Texas Health Care Briefing No. 13
LOOKING AHEAD: The 87th Session Must Prioritize Seniors
Legislators focused on Texas schoolchildren during the 86th session, increasing funding and implementing reforms to improve education in our state.
Next session, they should give the same emphasis to those on the other end of life’s spectrum: the elderly.
Despite the fact that seniors turn out to vote far more than any other age group, their care has not made it to the top of the legislature’s agenda.
This has been especially true for those who live in nursing homes.
Most residents living in Texas nursing homes rely on Medicaid to help pay for their care. It isn’t that they want a handout — rather, health care expenses often pile up so high that an individual has no more assets, thus needing Medicaid to cover their stay in a facility.
The rate for Medicaid is set by the legislature, and this is what nursing homes use to pay staff, purchase equipment for the facilities, develop programs and activities for the residents, and most other expenses they incur. But the rate the legislature pays is not required to cover the cost of the care for the individual’s nursing home. The gap between actual cost and Medicaid reimbursement has grown steadily over the years until it has swelled to $27 per resident per day.
Nursing homes survive through other pay sources, but the ability to cover costs is a challenge. Texas facilities struggle to pay their staff competitive wages and often lose employees to other industries all together. When this happens, quality suffers. Texas ranks near the bottom in both funding and quality of care. And more than 25% of nursing homes in Texas face a shortfall that puts them at risk of closure. As caregivers providing care in the communities continue to age, they will need to turn to local nursing home providers to care for their loved ones. As the number of Texans 65 and older with Alzheimer’s and other related dementias continues to increase, the need for local facilities with trained and consistent staff will be critical to ensure our communities are being cared for properly.
These problems are known to the legislature, but so far they have not been addressed. No funding increase has been provided for nursing homes in the last three sessions. Even an effort to pull down federal funds at no cost to the state budget failed to pass last session.
But the problem can only be swept under the rug for so long. The state is aging and more Texans will need to be cared for in nursing homes in the years ahead. They and their families will demand quality facilities that are properly staffed and prepared to meet all their residents’ needs.
The legislature has not provided the funding needed to ensure quality care is available to nursing home residents. They will find an increasing number of families in their districts will be asking why they have not adequately invested in our seniors.
Next session, seniors should move to the top of the agenda.