04/18 - Balancing Eldercare | Louisiana Public Square | LPB
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Video Playlist:

Play Button  Full Program - Balancing Eldercare
Play Button  Three Things - Andrew Muhl with AARP Louisiana indicates the three things that bringing seniors on Medicaid under a managed care system achieves.
Play Button  AARP Question - Joe McPherson, a nursing home owner and former state senator, voices his opinion about what he sees as an AARP conflict of interest.
Play Button  Demand is There - Sen. Conrad Appel, R-Metairie, who sponsored Medicaid managed care for the elderly explains why he feels the model is needed in Louisiana.
Play Button  The Young in Nursing Homes - Rebekah Allen, reporter for The Advocate, explains how young people with disabilities end up in nursing homes.
Play Button  Supreme Court Consequences - Rebekah Allen, reporter for The Advocate, says that community-based services are not optional per a Supreme Court ruling.

04/18 - Balancing Eldercare

How much does Louisiana spend on nursing homes versus home and community-based care?

Nationally, there is a shift towards providing care for the elderly at home and through community-based services rather than at institutions. But analysts say that Louisiana has a bias towards nursing home enrollment both in policies and funding. A series of bills being proposed this legislative session would address what some consider an imbalance in how the state supports care for its aged population.

So, how much does Louisiana spend on nursing homes versus home and community-based care? Is the demand for institutional care rising or on the decline? And what options are available to provide the funding and the care that the state’s older residents desire? Louisiana Public Square looks for answers to these questions and more on “Balancing Eldercare” Wednesday, April 25 at 7 pm on LPB and in New Orleans on WLAE. (Recording Tuesday, April 24.)

Our panelists are
· Jeanne Abadie, The Advocacy Center
· Mark Berger, Louisiana Nursing Home Association
· Hugh Eley, Former Deputy Sec. of Louisiana Dept. of Health
· Senator Jay Luneau, D-Alexandria

LPB CEO, Beth Courtney and Public Affairs Research Council of Louisiana president, Robert Travis Scott, moderate the discussion.

Our Panelists:

BR Advocate just had a strong article about the choke hold the Nursing Home lobby has on ou LA legislatures, specifically the Senate Finance Bill 357 that will NOT make it out of committee because of the 6-2 NO vote to ALLOW elderly and disabled citizens to make their OWN CHOUCE as to where we want to LIVE in our HOME and commUNITY! Angry!

Posted by Christy Paulsel  on  03/29  at  11:14 AM

I agree that people are biased towards Nursing Homes. They have a stigma of being “the place you go to die”. What most people don’t understand is that it’s so much more than that. The elderly have an opportunity to enjoy socialization, activities (not just bingo), therapy, and around the clock care, and more. Some come for a short stay and some end up staying long term, lots of times by choice. I work in a beautiful, clean, caring, and compassionate nursing home with amazing people. Home care does not always have the same benefits.

Posted by Felicia McPherson  on  04/13  at  08:19 PM

I want to maintain my independence and privacy of aging in my home.  I have lived with my mother in an institution and it was like being a prisioner, eat, bathe, sleep, when and where you are told.

Posted by Barbara Wheat  on  04/19  at  10:17 AM

Me and my family cared for my grandmother.  She wanted to stay in her home but unfortunately she had no other choice but to wait for a waiver. 

We all pitched in and cared for her as long as we could but ultimately she had to go into a nursing home because we just didn’t have the ability to do it, with our jobs and everything.

She could have been cared for and stayed in her home which is what she wanted, if there were options available to her.  I wish our legislators (AND GOVERNOR!!) could do more to help this situation.

Posted by George Chambers  on  04/19  at  10:47 AM

I want to have options as to where I live as I age.  The more independent I can remain the better.  I prefer home health care if needed as I age.  I may have to to go to a nursing home, but I want that to be my final and last option.  Remaining home with some assisted is ideal.

Posted by Martha Hays  on  04/19  at  11:11 AM

Seniors and families should have options. I was fortunate enough to be engaged in my 99 year old grandmothers care, which took place in her home that my grandfather built, until she absolutely had to be in a nursing home. We were also able to do this with an aunt with developmental delays, and currently I regularly support the maternal side of my family with my other grandmother’s in home care. Having this option and resources for aging in place should be a standard, not just only found in West Virginia or Georgia. My dad lives in Carencro and when the time comes I want to be able to give him options in his care and know that in-home support is available to our family.

