This week, 1,000 families will get letters reducing home health-nursing services. This is your life. Take action.

What you can expect!

1. The letter from your managed care company will give you a 10 warning before the reduction or cuts happen.
2. The reduction and cuts will be deep. For many people, your hours will be reduced from168 hrs/week to less than 30 hrs/week.
3. It does not matter how sick you are. TennCare is planning on reducing your nursing services.
4. Private duty nursing has been re-defined as nursing services of 8 hours or more per day and only for folks (adults 21 and older) who have a trach and need various additional nursing assistance or a ventilator patient who is on a ventilator for 12 or more hours per day. However, the new limits for trach and ventilator patients limit nursing services to no more than 30 hrs/week for nursing services.
5. You managed care company has already talked with your doctor to reduce your care.
6. These initial letters will deal with reducing nursing services for adults, but children will be next.
7. MR waiver enrollees should not get a letter. If you do, call us immediately and let us know that you are receiving MR waiver services.
8. TennCare managed car companies in middle Tennessee will realize large profits from these new limits. Remember, managed care organizations get to keep monthly capitation payments paid to them by TennCare for tens of thousands patients who do not go to the doctor each month.

What you can do?

1. If you want to keep your nursing services during the appeal, you have to appeal within the 10 day limit.
2. Appeal only if the hours offered by your managed care company are less than the new limits.
3. Call your doctor and talk with your doctor about these drastic reductions/cuts.
4. Whether you appeal or not, call your state senator and your state representative and tell them how these drastic reductions/cuts will impact your family. Also, ask them to attend the TennCare Legislative Oversight Committee on Sept. 30, 1:30 PM, Room 12, Legislative Plaza, Nashville, TN
5. Attend the TennCare Legislative Oversight Committee in Nashville on Sept. 30, 1:30 PM, Room 12, Legislative Plaza.
6. Call the Tennessee Health Care Campaign, 1-877-431-7083
7. If you are on the MR waiver and received a letter about the reductions, immediately call the Tennessee Justice Center at 1-877-608-1009.
8. Be politically active because this is your life and you must be an active player, not a passive objects. The state is counting on you to accept what the managed care company any will offer you, not to appeal and fight under the rules.

Why is this happening?

1. This is about money. TennCare wants to guarantee profits for the managed care companies.
2. TennCare is more interested in guaranteeing profits for the managed care organizations than they are in providing services.
3. TennCare has a reserve of $600 million state dollars. If this were used for medical care, it would equal $1.8 billion state and federal dollars.
4. The state is having a revenue short-fall. For the 4th year in a role, the Governor wants to use TennCare cuts to fund other state programs.

More more information, see the attached Question and Answers for answers to 12 important questions. Also go to our web site, www.thcc2.org, and click on Action Alerts for more information on these cuts in nursing services.

Take care,

Tony Garr, tgarr@thcc2.org
Tennessee Health Care Campaign
1103 Chapel Ave.
Nashville, TN 37206
1-877-431-7083 Toll Free
1-615-227-7500
1-615-846-1946 Fax