A children's nursing service that announced a shut down at month's end may have a change of plans, if negotiations with the state can keep it afloat.

Castle Community Care blamed low state-reimbursement rates in recently announcing a planned closure. But talks are on to see if it can be saved -- meanwhile, other agencies offer similar services, with 2 more signing on with the state.

Medically fragile children like Josiah Rodriguez receive in-home care from nurses through a Castle Medical Center program.

Medicaid rates that share the cost hadn't budged for more than six years.

So Castle planned to close the service at the end of July, stating "The escalating costs to provide care, combined with low reimbursement rates" meant they operated at a loss.

Now the state is in talks to see if rates for Castle can be raised.

"We're also looking at what would the cost be if we increase it for all of the providers if we're not successful in distinguishing castle's hospital from all the others,” said Lillian Koller, director of the state Department of Human Services.

Fifteen agencies statewide -- and 2 more signing on this month -- also provide in-home nursing.

If DHS is not able to work out a deal with Castle, DHS says a transition plan will be discussed with each of the families as was done when other agencies closed in 2000 and 2001.

"What we do under those circumstances is we work with the families and the nurses to have the nurses basically hook up with one of the many other agencies," Koller said.

The overall Medicaid reimbursement base recently went up, but additional money for the children's program wasn't singled out. DHS says there's still enough to keep the other providers in business.

"That program isn't going anywhere,” Koller said. “That program is sound, it is here, it is staying."

There are 5 children in Castle's medically fragile program and 40 families in its entire community care Medicaid program.

DHS says it expects to talks will wrap up later today or tomorrow.

For more information or resources, contact DHS at 586-5390.