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NURSING HOME REFORM NEWSLETTER

August 16, 2005


QUICK UPDATE ON WHERE WE ARE

We get a number of calls and e-mails about what we are doing currently in nursing home reform. People write us here at Kentuckians For Nursing Home Reform who are eager to do something…….. Well, the time is coming soon. A couple of key legislators are having meetings with people interested in nursing home reform issues. We applaud Rep. Tom Burch, D-Louisville, and Rep. Jimmie Lee, D-Elizabethtown, for taking the lead to keep these talks going. We will have our turn "in the box" one of these days and will need some of you to help us. We will let you know. Of course, the 2006 legislative session which begins in January is hard to think about now in these dog days of summer, but we will be getting ready for that, too. Also, we hope to be able to tell you soon about some educational seminars we will be sponsoring. So stay tuned, enjoy the summer, and thanks for all your support. If you have any questions, just contact us.

MEDICAID COULD BE THE SPOILER

Talks continue in Kentucky and in Washington on the Medicaid funding problem. In Frankfort, all you hear is the approximately $220 million deficit we face in Medicaid funding this fiscal year. Medicaid, as you know, funds more than 70 percent of nursing home residents. One of our big concerns is that in order to cut the Medicaid deficit, the state will once again resort to kicking people out of nursing homes by questioning their eligibility to be there. That caused a great shock to nursing home residents during the waning days of the Patton administration, and to its credit the Fletcher administration stopped it. But now everything seems to be on the table to cut the deficit. A top state official, Mark Birdwhistell, told one group that kicking people out of nursing homes would be a last resort. But last week in a meeting, Mr. Birdwhistell, when asked about kicking people out of nursing homes (which he refers to as "eligibility reductions") said "yes, that is on the table." Supporting some 24,000 residents of nursing homes in Kentucky is a big chunk of Medicaid money, so be watchful of the moves the state bureaucrats do make. Mr. Birdwhistell said that the state would keep those interested in the Medicaid problem informed. "We are trying to do the right thing," he said.

PREDICTION COMING TRUE?

In our July 8 newsletter we made this prediction about saving Medicaid:

With their backs against an immovable wall of a $675 million shortfall, we think legislators will look to additional revenue to solve the problem, and that leads us to legalized gambling in Kentucky at casinos and racetracks. We think the racetracks have the inside edge and will win by a nose. Part of the sanctimonious rhetoric on the subject will be saving Medicaid "for the poor people."

Mark Nickolas, writing in a recent issue of the Bluegrass Report, said this: "I have received solid tips from several independent sources that Gov. Fletcher and Republican leadership have reached an agreement on a deal that will allow expanded gaming in the form of both land-based casinos and slots at the race tracks…."

We will keep you posted, although our prediction was easy. The state has to get the $220 million share of that $675 million from somewhere and so far nothing has been proposed that will do it.

DIVIDE AND….

We hate to see this: Two good organizations are working on the same thing, the Medicaid problem and the proposed cuts in it. One is something called ARMS, which stands for Advocates For Reforming Medicaid Services (it is an AARP-supported group) and the Medicaid Consortium that activist Sheila Schuster in Louisville has put together. At a recent meeting someone suggested that one of them fold. That caused hurt turf feelings. But if they stay separate the division could play into the hands of those who would oppose a good Medicaid program for Kentucky for their own special interests. We suggest that the two organizations merge under a new name and work together. Too much talent in both groups to be wasted on turf battles.

BEHIND CABINET DOORS….

With the Medicaid program in such turmoil, it is good that the state has named a deputy director in the Medicaid Division of the Cabinet for Health and Family Services. She is Jan Howell and she will help the division director Shannon Turner who has had some health problems recently. Ms. Turner is a sharp person but she could use some help at this critical time. Or as one official over there said, "Their (Medicaid) ranks are kinda thin"…. Another cabinet appointment: Delanor Manson, will, according to a news release, work in Louisville on "designing, organizing and implementing a system of root cause analysis to review adverse and sentinel events with the Department of Community Based Services." Figure that one out…… Three state nursing home ombudsmen administrators have jumped ship. We reported that director John Sammons had retired, and with him went two of his closest deputies, Mike Brown and Phil Cox….. As of this date, no replacement has been named for Mr. Sammons, or the others…. Not a cabinet position but still one important to nursing home reform: Robert Jenkins is leaving his LRC post as committee staff administrator for the Health and Welfare committees to become the assistant director for research at LRC. Congrats on a nice promotion to a well-deserving person…. Murray Wood will succeed Mr. Jenkins as the chief staff person for health and welfare.

CAN YOU HELP ON THIS ONE?

The statewide consortium that is fighting cuts in Medicaid is looking for Medicaid recipients (or their families) who could share their concerns on the effect of the cuts on nursing home care based on their personal experiences and situation. The media and legislators are interested in these stories. If you would care to share, please let me know right away and I will pass your name along.

THE REST OF THE STORY….

In a previous issue we told you about the nursing home in Henderson -- Medco Center operated by Extendicare – that had the whistle blown on them by two sisters whose mother was a patient there. They charged that back in May there was a three-hour period when there were only two direct patient care providers tending 93 patients. The sisters told their story to the Henderson Gleaner newspaper and the Evansville television station WEHT-TV. All that brought the state inspectors in and the result is "significant changes for the better," the newspaper said recently. We shall see how long that lasts, but the story points up the value of going to the media. Power of the press, and all that.

QUOTE OF THE MONTH

"….There are a lot of governors struggling with this issue (cuts in Medicaid services). So my plea is: Don’t have other governors go through what some of us are doing right now. But instead, let’s get at some of the fundamentals." – Tennessee Gov. Phil Bredesen (D) discussing cuts he has made in his state’s Medicaid program called TennCare.

YOUR COMMENTS….

"Whom should we contact in the state of Kentucky about getting the law changed to have more nurses and nurses’ aides on staff for the residents of nursing homes? In day care centers each employee is allowed only so many children, and it certainly does not take two or three people to change an infant’s diaper. However, it does take two to three people to change the elderly’s clothes." – Sharon Sallee, Horse Cave.

VOICES FROM OTHER STATES

I am told consistently by good staff in a facility that they ALWAYS know in advance when the surveyors are coming in -- items are stored away and brought out for "show and tell" when the surveyors come in -- rubber gloves, towels, etc., also there is a major cleaning within 48-72 hours before surveyors hit the door. As soon as they leave, the show and tell stuff is put up for the next time -- also additional staff is immediately called in and special activities take place for which only a 24- or 48-hour notice is given to residents or family members. It’s not on the regular pre-published activities calendar.

-- Anna Spinella, Nursing home reform advocate in Florida

P.S.

They talk another language in Frankfort, especially the bureaucrats and even sometimes the legislators. Take a meeting last week in which state officials presented a paper with their current thoughts on the Medicaid problem. In four pages they talked about …

HSAs,

MMIS,

MITA,

PBA,

KMAA,

EPSDT,

KCHIP,

SPA,

HIPP,

MH,

MR/DD,

GHA,

HCBS,

and that was just in the hand-out, not to mention the alphabet soup that permeated the rest of the meeting. We suggest some enterprising young writer produce a dictionary of Frankfort double-speak.

DON’T FORGET….

MORE THAN 30,000 PEOPLE IN NURSING HOMES IN KENTUCKY NEED US. THEY ARE KENTUCKY’S FORGOTTEN PEOPLE.




Bernie Vonderheide
KENTUCKIANS FOR NURSING HOME REFORM
Tel: (859) 312-5617