At least 14 residents of the Southeast Louisiana Veterans Home have tested positive for the coronavirus and at least four of them have died in what appears to be a significant and growing cluster of the virus in the St. John the Baptist Parish nursing home.

The Advocate’s fine editorial (“State relies too heavily on nursing homes, with tragic consequences”) got many things exactly right.

Stay-at-home support services are indeed more popular and less expensive than nursing homes. The editorial decried what happens when elected officials “make health care decisions based on campaign contributions.” More than 11,000 people on waiting lists may someday be forced out of their homes, because “Louisiana’s public policy choices force them into nursing homes.”

Our state’s inadequate system of home health care cost us dearly in this coronavirus crisis. It explains in large part why “the toll in nursing homes has been jaw-dropping,” now accounting for about 40% of all deaths in Louisiana. Making home health services more available to Louisiana’s elderly and disabled would be an obvious, compassionate, and cost-effective response to the crisis.

But in addition, expanding home health care would boost economic development. Our shattered economy lost about 100,000 jobs over the last year. We need to put people back to work.

Hotel and food service workers were particularly hard hit. What if they could be retrained for jobs that paid a living wage with benefits, while also delivering a needed service to Louisiana’s most vulnerable residents? That’s the promise of proposed federal legislation by U.S. Sen. Bob Casey, of Pennsylvania.

The Casey bill won’t take money away from nursing homes. It simply gives states additional Medicaid dollars dedicated to funding home and community-based services.

Our Views: Louisiana relies too heavily on nursing homes, and the consequences are tragic

The “Coronavirus Relief for Seniors and People with Disabilities Act” funds training and enhances salaries and benefits for personal care assistants who deliver the essential services that enable people to continue living at home and avoid nursing homes.

PCAs can be trained in about 30 hours. A rapid expansion in PCA jobs will not only fast-forward economic recovery but will also help diversify our economy over the long haul.

For too long, we’ve depended predominantly on tourism and the oil-and-gas industry for regional economic growth. Just contemplate the wreckage inflicted by the downturn that COVID-19 caused in both sectors. The Casey bill will grow a new sector that gets stronger, not weaker in a public health emergency.

When House and Senate negotiators convene to seek consensus on the next stimulus bill, Republican and Democratic senators should embrace funding for home health care.

Right now, some vulnerable seniors and disabled people don’t have a real choice when ordered to “stay at home.” Instead, many are forced into nursing homes, where their risks of contracting COVID-19 skyrocket.

That’s not a “red” or a “blue” issue. That’s an issue of life or death, because we’ve failed to provide them with the supportive health services needed to remain at home.




executive director, Tulane University Public Law Center

New Orleans