AHCA, however, is working on a massive marketing campaign to convince Congress the nursing home industry needs more money to improve quality. The facts about funding for the nursing home entitlement are much different then AHCA would have Congress and the general public believe. Consider the following numbers: (data taken from MEDSTAT - www.medstat.com) 

• Since 1989 Medicaid funding for nursing homes has increased $35.9 billion dollars over 625% since 1989. This is an increase from $6.8 billion in FY 1989 to $42.7 billion in FY 2001. 

• Compare this to all home and community spending in FY 2001 $22.2 billion dollars. This figure includes all the Medicaid funding for all Medicaid home and community waivers, for Personal Care, and for Home Health combined. This is a $18.9 billion increase since 1989. 

• Over the last decade (since 1992) nursing home expenditures have increased $18.3 billion dollars from $24.4 billion in FY 1992 to $42.7 billion in FY 2001. 

• If you just look at the last five years FY 1996 - FY 2001 spending on nursing home services has increased almost $12 billion dollars from $31 billion in FY 1996 to $42.7 billion in FY 2001. 

• What is MOST amazing about these funding increases is that the number of people in nursing homes has been relatively stable over this period 1996 - approx 1.65 million 2001 - approximately 1.70 million. (Hoechst Marion Roussel - Institutional Digest).

• Statistics on the increases in people using community services are not easily available but it is clear that the numbers are rising dramatically and shows the preference for community services rather than nursing homes. However the funding bias towards institutional services continue. 

Have the nursing home increases gone for improved quality? The scandals uncovered in every state answers that question: NO! 

The question that AHCA never gets asked and never offers to answer is - What did you do with all the public money appropriated over the last decade? It appears that "the industry" made bad investment decisions. Now they are looking for a public bailout. The corporate nursing home industry should be held accountable for the public funds spent not given more money to squander.

• Nursing home services are a Medicaid entitlement. Medicaid community services are still optional. 
• The nursing home industry has a monopoly on the long term service delivery system. There is no "Real Choice" for community services. 
• This is not free market economics. This is "corporate welfare". 
• This is bureaucratic government allowing the nursing home industry to tell people where and how they may live and receive needed support services. 

Please do not let AHCA convince Congress to throw good money after bad. Tell Congress it's time to fund what the people really want: COMMUNITY SERVICES FIRST! 

The nursing home industry needs to transition just as any other failing industry must. The US population, old and young, overwhelmingly wants support services in the community and in their own homes and apartments. 

We need to tell Congress. 

Thank you,

ADAPT 
www.adapt.org 
bkafka@juno.com