Louisiana legislators have always known that when their ideas are a bridge too far for their colleagues, they can save face by turning their bill into a “study resolution” — gather facts, see what other states do, regroup to fight another day.
That’s how the effort to legalize prostitution ended on Tuesday. Usually, few lawmakers disagree with launching studies.
“You can’t swing a cat without hitting a study,” Sen. Beth Mizell, R-Franklinton, said Wednesday when it appeared that accepted truth was about to change in a windowless State Capitol room.
River Ridge Republican Sen. Kirk Talbot proposed studying how to provide help for family members who care for their elderly or disabled at home rather than packing them off to a nursing home. Democratic President Joe Biden recently included $400 million in the stimulus package to help states expand home- and community-based offerings.
For once, opposition wasn’t partisan.
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The Louisiana Nursing Home Association rallied a “nothing to see here, citizens” argument and the Senate Health & Welfare Committee moved along to kill Talbot’s study resolution on a 7-1 bipartisan vote.
Like the Louisiana Association of Business & Industry members, those linked to the Louisiana Nursing Home Association are among the state’s most generous political donors. And like the river pilot groups, the third of the top three sources for campaign contributions, the nursing home industry doesn’t discriminate with its largesse — giving something in the neighborhood of $4 million to lawmakers of both parties, a quick scroll through Louisiana Ethic Board’s records indicated.
“The last study is eight years old,” Mizell said, referring to an analysis done on home-based care by the Louisiana Department of Health.
“Why wouldn’t we be open to finding a better way? We all just went through a debacle with care for the elderly during COVID,” Mizell added.
Nationally, more than 174,000 people died in nursing homes, assisted living facilities and group homes during the pandemic, often without family being able to visit their loved ones.
Home- and community-based services would help family members by providing home visits from nurses and physical therapists; access to medical equipment; support for hygiene, clothing, eating; guidance on how to turn the bedridden; and other personal needs, such as transportation. Families annually spend about $7,000 of their own money to help their loved ones at home, according to AARP.
Complex federal rules require states to use, mostly, Medicaid to pay for long-term care at nursing homes. States also can get waivers to those rules for some individuals to care for their elderly or disabled family at home, but there’s not much money for that option.
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Twenty-five states, as of November 2020, offer home-based care on a par with nursing homes. Talbot wants Louisiana to be No. 26. But facing withering opposition, he turned his bill into a resolution asking the Louisiana Department of Health to look into what it would take to do adopt such a plan.
Health department officials said such a study would require a monstrous amount of time and dollars.
First, they’d have to decide what services to offer and to whom. They’d have to figure out how those services would be delivered. Only then could they bring in actuaries to calculate the rates. Eighteen, maybe 48 months, at a cost of about $2.5 million for the first year and perhaps $500,000 a year thereafter until complete, said Tara LeBlanc, the state’s interim Medicaid executive director.
Mark Berger, of the Louisiana Nursing Home Association, held up a thick book to point out dozens of previous studies. “There is simply no evidence, where this was implemented, where access to home-based services increased, where care improved or that it saves money,” he testified.
A team of government experts and industry stakeholders spent more than two years painstakingly crafting a plan that would have reduced Louisiana’s expensive and unpopular reliance on nursing homes to house the state’s most helpless residents.
“We have good nursing homes and bad ones. Statistically, it’s not great. I want to give people the option to stay at home,” Talbot said. He then modified his resolution to remove the expensive bit about calculating rates, though costs are the main thing legislators would look at when determining whether to expand access to home-based care.
“The vote is really philosophical,” said Chairman Fred Mills, R-Parks, before his Senate Health & Welfare committee shot down Talbot’s study request.