OPINION: There’s no place like home for Houston children with disabilities

There’s no place like home. This old trope from a beloved children’s movie still rings true today, and for good reason. There’s nothing quite like sleeping in your own cozy bed, snuggling with your dog on the couch, or enjoying the intangible comforts of being surrounded by the things and people you are most familiar with. This is especially true for medically fragile children and their families, often living in a world of chaos and uncertainty, who cling to home as a much-loved security blanket. 

Private Duty Nursing (PDN), which is care provided in the home by nurses with specialized training for medically fragile children that allows these families to remain at home and out of hospitals or other institutions for routine, day-to-day care. In Texas, about 7,000 children rely on PDN services, which can include the use of complex medical equipment, such as a ventilator or gastrostomy tube.

Consolidated Home Health is one organization in a larger industry dedicated to meeting the medical and often, emotional needs of these PDN families. Our agency serves families across the greater Houston area, with a variety of needs, all of whom prefer to receive care at home rather than in an institution for myriad reasons.

With consistent access to home health, hospital stays are greatly reduced. According to a 2016 study, children with PDN care saw a 20% reduction in hospital admissions and a 15% reduction in hospital readmissions. PDN is also crucial in supporting working parents – a third of mothers with a child who requires complex medical equipment reported quitting their job to care for the child at home. For single parents that statistic is 15 times more likely. 

On the other end of the spectrum, PDN is a cost-containment strategy for the state, which is funded through the Texas Medicaid program, STAR Kids Managed Care. When PDN is appropriately staffed, fewer hospital stays result in increased savings for Medicaid – the average cost of one week of care for a respiratory infection would cost more than $25,000 in a hospital, compared to $2,300 with at-home PDN care. 

During the 2023 legislative session, the home care industry asked for a 40% increase to fund nursing salaries and benefits to attract skilled pediatric nurses with a competitive wage and benefits. In the end, PDN was funded an additional 2% for nurses’ salaries – a step in the right direction, but not enough to move the needle. 

Today, PDN organizations are still grappling with a nursing shortage and the inability to hire high-quality candidates and slow down turnover. The families we serve across Houston are in need of qualified, consistent nurses to provide care – I receive calls every day from parents looking for help, as their current agency cannot staff their case. Unfortunately, even with increased recruiting efforts and trying new tactics to attract nurses, we are still too short-staffed to help all these families. 

In 2024 and beyond, it's imperative that the Texas Health and Human Services Commission and our elected officials work hand-in-hand with the industry to underscore the importance of this issue and find solutions together for Houston and every Texas family who relies on PDN care. With all parties marching to the beat of the same drum down the proverbial yellow brick road, we can ensure that receiving care at home is a viable option for every Texas child who relies on PDN to thrive as they grow. 

Jonathan Willman is a registered nurse and the director of nursing services for Consolidated Home Health, which serves pediatric, private duty nursing families in the greater Houston area.