State lawmakers’ nearly $5 billion in budget cuts left behind a weakened medical safety net for the poor and elderly this year. But they did manage to put what many see as a financial patch on the nursing-home industry.
State lawmakers’ nearly $5 billion in budget cuts left behind a weakened medical safety net for the poor and elderly this year. But they did manage to put what many see as a financial patch on the nursing-home industry.
Gov. Chris Gregoire signed a bill into law last week that enacts a provider, or “safety net,” fee on nursing homes after July 1. It is designed to make financial life easier for most nursing homes.
If the plan works as drawn, the fee will trigger extra federal matching dollars in the Medicaid health program. And that money will go toward averting what would be a third round of cuts since June 2010. Some home operators feared that further cuts would close a few struggling nursing homes.
“We are basically making the nursing homes whole. We would have had to cut them about $20 million” a year, state Sen. Karen Keiser, D-Kent, said after the governor signed the bill she had sponsored. “We are able to restore that cut and not have the reductions. … Those cuts would have been devastating.”
Many House Republicans, including Rep. Gary Alexander of Thurston County, objected to the size of the fees – as high as $11 per bed per day for some homes. Alexander contended that a $6-per-bed fee was enough to cover the size of cuts that his caucus wanted to make in the budget. Those proposed cuts were smaller than what lawmakers ultimately passed.
Alexander said he also had concerns that federal dollars from the new fee might not come in, because Congress is looking for spending cuts and the state could wind up dealing with the same funding problems later in the year.
“We felt they were holding the nursing home owners somewhat hostage in this,” Alexander added. He said nonprofits such as Providence Health & Services, which operates the Mother Joseph facility in Olympia, opposed the fee, fearing that the new federal money would be redirected to other causes.
In fact, the original version of Senate Bill 5581 called for higher fees that would have generated $15 million a year in extra federal money. Advocacy groups such as AARP Washington hoped to see the money redirected to other elder-care health programs that eventually were cut.
In the end, even with the lower nursing-bed fee, deep cuts were made in the health care safety net this year. The Legislature cut some $4.8 billion in real and projected spending to close a shortfall for the two-year budget period that starts July 1.
Among cuts, those affecting the elderly totaled at least $300 million, according to a tally from AARP. The advocacy group’s outreach director, Ingrid McDonald, cited one $176 million reduction in assistance with chores that low-income elderly and disabled people can get in their homes.
This help with bathing, cooking, laundry, shopping and medication management lets many retirees live longer in their own homes, but the service already has been cut in past budgets. Cutting it more could push more seniors into more expensive nursing homes.
“Over and over in both (political) parties they said they wanted to protect the most vulnerable. I do not think this budget protects the most vulnerable,” McDonald said. Despite help for nursing homes, she said, some people could lose another 10 percent of their home-care hours, as well as eyeglass and hearing-aid coverage, meals assistance and more.
Yet another cut also ends the state Medicaid subsidy for prescription-drug co-payments for Medicare clients poor enough to also qualify for Medicaid, McDonald said.
“The thing to keep in mind with all of those cuts is the cumulative impact. The same individuals will feel a lot of those” at once, McDonald said. “It’s a huge impact there.”
Against that backdrop, however, Keiser said lawmakers climbed steep hills to keep some of the health care safety net intact – such as the Basic Health Plan for low-wage workers and the Disability Lifeline’s temporary aid for people unable to work.
“We did the best we could to maintain the safety net. But it is less comprehensive, and it will have fewer people covered,” she said.
In the case of nursing homes, an emergency may be averted for some. Craig LeVee, owner-operator of the RooLan Healthcare Center in Lacey, supported the new fee as a member of the Washington Health Care Association, the industry group of for-profit nursing facilities that lobbied hard for the fee.
LeVee said he was unsure how his facility could absorb its share of the cuts that it faced after July 1 had the fee not passed. He said the new money sustains quality care in his 75-year-old facility.
“Frankly, I don’t have to take one of the drastic measures I had contemplated to take … You can do three things: you can cut salaries, you can cut the actual work hours or you can cut the benefits,” he said.
The new fee is equivalent to $11 per bed per day for some, $1 for others and zero for a few operations – but a few won’t benefit after paying.
“It is a provider tax,” Vicki Christophersen, a lobbyist for Providence Health & Services, complained during a House committee hearing last month. Christophersen said the state should be reducing the number of excess nursing-home beds in the system, and she recalled how a $6 bed fee adopted in 2003 later was shifted to other purposes before it eventually was repealed.
