Candidates debate senior health care
A crowd of about 100 people turned out last Friday for a legislative candidate forum on health care for Minnesota's aging population.
The candidates talked about senior care funding, nursing home reimbursements, alternative care options and other issues.
The forum, held at the Knute Nelson Care Center Chapel in Alexandria, was moderated by Kari Thurlow of Aging Services of Minnesota.
It featured House of Representative candidates Mary Franson and Bob Cunniff, District 8B, and Paul Anderson and Rick Rosenfield, District 12B, as well as Senate candidates Bill Ingebrigtsen and Dan Skogen, District 8, and John Schultz and Torrey Westrom, District 12.
Following is a brief look at the topics addressed.
FUNDING FOR SENIOR CARE
Background: The Minnesota Legislature plays a significant role in setting funding levels for senior care providers. Over the past four years, nursing home rates have been frozen and there have been double digit reductions to the Medicaid program that pays for services provided in assisted living settings. These funding freezes and rate reductions have had a significant impact on senior care providers' ability to provide good wages and benefits to staff.
Question: Will you support increases for senior care settings such as nursing homes and assisted living settings to help support wages and benefits of caregivers and to support quality care for seniors?
All four representative candidates voiced similar opinions - that raising taxes wasn't the answer, but rather finding things to cut or redirect from other areas of government, eliminating redundancies, or finding new sources of revenue.
The Senate candidates varied a little more in their responses.
Ingebrigtsen and Westrom talked about the need for tax incentives for people to purchase long-term care insurance and Ingebrigtsen and Skogen both agreed that government needs to ease up on the regulation of funding and allow more local control.
Schultz noted that revenues were cut with the 2000 tax rates and that a solution would be to reinstate the codes and tax more from the wealthy. "The easiest way out of the situation is to redistribute finances," he said.
Westrom added that government needs to look carefully at spending in other areas, such as the Appleton prison that is currently empty, noting that there's enough money available in the system without tax increases.
NURSING HOME SUPPORT
Background: A recent nationwide report listed Minnesota with the seventh largest shortfall between Medicaid reimbursement and allowable Medicaid costs. Nursing homes are currently being underpaid about $28 per day per Medicaid resident. Current funding levels continue to threaten the livelihood of nursing facilities and have the potential to displace many seniors and endanger many jobs. Since 2000, 63 nursing homes in Minnesota have closed.
Question: What policies would you support to help correct this shortfall? Are you willing to support new revenue sources to Minnesota that are directly tied to higher reimbursement rates for older adult service providers?
Franson stated that Minnesota is forecasted to have 6 percent more new revenue without raising taxes. She said she supports tax incentives to help services with the goal of getting the economy running, but doesn't support pitting the rich against the poor by raising taxes on the wealthy.
Cunniff questioned Franson's comment on the 6 percent of additional revenue, asking where it would go, since the state is currently looking at a $4.5 billion shortfall. He noted that "everything should be on the table" when it comes to considering reform, cuts, etc.
Anderson noted that a 1 percent increase in reimbursement rates would cost the state $3 million, but would generate about $12 million in income. He also discussed the Racino gambling concept, which projected a huge revenue stream, but died due to opposition after it was suggested that a portion be dedicated to nursing homes.
Rosenfield said that there are revenue streams available that are not direct taxes. He noted that the bed tax should be assigned to the senior care system instead of the general fund, although he feels it is "not a good tax."
Ingebrigtsen noted that he'd like to see the Legislature more consistent on its intentions, citing that a 3/8ths of 1 percent raise in sales tax was to be put into the environment, but $67 million of that was diverted to the general fund this year. He noted that money was easily redirected to reopen the Evansville nursing home, and that plenty of money can be redirected to fund healthcare.
Skogen cited that 77 percent of people say more money needs to be invested in health care, and that 64 percent of those said yes to raising taxes to provide that funding. He warned against pushing money around and creating holes in other parts of the budget, which could have "unintended consequences."
Schultz noted that rich people should pay just as much as others, and that the 2000 tax rates were bad policy. He said he does not advocate earmarking money for anything, and that the Legislature should govern by "intelligent discussion."
Westrom noted that his first priority is finding reforms and savings in other programs, trimming back generous programs that still exist, such as subsidies and rebates given to people with higher incomes.
ACCESS TO NURSING HOME ALTERNATIVES
Background: The demand for senior care services has begun to shift from traditional nursing home service to more assisted living options as well as in-home care. In 2011 about 30,000 Minnesotans used the elderly waiver program - the Medicaid program that funds services in assisted living settings and home care for seniors. This program saved the state nearly $275 million in 2010, by avoiding nursing home care.
Question: What will you do to ensure that seniors have access to alternatives to nursing home care?
All of the candidates agreed that alternatives to nursing home care made good fiscal sense for the state and all said they would support those alternatives.
Westrom noted that the state needs to refrain from advocating more regulations on assisted living facilities as well as nursing homes, and that reform, repeal or the bed tax and tapping into volunteer opportunities are all possibilities.
Schultz noted that "seriousness and transparency" is needed in the Legislature in order to manage the funding issue.
Ingebrigtsen noted the money saved from home care should be diverted back into the senior care system instead of into the general fund or other areas, and warned against a tax increase without clearly identifying where it will go.
Skogen noted that the problem isn't just in funding home care and assisted living, but in fixing the other parts of the budget that are broken. He warned about "unintended consequences" that can happen when taking from one budget to help another.
Anderson noted that the way of the future is to try to "take better care of ourselves" and to add more care layers to the health care system.
Rosenfield again stressed that it is necessary to find the waste and redundancy in other areas and redefine those things in order to find money to fund home care and assisted living.
Franson noted that health services and education are always competing for funding and the mentality to cut health services has got to stop. She'd like to see waivers from the federal government "so we can spend money the way we want" locally.
Cunniff added that "a lot of good things are happening" with the way nursing homes are being built with exercise facilities, etc. He believes tax deductions for home care or long-term care insurance are ideas to explore but added that education at a young age on financing and caring for yourself is important, as is educating those who are caring for seniors to keep them out of skilled care as long as possible.