Conrad Appel

State Sen. Conrad Appel is reading “The Ottoman Empire” by Lord Kinross: “‘The Ottoman Empire’ is a one volume history – I believe if you don’t know history, you are doomed to repeat it.”

If the effort to contain coronavirus is a war, the nursing homes of Louisiana are the battlefield.

Elderly living in close quarters are the most vulnerable population, and nursing home workers have made great sacrifices to keep them safe.

Still, the toll in nursing homes has been jaw-dropping. About a third of all reported COVID-19 deaths have been in nursing homes. In Louisiana, the figure is 40%.

That raises doubt about Louisiana’s longstanding policies for elderly care, which rely disproportionately on nursing homes.

Older folks prefer to live at home, according to surveys by AARP, the powerful lobby for the elderly.

But Louisiana’s public policy choices force them into homes.

Citizens who cannot live independently can sometimes get by in their own homes with the help of aides, but they face waiting lists because nursing homes sponge up most of the money for elderly care. Currently, the waiting list for home health care assistance is more than 11,000 names.

In other states, nursing homes receive over half of the Medicaid dollars for elderly care. But in Louisiana, where state lawmakers have taken pains to protect industry funding — and the industry in turn showers campaign money into legislators’ coffers — nursing homes get four of five long-term care dollars, according to recent testimony from AARP.

Home health care is not only preferred by the elderly, it is also easier on the taxpayer.

Former state Sen. Conrad Appel, a Metairie Republican, said the state would save more than $100 million a year by letting more elderly live at home, because the cost per person is lower.

Appel sponsored legislation in 2018 that aimed to move some of the Medicaid population in nursing homes to home health care under a managed care model.

The Louisiana Nursing Home Association argued it would result in a reduction in the quality of care, and the legislation failed.

Appel left the Senate last year, sidelined by term limits.

But with the COVID-19 crisis highlighting the perils of group homes, he said his legislation makes more sense now than ever.

Louisiana’s current fix, he said, is “really a tragedy brought on by politics.” Aging Louisianians, he said, have been forced “into a situation that they could become infected, or at the very least they’re probably scared out of their wits.”

The people who work in nursing homes have done a great service, and for many elderly, a home is the only pragmatic solution.

But Louisiana cannot continue to make health care decisions based on campaign contributions. We need to respect the wishes of the people who receive the services.