Tough Choices Ahead, You Can Help Make a Difference. by Rick Gamache
Posted: 1/18/2008
Like all Rhode Islanders, our state's senior citizens are grappling with what's happening with the economy. But the issues they face are compounded with many more. Those on fixed incomes feel the impact of rising costs more severely than most. The Labor Department recently reported that inflation jumped by the highest amount in 17 years in 2007. Rising property taxes, thanks to huge increases in Rhode Island home valuations from 2000 to 2005, strap them further. And health care costs are skyrocketing while covered services are diminishing. Added to all that is the impact of an enormous state budget deficit which is seriously threatening the availability and quality of long term care. For some, surviving the "golden years" has become a game of precarious choices; prescriptions or heat, doctor's appointments or food. And even those who manage to stay in the game may find themselves out of luck when the chips are down because badly needed services aren't available.
Before you get too disheartened, I must admit that I bring up this negative news to alarm you, to pull you into action, albeit with a gentle reminder that Rhode Island does have a lot to offer, but it's up to us to make sure that we all do our part to insure that living here is a choice that we make without trepidation. The percentage of people leaving our state is rivaled nationwide only by Michigan which has seen massive job losses and terrible instability in its economy. Younger Rhode Islanders leave in search of better jobs and opportunities. For elders, whose lives were built here, the ties are stronger and we must make sure that they stay that way by insuring that their needs are met.
But what can we do, you ask? (And by "we", I mean a collective "we"; young, old, rich, poor; all of us who call Rhode Island home.) Remember the democratic system that this country is founded upon. Make your voices heard. Rhode Island has the third highest population of those over the age of 65 in the country. Our legislators need to know about the issues that concern them.
Foremost among those issues is long term care. Like the rest of the country, Rhode Island is seeking to honor consumer choice- to make sure that the most appropriate level of care is available to those who need it - by increasing home care opportunities for seniors. The Rhode Island Health Care Association, like our national counterpart, the American Health Care Association, applauds initiatives which offer consumers choices so that they can be cared for in the least restrictive appropriate setting as they age. The state's fiscal situation however, has left each member of the long term care continuum- home care providers, nursing home care providers, assisted living facilities and the like -scrambling for a shrinking piece of the funding pie. We're trying to expand services with shrinking resources.
From nursing home providers' standpoint, one type of long term care service cannot replace another. We each care for markedly different populations so robbing Peter to pay Paul is not an option. The nursing home of twenty years ago, which often served as a "rest home" for those requiring minor convalescence, is no more. Now nursing facilities care for an acutely ill population, one that requires 24-hour care for a variety of medical needs. And it's anticipated that the need for this type of care will increase as the demographic most in need of it grows with the aging baby boomer generation.
Nursing facilities, unlike other parts of the long term care continuum, are predominantly funded by the Medicaid system, a system designed to help the poor meet their health care needs. The care of three out of four nursing home patients is paid for by Medicaid which routinely under funds Rhode Island facilities for the cost of that care by millions of dollars each year. (Despite that, Rhode Island facilities manage to do a great job caring for their residents. Data from state wide satisfaction surveys shows that Rhode Island nursing homes routinely score good to excellent on satisfaction criteria.) Due to the heavy reliance on government funding, nursing homes receive a cost of living adjustment (COLA) each year to stave off inflationary increases. Without the COLA, most nursing homes have few options for raising the revenue needed to meet rising employment, utility and insurance costs, to name a few. Other providers of long term care services can raise prices. Nursing homes on the other hand, are bound by fixed reimbursement rates for roughly 75 percent of their resident population. Obviously, when a facility can't afford its costs, something has to go. Either services or quality, or both, are affected and with the talk surrounding this year's state budget, skilled nursing facilities are sure to be in for the fight of their life to preserve funding which insures that their residents are afforded quality, accessible health care.
For our part, the Rhode Island Health Care Association has set up an online "tool kit" on rihca.com to help people communicate the impact of funding cuts to nursing home care to our legislators. Given that approximately 9000 people live in Rhode Island’s skilled nursing facilities, and just as many are employed there, funding cuts will take an enormous toll on our state's population and economy.