Posted by Lani Gholston  on  04/20  at  09:22 AM

I simply do not understand the reluctance on the part of the Governor and legislature to accommodate the needs of their constituents. Yes, there is a need for nursing homes, but also a need and desire for in-home care.  We seniors and our families only want to be able to choose the option that best suits our situation.  And the fact that providing this option would cost government less makes it such a no-brainer.

Posted by Pam Sherburne  on  04/23  at  07:55 PM

The answer is to open PACE Center to serve every parish!

Posted by Tracey  on  04/25  at  07:59 PM

A fair and open discussion. Since the inception of state funded Home and Community Based Services the level of care in nursing homes has risen 10 fold.

All levels of care deserve adequate funding and with Louisiana nursing Facilities ranked 46th in national reimbursement I believe the legislature is doIng their best to fund care for the sickest and most frail citizens. Paying a third party or managed care organization is not the solution for a poverty state like Louisiana.

Posted by Scott Broussard  on  04/26  at  09:38 PM

This was finally a more balanced discussion about available programs and that conversation is healthy. I do not believe that nursing facilities are against options considering they are 4th lowest reimbursed in the country.

Posted by Scott Broussard  on  04/27  at  10:46 AM

I appreciate that this discussion allowed views from more than one side, and an option of choice does sound very good, provided the State can afford it.

I do want to point out that I have read very hostile articles against nursing homes and particularly from Ms. Allen of the Advocate that were highly misleading and because she was featured in this presentation, I feel an obligation to point out why her highly misleading or one-sided opinions are wrong. 

It is the goal of every nursing home Plan of Care to establish independence, and “Rehab to Home” is a goal of all homes for every resident if possible.  The statistics support that more patients are discharge home than those that pass away while in a nursing home. When presenting the national standards and how Louisiana homes are rated, it needs to be said that to attain a CMS 5 Star rating in staffing, the homes must provide 5+ hours of direct care (Nurses and CNAs) but the state only reimburses 2.65 hours of care. No nursing home administrator will say that 2.65 hours of care is sufficient care for most residents.  That is the “minimum” standard, but it is not enough for good care so the homes cover then difference.  Nurse practitioners are available 24/7 in most Louisiana homes but neither the State nor CMS pays for that care.  The homes do.  The comments about the protection of the rates didn’t mention that nursing homes pay $12.03 in provider tax for every day that a person resides in a home that helps allow for the stabilization of those rates.  That means that for a home with 100 patients, the provider tax paid in a year would be $440,920 a year (100 x $12.03 x 365 days).  Multiply that times roughly 2,000 homes and that is a staggering amount that is paid back into the system for this very purpose.  It is not fair to imply that nursing homes are unfairly protected when the nursing homes provide this level of provider tax to support it.  No home or community-based company does this.

Finally, I agree with the senator that our tax system will require changes to allow expansion of the care for our elderly or home bound citizens, and I agree that there should be changes made for this purpose.  It will certainly be necessary to be able to fund more systems of care and the choices that every person desires. 

I am very afraid for our state if the Medicaid cuts already coming are not stopped.  First there are thousands of elderly and very frail residents that will be suddenly discharged from nursing homes.  Many do not have a family to receive them.  Then, there will be more thousands of employees laid off.  Neither families with elderly nursing home residents nor the job market can absorb these numbers and for the state legislature to allow this is extremely reckless.

Posted by Mary Lynn Leach  on  04/27  at  11:55 AM

Re the Eldercare program on Public Square on 4/25/18—I thought Senator Jay Luneau was mistaken about comparative costs/needs/time. I have worked for 2 different home care companies. The pay is the minimum wage or slightly more, depending. Some clients have 24 hour shifts, so it is not true that they just receive care for 5 hours. Services can include housekeeping, food preparation, bathing, med administration or reminders, transportation, etc. Some people are mobile and others bed-ridden. People do not have to go to a nursing home when they become more fragile. Some people have stayed in their homes until the end and hospice comes to them. There are many companies that provide such services. In Lafayette, there are over a dozen. Caregivers are background checked, bonded and insured and receive initial and on-going training. The issue is, for those who cannot pay out of pocket or do not have long term care insurance, will Medicaid pay for it. I thought the program was slanted to nursing home care in so far as there did not seem to be a representative of a home care company on the panel.

Posted by Connie  on  04/28  at  02:27 PM
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