Governor’s budget would hurt seniors

While we commend the governor’s commitment to protecting the health care needs of Pennsylvania’s citizens, an objective review of his budget shows an unacceptably low 1 percent to 2 percent cumulative increase in nursing home funding levels for the year ahead. Considering the fact wage rates are rising 5 percent annually for our workforce, and the grim fact the Bush administration is simultaneously proposing massive cuts in Medicaid and Medicare spending, Gov. Rendell’s proposal is not adequate to continue to provide high-quality services.

Adding to our concern still more are the demographic realities confronting the commonwealth: Pennsylvania ranks third in the nation by percentage of population age 65 and older, behind Florida and West Virginia, and fourth in the number of residents age 85 or older — the most intensive users of nursing home care. In fact, nearly 70 percent of Pennsylvanians turning 65 this year eventually will require long-term care. Therefore, this is the time we must be strengthening and investing in Pennsylvania’s long-term care system. The governor’s budget goes in the opposite direction.

This is simply part of the bigger negative long-term care funding picture in which there is a dangerous, growing gap between the actual cost of providing quality care and the amount actually paid for by state government. A 2006 study of the nation’s Medicaid program by the national accounting firm, BDO Seidman, found that while the average cost of providing quality long-term care in Pennsylvania was $192 per day, the rate providers are actually reimbursed is just $179 per day, creating a Medicaid underfunding gap of more than $13 per resident per day.

Another worrisome facet of the governor’s budget is his plan to increase the number of elderly Pennsylvanians eligible to receive long-term care in their homes. Despite the fact every citizen should indeed have the right to receive care in the setting of his or her choice, there exists a mistaken notion that state resources can be “saved” by shifting significant numbers of nursing home residents towards HCBS care. In fact, just the opposite is occurring in other states.

The theory that nursing home utilization will decrease as seniors are moved towards HCBS has not panned out as planned — and is even less likely to do so in states like ours, with rapidly aging populations. In addition, the real costs of home and community care as they compare to the costs of nursing homes must be tracked: Costs such as housing, meals, therapies, housekeeping, social services and medication. Facility care and HCBS care are not mutually exclusive in a budgetary context — they are complementary, and each must be adequately funded as part of the entire long-term care continuum. You cannot rob Peter (nursing homes) to pay Paul (HCBS), and past commitments to nursing homes should not be sacrificed to create new entitlements.

Now that the governor’s budget is on the table, it is up to the General Assembly to stand up for the continued provision of quality nursing home care. More than ever, we need our legislative leaders — Sen. Waugh and Reps. Mackareth and DePasquale — to help us ensure that the budget eventually crafted in Harrisburg actually reflects the needs of our seniors in York. In the final analysis, Gov. Rendell’s budget outline does indeed seek to accomplish many worthy objectives, but it does so at the expense of our most vulnerable population of seniors. We cannot, as a matter of conscience, allow this to occur.

Susan Mitrzyk is administrator of ManorCare in Dallastown.