In addition, for families with medically complex adults or children private duty nursing hours are allotted on a case by case basis. The states does not mandate what portion of the state pay goes to the nurse. The hourly rate is meant to be divided among the agency and the nurse. I am happy to see competition among agencies however too many times agencies take advantage of the state hourly and take the lions share while providing subpar training/care. Many times the nurse would/could make more without the agencies involvement. As families with medically complex children we have to work with the agency as an unnecessary middle man. This is an unfortunate and unnecessary burden as the agencies are too distant to care about the quality of nursing they provide to these children. Cut out the agency and families regain the autonomy to hire whom they deem appropriate for their child. There is no one who knows a medically complex child better than their own family.
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