I urge you to take the time to visit RIHCA.com to see how you can help stave off funding cuts to nursing home care. If you want to communicate with your legislator regarding issues other than nursing home care, RIHCA.com can help you do that as well with legislator contact information posted right online. Hearing from the masses does make a difference. Please do your part to make sure that our legislators make the right decisions given the tough choices in front of them.
Before you get too disheartened, I must admit that I bring up this negative news to alarm you, to pull you into action, albeit with a gentle reminder that Rhode Island does have a lot to offer, but it's up to us to make sure that we all do our part to insure that living here is a choice that we make without trepidation. The percentage of people leaving our state is rivaled nationwide only by Michigan which has seen massive job losses and terrible instability in its economy. Younger Rhode Islanders leave in search of better jobs and opportunities. For elders, whose lives were built here, the ties are stronger and we must make sure that they stay that way by insuring that their needs are met.
But what can we do, you ask? (And by "we", I mean a collective "we"; young, old, rich, poor; all of us who call Rhode Island home.) Remember the democratic system that this country is founded upon. Make your voices heard. Rhode Island has the third highest population of those over the age of 65 in the country. Our legislators need to know about the issues that concern them.
Foremost among those issues is long term care. Like the rest of the country, Rhode Island is seeking to honor consumer choice- to make sure that the most appropriate level of care is available to those who need it - by increasing home care opportunities for seniors. The Rhode Island Health Care Association, like our national counterpart, the American Health Care Association, applauds initiatives which offer consumers choices so that they can be cared for in the least restrictive appropriate setting as they age. The state's fiscal situation however, has left each member of the long term care continuum- home care providers, nursing home care providers, assisted living facilities and the like -scrambling for a shrinking piece of the funding pie. We're trying to expand services with shrinking resources.
From nursing home providers' standpoint, one type of long term care service cannot replace another. We each care for markedly different populations so robbing Peter to pay Paul is not an option. The nursing home of twenty years ago, which often served as a "rest home" for those requiring minor convalescence, is no more. Now nursing facilities care for an acutely ill population, one that requires 24-hour care for a variety of medical needs. And it's anticipated that the need for this type of care will increase as the demographic most in need of it grows with the aging baby boomer generation.
Nursing facilities, unlike other parts of the long term care continuum, are predominantly funded by the Medicaid system, a system designed to help the poor meet their health care needs. The care of three out of four nursing home patients is paid for by Medicaid which routinely under funds Rhode Island facilities for the cost of that care by millions of dollars each year. (Despite that, Rhode Island facilities manage to do a great job caring for their residents. Data from state wide satisfaction surveys shows that Rhode Island nursing homes routinely score good to excellent on satisfaction criteria.) Due to the heavy reliance on government funding, nursing homes receive a cost of living adjustment (COLA) each year to stave off inflationary increases. Without the COLA, most nursing homes have few options for raising the revenue needed to meet rising employment, utility and insurance costs, to name a few. Other providers of long term care services can raise prices. Nursing homes on the other hand, are bound by fixed reimbursement rates for roughly 75 percent of their resident population. Obviously, when a facility can't afford its costs, something has to go. Either services or quality, or both, are affected and with the talk surrounding this year's state budget, skilled nursing facilities are sure to be in for the fight of their life to preserve funding which insures that their residents are afforded quality, accessible health care.
For our part, the Rhode Island Health Care Association has set up an online "tool kit" on rihca.com to help people communicate the impact of funding cuts to nursing home care to our legislators. Given that approximately 9000 people live in Rhode Island’s skilled nursing facilities, and just as many are employed there, funding cuts will take an enormous toll on our state's population and economy.
I urge you to take the time to visit RIHCA.com to see how you can help stave off funding cuts to nursing home care. If you want to communicate with your legislator regarding issues other than nursing home care, RIHCA.com can help you do that as well with legislator contact information posted right online. Hearing from the masses does make a difference. Please do your part to make sure that our legislators make the right decisions given the tough choices in front of them.
