If the true test of a people is how they treat the oldest and frailest among them, then New York State is failing miserably. In a dramatic example of how we are failing our obligation to care for the elderly, disabled and chronically ill, the governor’s proposed budget calls for damaging funding cuts to nursing homes, home health care and adult day health care programs.
The governor’s proposals are designed to save some $214 million in 2010-11. To place that “saving” in proper perspective, it equates to approximately one-sixth of 1 percent of the total budget, or approximately $11 per resident of New York. Today, that is the cost of five cups of coffee or two sandwiches, a t-shirt or a movie ticket. Our oldest and frailest mean too much to allow that to happen.
Elected officials in the New York State Assembly and Senate must reject these devastating budget proposals and, instead, develop a plan that rewards excellence and efficiency, and ensures that our long-term health care system meets the challenges that lie ahead, with intelligent and compassionate care.
A careful examination of the past three years shows that, while the state’s aged population continues to swell, health care for seniors has been cut seven times, with a combined loss of more than $1.2 billion!
During that same period, for example, the Parker Jewish Institute for Health Care and Rehabilitation, an independent, non-profit organization, has voluntarily continued to develop leading programs in post acute care, medical model adult day health care, social model Alzheimer’s day care and home health care, that help keep older adults at home, and avoid more costly institutionalization and hospitalization. The governor’s latest round of proposed cuts could diminish access to the programs and services that Parker now provides to more than 7,000 men and women each year.
Even more dismaying is the state’s plan to upend the current nursing home reimbursement system and replace it, commencing April 1, with a controversial new plan known as “regional pricing.”
Under this new system, payments to nursing homes would no longer bear any relationship to the actual costs that nursing homes incur in providing care. The new payment system would base payment to nursing homes on a “one-size-fits-all” model. In truth, one price simply does not fit all, and suggesting otherwise is misleading and dangerous.
Instead of promoting safety, quality, and adequate staffing – which should be fundamental goals – the regional pricing system will set off a “race to the bottom,” encouraging providers to dramatically cut costs and under-invest in the people and programs needed to deliver quality care. The plan would cut most deeply from the very facilities that have invested the most in a strong and adequate workforce, and from those that have provided the highest quality care. Instead of rewarding high quality of care, regional pricing would punish it, and the victims of this new plan will be the seniors and disabled citizens.
While achieving fiscal solvency in New York must be a shared burden, we cannot continue to do it on the backs of our most vulnerable citizens. Moreover, a strong adult health care system should be one of the growth industries in New York; and neither Governor David Paterson’s proposed health care cuts, nor his plan for regional pricing, will do anything to strengthen long-term care in our state. We are not asking for a bailout because we did not do our jobs, just fair treatment that will allow us to continue doing our jobs, providing what all of us may need some day.
Michael N. Rosenblut is President and Chief Executive Officer of Parker Jewish Institute for Health Care and Rehabilitation
