Louisiana lawmakers want to shift money from nursing homes to home health

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A group of Louisiana legislators wants to change the way the state provides care for its elderly and disabled residents by shifting funding and other support away from nursing homes and toward in-home services.

Lawmakers say the state's system is heavily biased toward nursing homes, which receive 77% of the state Medicaid budget. That leaves just 23% for home-based programs, while other states have a split closer to 60-40, The Advocate reported.

Legislators filed three bills this session targeting funding changes — and a potential savings of $200 million — while another allows surveillance devices in nursing homes so families can monitor care.

All four bills are scheduled for hearings starting today.

“This is really about seniors who want to have other options other than nursing homes,” state Rep. Tony Bacala, R-Prairieville, told The Advocate. “We don't rate well in the national average, if we're not last, we're darn close to it.”

The Louisiana Nursing Home Association did not respond to the newspaper's phone calls and emails seeking comment. But the association purchased more than $101,000 worth of ads to air in March and April espousing the benefits of nursing home care.

Sen. Conrad Appel, R-Metairie, is sponsoring a bill that would expand home- and community-based services.

“We're pretty much forcing people into a situation that they may or may not want to be in,” he said of nursing homes. “My expectation is that we're doing that at a great cost to the state when instead we could be giving people the option to go to a nursing home or not, subject to their own condition and choice, and maybe have a huge savings to the state. To me, it's a no-brainer.”

Appel's bill would rely on Medicaid managed care decision makers to determine whether elderly clients are best suited to live in a nursing home or help help at home. The lawmakers argue more people want to stay at home but currently don't have enough ways to pay for that care.

The Advocate reported about 28,000 people are on the state's waiting lists for home- and community-based care.