Nursing Homes Asking Schweitzer to Reconsider Budget Cut Freezes to Medicaid

by jhwygirl

Here you go, smokey – here’s some of that irony I was talking about.

Remember just a few months ago when the Good Gov was blocking payments to Sen. Greg Barkus’ friends – $600,000 in state money to clean up environmental contamination on a site that Swank bought at a discounted price knowing it had to clean it up?

The Good Gov was rounding up all kinds of cash, slashing money for remodeling of the state hospital, asking for money-saving ideas from citizens, and cutting funding for lots of obscure boards. Populists loved it….even when he took the school trust money $86 million from the Otter Creek coal leases and added it to the general budget to shore up slipping revenues.

Last month, Schweitzer approved a freeze on provider-rate increases as part of a $40 million cut in state spending. This cut will cost $2 million to Montana nursing homes, which care for about 3,000 people funded by Medicaid. That’s 60 percent of their patients.

These cuts can’t occur without rule changes – and public comment is due May 28th. A hearing was held Wednesday – this link takes you to the public notice from the Department of Health and Human Services (DPHHS).

Rose Hughes, executive director of the Montana Health Care Association, which represents nursing homes, said Montana pays an average of $161 a day for nursing home patients covered by Medicaid, while the average cost for all patients is $179 a day.

Hughes argued Wednesday it’s not necessary to cancel the scheduled 2 percent increase in Medicaid rates, because the state’s budget picture has improved since earlier this year and Congress may approve additional Medicaid funding for all states.

She also said that as much as $1.6 million in state Medicaid nursing-home funds remain unspent, because of fewer “patient days” than expected this year.

Nursing-home administrators said they’re already operating on a very thin margin and that freezing Medicaid rates can’t help but affect care for all elderly residents.

“It’s going to result in diminished quality of care,” said Jackie Meyers, director of nursing at Laurel Health and Rehabilitation Center. “It will result in increased unemployment. … Nursing home care is a necessity. It’s not a luxury.”

DPHHS is facing serious cuts – and we’ve not even gotten into the 2011 legislative session where the legislature is going to have to make deeper cuts to make up for the last-minute budget deal in the ’09 session in which permanent cuts were made that were shored up with stimulus cash. If it was one agency where this shouldn’t have been done, it was DPHHS.

Check out the DPHHS public notice page – there are cuts proposed to Medicaid inpatient and outpatient hospital services, cuts proposed to Medicaid reimbursement for hearing aid services, outpatient drugs, and eyeglasses, early and periodic screening, diagnostic and treatment services.

Cuts to home and community-based services for adults with severe disabling mental illness. Cuts to psychiatric residential treatment facility services.

The list goes on.

Many of these things are part of that “an ounce of prevention goes a long way” type of things? Early screening? Psychiatric treatment? Long-term effects will be felt in communities throughout the state.

I’m glad our Governor is watching out for our budget and working hard to keep us flush….but is he consistent? I have trouble seeing it. And as a Democrat, you’d think he’d find other things to save cash – like, perhaps, the Department of Livestock and its hazing of Yellowstone bison? Especially when you consider that our own State Veterinarian has verified that every known transmission of brucellosis to livestock has been the result of interaction with elk, and not bison.

How much does that hazing cost?

But cutting DPHHS services for Medicaid patients? Yeah – irony abounds. This is one where I find that both irony and inconsistency.

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  1. Big Swede

    I wonder if you’ll remember all these betrayals when he runs for the Senate.

  2. Smokey

    So, I take it you think the purchase of TNC land (the original subject of my question) is a poor use of the PPL money considering the state budget? How would you suggest the reinvestment of this money to the Trust?

    • Presumptuous, are we? Is it Trust land? Seems that legislative attorney Greg Petesch and legislative auditor Barb Smith don’t think that it is – that this is state money, requiring legislative appropriation.

      Maybe you missed George Ochenski’s column in this weeks Missoula Independent? Here’s a link for ya: http://missoulanews.bigskypress.com/missoula/strange-play/Content?oid=1257522

      According to Ochenski, both Petesch’s and Smith’s memos and inquiries have gone unanswered.

      So much for law and the Montana Constitution, I guess. Dems must be running scared, and Republicans are probably just waiting for their turn to ignore laws once they hold a majority of the 5 highest seats in the state.




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