As reported in a recent Advocate article, the Louisiana Nursing Home Association opposes House Bill 790. The Advocate depicted that this bill would provide greater access to home and community-based care services (HCBS). This is a misconception. The implementation of a managed-care program in Louisiana would have no effect on changing the utilization of long-term care services. An AARP report shows that Louisiana is an evenly-balanced state for elderly services under the Medicaid program, and DHH officials have acknowledged this on numerous occasions.
Health care organizations in other states report their managed-care programs having numerous problems that directly affect the delivery of services offered. Managed-care programs are operated by large national insurance companies that draw funds away from providing patient care to support their administrative costs. Currently, Louisiana is the fourth-lowest reimbursed nursing facility program in the nation. Serving a state that is ranked worst in the nation in health measures among its elderly leads to providing care to some of the nation’s sickest residents.
Louisiana nursing facilities have succeeded in achieving a number of quality initiatives. One example is evidenced by the substantial number of nursing facilities that improved their overall Five-Star Quality Rating between 2009 and 2014. During this time frame, the proportion of facilities with a one-star overall rating in Louisiana has decreased by 57 percent, facilities with a five-star rating increased by 438 percent, and facilities with a four-star rating increased by 70 percent. And, RN staffing increased 75 percent in Louisiana’s nursing facilities, compared with 44 percent nationally.
In the hearing, AARP referenced a waiting list for those interested in receiving HCBS. Yet the personal care program is an optional service (not a waiver), meaning that every individual who qualifies for it must receive the service. Many individuals on the waiting list are receiving other Medicaid services.
Continuing an attempt to shift funding away from the nursing facility program under the guise of managed care is both irresponsible and ill-advised. The HCBS program should seek new funding solutions and not rely on a quick fix that would directly damage services essential to 30,000 senior citizens who reside in long-term care facilities.
executive director, Louisiana Nursing Home Association