A bill in Louisiana that would have shifted more patients toward home health care services has failed, The Advocate reported.
The state’s Senate Health and Welfare committee rejected legislation that would have lifted some of the cost burden off institutional care in the state toward more access to in-home care services. Compared to most other states, Louisiana spends more on institutional care, with 28,000 people on a waiting list for home-based services, according to The Advocate.
The bill, SB357, aimed to shift the state’s nursing home Medicaid population into a managed care model that would have offered more options for at-home care.
Committee Chairman Sen. Fred Mills, who owns an interest in a nursing home, and other senators raised concerns about the reliability of managed care as a way to deal with seniors, even though most of the state’s Medicaid population is on managed care.
Supporters of SB 357 said the bill would be revenue-neutral, at minimum, but was likely to produce savings for the state over the next few years because Louisiana charges managed care companies a 5.5% tax — which could potentially result in $100 million in revenues.
Democratic State Sen. Jay Luneau was skeptical of that claim and expressed concern about diminishing care for the elderly, as seniors receive more limited hours of help from home health providers, compared with 24-hour assistance in nursing homes, where caregivers are always within walking distance.
The bulk of Louisiana’s Medicaid funds go to nursing homes in the state, with skilled nursing facilities receiving $8.7 billion and payments to privately-operated Medicaid nursing facilities growing by 54% between 2006 and 2016, according to a Louisiana Legislative Auditor’s Office report. Occupancy rates rose by less than 1% in that time period.
The Louisiana Nursing Home Association, which represents 250 nursing homes in the state, argued SB 357 would lead to a reduction in care quality. The state’s nursing homes, however, rank among the worst in the U.S., according to the AARP’s 2017 long-term care scorecard, The Advocate said. They also have financial protections ensuring regular rate increases, the publication added.
“Today, many members chose to ignore the tens of thousands of older adults in their districts who want to live at home, while offering no alternative or plan to help them,” AARP of Louisiana lobbyist Andrew Muhl told the paper.