of their patients. This means families must wait, sometimes up to 24 hours, until another person becomes available to do the pronouncement and the body may be taken to the funeral home. LPNs are not prohibited from pronouncing death in their scope of practice, so they are deemed competent to perform this work, Dr. Trudeau said.

To alleviate workforce strains and allow agencies to allocate care and resources to best meet the needs of patients and families, legislators are encouraged to support Senate Bill 1080 which would allow hospice LPNs to make death pronouncements for their patients.

Talking with legislators about this issue revealed that they were not aware of the enhanced LPN scope of practice that has evolved over the years. Dr. Trudeau updated them on the current LPN scope of practice so they can understand how LPNs have become a valuable source of care for Pennsylvanians.