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Every year about this time, citizens from all across the state
come to the Capitol to inform and educate their Legislators. These citizen
lobbyists are so critical to our democratic process. They provide insight
necessary to make wise public policy decisions. As Marcia Avner puts it,
“Public policy is the set of decisions that we make as a society about how
we will care for one another, our communities and the land.”
A couple weeks ago, farmers filled the Capitol halls. Last Wednesday was
Nursing Home Advocacy Day. If ever we need to make wise policy decisions
about the way we care for one another, it is how we care for our elderly and
disabled.
I had the opportunity to meet with Nursing Home Administrators from around
the state including our Senate District. They talked about being paid well
below their costs by the state’s Medicaid program and, as a result, about
wanting to improve buildings and upgrade facilities and not being able;
about wanting to pay their workers more and not being able.
Nearly 4,000 people in our Senate District work in nursing homes. Most of
these dedicated workers provide direct care to some of our most vulnerable
citizens. My first job was providing care to nursing home residents. I know
this work is very rewarding but I also understand the hours are longer and
the job is getting harder. Residents are sicker and require more care. And
resources are much tighter.
For forty-five years, low-income, elderly Americans have depended on
Medicaid - the state health program for low-income people - to pay nursing
home bills. Nearly two thirds of all nursing home residents are Medicaid
recipients. The federal and state government has made a commitment to fund
nursing home care. This is not likely to change. But what changes are the
rates paid for care in our nursing homes.
For the second year in a row a national study of Medicaid payments to
nursing homes ranked Wisconsin as dead last. The study compared the rates
paid to nursing homes with their allowable actual costs. In 2009, Wisconsin
fell two hundred million shy of covering allowable costs to our four hundred
nursing homes. This translates to daily losses of twice the national average
or about $40 dollars a day per Medicaid resident.
The gap between costs and Medicaid payment continues to grow. And the
state’s financial problem has made more fragile the financial situation of
many nursing homes.
This translates to difficulties in finding and keeping good staff and
problems in maintaining and upgrading buildings. Add in residents who need
more care than years ago and our nursing homes are struggling to survive.
Many administrators are forced to raise rates to those who are private pay
residents. State-wide, nursing home administrators estimate private pay
patients pay $70 more than Medicaid residents despite receiving the same
care.
Wisconsin has seen a steady decline in the number of homes and beds.
Sixty-five homes have closed in the past eleven years. As facilities close,
families have fewer options close to home.
In the past ten years efforts have been underway to help elderly citizens
who can live at home to stay at home. While nursing homes care for the
sickest and most fragile, the Family Care program provides in-home services
and coordinates care which helps keep people in their homes and communities.
The Family Care program is expanding beyond cities to cover many rural
areas. But rising costs have many Legislators concerned about the future of
Family Care.
As the state struggles now to provide care to our elderly, all of us are
aging, increasing the pressure on an already fragile system. If we are lucky
we will have a comfortable retirement and good health. But should we need
good, quality affordable nursing home care, we must take care of our care
providers.
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