Texas Legislature Threatens Poor Seniors with Triple Whammy, AARP Says

The Houston Chronicle ran a cogent analysis by Ollie Besteiro, president of AARP Texas, showing how the Texas Legislature's proposed state budget for the next biennium would "devastate older Texans" in three different ways, compounding their misery and exacerbating health care costs for everyone who is not poor. Yet another example of conservative Republicans' willingness to sacrifice the genuine needs of real human beings to their ridiculous fiscal ideology that increasing government revenue is never a good thing:

What does it say about the value that Texas places on its older citizens when we pay fast-food restaurant workers more than those who provide care for our elders?

Who will take care of our aging parents and grandparents if we keep putting up roadblocks to quality long-term care, both community-based and in nursing homes? Will the services be there for us some day if we need them?

All these are fair questions in light of recent budget proposals being bandied about at the Texas Capitol.

Under consideration is a 10 percent cut in payments to Medicaid providers — including community-based services and nursing homes - on top of a recent 2 percent rate cut that's already gone into effect for nursing homes.

AARP believes that pulling the rug out from under seniors on both ends of the long-term care service spectrum is penny-wise and pound-foolish.

Why? For starters, it's a little-known fact that Medicaid helps pay for two out of three nursing home stays in Texas. Medicaid is easily the largest payer of long-term care in our state, with more than 60 percent of its dollars devoted to the care of the elderly and disabled. That's more than the program spends on low-income women and children. Plus, Medicaid brings important federal matching dollars to the state, to the tune of $1.47 for every one dollar the state puts up.

Texas currently pays the second lowest Medicaid reimbursement rates for nursing homes in the country. Further cuts would have a direct impact on the quality of care received by residents, leaving nursing homes with no option but to reduce staffing. There are volumes of research documenting the relationship between staffing levels and the quality of care. Reduced payments to nursing homes will place our most vulnerable seniors in a highly dangerous situation.

At the same time, the Legislature is proposing to reduce oversight of nursing homes by reducing the number of staff responsible for their monitoring. This would only add insult to injury when it comes to ensuring our seniors are safe.

Cutting Medicaid funding for community-based care would push more people into nursing homes, which are more expensive for the state. We also know that the vast majority of older Texans want to stay in their homes for as long as they are able. On average, nursing home care costs the state more than $3,000 per person per month. Care at home costs the state between $700 and $1,500 per person per month. Community care funds are wisely spent state dollars because they provide coverage while people are still in reasonably good health, preventing the need for more costly treatment later.

Reducing payments for community care programs will make it increasingly difficult for Texans getting help from them to find workers who are willing to care for them. These programs already pay about minimum wage, $7.25 per hour.

In a nutshell, the Legislature's approach is seriously misguided. Lowering payment rates would put the lives of nursing home residents at risk by reducing the number of facility staff. Reducing oversight of these facilities by state personnel will degrade the quality of care received by patients, potentially putting their health at risk. At the same time, reducing rates for community-based care would have the effect of pushing more people into nursing homes, which are more expensive for the state.

Wages for workers who care for clients either in the community or in a nursing home have not kept pace with the cost of living. It's essential that direct-care workers be paid a living wage in order to ensure quality care.

Rather than saving money, the proposed state budget is dangerous for our seniors as well as costly for taxpayers. Both in terms of money and human lives, it is a plan we just can't afford.