“We have been here before, and it didn’t work,” Christophersen said.
Gov. Chris Gregoire signed a bill into law last week that enacts a provider, or “safety net,” fee on nursing homes after July 1. It is designed to make financial life easier for most nursing homes.
If the plan works as drawn, the fee will trigger extra federal matching dollars in the Medicaid health program. And that money will go toward averting what would be a third round of cuts since June 2010. Some home operators feared that further cuts would close a few struggling nursing homes.
“We are basically making the nursing homes whole. We would have had to cut them about $20 million” a year, state Sen. Karen Keiser, D-Kent, said after the governor signed the bill she had sponsored. “We are able to restore that cut and not have the reductions. … Those cuts would have been devastating.”
Many House Republicans, including Rep. Gary Alexander of Thurston County, objected to the size of the fees – as high as $11 per bed per day for some homes. Alexander contended that a $6-per-bed fee was enough to cover the size of cuts that his caucus wanted to make in the budget. Those proposed cuts were smaller than what lawmakers ultimately passed.
Alexander said he also had concerns that federal dollars from the new fee might not come in, because Congress is looking for spending cuts and the state could wind up dealing with the same funding problems later in the year.
“We felt they were holding the nursing home owners somewhat hostage in this,” Alexander added. He said nonprofits such as Providence Health & Services, which operates the Mother Joseph facility in Olympia, opposed the fee, fearing that the new federal money would be redirected to other causes.
In fact, the original version of Senate Bill 5581 called for higher fees that would have generated $15 million a year in extra federal money. Advocacy groups such as AARP Washington hoped to see the money redirected to other elder-care health programs that eventually were cut.
In the end, even with the lower nursing-bed fee, deep cuts were made in the health care safety net this year. The Legislature cut some $4.8 billion in real and projected spending to close a shortfall for the two-year budget period that starts July 1.
Among cuts, those affecting the elderly totaled at least $300 million, according to a tally from AARP. The advocacy group’s outreach director, Ingrid McDonald, cited one $176 million reduction in assistance with chores that low-income elderly and disabled people can get in their homes.
This help with bathing, cooking, laundry, shopping and medication management lets many retirees live longer in their own homes, but the service already has been cut in past budgets. Cutting it more could push more seniors into more expensive nursing homes.
“Over and over in both (political) parties they said they wanted to protect the most vulnerable. I do not think this budget protects the most vulnerable,” McDonald said. Despite help for nursing homes, she said, some people could lose another 10 percent of their home-care hours, as well as eyeglass and hearing-aid coverage, meals assistance and more.
Yet another cut also ends the state Medicaid subsidy for prescription-drug co-payments for Medicare clients poor enough to also qualify for Medicaid, McDonald said.
“The thing to keep in mind with all of those cuts is the cumulative impact. The same individuals will feel a lot of those” at once, McDonald said. “It’s a huge impact there.”
Against that backdrop, however, Keiser said lawmakers climbed steep hills to keep some of the health care safety net intact – such as the Basic Health Plan for low-wage workers and the Disability Lifeline’s temporary aid for people unable to work.
“We did the best we could to maintain the safety net. But it is less comprehensive, and it will have fewer people covered,” she said.
In the case of nursing homes, an emergency may be averted for some. Craig LeVee, owner-operator of the RooLan Healthcare Center in Lacey, supported the new fee as a member of the Washington Health Care Association, the industry group of for-profit nursing facilities that lobbied hard for the fee.
LeVee said he was unsure how his facility could absorb its share of the cuts that it faced after July 1 had the fee not passed. He said the new money sustains quality care in his 75-year-old facility.
“Frankly, I don’t have to take one of the drastic measures I had contemplated to take … You can do three things: you can cut salaries, you can cut the actual work hours or you can cut the benefits,” he said.
The new fee is equivalent to $11 per bed per day for some, $1 for others and zero for a few operations – but a few won’t benefit after paying.
“It is a provider tax,” Vicki Christophersen, a lobbyist for Providence Health & Services, complained during a House committee hearing last month. Christophersen said the state should be reducing the number of excess nursing-home beds in the system, and she recalled how a $6 bed fee adopted in 2003 later was shifted to other purposes before it eventually was repealed.
“We have been here before, and it didn’t work,” Christophersen said.
Source http://www.thenewstribune.com/
No comments:
Post a Comment