Published in Pawtucket Times on June 9, 2003

In the final days of this year’s legislative session, the Coalition to Ensure Funding for Quality Long-Term Care rallied its troops at the Statehouse rotunda to push for the passage of two legislative proposals that would fix an ailing Medicaid reimbursement system.

The goal of last Wednesday’s rally was to keep the Coalition’s two legislative proposals on the radar map of the Rhode Island General Assembly, which has been bogged down with a multitude of heated legislative issues – separation of powers , fire code changes, smoking bans in restaurants to name a few.

Even with an expected $ 225 million budget deficit for fiscal year 2004, the long-term care advocates, including provider groups, consumer advocates, state policy makers and legislators, urged lawmakers to pay a fair Medicaid rate for nursing facilities, required by state and federal law to provide quality of care to 9,000-plus vulnerable Rhode Island seniors who need intensive, 24-hour-a-day care.

Rally supporters gave a thumbs-up to two legislative proposals ( H 5803/ S 0899). The companion bills, if enacted would revise the state’s Principles of address the inadequate funding of the state’s nursing facilities.

The two legislative proposals, still in the House and Senate Financial Committee, reflected the findings of an 18-month study of B.D.O. Seidman, a consulting firm hired by the state Department of Human Resources to re view and recommend fixes to the state’s flawed reimbursement system.

A major finding of this state-financed study found that the state was underpaying facilities in excess of $ 29 million annually.

These bills call for an additional $ 14 million to state funding for Medicaid reimbursement to nursing facilities. With the infusion of state dollars, the federal government would then kick in $ 16 million for a total increase of $ 30 million.

Eighty percent of the state’s nursing facility residents rely on the Medicaid program to pay for their care, John Gage, administrator of the Coventry-based Riverview Health Care Community and a Coalition member, told those who intended the rally.

Many facilities are left struggling to remain open because Medicaid does not pay for the actual cost of care, he said, noting a number of Ocean State nursing facilities have already filed for bankruptcy of receivership, and some are even closing their doors.

An inadequate reimbursement rate continues to fuel Rhode Island’s critical nursing shortage, too, said Gage. Due to the current  reimbursement system, facilities are hard-pressed to come up with the necessary funds for increases in salaries and benefits to retain nursing staff.

Lt. Gov. Charles Fogarty, who chairs the state’s Long-Term Care Coordinating Council, warned the crowd that Rhode Island’s nursing home industry “is on verge of a meltdown.”

He- along with Sen. Stephen D. Alves (D-West Warwick) and Rep. Steven M. Costantino (D-Providence), sponsors of the Coalition’s nursing home payment reform bills – urged Gov. Donald Carcieri and House and Senate leaders to include funding in the fiscal year 2004 budget to begin the steps needed for Medicaid reform.

Throughout the afternoon rally, until 6:00 p.ml, the Coalition gathered hundreds of signatures to support efforts to increased Medicaid reimbursement to nursing facilities.

Meanwhile, posters strategy placed outside the House and Senate chambers illustrated the rally supporters point that the state is not paying enough for care  of family members in nursing facilities.

At one poster site, piles of dirt were placed on a 6-foot table.  A  poster said: “Did you know this mulch topsoil costs more than $ 5.63 – that’s more than the Medicaid system’s pay for an hour’s worth of nursing facility care for your loved one.  Isn’t your grandmother’s care worth more than the cost of a pile of dirt.”

In a previous All About Seniors column, this writer called for lawmakers to fix the state’s flawed Medicaid reimbursement system once and for all.

The legislative session will soon be ending, and immediate action must be taken now by lawmakers to pass the Coalition’s two legislative proposal, with Gov. Carcieri hopefully signing the bills into laws.

State policy makers must no longer use a Band-Aid approach to fix  broken Medicaid payment system, especially with the graying of the Ocean State’s population. A growing number of Rhode Islanders will soon require this level of intensive care.

It’s time for lawmakers to ratchet up the Medicaid rates to pay for actual costs of care, allowing facilities to deliver quality services.