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9/22/98, 8:03 am
The Motion:
There was only one courageous person at yesterday's Long-Term Care Advisory Council meeting. Read the Commercial Appeal's Article about the meeting Pitch shrill over long-term care issue
By Paula Wade
The Commercial Appeal
Nashville Bureau
NASHVILLE - For years, the battle over long-term care options has come down to whether the state should divert some of the $750 million it gives to nursing homes into services that would allow frail Tennesseans to remain at home.
On Monday, Health Commissioner Nancy Menke tried to assure advocates for the elderly and disabled that the Sundquist administration is "committed" to improving long-term care services outside nursing homes. But, at a meeting of the state's Long Term Care Advisory Council and Long Term Care Planning Council, Menke fought off an effort by disabled activists to claim part of the nursing homes' budget to provide home and community-based services.
"We're making a concerted effort to try to find as significant an amount of money as we can find for long-term care options," said Menke, who gave no clues about how much funding Sundquist budget-makers are considering for any proposed expansion of long-term care services. Her statement is a reversal of Gov. Don Sundquist's statement last month that he was not committed to do anything to improve long-term care options.
But Menke hastened to assure members of the nursing home industry that whatever is spent on the new programs won't come out of nursing homes' budgets. "But to those of you from the nursing homes, we don't want to do anything to endanger anyone we're caring for in our nursing homes now."
Tennessee ranks 49th in the nation in the per-capita amount it spends to help disabled people live at home, rather than in a nursing home. Instead, the state's Medicaid program channels almost all of its long-term care money into funding nursing homes. Menke now chairs the commission charged with developing a comprehensive long-term care plan for the state, a panel whose numbers are stacked in favor of the nursing home industry.
So when Memphian Dawn Russell, an advocate for the disabled, proposed adoption of a position statement declaring that the state's Medicaid funds for long-term care "is not an entitlement for nursing home(s). . . and must be used to formulate a comprehensive plan for long term care. . .", the meeting came to a screeching halt.
Ultimately, Menke reworded Russell's motion to say only that the state should not rely solely on nursing homes to provide all long-term care. Russell left disappointed.
"At least the state took ownership of the fact that it doesn't provide choices for long-term care in Tennessee," Russell said. "All of the meetings (of the council) have been lip service. They didn't ever commit on the money issue. I wish I had taken my stand and then walked out."
Long-term care services encompass a range of services that allow frail people to stay at home, including help with chores, transportation, respite services for caregivers, meal delivery, adaptive devices to aid mobility and home health services. Meeting participants expressed the hope that a comprehensive program could be set up for the Medicaid-eligible, medically frail population and that the program could be broadened to include others, who could pay a portion of costs according to their income.
Nursing home industry officials argue that they accepted a $2,600 tax on nursing home beds in order to help fund Tennessee's Medicaid long-term care program and that it would be unfair to divert that money to other uses. They also argue that the state's nursing homes cannot afford any diversion of funds.
Advocates for the disabled argue that Tennesseans should be able to choose where and how they live and that state funding should be designed to support whatever services eligible elderly and disabled people need and demand.
But both sides appear to agree that a comprehensive system is needed as the population ages and more need in-home or community-based care.
"This is a steam engine bearing down on us, and if we don't move on some kind of a fast track to get this thing organized, the state will pay more in the long run," said Doug Pace, executive director of the Tennessee Association of Homes and Services for the Aging.
To reach reporter Paula Wade, call (615) 242-2018, or E-mail wade@gomemphis.com
The Memphis Center for Independent Living
1633 Madison Avenue,
Memphis, TN 38104
(901) 726-6404 v/tty (901) 726-6521 fax
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MCIL is a United Way of the Mid-South member Agency
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