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House of Representatives
Session of 2021 - 2022 Regular Session


Posted: December 11, 2020 02:53 PM
From: Representative Timothy J. O'Neal and Rep. Sheryl M. Delozier
To: All House members
Subject: Preserving Access to Ventilator Care in Pennsylvania - Former HB 2359
Over the last year, few medical services have garnered more attention than ventilator care. The COVID-19 pandemic has placed an unprecedented focus on respiratory care and the vital role that entities providing such care have in our healthcare system.
However, for many families throughout our state, the difficult realities that come with caring for patients in need of this care and related tracheostomy services have been prevalent long before the pandemic. And, unfortunately, these realities include the very real concern that without added state support the specialty facilities that provide this care may soon be a thing of the past.
Caring for patients who require ventilator and tracheostomy services is difficult and expensive. This highlights why only a limited number of nursing facilities offer this service throughout the Commonwealth. As Medicaid reimbursement payments for this care have declined significantly over the past ten years, more and more providers have stated their intent to limit or entirely cease providing ventilator care in the future.

Undoubtedly, Pennsylvania is nearing an access to care crisis. If these facilities begin to close their doors, families with loved ones requiring access to ventilator and tracheostomy care will be forced to move them into costly hospital beds or drive several hours to find a location accepting patients.
For those who recognize and prioritize the importance of fiscal responsibility within government, it is imperative that we all consider that the cost of treating these patients in a hospital is more than four times the cost of treatment in a nursing facility. Besides being more expensive, patients receiving care in a hospital are less likely to successfully be weaned from their ventilators.

Last session, Rep. O’ Neal introduced House Bill 2359 to help ensure these patients and their families are not left behind, but rather prioritized due to the critical nature of their care needs. This legislation dedicated additional Medicaid funding to those facilities already demonstrating a significant commitment to caring for these medically vulnerable Pennsylvanians, while also creating an incentive for other facilities to expand geographic access to this critically important care.
For the coming 2021-22 session, we ask that our colleagues please consider sponsoring this proposal with us again.
While there is no doubt this legislation promotes care that helps our state’s fight against those directly effected by COVID-19, the needs go far beyond the pandemic. It will serve as a lifeline for individuals and their families who are faced with degenerative illnesses (i.e. ALS, MS, or Alzheimer’s Disease) and the effects of strokes, or seriously injured in serious accidents -- more than half of whom are under the age of 65.
Ventilator care is not end-of-life care, nor is it always a permanent state. In fact, the specialized expertise of the skilled nursing providers often free patients of their dependence on a ventilator and even help them to return home. But these folks need our support.
As elected officials, we all prioritize the importance of supporting Pennsylvania’s “most vulnerable” citizens -- as we should. And in this case, there are few populations that exemplify this mantra more than those dependent on ventilator and tracheostomy care. These individuals and their families deserve better from the state, and we have an obligation to help them.

Please consider cosponsoring this proposal and joining us in support of these medically-fragile Pennsylvanians and those who care for them.


Introduced as HB1012