Unlike most other states, Tennessee authorizes nursing homes to be reimbursed through its Medicaid system for the dues they pay to an industry association. 
-The Commercial Appeal  [May 14, 2001. p. B1]

Long-term care funds are diverted to the nursing home lobby

The money intended for the long-term care needs of Tennesseans with disabilities is channeled almost exclusively into the nursing home industry. Our state's Medicaid funding bias to institutions drives out more desirable and less expensive home and community-based options of long-term care. Not only does the state subsidized nursing home industry have a disproportionate share of the public funding, the nursing home lobby is the beneficiary of hundreds of thousands of dollars from the Medicaid funds.

The nursing home lobby, the Tennessee Health Care Association, claims that under the IRS definition of lobbying, only 13% of the funds are used to lobby; however, public funding makes up nearly a million dollars of their $2.3 million budget. Unlike other state professional organizations, for instance teachers and state employees, nursing home residents have no say in the disposition of the funds.

Clearly, Willie Robinson who moved out of Tennessee because this state will only provide needed long-term care services in a nursing home, does not support the nursing home lobby and its dominance of Medicaid funds. Mr. Robinson now lives in his own apartment in another state because public funding does not have to lock away people with disabilities.

Missouri, for example, with a larger total population than Tennessee, spends nearly $100 million less of state money on long-term care and over $200 million less in federal funds [Medicaid Financial Management Report FY 2000]. Tennessee is the most chronic example of the need for national Medicaid reform. Ninety five percent of the public funding for long-term care is funneled into the nursing home industry. Our state offers, almost exclusively, the most expensive and least desirable form of long-term care: an institution.

The fourth largest provider of political gifts in Tennessee, the nursing home lobby, pushes an agenda of continued and expanded public subsidies to the dominant and wasteful facilities that citizens pray to avoid. The lobby further works to weaken consumer protections and state inspections.

It is unconscionable that the money intended for the long-term care for Tennesseans goes to limit long-term care options and undermine protections. The thirty-year old Medicaid policy must change to end this bias to the nursing home industry. The nursing home industry has developed over the past 30 years from a non-profit altruistic venture into a for-profit government subsidized monolith.

SUPPORT MEDICAID REFORM! SUPPORT MiCASSA!

- Tim Wheat