Mileage Study Press Conference Highlights: Stephanie Crawford on the Importance of Nurse Practitioners
January 26, 2016 12:56 PM
On December 16, 2015, the Foundation for Hospice and Homecare and the National Association for Home Care & Hospice (NAHC) held a press conference (see previous NAHC Report article here) to present the findings of a study documenting that nurses, therapists and home care aides who serve chronically ill, elderly and disabled patients drive nearly 8 billion miles each year. The press conference included remarks from a number of experts in the home care and hospice community, and NAHC Report is publishing a series of articles providing in-depth coverage of their remarks.
Stephanie Crawford is a Nurse Practitioner at the Visiting Nurses Association in Rockford, Illinois. NAHC President Val J. Halamandaris introduced Ms. Crawford by saying her “remarkable” experience as a Nurse Practitioner allows her to explain the importance of the Home Health Care Planning Improvement Act (S. 578 / H.R. 1342), which would permit non-physician practitioners to certify Medicare home health plans of care for those who need it. The legislation currently has 43 cosponsors in the U.S. Senate and 173 cosponsors in the U.S. House of Representatives.
In seeing patients with advanced illnesses in their homes, Ms. Crawford sees patients for whom “it takes considerable and taxing effort” to leave the home. As a result, such patients often “don’t leave the home until they are in a critical situation and they end up in the emergency room and hospital.” Ms. Crawford works with the home health care nurses in order to avoid unnecessary hospitalizations. “It’s vital when I see these patients in their homes because I can try to catch things before they end up in a critical state that lands them in the hospital,” she said. “I rely heavily on the nursing staff that are out there to see the patients, that are doing assessments and telling me what they are seeing in the homes, so I can make changes in their medication and their plan of care.”
She told the story of shortly after becoming a Nurse Practitioner seeing a patient who told her he “hated” going to the hospital. She offered instead to come to his home, and that “started my journey in seeing patients in the home as a Nurse Practitioner. And I saw this man for four years up until his death. He was hospitalized one time in those four years, where before he was going to the hospital probably every month to two months because he would wait.”
These reduced hospitalizations result in “considerable savings not only to Medicare but also to the patients,” she said. “And this is why I do what I do. Patients don’t want to go to the hospital. They want to be at home.”
At the same time, Ms. Crawford and other non-physician practitioners are unable to certify Medicare home health plans of care, which causes delays in care. Even though she is the one providing the care, she said, “I can’t sign home health care orders. I have to find a physician, a collaborative physician, to do that for me.” As a result, “there is a delay oftentimes in getting nursing out there when I can’t sign these orders.” This is why it is so important for Congress to pass S. 578 / H.R. 1342.
“We keep people at home,” she said. “We keep their symptoms managed, and this is why it’s so vital that home care is recognized.”
To view the final study, click here.
Video footage of the press conference is currently available on the NAHC website (www.nahc.org).