Training to work with medically fragile children

Specialties Private Duty

Published

Hi all!

I'm an LPN student graduating in two weeks. I currently provide care for a young boy with several disabilities deeming him medically fragile. Upon graduation, I will become his Private Duty Nurse through Medicaid. Here in NY, nurses get an extra 30% of their rate added on for working with a medically fragile child. However, the form to fill out for this enhanced rate(https://www.emedny.org/info/ProviderEnrollment/ProviderMaintForms/432301_MEDFRAGPGM_Medically_Fragile_Children_Program.pdf) mentions training on skills with medically fragile children.

I'm unsure of where to find training for this. I've Googled with no real help. Anybody know what I can do? Is there an online class somewhere? Or am I misunderstanding?

Thanks in advance! :)

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Never heard of this, but it seems to me, that on the job training at a home health agency would suffice. Since the DPCS typically holds a BSN or higher, s/he should be able to sign off on the paperwork. But of course, I doubt the agency would like the idea of training you and then you don't continue working for them at all.

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Specializes in Complex pedi to LTC/SA & now a manager.

New grads generally don't work as independent providers. If otherwise qualified they work for an agency that provides orientation and training as well as verification of training for Medicaid and other insurers. Online training should not suffice to demonstrate competency who is going to verify your skills and knowledge?

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Specializes in Pediatrics.

Can an LPN be an independent provider in the state of New York? I thought they had to go through an agency due to initial assessment, RN oversight, etc.

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Can an LPN be an independent provider in the state of New York? I thought they had to go through an agency due to initial assessment, RN oversight, etc.

Nope, LPNs are able to be independent providers here. :) For more info, you can check http://emedny.org.

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Specializes in Complex pedi to LTC/SA & now a manager.
Nope, LPNs are able to be independent providers here. :) For more info, you can check http://emedny.org.

But your plan of care must be created by an RN and signed off by a physician. Are you being paid by Medicaid now as a home health aide/caregiver? If so, who is the RN signing off? While LPNs can bill NY Medicaid directly, this not a role for an inexperienced new grad. The role is intended for an experienced independent nurse qualified with verifiable skills and demonstrated competency

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But your plan of care must be created by an RN and signed off by a physician. Are you being paid by Medicaid now as a home health aide/caregiver? If so, who is the RN signing off? While LPNs can bill NY Medicaid directly, this not a role for an inexperienced new grad. The role is intended for an experienced independent nurse qualified with verifiable skills and demonstrated competency

I'm not being paid by Medicaid now as I haven't graduated yet and am currently employed as their personal care attendant.

I will have to look more into this as I was wondering myself. Thanks! :)

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Specializes in Complex pedi to LTC/SA & now a manager.
I'm not being paid by Medicaid now as I haven't graduated yet and am currently employed as their personal care attendant.

I will have to look more into this as I was wondering myself. Thanks! :)

Who pays you? Parents direct? Agency?

If s/he is stable enough for just a personal care attendant s/he may not be complex enough to qualify for skilled nursing services unless there is a change in status. An RN would have to do an intake assessment to make that determination (whether agency or independent)

PCAs aren't to be doing medication administration, assessments or tube feeding especially in pediatrics. Those are nursing skills with RN case managers.

There are few complex pedi cases at the personal care/HHA level. Those that are are safety assist, fall prevention, monitor PO feeds, personal care (toileting, bathing, hygiene, ADLs, meal prep & assist, perhaps lift if limited mobility).

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Can you answer my original question?

I am paid partially through a local disability center, and the parents pick up the rest of my pay out of pocket. This case has several nurses and other specialists involved.

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Why don't you ask your employer?

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Specializes in Complex pedi to LTC/SA & now a manager.

Ask the other nurses or the disability center that employs you.

As I explained before private duty/home health agencies offer this training to their employees. Pediatric hospitals and long term care facilities offer this training to their employees. This is not something you can take an online class to demonstrate competency, that's impossible. New grads that take on this kind of work are not independent contractors but agency employees that go through orientation, lab, preceptorship and training through the nurse educator at the private duty/home health agency that hired them. I seriously doubt any agency as explained several times will allow you to do their training as a non-employee and accept responsibility to sign the form and declare you trained and competent.

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OP: Did you ever become a Private Duty Nurse - Medicaid Independent Provider/Contractor? Did you ever find a place to obtain the skills asked for on the Medically Fragile Peds form?

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