THEM Counties use several tactics to undermine the doctor-patient decision making about paramedical services. There are ways to stop them from working. County tells you that some service may not be allowed as a paramedical service. Discuss its claim with doctor. Doctors generally know what these are.
County tries to persuade doctor to change the order for services or hours.
Consult with doctor first and get approval of hours based on your log, discuss your conditions and the need to preserve the doctor-patient relationship from outside interference. Explain that the doctor's decision on a signed Form 321 is final and the county must comply. County nurse observes one day and bases lower hours on her observations and calls doctor. Home health agency will provide, apply there first. Not alternate resource since time limited.