Roderick Bremby, Commissioner of the CT Department of Social Services (DSS), went on a Medicaid home health visit in Hartford’s north end on March 7 to witness front-line care coordination provided by a home health aide, registered nurse and administrator.

The Commissioner participated in the experience to observe the practice of care delivery in the home first-hand provided under the state’s CT Home Care Program for Elders. This was his first home health visit as DSS Commissioner.

Susan Adams, RN, BSN, PhD and V.P. of Alliance Integration for Masonicare, planned the home health visit for the Commissioner. Both Ms. Adams and Commissioner Bremby are appointees to the Lieutenant Governor’s Healthcare Cabinet – an entity exploring options for the state to improve access and quality of care while reducing Medicaid expenditures. Home health care is recognized as the most cost-effective care setting for individuals with chronic conditions, and a place that 9 out of 10 individuals say they want to receive their healthcare.

Connecticut’s licensed home health agencies have been collaborative partners with DSS in advancing the state’s rebalancing initiative, contributing to state budget savings of $103-million annually (totaling more than $1-Billion over the past 10 years) by caring for Medicaid clients in home and community-based settings as opposed to institutionalized care.

The Commissioner observed the technology used during the home visit including the patient’s medical record on the nurse’s laptop, and the dispensing of prescribed medication from a preloaded automatic VRI medication box. The nurse assessed the patient for changes in health status and noted other health-related concerns. She then filled the VRI box with physician-prescribed medications for the following week. The nurse also discussed each of the diagnoses with the patient to enhance disease self-awareness and an understanding of the inter-relatedness of various diagnoses to overall health.

Commissioner Bremby observed the home health aide dialing out on the patient’s home phone to activate Masonicare’s Electronic Visit Verification (EVV) system to document and timestamp the specific services the home health aide provided during the home visit. It was also explained to the Commissioner that the aide would need to repeat the call in and out on the state’s Sandata’s EVV system, essentially duplicating the EVV process as a result of a new DSS single vendor mandate. The Commissioner then observed the home health visit documentation by the registered nurse and the process necessary for the care delivered to be submitted for DSS Medicaid billing.

Masonicare’s care team of Allison Breault, Interim Administrator;  Nancy Walker, RN Case Manager; and Maria Merced, home health aide, were honored to host the Commissioner and Ms. Adams on the home health visit.  The patient thanked the Commissioner for the help she receives from her home health team under the state Medicaid program so that she can remain in her own home. She explained that without the nursing and home health aide support, she could not live alone.